Available data for diesel hybrid bus fuel economy in London. The values for l/100 km have been converted from miles per gallon using Litres100 km = (100*4.54609)/(1.609344*mpguk).
\\n\\n
Released this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\\n\\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
\\n"}]',published:!0,mainMedia:null},components:[{type:"htmlEditorComponent",content:'IntechOpen is proud to announce that 179 of our authors have made the Clarivate™ Highly Cited Researchers List for 2020, ranking them among the top 1% most-cited.
\n\nThroughout the years, the list has named a total of 252 IntechOpen authors as Highly Cited. Of those researchers, 69 have been featured on the list multiple times.
\n\n\n\nReleased this past November, the list is based on data collected from the Web of Science and highlights some of the world’s most influential scientific minds by naming the researchers whose publications over the previous decade have included a high number of Highly Cited Papers placing them among the top 1% most-cited.
\n\nWe wish to congratulate all of the researchers named and especially our authors on this amazing accomplishment! We are happy and proud to share in their success!
\n'}],latestNews:[{slug:"intechopen-authors-included-in-the-highly-cited-researchers-list-for-2020-20210121",title:"IntechOpen Authors Included in the Highly Cited Researchers List for 2020"},{slug:"intechopen-maintains-position-as-the-world-s-largest-oa-book-publisher-20201218",title:"IntechOpen Maintains Position as the World’s Largest OA Book Publisher"},{slug:"all-intechopen-books-available-on-perlego-20201215",title:"All IntechOpen Books Available on Perlego"},{slug:"oiv-awards-recognizes-intechopen-s-editors-20201127",title:"OIV Awards Recognizes IntechOpen's Editors"},{slug:"intechopen-joins-crossref-s-initiative-for-open-abstracts-i4oa-to-boost-the-discovery-of-research-20201005",title:"IntechOpen joins Crossref's Initiative for Open Abstracts (I4OA) to Boost the Discovery of Research"},{slug:"intechopen-hits-milestone-5-000-open-access-books-published-20200908",title:"IntechOpen hits milestone: 5,000 Open Access books published!"},{slug:"intechopen-books-hosted-on-the-mathworks-book-program-20200819",title:"IntechOpen Books Hosted on the MathWorks Book Program"},{slug:"intechopen-s-chapter-awarded-the-guenther-von-pannewitz-preis-2020-20200715",title:"IntechOpen's Chapter Awarded the Günther-von-Pannewitz-Preis 2020"}]},book:{item:{type:"book",id:"404",leadTitle:null,fullTitle:"Laser Systems for Applications",title:"Laser Systems for Applications",subtitle:null,reviewType:"peer-reviewed",abstract:"This book addresses topics related to various laser systems intended for the applications in science and various industries. 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However, this comes at an environmental cost, for example, over 600 kt of CO2 was emitted by London’s bus fleet in 2015 [1]. It is these carbon emissions and their link to climate change that have provided one of the major drivers in recent years to develop and deploy alternative technologies for bus propulsion [2]. Other emissions associated with diesel vehicles such as NOx and particulates have provided a local driver to change due to their detrimental impacts on human health [3–5]. In 2008, it was estimated over 4000 deaths were brought forward as a result of long-term exposure to particulates in London [6]. In order to combat these concerns, many cities have introduced measures such as the ‘low emission zone’ in London and emission control targets [7]. London is to introduce the first ultra-low emissions zone (ULEZ) in 2020, which, amongst other targets will aim to replace conventional diesel powered buses with low emissions alternatives [8, 9]. Despite this drive for change, it is evident that finding a replacement for diesel buses is not simple. In addition to the low cost, simplicity, reliability and maturity of the technology, diesels also offer excellent characteristics to meet the required power demands and operational needs of city buses. It can be seen from Figure 1, the diesel engine that is a type of internal combustion engine (ICE) provides high output powers and uses energy dense fuel making them ideal for both the range and operating times expected of city buses and also for meeting the high transient power requirements during acceleration.
\nComparison of various technologies for the power and energy densities (based on Ref. [10]).
In order to address the environmental concerns posed by diesel buses, a number of technologies are being investigated and implemented. The most widespread of these are diesel-hybrid buses, which make use of an on-board energy storage system to effectively recycle captured kinetic energy obtained through regenerative braking. Although hybrid buses are capable of significantly reducing fuel consumption, they are still reliant on diesel as the primary fuel source and hence do not address the fundamental problems associated with emission that come from using diesel as a fuel. As such, there has in recent years been an increased focus on the development of zero emissions buses, with two main competing technologies. These are battery electric buses and hydrogen fuel cell (FC), both of which exhibit zero operating emissions, hence eliminates the environmental and health issues associated with diesel buses [11]. Such technology solutions are less mature and result in significant changes to the propulsion system. Although these technologies have been deployed in operational bus fleets, there remain a number of barriers to widespread deployment.
\nLondon has one of the most comprehensive and busiest public transport networks in the world, operated by Transport for London (TfL). There are over 9000 buses in operation [12], which are estimated to account for 21% of the CO2 emissions in London [7], 63% of NOx and 52% of PM10 particulate emissions [13]. It is reported that the TfL bus fleet carries 6 million passengers each working day, which the number of bus passenger journeys grew by 64% between 2000 and 2013 and is continuing to increase [14]. The Greater London Authority (GLA) has introduced a number of strategies in an attempt to reduce emissions from buses, part of which is the London hybrid bus project which aims to replace the conventional bus fleet with diesel hybrid buses [7, 15]. This is to be furthered with the introduction of the ultra-low emissions zone (ULEZ) in 2020, which, amongst other targets will require all 3000 double-decker buses operating in the ULEZ to be diesel hybrid and all 300 single decker buses to be zero emissions [8, 9, 16]. Since 2004, a number of technologies have been deployed as part of the operational bus fleet, as shown in Figure 2, as a means of reducing emissions. London has been used as a case study throughout this chapter due to both the comprehensive bus network and the operational deployment of new technologies.
\nTimeline of the milestones for the London low emission bus deployment.
Within this chapter, the development of low emission bus propulsion technologies will be discussed, through the evolution of diesel to diesel hybrid buses and onto the development and deployment of battery electric and FC buses. The aim is to outline the benefits of such technologies and the barriers that exist to their widespread implementation from both a technical and economic perspective. Part 2 discusses the implementation of diesel electric hybrid buses and their evolution from diesel buses. Parts 3 and 4 consider battery electric buses and fuel cell buses, respectively, whilst part 5 provides a comparison of these emerging technologies.
\nThe principle difference between diesel hybrid buses and diesel buses is the inclusion of an electrical energy storage system in conjunction with an electrical motor/generator. The primary source of energy is still the diesel engine; however, the inclusion of the electrical system provides a number of advantages such as facilitating regenerative braking and allowing reduced idling time [17]. The utilisation of a hybrid system results in improvements fuel efficiency and emissions, although these come at the price of additional cost and complexity [17].
\nThe integration of the electrical energy system can be utilised through a number of configurations, with the common options being the series, parallel and series-parallel hybrid configurations, as shown in Figure 3. In a series hybrid drivetrain, the mechanical output from the diesel engine is converted into electrical power via a generator when operating at its most efficient loading. This is supplemented with a battery to provide for the electric drive motor requirements. Since the propulsion needs are met by an electric motor, this results in the complete decoupling between the diesel engine and the wheels, meaning that engine control is not dependent on vehicle speed so offering additional flexibility [18]. This is a major advantage of series hybrid drivetrains, where the engine can operate at any point on its speed-torque map, which is impossible for conventional vehicles. Therefore, the engine is capable of constantly operating at near optimum load, which minimises fuel consumption and emission [19].
\nSchematic of the three available layouts for the propulsion system of a diesel/electric hybrid drive train.
