Solving the Biggest Health Risk You’ve Never Heard Of

About the author: Jacob Moss joined EPA’s air program in 1999 and has led a variety of air quality, energy, and international efforts since that time.

During my Peace Corps service in Togo, West Africa, in the late 1980s, I would often chat with local women while they cooked in their kitchens. These visits couldn’t last more than a short while simply because the smoke from the stoves was so dense I would start coughing, my eyes would sting, and I would have to go outside to breathe. These women, like nearly half the world’s population, cooked on rudimentary stoves using solid fuels. They typically used wood or charcoal, but in other regions of the world crop residues, coal and dung cakes are also used extensively.

In 2002, the World Health Organization ranked indoor smoke from cooking stoves as the 4th worst health risk factor in poor developing countries – after undernourishment, unsafe sex, and lack of clean water supply and sanitation. Breathing elevated levels of indoor smoke from home cooking and heating practices more than doubles a child’s risk of serious respiratory infection; it may also be associated with adverse pregnancy outcomes such as stillbirth and low birth weight.

In 2002, I helped EPA start an initiative called the Partnership for Clean Indoor Air (PCIA), to help galvanize global efforts to address these risks. Since its foundation, we’ve grown from 13 initial partners to more than 190 partners today. In India alone we have over 20 partner organizations from the government, NGO, academic and private sectors. Similarly, in the East African region (Ethiopia, Kenya, Tanzania, Uganda), we work with over a dozen partnering organizations. EPA’s projects will bring cleaner cooking practices to over a million people, while our partners collectively plan on reaching about 30 million people in the next couple of years. We’ve worked with partners to ensure that the clean stoves and fuels being promoted are measurably and significantly reducing people’s exposure to this smoke.

Now I’m leading a process to expand PCIA to make it independent, sustainable, and capable of achieving large-scale results. In the next five years, we’d like to work with partners to demonstrate the ability to reach 50 to 75 million people who are currently exposed to poor indoor air quality. In the longer-term (say, 15 years), we’d like to work with our partners to design and implement a strategy to eliminate these risks for half of the affected global population – about 1.5 billion people.

I am happy to discuss some of our lessons learned from the field in future blogs. In the meantime, let me know what you think. How do you think we can most successfully expand PCIA?

Editor's Note: The views expressed here are intended to explain EPA policy. They do not change anyone's rights or obligations. You may share this post. However, please do not change the title or the content, or remove EPA’s identity as the author. If you do make substantive changes, please do not attribute the edited title or content to EPA or the author.

EPA's official web site is Some links on this page may redirect users from the EPA website to specific content on a non-EPA, third-party site. In doing so, EPA is directing you only to the specific content referenced at the time of publication, not to any other content that may appear on the same webpage or elsewhere on the third-party site, or be added at a later date.

EPA is providing this link for informational purposes only. EPA cannot attest to the accuracy of non-EPA information provided by any third-party sites or any other linked site. EPA does not endorse any non-government websites, companies, internet applications or any policies or information expressed therein.