Nonprofits that make cookstoves for the global poor have not been blessed with an abundance of resources. So you would think that the community of stovers, as they’re known, would be pleased by a big infusion of money into the sector from the US government and the Bill & Melinda Gates Foundation. Nope.
The National Institutes of Health (NIH) last fall announced that, with support from the Gates Foundation, it will fund a $30.5 million, multi-country, five-year study to see if cookstoves that burn liquified petroleum gas (LPG) reduce deaths and illnesses, especially in women and children who suffer the greatest exposure. This is almost surely the biggest single grant in the history of the sector, and it sets the stage for further investments in cookstoves, if the study finds that cleaner LPG stoves deliver meaningful health benefits.
A byproduct of crude oil or natural gas, LPG is made of propane or butane or both — it’s similar to the fuel that powers backyard gas grills in the U.S. — and it’s distributed in poor countries in 12kg cylinders. It’s easier to get LPG to poor people living without electricity than it is build out a grid, says Michael Kelly, the deputy managing director of the World LPG Association. “It’s a very good solution for countries that are rapidly developing,” he told me. “You can essentially take a cylinder of natural gas and put it on a donkey and you can have clean energy anywhere.”
Well, sure, clean energy in the sense that LPG burns cleanly and thus shouldn’t, if used properly, contribute to the household air pollution that causes more than 4 million premature deaths each year, according to the World Health Organization (WHO). Then again, it’s not truly clean because LPG, like all fossil fuels, generates CO2 emissions that threaten the health of the planet and its inhabitants by contributing to climate change.
That’s one reason why some stovers are underwhelmed by the NIH-Gates LPG study. Others say that it’s clear that LPG stoves will deliver health benefits, if properly used, so why do a study? Still others worry that the NIH-Gates study could lead funders with deep pockets to favor LPG over cookstoves that burn biomass, i.e., wood, charcoal, dung or agricultural waste. The vast majority of cookstoves in poor countries burn biomass.
So what should we make of the NIH-Gates grant? As always, nothing is simple in the cookstove sector, which has an unfortunate history of promising more — improved health! climate change mitigation! empowered women! local jobs! — than it can deliver. And yet, until the world finds a way to get clean energy to the roughly 1.3 billion people who lack it, cookstoves are too important to ignore.
A lack of clarity about goals
The trouble is, the cookstove sector has suffered over the years from a lack of clarity about definitions and goals. Terms like “clean,” “efficient” and “improved” cookstoves are used carelessly. Standards to measure the emissions and efficiency of cookstoves are still being developed, amidst controversy. And there are unavoidable tradeoffs involving costs and quality. (For more, you can see my previous writing about cookstoves here, here and here.) We can be sure of one thing: There’s no one-size-fits-all cookstove solution.
As it happens, the NIH-Gates study emerged from the foundation’s work on pneumonia, which remains the world’s leading cause of death among children under age 5. Pneumonia is said to be responsible for about 18 percent of child deaths worldwide, nearly all in poor countries.
The study has a well-defined goal, according to Dr. Gail Rogers, senior program officer for pneumonia at the Gates Foundation. The foundation wants to find out, definitively, whether “a clean cookstove solution” can deliver health benefits, she told me. To that end, NIH and Gates, after consulting with the Global Alliance for Clean Cookstoves, a public-private partnership that is part of the UN Foundation, set a high bar for the cookstoves they wanted to test in the October 2015 RFP (request for proposal) to researchers:
Only studies assessing the use of demonstrably clean cooking technologies (i.e. those with the potential to achieve extremely low emissions and associated health benefits) will be considered. In order to maximize public health benefits, ‘demonstrably clean’ is defined here as clean cookstoves at IWA tier 3 or higher for indoor air emissions, based on third-party verification, or clean fuels (LPG, electricity, ethanol, biogas).
This requirement pointed researchers toward LPG stoves because very few biomass cookstoves can achieve the Tier 3 standard for emissions. The NIH-Gates study will deploy sophisticated electronic devices that can measure tiny particulates, and identify their sources, both in the household and in the lungs of mothers and young children, who will be followed for at least two years. “This is quite a comprehensive study,” Dr. Rogers says.
The $30.5 million grant was awarded to researchers at Emory, Johns Hopkins and Colorado State University, who will work with local partners in India, Guatemala, Peru, and Rwanda. In a press release, Thomas Clasen, a professor of environmental health at Emory, explains the decision to use gas stoves:
Previous interventions have provided cleaner solid fuel-based stoves, but have generally failed to produce expected reductions in exposure to household air pollution and improvements in health…There have been no large-scale field trials with gas stoves, which are likely the cleanest scalable intervention in these settings.
He’s right. This could be the first large-scale field trial to demonstrate the health benefits of cookstoves in a convincing way. Wouldn’t that be a good thing?
Not necessarily, say some stovers.
By email from Mozambique, Christa Roth of Food and Fuel, who has worked on cookstove projects in Africa and elsewhere since the late 1990s, wrote: “My objection to LPG in general is that it is a fossil fuel. We should not only consider people’s health but climate impact.” On a recent research trip to Ghana, she found that people who had bought or were given LPG stoves had stopped using them. “None had refilled the gas in the past six months, and all were cooking on biomass. Everybody agreed that the gas is too expensive for cooking,” she said.
Leaving the poorest behind
Others see the study as unnecessary. One veteran stover emailed me to say: “Gates $30 million will go to the pockets of bunch of academics and researchers who will play with their time on their comfy office chairs. Waste.” Adam Creighton of InStove, a nonprofit that makes institutional stoves (and thus has no stake in this argument over biomass vs. LPG), worries that the study is superfluous:
I think the health case for LPG is made already (analogous to many as a proof of concept study of whether hammers are effective for driving nails when compared to rocks). I also think the market case is made: where women can afford it, they prefer to use LPG; and, we in the “developed” world use gas for cooking.
The affordability question is key. Nancy Hughes, the founder of StoveTeam International (who I wrote about here), told me: “The poorest of the poor will be left behind with LPG unless the governments heavily subsidize it. LPG costs $$$$. Wood is usually free. If you live on $1.00/day this is an issue.”
LPG advocate Michael Kelly agrees, saying: “LPG isn’t a solution for the poorest of the poor.”
My takeaway: In a world of limited resources, and within a sector that has struggled to raise capital, it’s probably inevitable that the Gates Foundation support for an LPG study is seen as coming at the expense of biomass stoves. On the other hand, the study represents an opportunity to validate claims about the health benefits of cookstoves. This is important to the sector’s credibility because so much has been said — and so little has been proven — about the ability of cookstoves to save lives. See, for example, these sweeping claims from the global alliance’s Chef Jose Andres on the Obama White House blog.
What’s more, advocates of advanced biomass cookstoves are getting their own study, albeit a smaller one, from the NIH. This $2.5 million study, led by researchers at the University of North Carolina, is examining the impacts on health and poverty of cookstoves provided by Inyenyeri, a startup company in Rwanda with an innovative business model. Remarkably, Inyenyeri provides its customers with a couple of high-quality, relatively high-cost biomass stoves at no expense, and then aims to recover the costs through the sale of biomass fuel pellets. I’ll be back with the Inyenyeri story in an upcoming blog post.