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RR RUEHAST RUEHHM RUEHLN RUEHMA RUEHPB RUEHPOD RUEHTM
DE RUEHNE #2587/01 2701044
ZNR UUUUU ZZH
R 261044Z SEP 08
FM AMEMBASSY NEW DELHI
TO RUEHC/SECSTATE WASHDC 3585
INFO RUEHCI/AMCONSUL KOLKATA 2809
RUEHCG/AMCONSUL CHENNAI 3566
RUEHBI/AMCONSUL MUMBAI 2626
RUEHKP/AMCONSUL KARACHI 8975
RUEHLH/AMCONSUL LAHORE 4475
RHEBAAA/DEPT OF ENERGY WASHDC
RUCPDOC/USDOC WASHDC
RUEHC/DEPT OF INTERIOR WASHDC
RUEHPH/CDC ATLANTA GA
RUEAUSA/DEPT OF HHS WASHDC
RUEHRC/USDA FAS WASHDC
RUEAEPA/EPA WASHDC
RUEHZN/ENVIRONMENT SCIENCE AND TECHNOLOGY COLLECTIVE

UNCLAS SECTION 01 OF 03 NEW DELHI 002587 
 
SIPDIS 
 
STATE FOR OES/PCI, OES/ENV, OES/IHA, AND SCA/INS 
HHS FOR OGHA STEIGER, HICKEY AND VALDEZ 
NIH FOR GLASS AND MAMPILLY 
CDC FOR BLOUNT, FARRELL, AND MILLER 
STATE PASS TO NSF FOR INTERNATIONAL PROGRAMS 
 
E.O. 12958:  N/A 
TAGS: SENV TBIO SOCI KSCA IN
SUBJECT:   KILLER IN THE INDIAN KITCHEN: INDOOR AIR POLLUTION 
 
NEW DELHI 00002587  001.2 OF 003 
 
 
¶1.  SUMMARY.  On September 5-6, 2008, the Indo-U.S. Collaboration on 
Environmental and Occupational Health Joint Working Group convened a 
workshop on indoor air pollution (IAP) and respiratory health in 
Chandigarh, India.  IAP kills between 400,000 and 2 million Indians 
each year and is one of the country's top environmental health 
threats.  The Government of India (GOI) has a mixed record 
addressing the IAP issue in that it can be credited with creating 
programs targeted at reducing IAP but faulted for poorly 
implementing them.  Indian NGOs feel the Ministry of Health (MOH) 
should become more involved and that future programs should combine 
the efforts of several ministries and make greater use of public 
awareness and social marketing techniques to help people understand 
the negative health impacts of indoor air pollution.  END SUMMARY. 
 
¶2.  According to the World Health Organization (WHO), indoor air 
pollution from cookstoves fuelled with wood, cow dung, coal, and 
other solid fuels ranks third amongst risks to human health in India 
- just below malnutrition and lack of safe sanitation and drinking 
water.  The WHO cites a growing body of scientific studies 
indicating India suffers between 400,000 and 2 million premature 
deaths annually from IAP with a majority of deaths occurring in 
children under five due to acute respiratory illness or chronic 
obstructive pulmonary disease.  The threat of IAP disproportionately 
affects women and children who spend more hours inside the home as 
compared to men. 
 
--------------------------------------------- ---- 
GOI Cooking Technology:  Millions Poorly Served, 
Millions More Still Waiting 
--------------------------------------------- ---- 
 
¶3.  The GOI has supported several large-scale programs since the 
1980s to reduce exposure to IAP.  The Ministry of New and Renewable 
Energy (MNRE) implemented the National Program on Improved Chulas 
(NPIC) from 1986 until 2002, in partnership with other governmental 
entities, NGOs, and rural entrepreneurs.  The program distributed 
over 35 million improved clay and mud chulas (stoves) throughout the 
country, covering nearly 30 percent of the estimated potential of 
120 million households.  An evaluation study in 2001, however, found 
that only 57 percent of the chulas installed were still in use. 
 