The parallel hybrid configuration maintains the direct mechanical link between the diesel engine and the wheels, using the battery for regenerative braking and supplementing the peak power demands. The main advantages over the series hybrid are that the additional generator is no longer needed so has higher efficiency as well as reducing the size of the required drive motor. The parallel configuration, however, does not decouple the diesel engine from the wheels and hence operation is directly linked to the vehicle speed hence for low speed city operation the ICE will often operate at a low efficiency [20]. As a result, the parallel configuration is more appropriate for longer distance and higher speed routes. The series-parallel hybrid can operate in either the series or parallel configurations and so can utilise the advantages of both systems; however, the additional complexity and capital cost of the system mean that they are currently not a viable option for transportation applications [19]. The most popular option for city buses is the series configuration due to the simplicity of a single drive system as well as higher efficiency during city driving where buses have a start-stop traffic pattern with generally low speed operation [19].
\nThe benefits offered by the hybridisation of the drive system relate to the increase in fuel economy and reduction in emissions compared to a diesel bus and can be attributed to the following points.
\nOn average buses idles for around 30–44% of urban driving time [21]. By using a hybrid system, the vehicle can turn off the engine to prevent idling and low loads because it can use the electrical energy storage and motor for initial acceleration. This can save 5–8% of fuel consumption [17].
A significant amount of energy is lost and dissipated by heat due to friction during conventional braking. When a hybrid vehicle is braking, the drive motor can work as generator to charge the electrical energy storage system and thus recycle some of the energy used to propel the bus. Typically, 10–20% of the kinetic energy is recovered.
In a conventional bus, the diesel engine needs to be large enough to provide for all of the peak transient power demands. A hybrid vehicle is able to use the electrical system to provide for a portion of these peak demands, and therefore, the engine can be downsized [17, 19].
A diesel engine operates at its lowest efficiency during low load and low speed operation. The electrical system can drive the electric motor to power the bus during low load and start-up to avoid this. It is expected that diesel hybrid technology can achieve reductions of between 24 and 37% CO2 emission [22], 21% to NOx emission and 10% to fuel consumption compared with conventional diesel buses [7, 15].
In contrast to these benefits, the hybridisation of the drive system has a number of drawbacks. These predominately amount to the additional capital cost, where a diesel hybrid typically costs £300,000, this is £110,000 more than a conventional diesel bus and constitutes an increase of about 50% [23]. The additional complexity of both the drive system and its control results in additional maintenance time and cost, where a diesel hybrid typically requires 50% more maintenance time than a conventional diesel bus [22].
\nInitially a trial consisting of eight diesel hybrid buses was carried out in 2007 and was found to have very high (96%) customer support [24]. After analysing the trial, the official deployment of diesel hybrid buses began in central London. The number of diesel hybrid buses has steadily increased, where in 2015, more than 1200 diesel hybrid buses were in operation in London, as can be seen in Figure 4, and exceed the target of 1700 in 2016 [12]. This consists of old buses redesigned for hybrid operation and new designs such as the new Routemaster.
\nTotal number and percentage of the TfL bus fleet of diesel-hybrid buses in operation. Data from Ref. [12].
The impact of the deployment of the low emission bus fleets has already begun to have an impact on emissions in London, as shown in Figure 5. In the last few years, emissions of NOx and CO2 have begun to drop due to the introduction of diesel hybrid buses into the TfL fleet and the retrofitting of selective catalytic reduction measures into the existing fleet. The level of PM100 emissions dropped considerably due to the introduction of PM filters in the early 2000s. It is expected that these will continue to drop as further deployment of diesel hybrid and zero emissions vehicles continues.
\nExpected reduction in CO2 and NOx emissions from the TFL bus fleet with the deployment of diesel/electric hybrid buses [1, 15, 25].
The performance of the diesel hybrid bus fleet in London is very variable, as might be expected due to differing models and routes. It was claimed that the average Euro V bus achieved a fuel economy of 32.9 l/100 km in London [9]. The reported fuel economy of diesel hybrid buses operating in London is presented in Table 1. As may be expected, the type of bus and bus route significantly affects the fuel economy, where a single decker bus generally exhibits a higher fuel economy than a double-decker bus. It was found that the introduction of diesel hybrid technology improved the fuel economy on nearly all routes; however, there were a couple of discrepancies to this, such as on the E8 bus route where the fuel economy actually decreased. The introduction of the new Routemaster bus appears to provide a slight improvement over previous diesel hybrid buses; however, there appears to be significant discrepancies between the recorded and expected performance. Results released by TfL in 2014 suggest a fuel economy in the range of 38.2–45.6 l/100 km, whereas it is claimed by the manufacturer that a fuel economy of 24.4 l/100 km was recorded on the 159 bus route. Unfortunately, the details for these results are not available and so it is difficult to determine the validity of the results. This discrepancy could be the result of a number of factors such as the route topology, traffic conditions, driving style and passenger conditions.
\nBus type | \nRoute | \nDiesel | \nDiesel hybrid | \nYear | \nReferences |
---|---|---|---|---|---|
Fuel economy (l/100 km) | \nFuel economy (l/100 km) | ||||
Single decker (Euro V) | \n276 | \n44.8 | \n43.5 | \n2010 | \n[26] |
360 | \n36.7 | \n34.9 | |||
371 | \n34.1 | \n26.7 | |||
E8 | \n35.3 | \n42.2 | |||
129 | \n47.1 | \n33.6 | |||
Double decker (Euro V) | \n141 | \n60.1 | \n50.4 | \n2010 | \n[26] |
328 | \n65.7 | \n54.3 | |||
24 | \n49.6 | \n42.2 | |||
482 | \n50.4 | \n34.9 | |||
16 | \n50.4 | \n39.2 | |||
New routemaster (Euro V) | \n11 | \n60.1 | \n38.2 | \n2014 | \n[27] |
24/390 | \n52.3 | \n38.2 | |||
9 | \n72.4 | \n45.6 | |||
148 | \n56.5 | \n40.9 | |||
10 | \n64.2 | \n43.5 | |||
159 | \nNot available | \n24.4 | \n2013 | \n[28] |
Available data for diesel hybrid bus fuel economy in London. The values for l/100 km have been converted from miles per gallon using Litres100 km = (100*4.54609)/(1.609344*mpguk).
In summary, TfL has successfully introduced a large number of diesel hybrid buses into their bus fleet. This has resulted in a decrease in the emissions associated with the bus fleet, with considerable further reductions expected. It provides an example of the successful deployment of diesel hybrid buses into a large operational bus fleet to achieve reductions in emissions and fuel consumption. However, the increased cost and system complexity remain problematic.
\nThe battery electric bus, often described as a pure electric bus, uses an electric motor for propulsion and a battery for energy storage [29]. In most cases the battery is the primary energy source, although for trolley buses power is delivered from overhead cables during operation.
\nThe configuration for electric buses is typically fairly straightforward since it is basically a battery driving an electric motor to propel the vehicle [30], as shown in Figure 6. During braking it is also possible to make use of regenerative braking to recharge the battery during braking. The main battery technologies that have been used in transportation are Ni-MH, Zebra (Na-NiCL2) and lithium batteries [31]. The most promising of these are the lithium batteries, where three main categories exist, these being Li-ion, lithium polymer (LiPo) and Lithium-iron-phosphate (LiFePO4) batteries [32]. Most current buses use lithium-based batteries [33] due to their high power and energy densities and fast charging capabilities, although their high cost is still problematic [32]. A problem faced by all battery technologies is their cycle life; typically, these are short and hence require relatively regular replacement [34]. In addition to a battery pack, some buses utilise supercapacitors in conjunction with a battery as supercapacitors are much more effective in shielding batteries from high current load and thus increase battery life [35]; however, their low energy density means they are unsuitable to be used as the primary energy source, as shown in Figure 1. They do, however, have several key advantages over existing battery technologies, such as very high power densities and discharge rates as well as very long cycle life [34]. There is no simple answer to which battery technology is best, as it will depend on the application. Mahmoud et al. [36] carried out a detailed comparison study of different electric powertrains and concluded that a single technological choice would not satisfy the varied operational demands of transit services because electric buses are highly sensitive to the energy profile and operational demands. Electric buses are zero emission at the point of use and therefore offer great emission savings particularly in terms of local air pollution when compared to ICE or hybrid buses, as well as very high efficiency. However, there are a number of barriers to widespread deployment, the main ones are recharging time, vehicle range, infrastructure and cost [34].
