Household Air Pollution Investigation Network (HAPIN)​

The Household Air Pollution Investigation Network (HAPIN) is a large NIH initiative designed to tackle the challenge of reducing the burden of disease from household air pollution (HAP). The World Health Organization (WHO) estimates that almost 3 billion people worldwide – mostly in low and middle income countries (LMIC) – depend on solid fuels (wood, dung, agricultural residue) for cooking and heating their homes. Burning solid fuels on open fires or traditional stoves produces high levels of dangerous HAP. Strong evidence suggests that HAP leads to numerous negative health outcomes, such as acute lower respiratory infections in children, and ischaemic heart disease, stroke, chronic obstructive pulmonary disease and lung cancer in adults. The WHO estimates that HAP is responsible for over 7.0% of the global mortality.

HAPIN is approaching the problem of reducing the burden of disease from HAP by addressing two separate but complementary questions: 1) how “clean” must a stove be before meaningful improvements in health outcomes are observed? and 2) how do organizations and governments promote sustained adoption of clean cooking technology? HAPIN is addressing question 1 through a biomarker development and validation initiative as part of the trans-NIH Household Air Pollution (HAP) Health Outcomes Trial and question 2 through the Implementation Science Network (ISN).

Household Air Pollution (HAP) Health Outcomes Trial

The National Heart, Lung, and Blood Institute (NHLBI)-led HAP trial is a public/private partnership between 6 NIH Institutes and Centers (ICs), the Bill & Melinda Gates Foundation, the Global Alliance for Clean Cookstoves (GACC), and the Global Alliance for Chronic Diseases (GACD). The HAP trial aims to accomplish its goal of assessing the maximum health benefits that may result from reduced HAP through clean cooking intervention through two interrelated initiatives. Initiative 1: to provide liquefied petroleum gas (LPG) stoves and fuels to approximately 3,200 homes in four countries (Rwanda, India, Peru, and Guatemala) to assess the maximum health benefits that may result from reduced HAP through a clean cooking intervention. Initiative 2: establish a biomarker center for the development and validation of clinical, physiological, chemical, biochemical and/or microbiological markers of exposure and pathophysiological responses. The biomarkers initiative is funded by the NIH Common Fund. The Household Air Pollution Outcomes Trial is expected to start in 2018. 

Implementation Science Network

The NIH, in partnership with USAID, the Centers for Disease Control and Prevention (CDC) and the Global Alliance for Clean Cookstoves (GACC) has launched an Implementation Science Network (ISN)  under the Fogarty International Center's (FIC) Center for Global Health Studies to advance the science of uptake and scale-up of clean cooking technology in the developing world. Sustained adoption of clean cooking technology requires understanding and addressing many disparate issues; socioeconomic considerations of access to stoves and fuel, household behaviors, family roles, and environmental conditions. ISN is conducting 4 research projects and 11 case-studies to develop an implementation science platform to best understand how to improve the uptake and appropriate use of clean cooking interventions to maximize their benefits on the health of LMIC populations. The ISN is funded entirely by the Common Fund. An initial ISN paper was published in Environmental Health Perspectives in January 2017. In addition, a second manuscript, “Clean Cooking and the SDGs: integrated analytical approaches to guide energy interventions for health and environment goals,” was published in Energy for Sustainable Development in February 2018.