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Energy use, development, air pollution, human and ecosystem health are all inextricably interrelated. Access to energy is essential for development, but energy generated by the combustion of fossil fuels and biomass often results in air pollution, with negative impacts on human and ecosystem health. The impacts of indoor and urban outdoor air pollution warrant urgent action (Box 6). The good news is that clean technology is now largely available to provide access to energy, without compromising public and ecosystem health.

To achieve a more sustainable energy future we need political will and leadership at national, regional and global levels; global cooperation, particularly on technology transfer; and economic resources. More efficient technologies and measures to promote more efficient use of energy by consumers can help reduce the demand for energy, while new energy technologies can have longer-term benefits by reducing the negative impacts at source. Specific tools to control air pollution include standards, enforcement and monitoring.

National and regional air quality standards are needed to establish tolerable levels of pollutants. A wider range of air pollutants need to be monitored to measure exposure levels, and also the success of abatement measures. Emission standards for mobile and stationary sources and for fuel quality improve air quality, and at the same time provide an essential impetus for improvements in technology. Clearly defined national and regional targets related to air quality could help in ensuring progress. For instance, the United Nations Millennium Project calls on countries to adopt a target to halve, by 2015, the number of people without effective access to modern cooking fuels, and make improved cookstoves widely available (Millennium Project 2005). Awareness and access to information are essential tools for cleaner air.

Consistent education and awareness programmes are needed to warn of the health impacts of pollution, and possible preventive measures. Like water and sanitation, indoor air pollution can be made a focus of primary health care programmes. With a consistent health focus, over time people will better understand the risks they and their children are exposed to, and this will enable them to make better decisions about fuel use. In urban areas, pollution alerts are an important tool in warning the public of days with high pollution levels. Such alerts are given out in several parts of the US, Europe and also in some cities in Mexico. Participation of affected people and user groups is essential for success.

Programmes to design and introduce more efficient stoves in the past often had limited participation from women, the main user group. Stoves were often rejected because they did not cater to user needs. This can be overcome through improved participation of women early in the design of stoves, and in designing programmes to promote cleaner fuels. Local entrepreneurship should be encouraged in the promotion and introduction of new technologies. Involvement of women in sales and promotion of stoves, for example, could become an agent of change in itself by providing women with incomeearning and entrepreneurial opportunities outside the home.

Economic policies send important signals to producers and consumers. For instance, access to micro-credit and innovative fuel and technology subsidies are essential to encourage the use of cleaner fossil fuels like kerosene and LPG. Examples of economic instruments to deal with outdoor pollution include the recent move in Europe to shift from taxing labour to taxing energy use to better reflect its external costs, and the congestion tax in central London. Investments in highly efficient, service-oriented and clean public transport followed by incentives for its use are another effective measure in controlling urban pollution. Collaboration across different ministries (dealing with health, housing, energy, for instance) and sectors is required to deal with both indoor and outdoor pollution, because while the benefits may not seem large in one sector, they are significant when combined.

The cooperation of different ministries is also required to implement measures such as better urban planning to minimize travel needs, and improving building laws and standards to promote energy efficiency. Investments in scientific and technological research on indoor and outdoor pollution need scaling up. For instance, further work is needed to:

● develop reliable clean-burning biomass stoves using pellets, blowers, secondary combustion, and other means to use
   biomass cleanly;
● improve fuel quality;
● study the environmental impacts of using biodiesel and ethanol in transport; and
● understand the impacts of long-range transport of pollutants.

Harnessing co-benefits through measures that reduce the negative impacts of air pollution and of global warming, while ensuring energy security, offer considerable potential. Measures that offer substantial social co-benefits, such as the provision of better household energy technologies to the poor, can be prioritized. Easily achievable goals that can result in a considerable reduction of impacts can be given priority for quick results – such as removing toxics like lead and sulphur from fossil fuels, and phasing out household use of poisonous coals contaminated with toxic elements such as fluorine and arsenic.

Long-term solutions to air pollution from energy sources will often require radical changes in the way we use and generate energy. Renewable energy technologies already show considerable promise, but in order to become commercially competitive they need the policy and system support that fossil fuel-based systems have received over the last century. Further policy support is needed to accelerate technology development, boost markets, and provide economic incentives to offset start-up costs (Salwin 2004).

The growth in modern non-hydropower renewable energy over the past decade has taken place mostly in six countries: Denmark, Germany, India, Japan, Spain, and the US. These countries have pursued policies to create a demand for these technologies, including access to the electric grid at attractive prices; low-cost financing; tax incentives and other subsidies; standards; education and stakeholder involvement (Salwin 2004). Although the form of this support will clearly vary from technology to technology and from country to country, depending on the overall policy framework in place, it is an essential ingredient in the widespread increase in renewable energy use.

Finally, the present time is ripe for change, when we have seen peaks in extreme weather events and in energy prices. An increasing number of polices have already been adopted to support renewables, and many companies in the energy industry have recognized that the future is ‘beyond petroleum’. International cooperation to promote research and development, mobilize investment, create markets or share experiences could form a powerful tool to strike while the iron is hot.

Box 6: Pricing benefits of air pollution abatement
Economists are constantly refining methods to evaluate the costs of air pollution – and hence the benefits of abatement measures – due to impacts such as mortality and morbidity among humans; damage to ecosystems, agriculture and materials; and visibility impairments. The widely used ‘damage function’ approach, for instance, measures the impact of abatement measures on human health using epidemiological studies and information on real or projected changes in ambient air pollutant concentrations resulting from abatement measures and population exposure levels. The impacts are then calculated as economic benefits that could be achieved from saved medical costs and productivity gains, and from people’s own willingness to pay to obtain these benefits. These are generally conservative estimates, as they monetize only some of the benefits of improved human health. Some equally important impacts, such as personal pain and suffering, and loss of uncompensated labour (such as child care) are not adequately captured. In a national-level study, the US Environment Protection Agency (US EPA), for example, projected the benefits of the Clean Air Act from 1990 to 2010 to be around US$690 billion. Of this, US$610 billion came from reduced mortality risks, US$49 billion from reduced morbidity, and the rest from ecological and welfare effects (US EPA 1999). These figures represent the health benefits of reductions in several air pollutants, including PM10 and ozone, to the whole country. No such studies have been carried out at the national level in developing countries, but some studies have been carried out in specific cities. One study in Mexico City estimated that a ten per cent reduction in ozone and PM10 levels would bring annual economic benefits of US$1 billion and US$1.4 billion respectively when considering society’s willingness to pay, and US$493 million and US$158 million when only productivity losses and medical costs are considered (World Bank 2000).
Willingness to pay estimates are usually higher since they take into account all the changes in people’s welfare, not only medical costs and productivity losses. Another study in Santiago, Chile, assessed the benefits of compliance with standards set in the Santiago Decontamination Plan at US$4 billion over a period of 15 years (DICTUC 2000). In both the US EPA and Santiago studies, the cost-benefit ratios were remarkably similar: the benefits were six times higher than the costs. Considerable uncertainty about benefits still exists, but in the majority of cases it is likely that the benefits of reducing air pollution would be higher than the costs in these studies. Studies also show that the actual costs of measures may be less than the predicted costs. This was the case of air pollution measures taken in the UK (Watkiss and others 2004). Policy makers do not need to wait for local data and local studies to confirm the negative impacts of air pollution on human health before taking action. Studies are often transferable after being adjusted for pollution characteristics and demography. For instance, poorer people are more vulnerable to air pollution, and therefore background mortality figures will be higher. Children, older people, and those with existing respiratory illnesses are also more vulnerable.
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