\nBattery electric drive bus basic configuration.
Battery electric buses normally operate in one of two different forms: opportunity and overnight [32]. Opportunity e-buses have a smaller energy storage capacity that offers limited range but can be charged much quicker (5–10 minutes); while overnight e-buses have a much larger energy storage but at the cost of longer charging time (2–4 hour) [36]. These represent two different approaches for electric buses in the urban environment. The opportunity approach aims to minimise the weight of the battery pack by utilising frequent and fast recharging at points along the bus route, such as bus stops or the end of route [32]. This holds the promise of high efficiency and lower projected bus costs but requires a comprehensive recharging network [37]. Route flexibility of the bus is, however, limited, as it is required to follow the assigned bus route to recharge the battery. The overnight method utilises a large energy storage system to extend the range so that the bus can drive the entire route/day without recharging [37]. This holds the promise of greater route flexibility and convenience as well as utilising a centralised recharging infrastructure, but suffers from passenger loss due to increased battery weight as well as battery lifetime issues [38] and battery cost [34]. An alternative approach is offered by the Trolleybus, which has a small battery but receives power from overhead cables along the assigned route. This overcomes problems associated with range and recharging times but is very limited in terms of route flexibility.
\nThe process of recharging a battery electric bus can be completed through plug-in (conductive), wireless (inductive) or catenary (overhead power lines) charging. Plug-in charging requires a direct connection through a power cord [39] and is well-suited to overnight bus charging, but can be used in some instances for opportunity charging. This is popular due to its simplicity and high efficiency [39]. Wireless charging relies on induction between two coils, this is better suited to opportunity buses where recharging can take place along the route without the need for a physical connection [39], such as the PRIMOVE bus where charging is carried out at each end of the route and at five intermediate stops [40]. This form of charging, however, suffers from increased charging times and relatively low efficiency [39]. The trolleybus uses overhead catenary to provide power to the bus [41]. This type of charging exhibits high efficiency but requires an extensive network of overhead cables.
\nTable 2 shows a selection of operating pure electric buses in different locations and utilise a number of battery technologies and operating approaches. In 2015, there were an estimated 150,000 battery electric buses, mostly located in China, with a sixfold increase between 2014 and 2015 [42]. The electric bus market is growing quickly where it had a 6% share of global bus purchases in 2012 but is forecasted to grow to 15% by 2020 [43]. Battery electric bus development has been carried out all over the world with the largest shares in China, Europe and North America [44]. It is clear that some of the buses listed in Table 2 utilise more than one mode of operation to provide for the operational power requirements, such as the complete coach works bus, which uses both overnight and opportunity charging. The differences in operating regimes are reflected in the sizing of the batteries and as a result the range of the buses, where they vary from 5.9 kWh for the trolleybus design to >300 kWh for overnight charging. This will have a significant impact in terms of the bus’s battery costs; however, the charging infrastructure for overnight charging does not need to be as comprehensive as for the alternative methods.
\nManufacturer | \nLength | \nCapacity | \nBattery type | \nBattery capacity | \nType, range | \nDeployment location |
---|---|---|---|---|---|---|
ABB TOSA | \n18 m | \n135 | \nLithium titanate oxide | \n38 kWh | \nTrolley, on-route | \nSwitzerland |
BYD | \n12 m | \n40 | \nBYD Iron Phosphate | \n324 kWh | \nOvernight, 250 km | \nWorldwide |
Complete Coach Works | \n12 m | \n37 | \nLithium-iron Phosphate | \n213 kWh | \nOvernight/opportunity, 145 km | \nUS |
EBusco | \n12 m | \n76 | \nLithium-iron Phosphate | \n242 kWh | \nOvernight, 250 km | \nChina, Finland |
Hengtong EBus | \n12 m | \n70 | \nLithium Titanate | \n60.9 kWh | \nOpportunity, 39 km | \nChina |
New Flyer | \n12 m | \n40 | \nLithium-Ion | \n120 kWh | \nOpportunity, 72 km | \nUS, Canada |
Primove | \n12 m | \n44 | \nLithium-Ion | \n60 kWh | \nWireless, on-route | \nGermany |
Proterra | \n10 m | \n35 | \nLithium Titanate | \n74 kWh | \nOpportunity, 42 km | \nUS |
Siemens | \n8 m | \n40 | \nLithium-iron Phosphate | \n96 kWh | \nTrolley, on-route | \nAustria |
Sinautec | \n12 m | \n41 | \nUltra-Cap and Battery | \n5.9 kWh | \nTrolley, on-route | \nChina |
Selection of operating electric bus models worldwide [40].
London has been working on overnight e-bus demonstrations since 2012 and is also investigating the potential of opportunity e-bus technologies. From the overnight e-bus perspective, TfL has collaborated with BYD, which is one of the largest electric bus manufacturer in China, to test the potential of battery electric buses in London, starting from 2012 [45]. The first two battery electric buses were handed over to TfL in 2013 and then entered daily service on two central London routes, numbers 507 and 521, which were the first battery electric buses in London. These single-decker 12-metre BYD buses utilise Lithium-Iron-phosphate batteries and have demonstrated a range in excess of 250 km on a single charge in real world urban driving conditions [46]. The 507 and 521 bus routes are relatively short commuter service routes and were chosen so that the bus can start operating in the morning peak alongside the diesel bus fleet and return to the depot to recharge during the day before resuming service for the evening peak [34, 47]. The battery takes 4–5 hours to recharge when fully discharged and has been designed for a cycle life of more than 4000 cycles, meaning a 10-year battery lifetime under normal operating conditions [48]. The trail fleet was extended to six buses in the summer of 2014. The trail buses in London not only provide a zero emission environmental benefit but also have shown promising result in terms of both technical and economic performance, and hence TfL has taken further steps towards adopting this new clean technology in the capital. The development timeline and future plans for London electric buses are plotted in Figure 7.
\nNumber of electric buses in London.
The latest data in 2016 showed that there are currently 22 battery electric buses operating in London including 17 single-decker battery electric buses and five double-decker battery electric buses. This is a world first for double-decker battery electric buses, as shown in Figure 8, and entered service in May 2016. These are 10.2 m buses with a capacity of 81 passengers and a claimed range of 303 km. The battery is a Lithium-Iron-Phosphate battery with a capacity of 320 kWh [49]. They utilise a combination of both overnight and opportunity e-bus technology and will operate on route 69 in Central London. They will use a high powered wireless inductive charging system to top up their battery system at the beginning and end of this route to keep the bus operating throughout the entire day [50]. The recent double-decker electric buses have used wireless charging technology as part of innovative charging technology development. However, this is still far from a mature technology and requires a massive recharging infrastructure network [51]. The electric buses in London have shown promising performance on short commuter routes; however, pure e-buses are still best suited for shorter routes with operational flexibility and scope to recharge them in inter-peak periods due to the limit of present battery capacity and recharging technology [52].
\nThe first electric double-decker bus in the world (photo from Business Green, 2016).
In 2015, BYD and Alexander Dennis (ADL) announced a partnership to provide 51 further single-decker buses to route operator Go-Ahead with an expected delivery in late 2016 [53]. BYD will provide the batteries and electric chassis technology, and ADL will provide the bus body-building technology [54]. The cost of each bus is expected to be £350,000 [55].
\nIn summary, the recent development and deployment of battery electric buses in London have shown that electric buses are technically feasible. It can be seen that electric buses will also have an important role to play in the coming ULEZ implementation in 2020. However, more time is needed to evaluate the actual performance and address the key challenges facing electric buses such as limitations of battery technology that restricts range.
