India’s leaders are engaged in fostering a number of economic and social programmes aimed at improving the lives of its citizens. But with renewed government attention and continued support from the nation’s private and non-profit sectors, there is one public health initiative with particular promise to help families in India: A clean cooking movement.
Research prepared for the United Nations Foundation’s Global Alliance for Clean Cookstoves shows that every day, an estimated 166 million of India’s households rely on solid fuels as the primary source of cooking fuel, often self-collected and burned using open fires or traditional chulhas in homes with little or no ventilation.
Current public health estimates indicate approximately 400 million people in India are exposed to the negative health effects of indoor pollution based on these traditional practices. Equally important, over 90% of those exposed to this harmful pollution are women and girls.
The public health costs are staggering. Household air pollution in India is a major cause of premature deaths and the leading cause of lower life expectancy caused by cardiovascular disease, lung cancer, pneumonia, and other acute lower respiratory infections, along with cataracts and blindness. Additionally, unsafe cookstoves are a primary cause of debilitating burns suffered annually by more than 500,000 women.
Estimates suggest that every year, India experiences 875,000 deaths and the loss of 16.9 million disability-adjusted life years (DALYs) due to indoor air pollution traced to poor ventilation and cooking methods.
Non-communicable diseases (NCDs), which include heart and lung disease, stroke, diabetes and cancer, remain the world’s leading causes of death, claiming more lives than all other causes of disease combined.
Chronic conditions like heart or lung disease are not just about men with ‘bad habits’, it is also the leading cause of death among women in developing countries, including India, causing over 3.6 million deaths each year. The vast majority of these women do not smoke, are not overweight, are physically active, and do not abuse alcohol. And yet, most of these women share a risk factor common to 150 million Indian households: Air pollution from cooking with solid fuels, often in poorly ventilated conditions.
An estimated 140,000 children under five die every year from preventable diseases connected to indoor air pollution.
In order to scale up supply and demand for safe cookstoves and fuels, support led by the government is needed in four key areas: Facilitating more partnerships aimed at creating economic incentives for household energy security including clean cookstoves and fuels; providing a wider base of financing for both consumers and suppliers; continued work on developing acceptable standards for stove performance; and, continuing to promote awareness of the positive benefits of clean cookstoves and fuels.
India needs to act now to tackle a complex problem that could escalate into a significant drain on the nation, its most vulnerable people and the environmental balance. The first step is to start with leadership and ownership of the issue. An inter-ministerial approach is needed to bring together departments to initiate a programme with clear targets. India must set its sights on the end goal of a focused, targeted, multi-stakeholder drive to ensure that secure household energy options, including clean cookstoves and fuel, are available in every single Indian home.
After all, a healthy family starts with a healthy hearth.
(K Srinath Reddy is president, Public Health Foundation of India and Gro Harlem Brundtland is director general emeritus, World Health Organization. The views expressed by the authors are personal.)