Professor Daniel Pope BSc(hons) MSc PhD MFPH

Understanding the causal relationship and associated disease burden from household air pollution and adult and child health. Our work has previously contributed systematic review and meta-analyses (SRMA) evidence from HAP on child acute lower respiratory illness, child mortality, adverse pregnancy outcomes, and lung cancer used in comparative risk assessment for burden of disease estimation. We continue to explore how HAP exposure from combustion of solid fuels and kerosene is related to chronic respiratory and cardiovascular disease and how prevention through clean cooking impacts on these outcomes. We are also investigating less well articulated burdens from reliance on these fuels including fuel/ technology related burns and poisoning through ingestion of kerosene.

We have studied prevention strategies both through interventions to burn biomass/ solid fuels cleaner (so called 'improved cookstoves') and through transition to clean domestic fuels such as gas and electricity. Research on improved cookstoves in Guatemala, Nepal, Kenya and Malawi found disappointing results in terms of reduced HAP exposure and reductions in health outcomes (e.g. child pneumonia). SRMA evidence reinforced this message identifying that few interventions designed to burn biomass more cleanly reduced levels of HAP exposure (PM2.5 and CO) to safe levels for health. This empirical primary and secondary research formulated the focus for our research group in its focus on primary prevention through scale of clean fuels and energy.

We are also tackling primary and secondary prevention of HAP disease burden through health systems strengthening via our CLEAN-Air(Africa) program:

1.Through training community health workers (CHWs) in HAP, health and prevention to raise awareness of the health issue of HAP and how to minimise exposure at a population level. Our national CHW training initiative in Kenya has been effectively implemented in all 47 counties under Kenyan Universal Health Coverage.

2. Through training clinicians, physicians and medical students on health risk and secondary prevention of HAP to raise the profile of household fuel combustion as a leading risk factor for cardiovascular and respiratory health in LMICs. Working with the WHO we have developed training symposia for African medical students and clinical specialists that have been successfully piloted and implemented in Cameroon.

Our group help steer development of the WHO Indoor Air Quality Guidelines (IAQG) for Household Fuel Combustion which set emissions targets to benefit health and made explicit recommendations on how these should be achieved including scaling access to and adoption of clean fuels for household energy. The current context for our research is to implement IAQG recommendations by providing an evidence-base for policy and practice to help achieve the UN Sustainable Development Goal 7 target of "universal access to clean modern energy" by 2030. Working in sub-Saharan Africa, where the burden of solid fuel reliance is at its greatest, we have led programmes of research funded by NIH, CDC and African Development Bank (in Cameroon), NIHR (in Cameroon, Kenya and Ghana), MRC Newton (Kenya), MECS/ FCDO (Kenya and Cameroon) and NORGLOBAL (Tanzania) that has sought to understand how populations can be supported to adopt clean fuels for cooking, heating and lighting. At the same time we quantify the positive impacts on health, gender, environment and climate that these energy transitions can have to reinforce the SDG agenda. Working with partners from Kenya, Cameroon, Tanzania, Rwanda and Uganda, our NIHR CLEAN-Air(Africa) Global Health Research Unit (2022-2027) (see www.cleanairafrica.com) aims to accelerate adoption of clean cooking for households and institutions by providing an evidence-base for national policies set by government stakeholders to achieve SDG7.