Beyond access: clean energy use in low-income and middle-income countries
Access to clean energy-here defined as electricity, liquefied petroleum gas, biogas, and ethanol-has increased substantially in low-income and middle-income countries over the past three decades. However, millions still lack reliable and affordable access to electricity and clean cooking fuels. This Series paper explores the drivers of clean energy adoption, assesses tools for tracking progress, and examines persistent barriers-including high costs, unreliable supply, and insufficient availability. Simplistic metrics, such as Sustainable Development Goal 7's binary indicators (eg, whether an individual has an electricity connection or not), risk overstating the health and equity impacts of energy transitions by overlooking fuel stacking, dynamic consumption patterns, and the gendered burden of polluting fuels. Drawing from historical trends and national policies, we show how targeted subsidies, robust supply chains, and coordinated investments have spurred increased clean fuel use. Meaningful gains require moving beyond technical fixes to inclusive, evidence-based strategies that address inequities, ensure affordability and reliability, and deliver lasting health benefits.
Authors
- Marc Jeuland (ORCID: https://orcid.org/0000-0001-8325-2622)
- Rebekah Shirley (ORCID: https://orcid.org/0000-0003-2333-2246)
- Darby Jack (ORCID: https://orcid.org/0000-0002-9932-0201)
- Carlos Gould (ORCID: https://orcid.org/0000-0002-7736-3905)
- Karin Troncoso (ORCID: https://orcid.org/0000-0002-4348-0994)
- Annelise Gill-Wiehl
- Simon Batchelor
- Laura H Kwong
- Shonali Pachauri
- Matthew Leach
- Daniel M Kammen
- Ajay Pillarisetti
Institutions
- International Institute for Applied Systems Analysis (AT)
- World Bank (US)
- Loughborough University (GB)
- Johns Hopkins University (US)
- Duke University (US)
- Columbia University Irving Medical Center (US)
- Johns Hopkins Medicine (US)
- University of Surrey (GB)
- University of California San Diego (US)
- Duke Institute for Health Innovation (US)
- Berkeley Public Health Division (US)
- Columbia University (US)
- University of California, Berkeley (US)
Publication Details
- Journal
- The Lancet Global Health
- Published
- 2026-03-17
- DOI
- https://doi.org/10.1016/s2214-109x(25)00532-7
- Citations
- 3
- Primary Topic
- Energy and Environment Impacts
- Type
- article
- Field-Weighted Citation Impact
- 54.97
Funders
- Foreign, Commonwealth and Development Office
- National Institutes of Health