As Sierra Leone emerged from an Ebola epidemic in 2015, it was clear that health facilities lacking a reliable energy supply had been a big obstacle to treating patients.
But putting solar panels on the roof of every clinic wasn’t the right answer either as often such projects fall into disrepair within a year, said Nick Gardner, the Sierra Leone manager for the UN Office for Project Services (UNOPS).
Instead, the government and UNOPS decided to bring electric power to 94 communities – starting with their health centres – by using nearly $50 million in aid funding to build solar mini-grid systems, seen as more sustainable.
Fifty have now been switched on and handed over to companies, which are investing $14 million of their own money and running them as businesses, charging customers fair tariffs.
“We wanted these to be commercially viable standalone mini-grids that do not need ongoing subsidisation from the government or donors,” Gardner told an online event this week.
Most community health centres still struggle to pay for electricity, he said – but that problem was solved by getting the facilities to donate public land to site the grids in exchange for free power.
Gardner said the newly electrified health centres have won over villagers, with visits to seek advice on diseases or for maternal healthcare rising by up to 26 per cent after reliable electricity was brought in.
What we really need are the longer-term solutions to make the system more robust for the next pandemic, the next issue – because they’re going to keep coming.
Nick Gardner, Sierra Leone manager, UN Office for Project Services
But Sierra Leone’s success story wasn’t replicatedly widely in West Africa after the Ebola outbreak, energy experts said – though this time, with the coronavirus pandemic, they hope that will change.
Damilola Ogunbiyi, CEO of international energy access body Sustainable Energy for All (SEforALL), said many promises to power up healthcare post-Ebola had not been kept – but there was now a better understanding of how to scale sturdy solutions.
“This time it feels like something is going to happen,” with virus tracking facilities and labs, for instance, getting sustainable solar power supplies, she told the Thomson Reuters Foundation.
Maria Neira, who leads the World Health Organization’s work on environmental issues, said the Covid-19 pandemic had reminded the world that health facilities need electricity – ideally from renewables such as solar – “more than ever”.
Hospitals and clinics require electric power for myriad uses, from lighting, ventilation and cleaning to refrigeration for vaccines, lab work, surgery and running life-saving equipment such as ventilators, she said.
Yet more than 1 billion people worldwide do not have access to health facilities with a reliable power supply, putting basic care at risk, she told the webinar.
A multi-agency report released in May showed that 25 per cent of health clinics in six surveyed countries – Cambodia, Myanmar, Nepal, Kenya, Ethiopia and Niger – lacked any electricity access at all.
Jem Porcaro, who works on energy for healthcare at SEforALL, said governments and medics had begun to realise that could change as the technologies and companies to fix the problem surged over the past few years.
“In the context of Covid, ministries of health and their development partners … are really picking up on this issue,” he said.
But both new business models and more efficient medical equipment, designed to run on off-grid power, will be needed for a large-scale shift, as well as increased funding, he added.
Huda Jaffer, lead designer with India’s SELCO Foundation, which works to expand energy access, said the coronavirus pandemic had focused government attention on off-grid renewable energy as a way to improve healthcare.
“You don’t have to convince people as much anymore or show as much data,” she said. “There is such a need that is felt and an understanding that, one way or the other, this is going to help us meet (our) health goals.”
SELCO has been working with local authorities and businesses across India to provide emergency solutions for the pandemic, including solar-powered quarantine centres and van-based mobile clinics that travel on the streets collecting swabs for testing.
It also plans to pilot testing kiosks and intensive care units with sustainable energy supplies in three African nations.
Jaffer said that when setting up solar power systems for clinics or hospitals, including technical training, spare parts and other things to keep them functioning was crucial.
The experts welcomed donor efforts to help developing countries take on the pandemic, such as the World Bank Group repurposing loans to Nigeria and Sierra Leone to procure solar-hybrid power systems for Covid-19 quarantine centres.
Now, as governments design their coronavirus recovery packages, they are being urged to include mini-grids and other clean energy for healthcare facilities to better equip them to cope with future health threats.
Nigeria’s economic plan for “bouncing back” includes a goal to create 250,000 jobs as part of a push to provide solar power to 5 million households by 2023 – and leaders say they will make provision of reliable electricity to health clinics a priority.
Experts have also flagged the importance of being able to reliably run refrigerators to store vaccines safely, especially if one becomes available for Covid-19, with cases still rising in many developing countries.
As part of its response to the coronavirus pandemic, global vaccine alliance Gavi has decided to look at how its push to deploy vaccine refrigerators could also bring reliable solar power to health facilities in Africa and Asia.
Porcaro said off-grid energy firms whose business and sales have shrunk due to lockdowns should think about filling the gap by expanding their client base to include healthcare facilities.
UNOPS’ Gardner urged governments and aid agencies to focus not only on providing emergency healthcare during Covid-19, but to consider how to improve systems for the future as well.
“My fear is that this is the fashion of the hour. It’s in the news right now,” he said.
“But what we really need are the longer-term solutions to make the system more robust for the next pandemic, the next issue – because they’re going to keep coming.”