An estimated 400 million people depend on health facilities that have little or no access to electricity in sub-Saharan Africa and South Asia. A World Health Organization (WHO) review revealed that one in four health facilities in sub-Saharan Africa had no access to electricity, while only 28 percent of health facilities and 34 percent of hospitals had what could be called "reliable" access to electricity (without prolonged interruptions in the past week). Rural Health Statistics 2018 data showed nearly 40,000 government health facilities which serve an estimated 580 million people in rural India are still operating without electricity supply. Even when health facilities are connected to the grid, many suffer frequent power outages.

WHO estimates that nearly 70 percent of medical devices used in developing countries (which are sensitive to voltage fluctuations) fail, with poor power quality a major contributing factor. Imagine the impact of power deficiencies on the provision of health care. Health workers struggle to work in near-darkness, relying on kerosene lanterns, candles and cell phones. Medical equipment dependent on electricity lies dormant. Storage of vaccines or medications reliant on refrigeration and blood banking becomes impossible. Electricity is critical for operating ventilators and other medical equipment in the hospitals treating the soaring numbers of sick people. There is an urgent need for back-up power solutions at hospitals throughout sub-Saharan Africa and South Asia to ensure that these facilities can adequately treat Covid-19 patients. Diesel generators are in most cases the cheapest and fastest solution, but the pollution from such systems can be detrimental to the health of Covid-19 patients.

In order to address this challenge, a three-pronged approach is needed. First, we need to collect data and develop tools that will be useful for multiple practitioners in their efforts to identify, prioritize, analyze health facilities for electrification. Second, a coordinated inter-governmental effort is needed to rapidly deploy vaccine refrigeration with off-grid solar products to power them in anticipation of a global COVID-19 inoculation effort, and to support other important vaccination efforts. Other off-grid products such as those focused on improving maternal and neo-natal health should also be prioritized in the near-term. Finally, an inter-governmental effort to support negotiations at the ministerial level and with the private sector is required for long-term power purchase agreements to install, operate and maintain permanent roof-top solar systems, and support procurement of medical equipment.

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