I recently published a duo of papers in the Lancet Global Health, as part of a series on energy and health in low-income and middle-income countries. It was a pleasure crafting these papers with some of my favorite authors and peers, all experts in the topic, and also complementing research papers I’ve produced on Powering Jobs and Powering Agriculture.
In producing these two papers on clean energy use in low-income and middle-income countries (LMICs) simultaneously, the global challenge of energy access becomes ever clearer, particularly in relation to health. The research presented in these papers highlights both the progress made and the persistent barriers hindering equitable and sustainable energy transitions.
The first paper, Powering Health with Energy in LMICs, emphasizes the critical role that energy plays in powering essential services such as cooking, healthcare, and infrastructure. Despite significant global energy consumption, large sections of the population in LMICs continue to suffer from energy poverty. This reality disproportionately affects rural areas, where access to clean energy services, such as electricity and cooking fuels, remains limited. The burden of disease from air pollution, especially from the use of biomass fuels for cooking, continues to be staggering, with millions of deaths reported annually due to respiratory illnesses caused by poor air quality. These health impacts are compounded by climate change, which exacerbates heat-related mortality and the spread of vector-borne diseases.
Furthermore, the paper underscores the disparities in energy access, particularly among vulnerable groups such as women and girls. They often bear the brunt of health risks from polluting fuels and the time burdens of fetching firewood or cooking on open fires, further restricting their socio-economic opportunities. While the transition to clean energy could mitigate many of these health risks, the paper points out significant barriers: political and regulatory challenges, technological hurdles, and financial constraints. Overcoming these obstacles will be essential for improving health outcomes in LMICs.
Our second paper, Beyond Access: Clean Energy Use in LMICs, builds on these findings, focusing on the ongoing gaps in achieving clean energy adoption. While access to clean energy has improved globally, billions remain without reliable and affordable sources, particularly in sub-Saharan Africa. It challenges the simplistic approach of tracking energy access based solely on whether households have electricity or use clean cooking fuels. The paper critiques current metrics, particularly the Sustainable Development Goal 7 indicators, which fail to capture the full complexity of energy use patterns. For instance, many households rely on a mix of clean and polluting fuels, a practice known as fuel stacking, which undermines the health benefits of clean energy.
The paper argues that economic factors are the primary drivers of clean energy adoption, with affordability being the key barrier. Subsidies and price reductions for clean energy technologies have proven effective in some regions, but high upfront costs and unreliable fuel supply chains continue to limit broader adoption. Furthermore, while policy initiatives such as targeted subsidies have spurred progress, these efforts must be more inclusive and address deeper systemic inequalities.
In summary, our papers together highlight the intersection of energy and health in LMICs and the urgent need for a comprehensive, equitable energy transition. The shift to clean energy not only promises health benefits but is also a critical component of sustainable development. However, to ensure that these benefits reach the most marginalized populations, a more nuanced understanding of energy access—one that includes both historic context, as well as attention to factors like reliability, affordability, and socio-economic barriers—is essential.
Check out our two papers and the full series here: Energy and health in low-income and middle-income countries