\nHydrogen fuel cells (FCs) are considered a clean energy source with the main benefits over ICEs of zero harmful emissions during operation and high efficiency [56]. Although many types of FCs exist, this paper will only consider the application of FCs in transportation, considering the operating temperature, start-up time and technology maturity, Proton Exchange Membrane Fuel Cell (PEMFC) offer most promising solution [57]. Significant research into solid oxide fuel cells (SOFCs) in transportation has been carried out [58–60], although these have yet to been applied in real world bus applications. A PEM FC uses hydrogen as the fuel, which, through an electrochemical reaction with oxygen (usually from air) generates electricity with water as the only by-product from the chemical process [61]. By replacing the internal combustion engine in conventional buses, FCs can be used as the primary energy source to power a bus with electrical energy, therefore, achieving zero operating emissions. An additional advantage over ICE’s comes from the higher efficiencies exhibited by FCs [62, 63]. However, there are a number of barriers that need to be overcome before widespread deployment can be achieved. These are primarily cost and infrastructure [64, 65]. FC powered buses cost approximately five times more than a conventional diesel bus with the similar power output [66], where they typically cost in excess of £1,000,000 [67], due primarily to the expensive FC stack and the small scale of production [68]. In addition, the widespread deployment of FC buses would require a significant investment in hydrogen refuelling infrastructure [64]. The implementation of FC buses has shown that the technology is a promising solution for zero emissions buses if these barriers can be overcome.
\nFigure 9 shows the configuration usually used in FC vehicles. The basic drive train utilises a FC to power the propulsion motor; however, FCs are not well suited to providing for the transient power demands associated with city driving buses [69–73]. As such, most FC buses utilise a form of energy storage in a series configuration to both address this and also to utilise regenerative braking [74]. An additional benefit of such an approach is that the size of the expensive fuel cell stack can be reduced [75]. The energy storage implemented is usually either electrochemical battery technology such as Li-ion or NiCd batteries or electrostatic supercapacitors (sometimes referred to as ultracapacitors). The choice between these depends on the particular design and requirements of the system, with batteries offering reasonable power and energy densities although they have a relatively short cycle life and supercapacitors offering poor energy densities but excellent power densities, as shown in Figure 1. Additionally, supercapacitors have very long lifetimes of up to 40 years [31].
\nSimplified architectures of FC drivetrain.
In a series configuration, there are three main modes of operation that can be utilised to provide for the buses power demands, as shown in Figure 10. Although these are the main modes of operation, the way these modes are utilised will depend on the control strategy implemented [76].
\nModes of operation for a series hybrid FC drive train [77].
Mode 1: The SC discharges to supplement the FC to provide for high transient power demands. This type of operation is expected to occur under heavy loads such as during acceleration or going uphill.
Mode 2: The FC will both power the load and use excess power to charge the SC. This is expected to occur under low loads, when the FC power output is higher than the required load.
Mode 3: The power from the FC and generated power from regenerative brake will both be used to charge the SC. This is only expected to occur when the drive motor is operating as a generator in the regenerative brake mode.
There have been a number of projects aimed at utilising FC technology for bus propulsion applications. Table 3 lists many of the projects currently in operation along with the FC size and energy storage used. The projects are split into two main categories depending on the relative size of the FC and energy storage systems. The majority of the current projects are FC dominant, whereby the FC is expected to provide for the majority of the propulsion needs. Alternatively there a few examples of battery dominant hybrids, where the battery is the main source of power with the FC used as a supplementary power source. It was announced in 2017 that the JIVE project is to implement 142 buses across nine European cities with 56 new FC buses in the UK, which will be the first large scale validation project of FC bus fleets [78].
\nProject | \nFleet | \nYear | \nLocation | \nLength (m) | \nFC size (kW) | \nBattery type | \nBattery size (kWh) | \nDrive type |
---|---|---|---|---|---|---|---|---|
JHFC | \n2 | \n2006 | \nTokoname, Japan | \n10.5 | \n180 | \nNickel Metal Hydride | \nNot available | \nFC dominant hybrid |
University of Delaware | \n2 | \n2007 | \nDewark, US | \n6.7 | \n40 | \nNiCad | \n60 | \nBattery dominant hybrid |
TriHyBu | \n1 | \n2009 | \nNeratovice, Czech Republic | \n12 | \n48 | \nLithium Ion | \n26 | \nBattery dominant hybrid |
BurbankBus | \n1 | \n2010 | \nBurbank, US | \n10.7 | \n32 | \nLithium Titanate | \n54 | \nBattery dominant hybrid |
HySUT | \n2 | \n2010 | \nTokyo, Japan | \n10.5 | \n180 | \nNickel Metal Hydride | \nNot available | \nFC dominant hybrid |
NFCBP | \n1 | \n2010 | \nSan Francisco, US | \n12.2 | \n32 | \nLithium Ion | \nNot available3 | \nFC APU Compound |
Toyota FCHV | \n1 | \n2010 | \nToyota City, Japan | \n10.5 | \n180 | \nNickel Metal Hydride | \nNot available | \nFC dominant hybrid |
NFCBP | \n4 | \n2010 | \nHartford, US | \n12.2 | \n120 | \nLithium Ion | \n17.43 | \nFC dominant hybrid |
CHIC | \n8 | \n2010 | \nLondon, UK | \n12 | \n75 | \nSupercapacitor | \n0.5 | \nFC dominant hybrid |
CHIC | \n3 | \n2011 | \nMilan, Italy | \n11.9 | \n120 | \nLithium Ion | \n26 | \nFC dominant hybrid |
SunLine1 | \n6 | \n2011 | \nThousand Palms, US | \n12.2 | \n150 | \nNanophosphate Li-ion | \n11 | \nFC dominant hybrid |
NFCBP | \n12 | \n2011 | \nMulti-city, US | \n12.2 | \n120 | \nLithium Ion | \n17.4 | \nFC dominant hybrid |
CHIC | \n4 | \n2011 | \nCologne, Germany | \n18.4 | \n150 | \nNiMeH and Supercapacitor | \n23 and 0.6 | \nFC dominant hybrid |
CHIC | \n5 | \n2011 | \nAargau, Switzerland | \n11.9 | \n120 | \nLithium Ion4 | \n26.94 | \nFC dominant hybrid |
CHIC | \n5 | \n2012 | \nOslo, Norway | \n13 | \n150 | \nLithium Ion | \n17.5 | \nFC dominant hybrid |
NIP, CHIC | \n6 | \n2012 | \nHamburg, Germany | \n12 | \n120 | \nLithium Ion | \n26 | \nFC dominant hybrid |
CHIC | \n5 | \n2013 | \nBolzano, Italy | \n11.9 | \n120 | \nLithium Ion | \n26 | \nFC dominant hybrid |
HyTransit, HighVLO City | \n14 | \n2014 | \nAberdeen, UK | \n12.2 | \n150 | \nNot available | \nNot available | \nFC dominant hybrid |
HighVLO City | \n5 | \n2014 | \nBrussels, Belgium | \n12.2 | \n150 | \nNot available | \nNot available | \nFC dominant hybrid |
NFCBP2 | \n1 | \n2014 | \nAustin, US | \n10.7 | \n30 | \nLithium Titanate | \n54 | \nBattery dominant hybrid |
NFCBP2 | \n1 | \n2014 | \nBirmingham, US | \n9.8 | \n75 | \nLithium Titanate | \n54 | \nBattery dominant hybrid |
London has been involved with the testing and deployment of FC buses, Figure 11 shows the evolution of FC bus implementation in London. Initially, this was through the EU funded Clean Urban Transport for Europe (CUTE) project, which aimed at introducing hydrogen FC buses into European cities, where a test run of three buses were operated on the RV1 bus route between 2004 and 2006, this was increased to five buses from 2007 to 2009 [83]. London is now part of Clean Hydrogen in European Cities (CHICs) project with the first deployment in full service of the next generation of FC bus in 2011 and is expected to continue until 2019. There are currently eight Hydrogen buses operating in Central London as part of the CHIC project, fully covering the RV1 bus route, which is 9.7 km in length [83]. It is expected that by 2017 a further two buses developed as part of the 3Emotion project will be deployed through Van Hool [84]. The buses operate for 16–18 hours/day, before returning to the depot for refuelling at the central depot, which takes <10 minutes [85]. The workshop, which is responsible for routine maintenances and hydrogen management, was specifically designed and built for hydrogen FC buses [86]. The hydrogen has been transported in liquid form to the depot and converted into gaseous form to refuel buses [83], it is then stored on site in gaseous form at 500 bar [86].
