Priorities and opportunities for clean energy transitions to advance health in low-income and middle-income countries

Energy supports health and economic prosperity, yet low-income and socially or politically marginalised populations consume the least energy and depend on the most polluting fuels (ie, biomass). Despite decades of efforts to replace biomass, which is more damaging to health and the climate than cleaner alternatives (ie, gas and electricity), hundreds of millions of people remain without the benefits of clean and modern energy. We outline four priority areas for transitions to clean energy in low-income and middle-income countries: (1) rapidly reduce use of polluting fuels; (2) leverage clean energy to deliver direct health benefits; (3) align energy transitions with climate mitigation and adaptation goals; and (4) address persistent inequalities in energy access across and within countries. We highlight strategic, cross-cutting opportunities to strengthen policy design and implementation: targeted energy subsidies for populations facing the greatest barriers to access and sustained use, bundled interventions that combine clean energy with health care and nutrition services, integrated infrastructure and urban planning, and digital tools for improving data, payments, and service delivery. Clean energy must do more than reach households; it must fully displace polluting fuels and contribute to improved health, equity, and climate resilience where the need is greatest.