¶4.  MNRE also currently supports a long-standing and slow-moving 
project to develop household biogas plants called the National 
Biogas and Manure Management Program.  Launched in 1982, the 
project's stated goals are to provide biogas cook fuel, produce 
manure for agriculture, mitigate the drudgery of rural women, reduce 
pressure on forests, and to improve sanitation in villages by 
linking toilets with biogas plants.  As of March 2007 the program 
has distributed 3.9 million plants with a total expenditure of 
approximately $270 million.  The 2008 - 2009 target is to add an 
additional 116,500 biogas plants. 
 
¶5.  MNRE has also been working with state governments and NGOs to 
promote and distribute 600,000 solar cookers at a cost of $22 to $55 
per unit.  However, according to a report prepared for the 
Partnership for Clean Indoor Air (PCIA) by Winrock International, 
solar cookers have not been widely accepted because much of the 
rural population does its cooking before sunrise thereby rendering 
solar cookers useless.  In addition, Indian cuisine relies heavily 
on frying which cannot be done in a solar cooker. 
 
¶6.  The GOI's Eleventh Five-year Plan (2007-2012) refers to IAP as 
an "important issue concerning women and children's health which 
requires immediate and special attention."  It proposes to provide 
up to 90 percent subsidies for a "common component for cooking" 
using renewable energy to one million households in remote villages 
and hamlets.  It also aims to subsidize up to 33 percent of the cost 
of 2 million biogas plants for families and communities. 
 
-------------------------------- 
Partnership for Clean Indoor Air 
-------------------------------- 
 
¶7.  The USEPA-sponsored PCIA has an active presence in India. 
 
NEW DELHI 00002587  002.2 OF 003 
 
 
Twenty-four local organizations have joined PCIA, including 17 NGOs, 
4 private-sector companies, 2 academic institutions, and a state 
government centre.  In 2002, EPA awarded two PCIA pilot grants for 
approximately $100,000 each to the Indian NGOs Development 
Alternatives (DA) and the Alternative Rural Technology Institute to 
introduce improved woodburning and biogas stoves in rural areas.  In 
2007 PCIA hosted its 3rd Biennial Forum in Bangalore, where more 
than 100 household energy and health leaders from around the world 
gathered to discuss their activities and share lessons learned. 
 
¶8.  PCIA also commissioned Winrock International to write a report 
titled "Household Energy, Indoor Air Pollution and Health: Overview 
of Experience and Lessons in India."  The report concluded that most 
of the beneficiaries of IAP related interventions in India had no 
information about the adverse health impacts of indoor air 
pollution.  In this respect the programs missed an opportunity to 
increase demand for their product.  The report also suggested 
designing and disseminating more "appropriate" stoves through user 
involvement and training, as well as providing technology with a 
need-based-approached, as opposed to a target-oriented approach, 
which has led to a mismatch in supply and demand. 
 
--------------------------------------------- ----- 
The View from the Village:  Indian NGOs Experience 
--------------------------------------------- ----- 
 
¶9.  EmbOffs met with staff from Development Alternatives and Winrock 
International to discuss their efforts to reduce exposure to smoke 
from household cookstoves.  Development Alternatives designs and 
tests stoves for communities throughout India and used their EPA 
grant to perform social marketing for improved cookstoves in rural 
areas of Madhya Pradesh and Utter Pradesh.  DA staff said many users 
felt the new stoves presented a tradeoff in that they reduced smoke 
and ash but were harder to heat quickly. In addition, DA fielded 
many complaints over the inability of the stoves to use cow dung as 
a fuel - not only as a matter of economy but also of taste.  DA told 
EmbOffs that many people feel dung smoke imparts a specific and much 
appreciated flavor to rural dishes which could not be duplicated by 
the new stoves.  DA said more R&D in stove technology is needed 
because incremental advances will not be sufficient to win over the 
rural consumer.  DA argues only a "quantum leap" in stove technology 
at a minimum increased cost (less than USD 5.00 per stove) will gain 
widespread acceptance. 
 
