All healthcare facilities in poorer countries could be electrified using solar energy within five years for less than $5bn, putting an end to the risk of life from power outages, experts will argue at Cop28 this month. “I would like the international community to commit to a deadline and funding to electrify all healthcare facilities,” said Salvatore Vinci, an adviser on sustainable energy at the World Health Organization and a member of its Cop28 delegation. “We have solutions now that were not available 10 years ago – there is no reason why babies should be dying today because there is not electricity to power their incubators. “It’s a low-hanging fruit. There is nothing stopping us,” he said. About 1 billion people around the world do not have access to a healthcare facility with a stable electricity connection, including 433 million in low-income countries who rely on facilities with no electricity at all, according to the WHO’s Energising Health: Accelerating Electricity Access in Healthcare Facilities report, which was published in January, and co-authored by Vinci. Electricity is the lifeblood of a functioning healthcare facility, not only powering devices such as ventilators and cardiac monitors, but providing basics amenities such as lighting. Without these basic facilities, even routine conditions can be deadly or lead to complications. Healthcare facilities in countries vulnerable to the impact of extreme weather events will often experience outages because of storms and flooding. “We don’t know how many people die each year because of power outages. Nobody puts ‘power outage’ as a cause of death on a death certificate,” said Hippolite Amadi, bioengineering professor at Imperial College London. “As we speak, patients in low- and middle-income countries are dying due to power outages and poor lighting. They’re dying because their life-support machines were switched off, or because they have been given the wrong medication by staff who cannot see what they are doing, or because the surgeon working in the dark made a mistake.” While lack of lighting puts maternal and surgery patients at the biggest immediate risk, an unreliable energy source makes long-term treatments, such as kidney dialysis, untenable. As the burden of chronic non-communicable diseases (NCDs) rises in the global south, the strain on poorly electrified facilities will increase. In Central African Republic – the African country whose citizens are most likely to die prematurely from an NCD – more than 60% of healthcare facilities report having no access to electricity. “The best surgeon in the world cannot do good work if he cannot see what he is doing,” said Emmanuel Makasa, an orthopaedic surgeon in Zambia, who at times has had to work using a torch or the light from his mobile phone. “You would never ask a tailor to work in the dark, why would you expect it from a doctor?” In Zambia, 60% of the rural population do not have access to a healthcare facility with electricity, according to the government, and even in large hospitals connected to the national grid the electricity supply is temperamental, said Makasa. “Sometimes the lights in the operating theatre switch off without warning, and that means that ventilators and life-support machines switch off too,” he said. Recently, he purchased a surgical headlight produced by an international organisation, Lifebox. “It means we go into surgery with less worries, there is nothing worse than losing a patient or getting a bad surgery outcome due to a power cut. “In Africa, we’re always looking for innovations. We wonder how we live in a land of sunlight, a potential energy source, and we still have these problems,” Makasa said. “We live in a land of plenty, but we are starving.” Amadi worked to electrify maternal healthcare centres in Nigeria’s Niger state as early as 2009. In October, his solar-powered neonatal ventilator won a prestigious Nigerian award and earned praise from the president, Bola Ahmed Tinubu, for “keeping Nigerian children alive”. “Before we implemented the solar energy system the mortality rate in [one of our hospitals] was between 35 and 45 per 1,000 deliveries [of babies],” said Mohammed Gana of Niger state’s health ministry, a former colleague of Amadi. “Now we’re hovering between 10 and 15.” Niger state’s health ministry is aiming to electrify all its healthcare facilities using solar energy within the next year. “In the last 10 years the cost of photovoltaic modules has decreased by 90%, and the cost of batteries has decreased by 60% on average,” said Vinci. “We can go and deploy a cost-effective and reliable solar energy system at a facility in a matter of a few days. We don’t need to wait any more.”