\nLondon FC hydrogen bus development timeline (bus photos from Citaro, TfL, Van Hool, 2016).
The buses themselves have developed throughout this project, where the first generation was powered only by a FC. These utilised a 250 kW fuel cell [82] and achieved a hydrogen economy of 18.4–29.1 kg H2/100 km [87]. The buses deployed as part of the CHIC project utilised a series hybrid configuration, with a 75 kW PEM FC from Ballard and a 0.5 kWh Bluways supercapacitor energy storage system [88]. This introduction of the hybrid system significantly reduced the hydrogen economy to <10 kg H2/100 km [87] and is one of the most significant results of the CHIC project in London. Figure 12 shows that the fuel economy of the buses operated as part of the CHIC project showed considerable improvements over those in the CUTE project. It can also be seen that the London buses performed better than the CHIC target, exceeding it by nearly 50%. For all of the London FC buses, the hydrogen is stored as a compressed gas at 350 bar, with the gas cylinders stored on the roof of the bus [82].
\nAverage fuel consumption of FC buses in CHIC project (figure from FCH JU, 2016) [87].
Between 2011 and 2016, the FC buses in operation in London have covered over 1.1 million kilometres [89], and a number of the FC buses have achieved the milestone of 20,000 hours of operation [90]. This reflects the improvement of availability seen over the course of the deployment of CHIC’s London fleet. Figure 13 shows the availability from January 2012 until May 2015. The monthly availability of London FC buses has also significantly increased after the availability upgrade program carried out in 2014. The availability is expected to improve to over 85% by the end of the CHIC project as operators gain more operational and problem-solving experience.
\nAvailability of London FC buses in CHIC project (figure from FCH JU, 2016) [87].
Apart from the technical and economic improvements, the London trail buses have also proven that the technology became more viable because of the full working schedule, direct diesel replacement, centralised infrastructure and high public acceptance [86]. The trial test of FC-powered buses projects has provided promising performance as a long-term solution to zero emission transportation.
\nThis part aims at to provide a comparison of the current state of low emission and zero emission bus systems. Diesel hybrid buses have been developed and deployed as a means of achieving emissions reductions, where a number of advantages in terms of efficiency, emissions and fuel consumption can be seen over diesel buses. There are, however, a number of problems associated with their widespread deployment. The first of these is the cost and is due to the additional components necessary for the electrical system. Second, the inclusion of the electrical system necessitates a significantly more complicated configuration [19]. Third, although diesel hybrid buses can offer significant improvements in terms of CO2 and NOx emissions, the primary energy source is still the ICE. As such, they fail to address the underlying source of emissions and are therefore fundamentally limited in the improvements that can be achieved. As such, they can only really be considered as a transitional technology to reduce emissions but are not a viable option for meeting zero emissions targets. In order to meet the requirements for zero emissions buses, which is the ultimate objective for a clean transportation network, technologies such as electric and FC buses have been developed as a long term solution for city bus transportation needs. Therefore, this section will mainly compare the battery electric bus (opportunity, overnight and trolley) and FC bus technologies as the two most promising zero emission solutions in terms of the operational requirements and is summarised in Table 4. The rankings are based on the authors’ opinions with reasoning given in the paragraphs below.
\nZero emission option | \nOpportunity E-bus | \nOvernight E-bus | \nTrolley E-bus | \nFuel cell bus |
---|---|---|---|---|
Daily range | \n4 | \n3 | \n1 | \n2 |
Route flexibility | \n3 | \n1 | \n4 | \n1 |
Refuelling time | \n2 | \n3 | \nNot available | \n1 |
Infrastructure | \n3 | \n2 | \n4 | \n1 |
Fuel availability | \n1 | \n1 | \n1 | \n4 |
Clean source | \n1 | \n1 | \n1 | \n4 |
Cost | \n3 | \n1 | \n2 | \n4 |
High level comparison of operational performance of zero emission bus concepts.
Notes: 1, best; 4, worst.
Range: Opportunity e-buses have a smaller energy storage that requires frequent recharging, which equates to poor performance in terms of daily range. Overnight e-buses utilise a much larger battery, which increases the range with reported values of over 300 km per charge. Trolley e-buses are continuously powered with electricity by overhead lines along the route which effectively gives unlimited range. FC buses use hydrogen cylinders as the fuel tanks, which allow the range to be greatly extended (up to 450 km) for as much as hydrogen fuel cylinder weight and size allows [91].
\nRoute flexibility: Opportunity and trolley e-buses require recharging infrastructures along the route which greatly limits their route flexibility. This is somewhat dependant on the size of the on-board battery and will likely be more acute for trolley e-buses. The overnight e-buses and FC buses are expected to be able to operate for an entire day’s service without recharging or refuelling. As such this allows for much greater route flexibility. This appears to be easily achieved for FC buses, however for overnight e-buses this is not always the case and will again be dependent on the size of the battery.
\nRefuelling time: Opportunity e-buses require frequent recharging throughout the entire route. Although each recharges for the opportunity e-bus only takes up to 15 minutes, it is still considered as a drawback due to the requirement for regular recharging. Overnight e-buses require a longer recharging time (average >4 hours) after each operation due to the increased battery capacity. The recharging time is heavily dependent on the charging power. Trolley e-buses are charged through overhead wires so that they require no refuelling time. FC buses are refuelled with gaseous hydrogen, which can be completed quickly (<10 minutes) [91].
\nInfrastructure: Opportunity e-buses and trolley buses require corresponding infrastructure along the route and each end of the routes. Therefore, opportunity e-buses and trolley buses require a comprehensive infrastructure network. Overnight e-buses and FC buses both require infrastructure to recharge/refuel at the end of daily operation. This can, however, be centralised at the service depot and hence does not need to be as comprehensive. It appears, however, that the current recharging times for overnight e-buses presents a problem since it is likely that a significant number of recharging points and a massive recharging power would be needed to recharge the batteries of a large fleet in time for the next day’s service. This could potentially be an issue for the electrical grid infrastructure if the number of buses grows significantly, while this would not be a problem for FC buses because of their short refuelling time.
\nFuel availability: All three battery electric bus technologies use electricity to recharge their batteries. This electricity could be central managed and distributed locally through the local electricity grids; however, widespread electric bus deployment could significantly stress this infrastructure. FC buses will likely require the development of a comprehensive distribution network for hydrogen, although on-site hydrogen production has been demonstrated. Additionally, hydrogen fuel storage would also create additional cost.
\nClean source: Real zero emissions bus technology needs to be clean throughout the manufacturing process, fuel production and bus operation. Currently, battery electric and FC bus technologies can achieve zero operating emission but the lifetime emissions are much harder to quantify. It is hard to forecast how the emissions from new technology manufacturing will change, but the fuel production method can be roughly estimated. In the UK, the GHG emissions for electrical energy were 0.44932 kgCO2/kWh in 2014 [92]. This is likely to change as the UK’s energy mix changes, where in 2015, 24.6% of electricity was generated from renewable energy sources [93]. Similarly, for FC buses, the source of hydrogen is critical in determining the overall emissions. Currently, about 96% of hydrogen is derived from fossil fuels [94] which results in 13.7 kgCO2/kgH2 [95]. Despite this, investigations into the use of renewable energy for hydrogen production through the process of electrolysis have been carried out offering potential for a low carbon source of hydrogen. Currently, electricity for battery electric buses is a cleaner fuel than hydrogen for FC buses.