¶10.  Emboffs also met with Winrock International India who had 
helped evaluate the NPIC program and currently has approximately 100 
stoves installed in pilot projects around India.  Winrock staffer 
Arvind Reddy noted several lessons learned from their experience 
fielding new cookstove technology in India including:  inability to 
install wind and weather resistant chimneys in existing huts; 
increased labor intensity as many clean-burning stoves require 
finely chopped wood for fuel; and lack of interest by husbands, who 
control major household purchases, in investing in new cookstoves 
due to the fact they spend most of their time outdoors and do not 
suffer from IAP to the same degree as their wives and children. 
 
¶11.  According to DA, the biggest collective mistake of NGOs in 
regard to IAP has been the failure to get the media more involved in 
warning of the danger of indoor air pollution.  DA also said IAP has 
not been an important issue for the government, although the PCIA 
has been helpful in networking non-governmental organizations. 
Winrock commented that no one in government, including MNRE, is 
talking about IAP as a health issue anymore despite the continued 
death toll.  Both NGOs agreed that the Ministry of Health needs to 
get more involved in getting out the message on indoor air pollution 
and that future programs must use more social marketing to help 
people understand the seriousness of the health impact of IAP. 
However, both NGOs candidly noted the GOI has shied away from 
improved cookstove distribution programs because they are an 
"administrative nightmare" which no GOI official wants to champion. 
 
--------------------------------------------- - 
Smoke on the Horizon:  Indo-U.S. Collaboration 
--------------------------------------------- - 
 
NEW DELHI 00002587  003.2 OF 003 
 
 
 
¶12.  In June 2008 the Indo-.S. Collaboration on Environmental and 
Occupational Health Joint Working Group agreed to create a small 
sub-group composed of key staff and experts from both countries to 
begin work on a defined plan for IAP and respiratory health related 
research to be conducted in India.  The plan will include the 
development of specific "concept proposals" for consideration by 
governmental and non-governmental funding agencies.  The Joint 
Working Group also agreed to convene a workshop on IAP and 
respiratory health which took place September 5-6, 2008 in 
Chandigarh, India. 
 
¶13.  The workshop was co-chaired by Dr. Surinder K. Jindal of the 
Post Graduate Institute of Medical Education and Research (PGIMER) 
and by Dr. William J. Martin of the U.S. National Institutes of 
Health.  The workshop was hosted by PGIMER Chandigarh and supported 
by CDC, NIH, the Indian Council on Medical Research, USEPA, and two 
private partners, the Health Effects Institute and the American 
Thoracic Society.  The workshop was attended by 40 U.S. and Indian 
experts in clinical and public health research.  Among the issues 
discussed were the prevalence of respiratory diseases in India, the 
impact of tobacco, emerging issues in the area of occupational 
respiratory disease, and the respiratory and health effects of 
indoor air pollution with a special focus on the effects of IAP on 
the health of women and children.  The attendees discussed several 
proposals for increased collaboration in both public health and 
education with the view to creating a National Consultation on 
Indoor Air Pollution. 
 
¶13.  COMMENT.  Although the GOI has several programs targeted at 
reducing indoor air pollution, the poor implementation and lack of 
interest by senior officials has provided very little relief for the 
800 million estimated Indians still suffering the respiratory 
impacts of using wood, cow dung, coal, and other solid fuels for 
household cooking.  In addition, since the early 1980s the issue has 
been driven mainly by the Ministry of New and Renewable Energy, 
whose primary interest has been on installations, with little effort 
put towards educating the public on the reasons why new and 
healthier cookstoves are necessary.  In order to substantially 
reduce IAP in India, the GOI needs an inter-ministerial effort, 
including a public awareness campaign, involving MNRE, the Ministry 
of Health, and the Ministry of Rural Development with buy-in from 
state and local governments.  END COMMENT. 
 
DAVISON