Energy and health: 2.4 billion people still cook with polluting fuels—killing 3.2 million yearly
Energy and health: 2.4 billion lack clean cooking—3.2 million deaths annually
Every morning before dawn, Fatima Diallo wakes her three children and starts the day’s first task: cooking breakfast over an open fire.
The 32-year-old mother in rural Mali gathers wood from increasingly distant locations—deforestation means a two-hour walk now. She lights the fire inside her small mud-brick home because cooking outdoors in the dark isn’t safe. Within minutes, thick smoke fills the one-room house where her family sleeps, eats, and lives.
Her youngest, four-year-old Amina, coughs constantly. The local clinic diagnosed her with chronic respiratory infections. The doctor suggested switching to clean cooking fuels, but liquefied petroleum gas (LPG) costs more than Fatima’s husband earns in a week. So she continues cooking with wood, breathing smoke, watching her daughter cough.
“I know the smoke makes us sick,” Fatima said, waving her hand through the haze. “My eyes burn, my throat hurts, Amina can’t stop coughing. But what choice do I have? We need to eat.”
Fatima is one of 2.4 billion people globally who lack access to clean fuels and technologies for cooking. According to WHO’s work on energy and health, household air pollution emitted from using polluting stoves and fuels causes approximately 3.2 million deaths annually.
That’s more than HIV/AIDS, tuberculosis, and malaria combined. And it’s entirely preventable.
Energy and Health: Inextricably Linked
Energy and health are inextricably linked. Access to clean, sustainable, and affordable energy—outlined in the seventh Sustainable Development Goal (SDG 7)—plays a crucial role in advancing health (SDG 3).
Energy is also critical for achieving almost all other global goals including eradication of poverty (SDG 1), opportunities for quality education (SDG 4), achievement of gender equality (SDG 5), access to clean water (SDG 6), jobs security and economic growth (SDG 8), and combat of climate change (SDG 13).
The links between energy and health are particularly evident in homes and health-care facilities. Access to clean and sustainable energy in homes is essential to protect people’s health from household air pollution due to use of polluting stoves and fuels such as coal and biomass. Access to clean and reliable energy in health-care facilities is important to ensure delivery of essential health care services for disease prevention and treatment.
For more on the health impacts of air pollution, see our article on air quality and respiratory diseases.
The Deadly Smoke Inside Homes
Globally, household air pollution from cooking is devastating. Women and children in particular are at greater health and livelihood risks since they’re often tasked with cooking and collecting fuelwood. Health burdens are even greater when polluting energy is used for other purposes like space heating and lighting.
According to WHO fact sheets on household air pollution, burning coal, wood, crop waste, and dung in inefficient stoves or open fires produces a dangerous mix of pollutants. These include small particles that penetrate deep into lungs and even enter the bloodstream, carbon monoxide that reduces oxygen delivery to organs, and numerous toxic chemicals.
The health consequences are severe: pneumonia in children, chronic obstructive pulmonary disease (COPD), lung cancer, heart disease, stroke, cataracts, and adverse pregnancy outcomes including low birth weight.
Dr. Sophia Mensah, a pulmonologist who works in rural Ghana, described the patients she sees daily: “Women in their forties and fifties with lungs that look like they’ve been smoking cigarettes for decades—except they’ve never touched tobacco. They’ve just been cooking meals for their families. Children with recurring pneumonia, wheezing, stunted growth. The smoke inside homes is killing them as surely as any epidemic disease.”
Sub-Saharan Africa: The Energy Access Crisis Deepens
Recent statistics show population growth currently outpaces increases in energy access in some regions, especially in sub-Saharan Africa. According to the 2025 Tracking SDG7 Report released by WHO and partners in June 2025, it remains the only region where the number of people without access to clean fuels and technologies is rising.
Only about 1 in 5 people in sub-Saharan Africa (17%) has access to clean cooking. Overall, more people without access to clean fuels and technologies reside in sub-Saharan Africa than any other region, with around 83% of the population—about 900 million people—lacking access to clean cooking.
WHO announced in June 2025 that energy access has improved globally, yet international financial support is still needed to boost progress and address disparities. In June 2024, WHO reported that progress on basic energy access reversed for the first time in a decade.
Unless rapid action is taken, the world will fall short of the universal access target for clean cooking, leaving more than one fifth (24%) of the population still lacking access in 2030, making them vulnerable to health and other consequences.
Health Facilities Without Power
Access to energy also plays a critical role in the functionality of health-care facilities and the quality, accessibility, and reliability of health services delivered to all.