\nCost: Both electric and FC buses have higher capital costs than a conventional diesel bus; however, FC buses are currently far more expensive than electric buses. The capital cost of electric buses is somewhat dependant on the type of operation expected, where overnight buses will have higher costs than opportunity and trolley buses due to the increased battery capacity. This does, however, need to be weighed up against the cost of infrastructure, where opportunity and trolley buses require a comprehensive and expensive charging network. Overnight electric and FC buses on the other hand can make use of a centralised recharging/refuelling infrastructure.
\nThroughout this chapter, the main technologies being implemented to meet the low emissions requirements have been presented. The most promising for these in terms of zero emissions are electric and FC buses; however, it is clear that there are still significant barriers to their widespread implementation. Following on from the challenges identified in the comparison section a number of challenges for future developments have been identified.
\nFor electric buses, it is clear that further improvements to battery technology are required in terms of their energy densities and lifetime as well as the development of an effective charging infrastructure. The challenges are somewhat dependant on whether the bus is intended to use the overnight or opportunity charging schemes. For overnight charging, the charging infrastructure can be centralised; however, this necessitates very large power requirements for the charging infrastructure, additionally the range of the buses needs to be addressed through battery developments. The opportunity charging schemes a comprehensive and distributed charging network. In most cases, this requires the development of high efficiency and power wireless charging technologies.
\nThe future development of FC buses requires development in a broader range of areas. This includes further work on individual components such as the FC stack and hydrogen storage. The FC stack is still the most expensive component of the FC bus. The further development of the control strategies for hybridised buses held significant promise in reducing the size of the required FC stack and improving the fuel economy. Hydrogen storage is a key area for future research for bus applications, where technologies such as solid state storage offer potential to improve the storage density of hydrogen. For widespread implementation, the development of the hydrogen infrastructure is vital. This includes the production of hydrogen, particularly from clean sources, the distribution of hydrogen or on-site production and purification.
\nWe wish to thank the Engineering and Physical Sciences Research Council (EPSRC) who have funded the HyFCap (Reducing the cost and prolonging the durability of hydrogen fuel cell systems by in-situ hydrogen purification and technology hybridisation) (grant number: EP/K021192/1) jointly carried out by University College London and University of Sheffield.
\nOver the last few decades, the proportion of the world’s population living in urban areas has grown to 55%, and is expected to increase to 68% by 2050 [1]. Africa’s urban growth is unfolding more rapidly than anywhere in the world, with the share of urban dwellers projected to exceed 50% by 2035 [1]. However this growth has been characterized as “rapid, unplanned and unmanaged” because 62% of the urban population in Africa lives in informal settlements characterized by conditions of squalor, overcrowding, and small make-shift structures mostly made of sub-standard housing materials such as mud and scraps of wood or corrugated metal [2]. Unplanned settlement in cities is associated with increased inequality, urban poverty, social deprivation and lifestyle changes that could lead to an increased burden of non-communicable diseases (NCDs) [3]. Thus, changes in physical and social environment in the urban space favor the adoption of behaviors that promote unhealthy lifestyles such as physical inactivity, unhealthy diets, tobacco consumption and harmful alcohol consumption that predispose individuals living in the slums to NCDs [4, 5]. Even so, there is generally lack of consensus as to whether there exists any NCDs health advantages in urban area.
NCDs represent a leading threat to human health and development [6]. In 2015 alone, four major NCDs-cardiovascular diseases (CVDs), cancers, diabetes, and chronic respiratory diseases accounted for 72% of all deaths globally; 85% of these were from low and middle income countries (LMICs) [7]. In urban areas of SSA, NCDs are rising faster than anywhere else in the world [8]. The economic consequences of NCDs are enormous across the globe, and are felt at the individual, household, community and health systems levels. Bloom et al. (2011) [9], estimated that economic losses due to NCDs could amount to approximately 75% of the global GDP. While there is wider recognition of the increasing burden of NCDs across Africa [5], scanty literature exists on the link between urban environments and NCD risks in Africa, as well as the associated health and social consequences, and access to health services. Considering that future population growth will take place predominantly in African cities, there is need for a deeper understanding of urban health and the context of NCDs in African cities to identify tailored interventions to curb the epidemic. Urbanization in sub-Saharan Africa provides a unique opportunity to explore the mechanisms by which urban environment influences NCD epidemiology.
This chapter describes both the health determinants and outcomes in African cities with special attention to low-income urban areas. It further highlights the burden, impact and possible interventions for NCDs in African cities. The chapter draws on insights from relevant peer-reviewed and gray literature on NCDs, and the authors’ own experiences on the subject in Africa.
While the African continent remains largely rural, it is one of the fastest urbanizing regions in the world [1]. Africa’s transition into the ‘urban age’ is seen in the prolific growth of megacities as well as smaller towns [10]. The urban population increased from 14 to 32% between 1950 and 1990 and is projected to rise to 54.1% by the year 2025 [11]. In absolute terms, the urban population will rise from 395 million in 2010 to 1.339 billion in 2050 [12]. Currently, the continent has seven megacities (cities with populations over 10 million): Cairo, Kinshasa, Lagos, Accra, Johannesburg, –Pretoria and Khartoum with cities such as Lagos having an average annual growth rate of 5.8% (Table 1).
Urban population as a percentage of total population* | Urban population average annual growth rate | |||||
---|---|---|---|---|---|---|
1970 | 1991 | 2000 | 1970–1980 | 1980–1990 | 1991–2000 | |
Low-income countries | 28 | 39 (3127) | −3686 | 3.7 | 5 | 2.4 |
Kenya | 10 | 24 (25) | 32 (34) | 8.5 | 7.8 | 7 |
Zimbabwe | 17 | 28 (10) | 35 (12) | 5.6 | 5.8 | 5.4 |
Nigeria | 20 | 36 (99) | 43 (128) | 6.1 | 5.8 | 5.4 |
Urbanization of low-income countries in sub-Saharan Africa.
Figures in parenthesis are estimates of total population in millions.
Other big cities expected to join the megacity list include Nairobi, Luanda, Dar es Salaam and Addis Ababa [13]. Urbanization trends in most of African countries are mainly demographically driven without commensurate socioeconomic development [14]. With no massive social, economic and infrastructural transformations in place, growing cities and towns in Africa experience high rates of poverty, unemployment, low wages and inequality [15, 16]. Urbanization in African is rather chaotic and is dogged with complex urban health crises arising from inadequate safe water supply, squalor and shanty settlements (Figure 1), poor sanitation, poor solid waste and toxins disposal that contaminates food and water [3]. These living conditions drive a high incidence of infectious diseases [17].
Korogocho slums in Nairobi. Credit: APHRC.
Injuries are also common because of inefficient, congested, and risky transport system [18]. It is estimated that up to 62 percent of SSA’s urban population live in informal settlements characterized by pervasive poverty and overcrowding [19]. While the poor in the cities continue to suffer marginalization and experience excess social and economic vulnerability from unstable employment, external shocks such as natural disasters, the affluent section of cities are much more planned and with significant policy attention, and development that ensures healthy living such as presence of walk ways, parks and playing fields (Figure 2) [20, 21]. Therefore, the divide between the rich and poor urban dwellers remains wide in African cities, and the extent of inequality reduces access to healthy living as well as essential and quality health services particularly for the poor. Young people face several challenges when transitioning to adulthood within such settings.
A section of the Nairobi Central Business District (CBD).
There is substantial evidence from studies conducted in Nairobi slums, indicating an increase of smoking along decreasing social economic status (SES) gradient, and within overcrowded settings, thereby elevating the risks of second hand smoking [22]. While urban poverty remains a critical trigger of NCD risks, the existing obesogenic environments and weak health systems in most of urban Africa portend a bleak future for NCD prevention and control. Studies in Kenya, Ghana and South Africa have also shown that living in a city is associated with higher odds of obesity and cardio-metabolic risk factors [23, 24, 25]. Similarly, Peer et al., (2013) [26], in South Africa found that urban environments are associated with an increase in prevalence of the traditional risk factors for NCDs including smoking, harmful alcohol consumption, inadequate physical activity, and inadequate fruit/vegetable consumption. In addition, early life exposure to urban environment has been linked to an increased risk of obesity and impaired fasting glucose in later adulthood [27].
