1. 1 | CLEAN COOKSTOVES AND FUELS Clean Cooking and Child Survival Workshop Haatiban, Pharping, Nepal March 28 - 29, 2015

2. 2 | CLEAN COOKSTOVES AND FUELS The Global Alliance for Clean Cookstoves will create a thriving market for clean cookstoves and fuels. PROBLEMMISSIONGOAL which leads to… Every day, 3 BILLION PEOPLE (500 million households) rely on solid fuels to power their rudimentary stoves -4,300,000 deaths annually -Wasted productivity -Climate, forestry & other environmental degradation -21% of global black carbon emissions -Health & economic burdens that disproportionately impact women & girls -SAVE LIVES -IMPROVE LIVELIHOODS -EMPOWER WOMEN -PROTECT THE ENVIRONMENT 100 MILLION HOUSEHOLDS ADOPT CLEAN AND EFFICIENT COOKSTOVES & FUELS BY 2020

3. 3 | CLEAN COOKSTOVES AND FUELS Our market based approach is built on three core strategies … Strengthen Supply Innovation Capacity Building Financing Inclusive Value Chain Enhance Demand Awareness Accessibility Affordability Enable Markets Standards & Testing Research Advocacy & Policy

4. 4 | CLEAN COOKSTOVES AND FUELS Strengthening the Impact of Clean Fuels Across the Value Chain Resource Availability Production/ Processing Distribution Use Impacts Evaluate social, economic and environmental impacts and research gaps across fuel value chain Fuel Enterprise Innovation, Scale, and Capacity Building Coordinate activities, including capacity building, with bioenergy/ethanol global strategic partnership networks Improve understanding of global clean fuels supply and demand Improve understanding of drivers of adoption of clean fuels and resulting impacts on pollution, exposure and health Expand access and affordability of LPG in Ghana, India and Kenya Improve access and scale to LPG and electricity in India through market research, awareness- raising and demand creation

5. 5 | CLEAN COOKSTOVES AND FUELS Clean Fuels are Central to Alliance Public Health Portfolio ‘Clean’ for Environment ≠ ‘Clean’ for Health! Credible International Standards Development Bodies Inform Definition of ‘Clean’ Cooking Technologies  Tier 4* for ‘indoor emissions’ will likely achieve the greatest health benefits ≠≠

6. 6 | CLEAN COOKSTOVES AND FUELS Demonstration Phase and Infrastructure Development Coordinated Collaborative Network for Evaluation Research Clean Cooking Exposure and Adoption: Network for Evaluation Research (CLEANER) Coordinated, multi-country applied research Coordinated evaluations of scale up – exposure and health effects 201220132014201520162017201820192020 PHASE 2PHASE 1 PHASE 3 Ensuring Sustained Adoption Health Effects of Air Pollution Impacts on Adult Chronic Disease (Cardiovascular and Pulmonary) Indicators and Outcomes Burns Research and Prevention Impacts on Child Survival Approaches to Measuring Cognitive Effects Measuring Exposure Reductions +more… Household Ambient Pollution

7. 7 | CLEAN COOKSTOVES AND FUELS Much of earlier research did not focus on very clean stoves Preliminary results from research on truly clean cooking and child survival in Ghana, Nepal, and Nigeria are more promising: – Exposure results demonstrate a remarkable shift in the distribution of women’s exposures to pollution – Very low levels suggest intense, near-exclusive use of clean fuels Are We Getting Clean Enough to Impact Child Survival?  When people have access to very clean fuels, they use it every day, and they stop using lesser technologies  ‘Intensive’ adoption of clean fuels can bring exposures down to WHO air quality guideline levels

8. 8 | CLEAN COOKSTOVES AND FUELS Enterprise Development Strengthening Fuel Supply Advocacy and Awareness Broad Communication Ensures Impact of Results Guidelines and Standards Demonstrating Adoption / Evaluation Integrate Results into Global Evidence Base Commission Research Research to Inform Key Evidence Gaps Research Prioritization Ensuring Widespread Relevance of Research Results

9. 9 | CLEAN COOKSTOVES AND FUELS Snapshot of Workshop Participants Active in 9 Countries: –Bangladesh, Ghana, Guatemala, India, Kenya, Malawi, Nepal, Nigeria, Rwanda Expertise: –Medicine (obstetrics, pediatrics, pulmonology, cardiology), Epidemiology, Applied Public Health Research and Evaluation, Exposure Assessment, Risk Assessment, Communications, Health Policy Range of Experience: –‘founders of the field’ –new investigators with expertise from related sectors

10. 10 | CLEAN COOKSTOVES AND FUELS Day 1 Agenda Exposure Assessment Nepal Study: Including Mix of Seasonality in Outcomes and Exposure Ghana Study: Exposure assessment outcomes Assessing the impact of an ethanol fueled cookstove on personal exposures in urban Nigeria Notes from the Field Nepal PEER Study Verma/Pokhrel A large-scale program to provide water filters and cook stoves in Rwanda Cookstoves and Pneumonia Study, Malawi, and the BREATHE consortium Context Matters: Influence of Covariates on Assessment of Impact of HAP Reductions on Health Clinical Assessments in the Field Lessons Learnt from Ongoing HAP Study in Nigeria Issues in Measurement of Health Outcomes in Field Settings: ALRI and Reproductive Outcomes Health Outcome assessments in Household Air Pollution Trials: Challenges and Experience of GRAPHS ATTEMPTED: Time for Adequate Open Discussion (dependent on speakers…ahem…)