Household Air Pollution in India: Where are we going?

Kirk R. Smith, MPH, PhD Professor of Global Environmental Health

University of California, Berkeley

Visiting Faculty Indian Institute of Technology Delhi

India Clean Cooking Forum

GIZ/MNRE, October 6, 2015

Relative disability-adjusted life years DALYs

LPG is benchmark

DALYs

Three major estimates of the direct premature mortality from not

using LPG (or similar clean fuel)

• Global – GBD–2010: 3.6 million – WHO-2012: 4.3 million – GBD-2013: 2.9 million

• India – GBD-2010: 1 million – WHO-2012: 1.2 million – GBD-2013: 0.9 million

%PM2.5 from “Residential” Emissions : NASA

5

Chafe, et al., 2014

Percent of primary ambient PM2.5 from household cooking fuels – population weighted

~25% in India

Nature, Sep 17, 2015

Percent of outdoor air pollution from households

Percent of outdoor air pollution from households

Percent of outdoor air pollution mortality from household fuels

• Varies by model and databases used • For example, 25-50 percent in India • 14-30% globally • Adds another 0.5-1.0 million deaths to the

direct impacts of “not having LPG” • Total for HAP: greater than 4 million

annually worldwide

First person in human history to have her exposure measured doing the oldest task in human history

Kheda District Gujarat, 1981

1990: 85%: 700 million people using solid fuels 2010: 60%: 700 million people ~1980 700 million people in entire country

700 million people in the Chulha Trap

Low- and Middle-Income Countries

More than any time in

human history

Recent trends give us an idea where we are going if nothing is

done.

Premature Deaths

Increasing Prosperity and Development

Dec

reas

ing

Hou

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ld A

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Very Low Income

200 million

Low Income 400 million

Middle Income 400 million

High Income 200 million

Crop Waste Dung

Coal

Kerosene

Natural Gas

Electricity

Non-solid fuels

Solid Fuels

Liquefied Petroleum Gas

Biogas/solar

Wood

Conceptual Indian Energy Ladder

How do we help people move into

this realm?

Smith/Pillarisetti, 2014

Increasing Prosperity and Development

Dec

reas

ing

Hou

seho

ld A

ir Po

llutio

n

Very Low Income

200 million

Low Income 400 million

Middle Income 400 million

High Income 200 million

Crop Waste Dung

Coal

Kerosene

Natural Gas

Electricity

Non-solid fuels

Solid Fuels

Liquefied Petroleum Gas

Biogas/solar

Wood

Conceptual Indian Energy Ladder

India already spends ~40,000 crore (6 billion USD) to promote clean cooking

• LPG subsidies per year • Seen as a political and economic burden • But can be considered a major asset to

promote clean fuels even further among the poor

• To do so, however, requires – Eliminating leakage to non-household sector – Target to poor – take away from rich

This being done now

• Stage I: began Jan 1 this year – Direct Bank Transfer: largest in human history – All LPG now sold at market rate. – LPG sales rapidly rising in commercial sector

• Stage II: began April this year – “Give it up” campaign – 3.5 million households have done so already,

rising at 30k per day – Provide to BPL families with stove and first

cylinder

Times of India Oct 2, 2015 Gandhi’s Birthday

LPG expansion, cont. • Phase III: Next year?

– Change from opt out to opt in system – Expect to go from 70+% of rich claiming

subsidy – To less than 30%

• Total impact of all phases: – 90%+ reduction in leakage – Movement of >20,000 crore from rich to poor

(3 billion USD)

India: What happened? Millions

India: What happened? Millions

In 30 years, “improved” biomass stoves had no impact on health. At the same time more than 400 million Indians took up clean fuels, mainly LPG

India: What If? Millions

9% instead of 5.5%/yr for 20 years

India: What If? Millions

9% instead of 5.5%/yr for 20 years

A Chulha Trap or a

Clean Fuel Gap?

Of course • Just providing affordable access to LPG or

other fuel does not mean people instantly switch

• However, since 60% of world uses gas and/or electricity it argues strongly that the rest eventually will.

• Is clearly what is needed in long term – why not sooner rather than later?

Subsidy or ?

• Health sector does not refer to programs to vaccinate or provide maternal care to the poor as “subsidies” but rather

• Social investments • In order for public support of clean fuels to be

termed social investments, they need to be far better targeted than in the past.

• Modern IT technology provides ways to do so

New Directions • Work to help target subsidies

– Embrace modern IT to do so • Work with others to explore entirely

different distribution modes – Including at the community level

• Develop marketing for enhancing use after adoption – Shorten “stacking” period

New Directions, cont.

• Consider partnering with health sector to firmly establish LPG and electricity as direct health investments – In parallel to vaccines, antibiotics, etc. – Large up front costs, but – Very large potential market – A major health benefit to the very poorest

Bottom Lines • New estimates of health effects will

continue – But household air pollution will remain one of

the biggest risks in India • Estimates will continue to be made, but

– household sources will remain a large source of outdoor air pollution in India

• In both case, unless strong action is taken to counter current trends

Saroj ASHA worker in Palwal Haryana

Please

• Do not let “clean” become the new “improved”

• That is, a way to hide information • We know now what clean means – the

WHO has provided us with guidelines that make it clear

• There is little room for ambiguity anymore • Keep “clean” to describe what is truly clean

Risk Curve for PM2.5 and Child ALRI risk

WHO IT-1 (35 µg/m3 PM2.5)

My appeal: cleanse your mind. • Focus on the problem and not on

preconceived solutions – Household sales – Local energy supplies – Climate neutral/renewable – Eliminate subsidy – Villagers are different from us

• Focus on improving the health of our fellow citizens who are not able to do so entirely on their own

For solid fuel users, expect varying rates of adoption of clean fuels across society ...

To ensure ‘best possible’ • Testing • Standards • Certification

WHO, 2014

Many thanks For publications and presentations: Just “Google” Kirk R. Smith