The world health organization (WHO), defines NCDs as any medical condition or disease that is non-infectious and non-transmissible among people. The four main NCDs include cardiovascular diseases, chronic respiratory diseases, diabetes, and cancers which share a set of four key behavioral risk factors: tobacco use, harmful alcohol use, physical inactivity, and unhealthy diet [28]. These behaviors mediate biological risk factors such as obesity, raised blood pressure, and increased blood glucose, elevated blood lipids which ultimately progress to more advanced disease [29]. Other examples of NCDs include mental illnesses, injuries, and chronic kidney diseases. From 1990 to 2015, NCDs related deaths in SSA increased from 25% (1.7 million) to 34% (2.7 million). During the same period, the total NCD burden expressed as disability adjusted life years (DALYs) increased by 45% [7]. Cardiovascular diseases (CVDs) are the leading cause of NCD deaths. In 2013, CVDs caused nearly 1 million deaths in SSA, constituting 38.3% of non-communicable disease deaths and 11.3% of deaths from all causes in the region [30]. Cancers come second causing 12% NCDs deaths with wide variations across regions in SSA. Among males in SSA, leading cancer cases (in age-standardized incidence rate (ASIR) per 100,000 population) included, prostate cancer (27.9), liver cancer (10.2), Kaposi sarcoma (7.2), oesophageal cancer (6.8) and colorectal cancer (6.4). While among females, cervical cancer (34.8), breast cancer (33.8), liver cancer (5.4), colorectal cancer (5.4), ovarian (4.6) [31], are the most common causes of death. Tragically, survival from cancer is worse than in the rest of the world. For many cancers, the risk of getting cancer and the risk of dying from it are nearly the same in SSA [32]. Chronic respiratory diseases and diabetes are each responsible for about 10% and 5% of total deaths in SSA respectively [7]. The NCD risk factors such as high blood pressure, poor diets, air pollution, high body-mass index, tobacco smoking, alcohol and drug use, high fasting plasma glucose, high total cholesterol, and low physical activity are the top 10 global risk factors for death [7].
Other forms of NCDs such as injuries are responsible for a significant proportion of DALYS. Injuries resulting from road accidents (motor vehicles and motor bikes) have increasingly taken a growing toll on human health [33]. Mental disorders, including depression and anxiety, or severe forms like psychosis, schizophrenia and bipolar, as well as alcohol and substance dependence are common. Over the next decade, it is projected that NCD associated DALYs will surpass that contributed by infectious diseases, perinatal and maternal conditions combined (Figure 3).
Projected burden of disease in SSA, 2008 and 2030. Source of data: Authors from (World Health Organization, 2008). NCDS*: Cardiovascular diseases, cancer, diabetes, chronic respiratory diseases.
Hypertension is a leading risk factor for mortality, and is the prime risk factor for the CVD epidemic in Africa [34]. Hypertension is defined as an average systolic blood pressure ≥140 mmHg and/or average diastolic blood pressure ≥90 mmHg among adults aged at least 18 years. Data available on hypertension prevalence are from a wide range of studies [35, 36], majority of which are not age-standardized, and this limits the opportunity for reliable comparison between different African countries and cities. Nevertheless, several WHO STEPwise surveys reported a hypertension prevalence of 19.3–39.6% in Africa [35, 37]. Additional data from epidemiological modeling project suggest that 216.8 million people will have hypertension by 2030. Urban settings consistently have a higher prevalence of hypertension compared to rural areas [38, 39] (Figure 4).
Prevalence of hypertension by rural–urban residence in selected African countries. Source of data: World Health Survey (2003).
Of great concern, is the proportion of individuals with hypertension who remain underdiagnosed, lack access to treatment and are prone to severe complications and increased risk of premature deaths [40]. Evidence from a review of hypertension in 23 African countries, shows that less than half of those with hypertension are aware of their diseases and only one third of those who are aware start treatment, and less than 10% of those on treatment have their blood pressure controlled [41]. It is thus crucial to understand the risk factors driving the rise of hypertension in urban areas to inform preventive interventions. Several factors have been cited as responsible for the rise of hypertension among urban populations in Africa.
Early studies by Donnison et al. (1929) in an African rural community established the role of civilization and urbanization on the development of hypertension [42]. Later, Poulter et al. (1990) established social-behavioral origins with sedentary lifestyles and increased consumption of unhealthy diets among rural–urban migrants in Kenya as major factors driving elevated blood pressure [43]. Researchers also observed that mean diastolic blood pressure of migrants (aged 15–34 years) who moved to the cities increased markedly over time, compared to their controls in the rural areas. In addition, migrants’ mean urinary sodium: potassium ratio, weight and pulse rate were higher than for controls [43]. Cooper et al., also hypothesized that environmental and behavioral changes that occur when individuals move from rural to urban settings all coalesce to increase predisposition to hypertension [44].
Urban poverty which is common in African cities, is also known to mediate deleterious risks factors for hypertension among urban residents [45]. In LMICs, poverty exposes people to behavioral risk factors for NCDs and in turn, resulting NCDs become an important driver for poverty. The urban poor experience increased vulnerability to unhealthy diets and physical inactivity. Evans et al., (2010) found that informal settlements within cities in South Africa had unhealthy diets and inadequate physical activity because they lacked access to organized markets for healthy foods, and had inadequate resources for physical activity [46].
Urban living in South Africa, Tanzania and Cameroon was also reported to be associated with increased exposure to tobacco use, excessive alcohol intake, unhealthy diets (high in salt, and sugar and less in fiber) and also physical inactivity [47, 48]. In the next section, we review how urban environment modifies NCD risk factors.
There is evidence alluding to the link between diet and development of overweight, obesity and occurrence of NCDs [49]. However, the understanding of the nexus between urbanization and changes in dietary patterns and nutrient intakes in Africa remains limited. As African cities grow, the rise in urban population’s increases pressure on arable land for farming, and coupled with rural urban migration, this reduces the ratio of food producers to food consumers [16]. This consequently leads to severe disruptions in healthy food availability, distribution, access and affordability [50, 51]. As healthy foods such as fresh vegetables and fruits, cereals and plant proteins diminish in urban settings, populations resort to the readily available which often unhealthy. A survey in major cities of Cape Verde, Ghana and Senegal reported an increased consumption of energy-dense foods such as candies, ice cream and sweetened beverages up to seven times as frequently as fruit and vegetables [50]. This finding affirms previous studies that showed rapid rise in fat intake across low income countries, including in Africa [52]. Proliferation of fast-food outlets, supermarkets, food vendors, and restaurants in cities have facilitated increased access to unhealthy diets, thus transforming urban settlements into highly obesogenic environments. Nevertheless, for individuals of higher socio-economic status, these changes may offer improved access to nutritious foods since they can afford more healthy foods [53]. While for the urban poor, choices for healthy foods are restricted and they easily resort to the most easily available and affordable diets that are largely unhealthy [54]. In the cities, there are aggressive powerful commercial and emotional advertisements and marketing through various media outlets, which greatly influence preferences and choices of fast-foods and sugary drinks, especially among children and young adults [55, 56].
Physical activity (PA) has many health-promoting effects and is associated with reduced risk of cardiovascular and metabolic diseases, obesity, and some cancers [57]. Insufficient physical activity is a leading risk factor for NCDs and has a negative effect on mental health and quality of life. Levels of physical activity in many African countries vary widely across geographic regions and population subgroups. For instance, country level prevalence of PA ranged from 46.8% in Mali to 96.0% in Mozambique [58]. While current data shows that SSA has the least prevalence of insufficient physical activity compared to the rest of the world [59], trend data shows decreasing levels of physical activity and increasing levels of sedentary lifestyles across all age groups [60]. Country-specific population-based data on physical activity prevalence show lower levels of PA in urban environments attributed to built-up environment leaving no green spaces for physical activity [61]. In addition, congestion in cities, availability of motorized transport and absence of paved walk-ways makes it impractical for physical activity to happen in African cities. In low income informal settlements in African cities, several physical barriers and insecurity limit physical activity [46]. In Kenya for instance, young adults in rural areas were found to be more physically active compared to those in urban areas. A study conducted by Mashili et al. (2018) in Tanzania also found that being employed, higher education and wealth status (mainly among urban residents) were associated with less physically activity [62].
