Do Clean Cookstoves Really Save Lives?

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A large-scale study shows cookstoves make no difference on a child’s likelihood of contracting pneumonia—a surprising and disappointing discovery.

By Francie Diep



Getting cleaner-burning cookstoves to low-income countries is a popular charity initiative. In 2010, the United Nations launched the Global Alliance for Clean Cookstoves, which aimed to bring 100 million clean cookstoves to families by 2020. But a new study has found that at least one cookstove benefit funders had hoped for may not pan out.

The study, published in The Lancet, finds that cleaner cookstoves didn’t prevent potentially deadly pneumonia in children in Malawi. The appliances were meant to replace open fires or traditional stoves that poorer families use, which burn fuels such as wood, coal, and dung, and spew smoke into the house. Living in that smoke can cause lung cancer, heart disease, asthma, and pneumonia. For reference, other research shows that, if the air in an American city were as polluted with burnt particles as the air measured in Nepalese homes, it would trigger a population-wide health alert. To combat the problem, charities give away technologically improved stoves that burn more cleanly, or vent smoke outside. The Global Alliance for Clean Cookstoves reports it generated $413 million in pledges from donors between 2010 and 2015.

That’s what makes this new research such bad news. The Malawi study, the largest yet to examine the effects of cleaner cookstoves on people’s health, followed more than 10,000 children for an average of a year and a half each, with field workers visiting the kids every three months. Comparing kids from families who received cleaner cookstoves with kids from families who didn’t, the researchers found similar rates of pneumonia and serious burns among all the children. Kids with cleaner cookstoves did suffer 42 percent fewer less-serious burns.

The study wasn’t set up to answer why the cleaner stoves didn’t make a difference, but the researchers — a team of doctors and public health scientists from the United Kingdom, Malawi, and the United States— had a few ideas. The kids were still exposed to a lot of smoke in their village, in part from families who didn’t get new cookstoves. The cleaner stoves broke down frequently, and while the research team offered families free repairs, there were inevitably periods when the family had to cook some meals before a repair-person could arrive, forcing them to go back to the old, dirty appliance.

The researchers say villages need comprehensive anti-smoke programs, aimed not only at cookstoves, but also at practices like trash burning and tobacco smoking. And they need even cleaner-burning, more reliable stoves.