Beyond access: clean energy use in low-income and middle-income countries

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The Lancet Global Health·2026-03-17·Peer-reviewed·View original paper ↗·Follow this topic (RSS)
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  • ✔ Peer-reviewed source
  • ✔ Published in indexed journal
  • ✔ No retraction or integrity flags

Overview

This Series paper examines clean energy adoption in low-income and middle-income countries, addressing the gap between measured access metrics and actual utilization patterns. Despite substantial increases in access to electricity, liquefied petroleum gas, biogas, and ethanol over three decades, millions remain without reliable and affordable clean energy. The analysis identifies economic constraints as primary determinants of fuel choice while critiquing oversimplified measurement approaches that fail to capture dynamic consumption patterns, fuel stacking behaviors, and gendered dimensions of energy transitions.

Methods and approach

The paper synthesizes evidence on drivers of clean energy adoption and assesses existing tracking mechanisms against persistent barriers to uptake. It reviews historical trends and national policy implementations to identify factors that have successfully increased clean fuel utilization. The analysis explicitly evaluates limitations of binary access indicators, such as those employed in Sustainable Development Goal 7, which measure only connection status rather than quality, reliability, or actual usage patterns.

Key Findings

Economic constraints emerge as the primary determinant of fuel choice and health outcomes. Targeted subsidies, robust supply chains, and coordinated investments have demonstrably driven progress in clean energy adoption. However, current metrics substantially overstate progress by overlooking fuel stacking, consumption variability, and the gendered burden of polluting fuels. Binary indicators fail to capture meaningful dimensions of energy access including supply reliability and affordability, thus obscuring actual health risks and inequitable outcomes among populations.

Implications

Clean energy transitions require policy approaches that move beyond technical infrastructure deployment toward inclusive, evidence-based strategies addressing systemic inequities. Affordability and reliability mechanisms are essential complements to supply expansion, as economic constraints fundamentally shape household fuel choices independent of connection availability. The findings indicate that current global health and climate objectives cannot be adequately assessed or achieved through existing access metrics, necessitating more nuanced measurement frameworks.

Disclosure

  • Research title: Beyond access: clean energy use in low-income and middle-income countries
  • Authors: Annelise Gill-Wiehl, Carlos Gould, Marc Jeuland, Ajay Pillarisetti, Shonali Pachauri, Rebekah Shirley, Karin Troncoso, Darby Jack, Matthew Leach, Simon Batchelor, Laura H Kwong, Daniel M Kammen
  • Institutions: Berkeley Public Health Division, Columbia University, Columbia University Irving Medical Center, Duke Institute for Health Innovation, Duke University, International Institute for Applied Systems Analysis, Johns Hopkins University, Loughborough University, University of California San Diego, University of California, Berkeley, University of Surrey, World Bank
  • Publication date: 2026-03-17
  • DOI: https://doi.org/10.1016/s2214-109x(25)00532-7
  • OpenAlex record: View
  • Image credit: Photo by Faqrul 2023 on Pexels (SourceLicense)
  • Disclosure: This post was generated by Claude (Anthropic). The original authors did not write or review this post.

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