Yet an estimated 1 billion people globally are served by health facilities without electricity. Around 25% of health-care facilities in 11 sub-Saharan African countries are estimated to have no access to electricity. While most large hospitals have access, rates drop dramatically for rural and remote clinics.
According to WHO fact sheets on electricity in health-care facilities, electricity is necessary for operation of critically needed medical devices such as vaccine refrigerators and surgical emergency, laboratory, and diagnostic equipment, as well as for operation of basic amenities such as lighting, clean water supply, cooling, ventilation, space heating, and communications.
Electricity is critical to health improvement and health protection and in many cases, it can make the difference between life and death.
Dr. James Omondi, who has worked in rural health clinics across East Africa, explained the consequences: “Imagine trying to deliver a baby at night with no lights. Trying to keep vaccines cold with no refrigeration. Trying to diagnose malaria with no microscope or rapid test. Trying to treat severe pneumonia with no oxygen concentrator. Without electricity, we’re practicing medicine like it’s the 19th century. People die from conditions that should be easily treatable.”
WHO’s Response: The Health and Energy Platform of Action
WHO has launched the Health and Energy Platform of Action (HEPA) to accelerate action on clean cooking and electricity access for health-care facilities.
HEPA operates through the High-Level Coalition on Health and Energy, bringing together governments, UN agencies, development partners, private sector, and civil society.
The coalition follows a Strategic Roadmap to promote healthier populations through clean and sustainable energy, focusing on two priority areas: accelerating access to clean cooking and accelerating access to electricity in health-care facilities.
WHO published the WHO strategic approach on air quality, energy access and health in October 2025, providing coordinating authority on international health to support countries in protecting public health through evidence-based policies and actions.
WHO has also developed practical guidance on green spaces as solutions for air pollution and health (September 2025), land use planning for air pollution and health (October 2025), and understanding health impacts of sand and dust storms (September 2025).
Tools and Training for Change
WHO provides numerous resources to help countries transition to clean energy.
The Household Energy Database tracks global progress on clean cooking access. The Household Energy Policy Repository, launched in October 2021, helps countries learn from successful policies implemented elsewhere.
WHO developed the Air Pollution and Health Training Toolkit for Health Workers to build capacity among health professionals to understand and address air pollution health impacts.
The Global Health Observatory provides comprehensive data on air pollution, including the Total Burden of Disease from Household and Ambient Air Pollution and the Global Database of Household Air Pollution Measurements.
WHO’s Air Quality, Energy and Health team coordinates global efforts, working within the broader Environment, Climate Change and Health department.
What Must Happen
Scaling up adoption of clean cooking solutions requires awareness raising, policies, financing, innovative delivery models, and technology development.
For households: Governments must subsidize clean cooking fuels and technologies, making them affordable for poor families. Distribution networks need to reach rural areas. Communities need education about health benefits and proper use of clean cookstoves.
For health facilities: Systematic electrification of health facilities must be prioritized in national health and energy plans. WHO’s Harmonized Health Facility Assessment helps countries assess and improve health facility infrastructure including electricity access.
Integration across sectors: Through integrated approaches to health and energy challenges, WHO works to accelerate access to clean cooking and electricity for health-care facilities. By working closely with the energy sector, the health sector can make critical steps in achieving health targets for non-communicable diseases and pneumonia prevention, vaccine coverage, digital health, and improved emergency preparedness and response.
WHO’s work on supporting country programmes, strengthening health services with quality, and capacity building and training all contribute to improved energy access for health.
Fatima, the mother in Mali who cooks over an open fire, dreams of something better. “If we had clean cooking fuel, Amina might stop coughing. I could see what I’m cooking without smoke in my eyes. Maybe I could work instead of spending hours collecting firewood. My whole life would be different.”
With 2.4 billion people still cooking with polluting fuels and 3.2 million dying annually from the smoke, the energy-health crisis demands urgent action. The solutions exist—clean cooking technologies, electricity for health facilities, sustainable energy systems. The question is whether we’ll deploy them fast enough to save millions of lives.
