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Case study: How CLEAN-Air Africa is tackling the hidden killer of household air pollution

How CLEAN-Air Africa is tackling the hidden killer of household air pollution

Around the world, smoke from domestic fuel causes more premature deaths and illness than malaria and HIV combined. The NIHR-funded CLEAN-Air Africa project, a partnership between UK researchers and health authorities and institutions in Kenya, Cameroon, and Ghana, is working to address the threat of household air pollution, improving health and reducing the harmful impact on the environment.

In sub-Saharan Africa, around 900 million people rely on polluting fuels such as wood, charcoal and kerosene for cooking, lighting and heating their homes. Smoke exposure from burning these fuels is the largest environmental cause of global disease, responsible for approximately 3 million premature deaths annually. Burning solid fuels also contributes to climate change, deforestation and the poverty cycle, disproportionately affecting women and children.

The NIHR Global Health Research Group: Clean Household Energy for the Prevention of Non-communicable Disease in Africa (CLEAN-Air Africa), led by the University of Liverpool, aims to address the burden of disease from household air pollution through a programme of policy research and capacity building of health systems.

Since 2018, the group has shown significant health and gender equity gains achieved by scaling liquefied petroleum gas (LPG) (also known as bottled gas) for household energy, as well as benefits for the environment from reduced solid fuel reliance and harmful climate emissions of pollutants from traditional fuel burning.


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Community health workers key to clean fuels transition

Working with national health ministries in partner countries and the World Health Organization (WHO), CLEAN-Air Africa has implemented domestic health programmes incorporating training in the prevention of household air pollution. These goals were developed to increase the population breathing in clean air in line with WHO Air Quality Guidelines. Further, CLEAN-Air Africa will help many sub-Saharan African governments achieve their targets to expand access to LPG as a clean fuel, given its potential for rapid scale, to meet the United Nations’ Sustainable Development Goal 7.

The Group has already realised impact across a number of different areas. In Kenya, 130,000 community health workers are being trained in household air pollution, health and prevention through new training adopted by the Ministry of Health as part of 2021 Universal Health Coverage. They will work across the whole country educating and supporting communities to adopt cleaner fuels and cooking technology and implement harm minimization strategies to reduce the exposure to harmful smoke.

Professor Dan Pope, Director of the NIHR CLEAN-Air Africa Global Health Research Group, said: “We have demonstrated that rapid transition to clean cooking with LPG in sub-Saharan Africa meets an immediate public health priority with climate, gender and environmental co-benefits”.

“While we are researching future green options for domestic energy, including electricity and bio-LPG, these solutions are unlikely to achieve the scale needed to meet SDG7 on time. More effort is needed to support clean cooking with LPG in countries where the infrastructure required for cooking with electricity or renewable fuels will not be available in the short-term. Our research has shown the benefits of both financial and technological innovation in assisting a rapid, equitable transition to clean cooking fuels”.

Partnering with leading clean energy innovators

In 2019 through a UKRI/MRC Fund Newton grant, CLEAN-Air Africa partnered with Moi University and the International Agency for Research in Cancer to understand how reliance on polluting fuels has contributed to an epidemic of oesophageal cancer in western Kenya.

In Ghana, CLEAN-Air Africa was asked by national authorities to lead evaluation of its pilot efforts to distribute LPG under a Branded Cylinder Recirculation Model to increase safety and accessibility across the national territory. In Cameroon, close to 5,000 beneficiaries have adopted clean cooking as a result of a pioneering microfinance programme co-developed with UK researchers and aligned with the Government’s aspiration to transition 58% of its population to clean cooking with LPG by 2030.

Recognising that clean energy access and affordability are key obstacles for achieving large-scale, equitable and sustained transition to clean fuels at the household level, CLEAN-Air Africa is partnering with leading clean energy innovators such as CircleGas and its subsidiaries. Receiving UK FCDO funding through the GSMA Mobile for Development Utilities Programme, this partnership will foster the expansion of clean cooking with smart metered pay-as-you-go LPG among the resource poor.

Looking ahead - beyond COP26

The group is assessing the positive impacts on the UN Sustainable Development Goals for health, energy access, gender and climate. This programme, including KopaGas in Tanzania and MGas and PayGo Energy in Kenya, was launched at the Kenyan Tech Hub in 2020 by then international development minister Alok Sharma, and is linked to the UK FCDO Modern Energy Cooking Services (MECS) Programme to rapidly accelerate the transition from wood and charcoal based cooking to modern, clean, low carbon energy-efficient energy with a focus on electricity and gas.

The CLEAN-Air Africa Group is the public health voice for MECS and have recently completed a policy review of the Cameroon cooking energy sector, also presented on 4 November at an African Union Development Agency event at the UN Climate Change Conference (COP26).
The group is also engaged with the UN Foundation Clean Cooking Alliance and Stockholm Environment Institute conducting global climate and health modelling of LPG transition at scale building on their quantification made for Cameroon. The climate neutrality of LPG have been recognised in the latest IEA World Energy Outlook report.

Dr Elisa Puzzolo, Co-Director for the Group, explains the latest evidence about LPG climate credentials: “LPG burns very cleanly in simple devices such as household cooking stoves and has a low carbon emission profile due to its high efficiency. Replacing biomass fuels with LPG reduces black carbon and methane emissions and preserves trees from being harvested for fuel. While it should be considered a transition technology towards fully renewable household energy, it has the potential for being increasingly decarbonised through adoption of bio-LPG generated from municipal solid waste and agricultural residues.”