Covid-19 has hit the reset button on the global economy. But at some point we will shift from emergency response into recovery mode, providing a rare opportunity for global economic retooling—an opportunity largely missed after the 2008 financial crisis. How can we “build back better” so we’re more prepared for the next pandemic?

Healthcare is the obvious place to start. To function properly, it needs reliable and affordable energy.

Renewable energy sources, such as wind and solar, should be used to power the health care sector. Photo: Karsten Wurth

The pandemic reinforces the need for reliable energy services to support “24/7” healthcare. Stable electricity supply is essential for nearly every aspect of modern healthcare, from vaccine refrigeration, to lighting, communication, medical appliances, clean water supplies, sanitation, water heating, and telecommunications (now more important than ever to support tele-medicine).

The traditional supply-side approach to energy sector development has worked well for most consumers. But there are still about 1 billion people globally without access to reliable electricity supply, other commercial energy services, clean water, and sanitation.  Electricity regulators generally require that consumers be categorized effectively as essential and non-essential customers, with health care facilities considered “essential.” However, poorer consumers—which can include health clinics and other facilities in developing countries—often “fall through the cracks” due to unreliable electricity services.

The rising availability and improving affordability of clean energy provides space for a new approach to healthcare that will serve these neglected communities. The priorities should be to provide energy for cooking, heating, transport, and productive activities essential to human health; electricity for improved health service delivery and to achieve universal health coverage; and to ensure power supplies which enable access to new medical technologies.

Clean energy sources are abundant in Asia and the Pacific. Renewable energy resources are available almost everywhere in the form of biomass, geothermal, hydro, solar, and wind. Solar and wind have demonstrated the best manufacturing economies of scale, and solar photovoltaic (PV) systems are more downward scalable than wind. Solar energy can be combined with energy storage and other energy resources to provide energy security for even the most remote communities.

To turn this vision into reality, we need business models which prioritize health care services with manufacturing economies of scale. For example, a “clinic in a box” powered by a “grid in a box” can provide basic services such as preventive check-ups, quick response (first aid), vaccinations, kit-based testing for specific diseases, and telemedicine.

The potential suite of services is limited by available electricity and the physical space in a modular facility. A village-scale facility  could be expanded over time simply by adding more modules. The beauty of this concept is that more of these clinics we build, the cheaper they get. In the absence of grid-supplied electricity, the electricity cost benchmark would be diesel- or gasoline-fired generation which is upwards of $0.35 / kWh. Remote areas suffer from very long supply chains for diesel and gasoline, which makes those sources risky as well as expensive, and further bolsters the case for locally available renewable resources to power these facilities.

Further enhancing the case for clean energy to power the new generation of 24/7 health services is the reality that health centers in rural areas generally lack access to electricity and in grid-supplied areas may experience frequent power outages.  Distributed energy systems utilizing local renewable sources, as opposed to centralized systems that require electricity to be transmitted over long distances, are a logical solution for rural health service centers, as well as for health clinics in poor communities in urban areas.

Solar is particularly well-suited to this task. Solar PV and solar water heaters are inherently modular and can be packaged along with water treatment, ice-making, and refrigeration units into standard shipping containers which can be readily transported anywhere.  It is a straightforward proposition to add a standard set of health services equipment and supplies to create a “clinic in a box” that can be deployed in rural communities and possibly save lives when outbreaks take hold.

Moreover, solar systems can be delivered for less than the cost of grid-connected electricity as well as petroleum-fired generators. But solar does require energy storage in some form to enable 24/7 energy services.  Batteries can perform this role and have been gaining popularity recently for use in modular energy storage. This is mainly due to their manufacturing economies of scale and relative ease of connecting with solar PV systems.

But most batteries used in combination with solar PV systems can store electricity for 2-to-3 days at the most. Hydrogen is emerging as a “new” option for long-term energy storage lasting months or even years. Another benefit of hydrogen that is usually overlooked is that the electrolysis process that produces hydrogen from water also produces oxygen, which is a critical for effective health care systems.

Also, recombining hydrogen and oxygen in a fuel cell reverses the process to produce electricity with two useful byproducts for health services: pure water and heat.  Hydrogen is an obvious option for communities located in areas with small-scale hydropower potential, where water supply for electrolysis is not a limiting factor.

Reducing the use of fossil fuels in healthcare removes harmful pollutants from the air and water, helping to boost resistance to illness. Modular clinics in boxes and other innovative services powered by clean energy are the next steps in our journey toward better health systems for people who need them most.

Authors:

Susumu Yoneoka is Energy Specialist (Smart Grids), Sustainable Development and Climate Change Department, ADB.

Dan Millison is Consultant, Sustainable Development and Climate Change Department, ADB.