Frequently Asked Questions (FAQs)
Energy and health are inextricably linked. Access to clean, sustainable, and affordable energy outlined in Sustainable Development Goal 7 (SDG 7) plays a crucial role in advancing health (SDG 3). Energy is also critical for achieving nearly all other global goals including poverty eradication (SDG 1), quality education (SDG 4), gender equality (SDG 5), clean water access (SDG 6), jobs and economic growth (SDG 8), and combating climate change (SDG 13). The links between energy and health are particularly evident in homes and health-care facilities. Access to clean and sustainable energy in homes is essential to protect people’s health from household air pollution due to use of polluting stoves and fuels such as coal and biomass. According to WHO fact sheets on household air pollution, globally 2.4 billion people lack access to clean fuels and technologies for cooking, and household air pollution causes approximately 3.2 million deaths annually. Access to clean and reliable energy in health-care facilities is important to ensure delivery of essential health care services. WHO’s Air Quality, Energy and Health team coordinates global efforts.
Globally, 2.4 billion people lack access to clean fuels and technologies for cooking. Household air pollution from polluting stoves and fuels causes 3.2 million deaths annually. Women and children face greater health and livelihood risks since they’re often tasked with cooking and collecting fuelwood. Health burdens increase when polluting energy is used for space heating and lighting. Recent statistics show population growth currently outpaces increases in energy access in some regions, especially sub-Saharan Africa—the only region where the number of people without access to clean fuels and technologies is rising. Only about 1 in 5 people in sub-Saharan Africa (17%) has access to clean cooking. Around 83% of the population (about 900 million people) in the region lacks access to clean cooking. According to the 2025 Tracking SDG7 Report released in June 2025, energy access has improved globally but international financial support is still needed. Unless rapid action is taken, more than one fifth (24%) of the population will still lack access in 2030. WHO’s Household Energy Database tracks progress.
An estimated 1 billion people globally are served by health facilities without electricity. Around 25% of health-care facilities in 11 sub-Saharan African countries are estimated to have no access to electricity. While most large hospitals have access, rates drop dramatically for rural and remote clinics. According to WHO fact sheets on electricity in health-care facilities, electricity is necessary for operation of critically needed medical devices such as vaccine refrigerators and surgical emergency, laboratory, and diagnostic equipment, as well as for operation of basic amenities such as lighting, clean water supply, cooling, ventilation, space heating, and communications. Electricity is critical to health improvement and health protection and in many cases can make the difference between life and death. Without electricity, health facilities cannot properly store vaccines, perform surgeries at night, run diagnostic equipment, or provide basic services. WHO’s Harmonized Health Facility Assessment helps countries assess and improve infrastructure including electricity access. The Health Resources and Services Availability Monitoring System (HeRAMS) monitors health facility functionality.
WHO launched the Health and Energy Platform of Action (HEPA) to accelerate action on clean cooking and electricity access for health-care facilities. HEPA operates through the High-Level Coalition on Health and Energy, bringing together governments, UN agencies, development partners, private sector, and civil society. The coalition follows a Strategic Roadmap to promote healthier populations through clean and sustainable energy. WHO published the WHO strategic approach on air quality, energy access and health in October 2025 and provides tools including the Household Energy Policy Repository (launched October 2021) and Air Pollution and Health Training Toolkit. WHO works on supporting country programmes, strengthening health services, estimating environmental health impacts, and capacity building.
Scaling up adoption of clean cooking solutions requires awareness raising, policies, financing, innovative delivery models, and technology development. For households, governments must subsidize clean cooking fuels and technologies making them affordable for poor families, expand distribution networks to rural areas, and provide education about health benefits. For health facilities, systematic electrification must be prioritized in national health and energy plans with reliable power sources for critical medical equipment. Through integrated approaches to health and energy challenges, WHO works to accelerate progress. By working closely with the energy sector, the health sector can make critical steps in achieving health targets for non-communicable diseases and pneumonia prevention, vaccine coverage, digital health, and improved emergency preparedness and response. WHO provides guidance on green spaces for air pollution and health (September 2025), land use planning (October 2025), and sand and dust storms health impacts (September 2025). The Global Health Observatory provides comprehensive data on air pollution including total burden of disease from household and ambient air pollution and the Global Database of Household Air Pollution Measurements.
- WHO Energy and Health Health Topic
- WHO Household Air Pollution Fact Sheet
- WHO Electricity in Health-Care Facilities Fact Sheet
- Health and Energy Platform of Action (HEPA)
- High-Level Coalition on Health and Energy
- Strategic Roadmap on Health and Energy
Disclaimer: This article is an adaptation of publicly available information from WHO’s Energy and health
health topic page (WHO, Geneva. Licence: CC BYNC-SA 3.0 IGO). WHO is not responsible for the
content or accuracy of this adaptation. This content is for informational and educational purposes
only and does not constitute medical advice. ObserverVoice.com is a news and information platform
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