Transcript: Inefficient Developing World Stoves Contribute to 2 Million Deaths a Year

Description: A team of NIH experts explain the impact of what the World Health Organization sites as the leading environmental cause of death worldwide.

Joe Balintfy: Indoor or household air pollution is not something people in the developed world often hear about. But it is something that affects 3 billion people worldwide.

Dr. William Martin: They may be living in small huts or households that barely protect them from the elements and yet like all of us they must cook their food, heat their homes, and seek light when it is dark outside.

Balintfy: That's Dr. William Martin at the National Institutes of Health. He's the lead author on a commentary in Science magazine explaining how inefficient stoves create indoor air pollution.

Dr. Martin: It is the leading environmental cause of death in the world today.

Dr. Francis Collins: Amazingly, almost two million people a year die as a consequence of that indoor air pollution exposure.

Balintfy: That's NIH Director, Dr. Francis Collins, who is a coauthor of the Science article.

Dr. Collins: Particularly tragically many of them are children under the age of five who die of pneumonia induced by this very heavy exposure to the soot that builds up in those homes over time and affects their lungs. Others who die are particularly women because they spend more time in the home over the fire and they end up with chronic obstructive pulmonary disease just like somebody who's been a long-term smoker or lung cancer.

Balintfy: The writers add that in many societies, women and girls, who often walk several miles from the safety of their home communities to gather wood, charcoal or crop residues, are at increased risk for gender-based violence. Dr. Collins emphasizes that indoor air pollution from primitive household cooking fires is a complex problem.

Dr. Collins: It involves technology. It involves cultural changes and education. It involves, of course, global health because most of these circumstances are in places in the world where incomes are very limited.

Balintfy: Dr. Martin points out that the places where cook stoves are needed are where people live on one or two dollars a day. And with new stoves, comes the need for training.

Dr. Martin: You could give the most advanced stove to a family and if they use as their fuel leaves or twigs that have been picked up along the side of the road you will still get a smoke bomb.

Balintfy: The authors, who also include NIH's Drs. Roger Glass and John Balbus, write that to successfully reach a goal set by a public-private partnership of 100 million households by 2020, governments, manufacturers and Non-Governmental Organizations have to commit to starting large-scale, research-based solutions.

Dr. Martin: To reach the hundreds of millions of homes necessary, it really takes a village, it takes a lot of people working together and that's actually one of the most rewarding aspects of this investment. You improve health but you have so many partners that are helping these families have a better life, a better economic standing in the community and better health for themselves and their children.

Balintfy: The authors estimate the costs of a research program on health and indoor air pollution to range from $150 million to $200 million. Dr. Collins says that while indoor air pollution may have escaped attention, this area of public health will be better addressed.

Dr. Collins: Now that we've realized the huge impact in terms of lives lost, we're all I think now going to be held responsible to try to do something about it. NIH is prepared to take on our share of that responsibility to do the right research, identify the interventions, make sure they work, and then offer that information for all of those out there who are ready to implement change.

Balintfy: Dr. Collins adds that the United Nations Foundation has launched the Global Alliance for Clean Cookstoves, a public-private partnership, to try to coordinate this effort. The Science authors conclude that the challenges of reducing indoor air pollution are great, but the potential of saving millions of lives could be relatively low cost. For more information on the Science article, visit For more on the Alliance for Clean Cookstoves, visit the website And to hear more from Drs. Collins and Martin, listen to the October 21 episode of the NIH Research Radio podcast. This is Joe Balintfy, National Institutes of Health, Bethesda, Maryland.

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