REDUCING RESPIRATORY ILLNESS THROUGH ALLEVIATING KITCHEN SMOKE

REDUCING RESPIRATORY ILLNESS THROUGH ALLEVIATING KITCHEN SMOKE IRISH FORUM FOR GLOBAL HEALTH (IFGH) BIENNIAL CONFERENCE November 29th 2010 Liz Bates

Outline • Health impacts • Limitations - health data • Need for proxy • Monitoring • Interventions – including examples – discussing benefits and constraints • Future actions

Worldwide deaths from indoor smoke from solid fuel include... • 64% occur in low-income countries, especially in South-East Asia and Africa. • 28% of global deaths caused by indoor smoke from solid fuels occur in China. *GLOBAL HEALTH RISKS: WHO Mortality and burden of disease attributable to selected major risks 2009

Mortality low-income countries* 10 leading risk factor causes of death by income group 2004 10th in the world * low-income < US$825

DALYs low-income countries* 10 leading risk factor causes of DALYs by income group, 2004 9th in the world * low-income < US$825

Environmental risk factorsPercentage of deaths / DALYs in low-middle income countries

Data included in these figures Based on data for which there is solid evidence • ALRI • COPD • Cancer Less evidence • Tuberculosis • LBW & Prematurity – (cause of 29% of all newborn deaths) • Cardio-vascular diseases

WHO 24hr air quality guidelines for particulate matter *AQG = Air Quality Guidelines (WHO)

Monitoring for PM and CO CO PM

Typical results for CO woman & room

Approaches to alleviation of IAP Behavioural changes • Cook and child keeping away from smoke • Cooking in a separate room • Cutting food small • Cooking outdoors • Transferring ownership of the problem to the cook and her family

Approaches to alleviation of IAP Not creating pollution - using clean fuels • LPG • Ethanol • New fuels such as plant oils

Approaches to alleviation of IAP Venting smoke out of the house • Smoke hoods • Chimney stoves • Eaves spaces

Approaches to alleviation of IAP Burning fuel efficiently • Using an improved stove • Using dry fuel • Using a pressure cooker

Reductions achieved in PM, Kenya, Nepal & Sudan – 30households

Issues....if people do not like a stove, or cannot afford it – the efficiency of the intervention to remove smoke is NIL

Quality of life benefits - Kenya

Quality of life benefits - Nepal

Quality of life benefits - Sudan

What works? • Start project with self-sustaining perspective • Starting with people where the are – not where we want them to be • Encourage people to ‘own’ the problem • Develop a range of options with community • Develop finance systems that suit them • Treating people as customers

New initiatives: Global Alliance for Clean Cookstoves • Coordinated through the UN Foundation (UNF) - $250 goal • Founding partner organizations signed up to 100 million clean cookstoves by 2020 • Primary focus on development of robust global stove industry / market • Unproven hypothesis -biomass stoves exist that are • clean enough to have major health/climate benefits • affordable by world's poorest half, to sustain sales - $US10 NO such device is available today Smith KR, What's Cooking? A Brief Update, Energy for Sustainable Development (2010), doi:10.1016/j.esd.2010.10.002

New initiatives:Global Cookstove Accelerator Facility • Developing mechanism to make it easier for cookstove programmes to tap funds through CDM, or the voluntary carbon market using Gold Standard • guaranteeing a price floor on future carbon credits low interest loans Smith KR, What's Cooking? A Brief Update, Energy for Sustainable Development (2010), doi:10.1016/j.esd.2010.10.002

New initiativesNational Biomass Cookstove Initiative (NCI) • Explicitly aiming to provide every household in India with combustion comparable to LPG in cleanliness and efficiency, whether from modern fuels or biomass • Competition to increase efforts on R&D • Carbon finance is ‘the icing on the cake’ – they are after ‘the cake’

Traditional kitchen

Improved kitchen Thank you...questions?

REDUCING RESPIRATORY ILLNESS THROUGH ALLEVIATING KITCHEN SMOKE