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The United Nations Commission for Sustainable Development may not appear, at first sight, to be a major playing field for public health. Nevertheless, when environment, energy and development ministers from around the world assembled in New York on 1-12 May 2006 for the Commission's 14th session, health concerns in relation to energy production and consumption emerged as a prominent argument in discussions on energy for sustainable development. In his opening speech, Secretary General Kofi Annan called attention to the fact that indoor air pollution from solid fuel use is one of the world's ten major causes of mortality and morbidity. (1) More than half the world's population--3.2 billion people--still burn coal and biomass fuels such as wood, dung and crop residues to meet their basic energy needs. (2) Indoor air pollution from burning these solid fuels on open fires or traditional stoves comprises a variety of health-damaging pollutants including particles, carbon monoxide and different carcinogens (3) and is the cause of a public health tragedy. Every year, 1.5 million people die from inhaling indoor pollutants that often exceed accepted guideline limits for outdoor air: in the case of fine particles, the limit is exceeded by 100 times or more. (4, 5) Children and women are disproportionately affected, with nearly 800 000 deaths attributable to indoor air pollution occurring among children under five years of age and more than 500 000 such deaths occurring among women. (5) Preventing deaths caused by polluted indoor air must no longer be delayed. In the short term, stoves that burn more cleanly and use fuel more efficiently, ventilation that is improved through smoke hoods or enlarged spaces in the eaves, and changes in housing design can substantially reduce pollutant levels. In the longer term, the use of cleaner fuels, such as liquefied petroleum gas, biogas or other modern biofuels, can eliminate the current indoor air pollution epidemic. Improving access to modern energy services--including electricity and modern cooking fuels and appliances--is essential if the world is to achieve its Millennium Development Goals (MDGs). The United Nations Millennium Project recommends an additional MDG target "to halve, by 2015, the number of people without effective access to modern cooking fuels, and to make improved cooking stoves widely available". (6) The challenge in working towards this target is enormous: every day for the next 10 years, 485 000 people will need to gain access to cleaner fuels or improved stoves. Even if the target is realized, 1.5 billion people will still be left on the sidelines of development in 2015. (5) "Effective solutions exist and the economic case for taking practical solutions to scale is just as strong as the humanitarian case", emphasized the late Dr LEE Jong-wook, Director-General of WHO. …

Indoor air pollution: 4000 deaths a day must no longer be ignored