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Post-2015 Consensus: Air Pollution Perspective, Jeuland

Summary

The assessment paper provides an accessible entry into a problem of major global importance for both health and environmental sustainability.

As discussed in Larsen’s paper, there are a number of important challenges with setting targets related to HAP. Unfortunately, technology-based targets do not properly address these issues because they may have undesirable side effects, and because air quality and the costs and benefits of specific changes vary considerably across households and locations. Thus, it is puzzling that this important variation does not figure in the subsequent benefit-cost analysis of clean cooking interventions, which instead looks like an analysis based on hypothetical air quality (not technology-based) targets.

The most striking omission is a significant discussion of the role and implications of behavior. In practice, individual decisions to invest in preventive health or environmental improvements usually involve a rational tradeoff with consumption of other goods and leisure. But people often make decisions which would seem to endanger their well-being, sometimes because they misunderstand the risks they face. Also, because of the non-linear response to air pollution, a relatively large investment may not be enough to deliver substantial health benefits.

Existing work supports the idea that there is something households and individuals like about traditional stoves. The study also ignores the fact that strikingly few households who obtain a cleaner biomass stove end up using it exclusively. In fact, surprisingly little is known at this time about how to induce the behavior change that effectively delivers long-term benefits. As such, setting technology-based targets creates a risk that policies designed to reach them will repeat the hard failures of related domains (e.g., water and sanitation, and malaria prevention), which generally failed to incentivize the pursuit of locally-responsive and desired solutions. Making prescriptive recommendations about the specific stoves that people should or should not own will likely result in dissemination of large numbers of stoves that households do not want or use. Behavior may also change and reduce the cost-effectiveness of interventions. In the case of clean stove promotion, one example of this type of behavioral feedback would be if household members increase the amount of time spent and cooking done indoors, thereby offsetting anticipated reductions in harmful exposures.

The author is deeply skeptical of the meaning and usefulness of the deterministic benefit-cost calculations used to justify promotion of cleaner stoves. This is borne out by the history of failures in similar sectors and reinforced by the dramatic divergence between the implications of the analysis and actual behavior. Even the impressive demonstration of the large variation in benefit-cost ratio between countries does not properly cover the heterogeneity; for example, most solid fuel users have low incomes and hence low VSLs.

The implications of preferences for behavior are often ignored by deterministic analyses. For example in India even among relatively wealthy rural households who own alternative stoves (mostly LPG), traditional stove use remains ubiquitous for cooking tasks such as making bread or simmering. On the other hand, some factors such as the broader environmental benefits of cleaner stoves are also left out of the assessment paper’s analysis. 

In spite of the clear negative implications of household use of solid fuels, it has proven difficult for many to make the switch to cleaner technologies. A successful approach must allow for tailoring of policies and interventions to local realities, must engage local institutions, and must acknowledge the fact that traditional technologies generate a large set of benefits for users that are systematically mischaracterized or ignored.