One billion people lack access to health care facilities with reliable electricity

One eighth of the world’s population lacks access to health care facilities with reliable electricity. The resulting treatment gaps threaten the health and lives of nearly one billion people worldwide.

Nearly one billion people in low- and middle-income countries lack access to health care facilities with reliable electricity, according to a joint report by the World Health Organization (WHO), the World Bank and Found the International Renewable Energy Agency (IRENA)..

Electricity is essential for running medical equipment such as ventilators, incubators and cold chain storage for vaccines, as well as basic hospital needs such as computers and air circulation systems needed to keep them running smoothly. Without a constant supply of electricity, health services such as childbirth, emergency care and vaccinations cannot be adequately provided.

Yet despite its importance, the electrification of health infrastructure has long been neglected, leaving one eight of the world’s population in danger of not being able to reliably access the care they need. In total, more than 430 million people are served by medical facilities without electricity.

The report is the first to map electricity access in low- and middle-income countries around the world and has revealed large gaps in electricity access in the world’s poorest countries. In South Asia and sub-Saharan countries, only half of health facilities reported having reliable access to electricity, while 12-15%, or 25,000 facilities, reported having no electricity at all.

“It is simply unacceptable that tens of thousands of clinics in rural areas of Asia, Africa, and Latin America are equipped with little more than kerosene lanterns and rapid diagnostic tests,” the report said. goes out, must be relegated once and for all to the annals of history”.

$4.9 billion to bring facilities up to a minimum standard

At least 912 million people in Latin America and the Caribbean, the Middle East and North Africa, South Asia and sub-Saharan Africa depend on medical facilities without access to electricity or with an unreliable energy supply. A World Bank analysis included in the report found that nearly two-thirds of facilities in these regions need urgent action to improve their access to reliable electricity.

With more than 100,000 facilities requiring new off-grid electricity connections and more than 230,000 others needing a backup energy system, the World Bank estimates that $4.9 billion will be needed to bring them up to a minimum standard of electrification.

But the cost estimate is limited to only the most basic level of energy needs needed to run essential health services, set at 15 kilowatts per hour for non-hospital facilities such as clinics and 500 kilowatts per hour for hospitals, and it does not reflect the same standard found in hospitals in rich countries.

But increasing access to non-hospital energy to 32 kilowatt hours, which would enable the delivery of a wider range of health services, raises the price to $8.9 billion.

Importantly, the estimates also do not include costs related to the acquisition of new medical equipment. Electrification without a parallel investment in such equipment, the report found, would be an incomplete strategy, meaning the real amount of investment needed is higher than the report’s figures.

“This required amount is far less than the social cost of inaction,” the report said.

No need to “wait for the network”

Sub-Saharan Africa and East and Pacific Asia, the two regions with the highest rates of non-electrified healthcare facilities, are ideally placed to take advantage of advances in solar technology.

Centralized grid extension has long been the gold standard strategy for expanding access to energy. But this approach often fails when trying to reach rural and remote regions of low-income countries due to the distance the network has to expand to reach populations living in the most remote parts of a country and its core network.

Technological advances and the falling prices of renewable energy, especially solar, have triggered a rethinking of the grid-based approach. Instead, the report found that decentralized sustainable energy solutions are often “the most technically and economically viable solution” for reaching people living in areas with difficult terrain for traditional infrastructure expansion.

In a presentation at the report’s launch event, Dr Maria Neira, Acting Deputy Director-General for Healthier Populations at WHO, said there is “no excuse” for not making progress on increasing the access to decentralized and sustainable energy sources given the availability and convenience of these technologies.

“No need to wait for the grill. IRENA highlighted the role of centralized renewable energy to increase access to electricity,” she said. “It is cheap and more resilient to climate change. This is a top development priority as it saves lives.

Decentralized approaches have the added benefit of allowing healthcare facilities to be energy independent, insulating them from the risks of fuel shortages or price shocks inherent in reliance on fuel generators. The increased reliability of renewable energy solutions, in turn, means longer uptime for life-saving medical equipment and essentials such as access to clean water, particularly in regions vulnerable to water insecurity or extreme weather events.

“Solutions are available and rapidly deployable,” the report added. “The impact on saving lives and improving the health of vulnerable populations would be huge.”

Access to electricity is a story of inequality

Stark inequalities in access to reliable electricity in healthcare settings emerge when comparing different countries based on income, facility type and location.

In general, facilities in low-income countries have less access to reliable electricity than those in lower-middle-income countries. Sub-Saharan Africa and South Asia have the lowest electrification rates, followed by the Pacific and East Asian regions.

Low electrification rates in medical facilities are often symptoms of a wider lack of energy infrastructure development. In South Sudan, for example, overall access to energy – not to mention access to medical facilities – was estimated at just 7.24% nationwide.

Disparities in access to electricity are also pronounced within countries. Non-hospital healthcare facilities, such as primary health centres, which often serve poorer regions due to their lower operating costs, tend to have less access to reliable electricity supplies than hospitals. A gap can also be seen between urban and rural areas, with urban healthcare facilities reporting better access than rural facilities in the same country.

Until the electrification gap is closed, one-eighth of the world’s population, equal to the populations of the United States, Pakistan, Indonesia and Germany combined, will remain in a medical no man’s land.

“Access to electricity in health care settings can mean the difference between life and death,” Neira said.

Image credits: WHO, World Bank.

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