The WHO considers tobacco use as the single leading cause of avoidable death and ill health, contributing to lung cancer, chronic respiratory disease and cardiovascular disease [63]. While the use of cigarette and other tobacco products has declined in high-income countries [64], cigarette use in LMICs including in SSA is rising [65]. Demographic Health Surveys (DHS) conducted in 16 African countries revealed that cigarette use was highest among urban dwellers, less educated, and lower socioeconomic status individuals [66]. Consistent with previous studies in Africa, urban residents are most at risk for cigarette use [67], and start smoking at a younger age [68]. A study by Williams et al., (2008) in Cape Town concluded that urbanicity was associated with smoking attitudes among women [69]. Notably, increased marketing of tobacco products target women and youths in urban SSA [66]. Young adults in African cities, for example in Nairobi, Kigali and Dar-es-salaam, have taken into trendier smoking habits such as “shisha” (pipe smoking) [70, 71, 72]. In addition, since informal settlements in the cities are overcrowded, there is increased the risk of second hand smoking and indoor pollution from cooking– all linked to cardiovascular and respiratory complications [73].
Comparative literature about alcohol use in urban and rural settings is rare. Some studies have linked urban living to the rise of psychological distress and alcohol-related problems. However, there is paucity of research that investigates the link between urbanization stress and alcoholism in SSA [74]. Similarly, harmful use of alcohol is often associated with injuries, violence, crime, suicide and risky sexual behaviors [75].
The link between obesity, poor health outcomes and all-cause mortality is well established. Obesity is known to increase the likelihood of diabetes, hypertension, coronary heart disease, and stroke, certain cancers, obstructive sleep apnoea and osteoarthritis. It also negatively affects reproductive performance [24, 27, 76]. Research evidence now characterizes the rapid rise in obesity levels in urban parts of Africa over the last 25 years as an epidemic. A study in Nairobi informal settlements found three times higher obesity prevalence than that rural areas in Kenya [77]. An analysis of demographic and health survey data from 24 African countries over the past 25 years revealed a consistent increase in obesity levels in all study countries. Obesity more than doubled or tripled in 12 of the 24 countries including Kenya, Benin, Niger, Rwanda, Ivory Coast and Uganda, Zambia, Burkina Faso, Mali, and Malawi, while Tanzania experienced a three-fold increase over the same period [78]. Substantial differences were observed between countries: Egypt and Ghana had the highest prevalence of obesity in the survey estimated at 39 and 22%respectively [79]. Obesity was higher among women aged between 15 and 49 years and those living in urban areas [80]-see Figure 5.
Differences in urban and rural overweight and obesity prevalence in Africa. Source of data: Demographic Health Surveys (DHS).
Several studies have described the role of urbanization in the rising obesity epidemic in the African continent [79, 80, 81]. Urbanization along with socioeconomic transformation lead to increased access to high energy-dense foods and more sedentary lifestyles resulting in a positive energy balance leading to obesity. Access to cheap foods, high in fat and sugar content among the urban poor is easier than in rural communities, thus the higher prevalence of obesity in urban areas [82]. In an analysis of data from seven African countries including Malawi, Senegal, Kenya, Ghana, Tanzania, Niger and Burkina Faso, Ziraba et al., found that the greatest increase in prevalence of overweight and obesity over a ten-year was among the poorest people living in the cities [83].
Many interventions for prevention and control of NCDs exist but because most African countries have limited resources, choices have to be made about which of the interventions are prioritized [84]. WHO proposed several NCD “best-buy” strategies - proven and cost-effective approaches for addressing NCDs- within LMICs through tacking of the modifiable risk factors for NCDs [85]. Examples of the “best buys” include increasing taxes on tobacco and alcohol, legislation to restrict smoking zones, bans on advertising, reducing salt and sugar in food and raising public awareness on dangers of all risk factors for NCD and promoting healthy behaviors. A number of African governments made commitments in domesticating and implementing NCD related international commitments, such as the Global NCD Action Plan 2013–2020 with targets and indicators to accelerate NCD control [86]. Nevertheless, progress has been slow, and in some cases off-track in achieving the NCDs indicators by the set deadlines [87]. Scarcity of resources and several competing priorities in the health sectors across African countries limits the ability of countries to achieve their targets. A recent WHO NCD Progress Monitor report revealed that less than half of WHO Member States have set NCD targets/indicators to track progress of implementing NCD “best buys” [88]. Some of the “best-buys” that have been implemented by African countries include; taxes and legislations to create a protective environment that limits exposure to harmful behaviors especially for the most vulnerable.
Both excise and sales tax on tobacco products in Kenya and South Africa were increased [89]. Similarly, several countries including Botswana, Kenya, The Gambia, Ghana, South Africa, Tanzania, and Zimbabwe have imposed taxes on alcoholic beverages [90]. While the enforcement of the alcohol and tobacco policies may be lacking the needed regulatory teeth, there is some evidence suggesting higher levels of alcohol and tobacco abstinence in countries implementing these interventions compared to countries without any regulations [90]. Between 1993 and 2009, cigarettes sales declined by 30% in South Africa, and the rate of smoking among adults dropped by 25%, even as government revenues from tobacco taxes increased by 800% [91, 92]. South Africa imposed taxes on sugary drinks in 2017, becoming the first African country to do so, in an attempt to reduce excessive consumption of sugary drinks [93], the effect of this is yet to be seen. South Africa also passed a legislation to enforce salt reductions in the food industry by establishing maximum sodium content limits to be achieved by 2019 [94]. Some countries are now pushing for bans on alcohol advertising. In Gambia, alcohol advertising is banned on national television and radio.
Some African cities have chosen a more positive and interactive approach through health promotion such as raising awareness about NCDs and encouraging disease screening through campaigns (e.g. for hypertension and diabetes). Most of these health promotion approaches are aimed at achieving positive health behaviors at individual and community levels [95]. For example in Kigali, Rwanda physical activity is promoted among city residents by encouraging people to leave work early once in a week to engage in physical activity [96]. Such preventive approaches to NCD control targeting the behavioral risk factors are more cost-effective than treating the NCDs. A more concerted, strategic, and multi-sectorial policy approach is essential to help reverse the negative trends of NCDs in urban Africa.
Several challenges hinder efforts to address the NCD burden in cities. The main challenges include lack of data needed to inform primary prevention, care and treatment, low community awareness on NCDs and risk factors, weak policies and poverty in the informal settlements.
Limited availability of representative data on the burden of NCDs in Africa [97], leads to a gross underestimation of burden, thus the inability to lobby for investment in NCD care service delivery. Some countries have collected national NCD data through the NCD WHO STEPwise surveys. Up to 33 countries in WHO African Region have conducted at least one round of STEPwise survey which draws a nationally representative sample and about 19 countries have conducted the global school-based student health surveys (GSHS) [98]. Routine data captured by health facilities on morbidity and mortality could be a potential sources of data, but these data are limited by non-representativeness due to differential use of health services, inaccuracies from paper-based data capture systems, thus the data are largely regarded as of poor quality [99]. Insurance firms also provide important morbidity data, but these have limited value since a small proportion of the population access health insurance. The Global Burden of Disease study combines several datasets to model national NCD morbidity and mortality estimates, but rarely reports NCD burden by rural versus urban locations. Data challenges such as the variation in methodologies used to capture data, the rigor of instruments, sampled populations, design used as well as the variations in how the indicators are defined continue to hamper the comparability and learning across countries [100]. Planning of NCD services without reliable data is almost impossible.
Lack of knowledge and awareness on risk factors at community level hinders healthy behavior change and uptake of early NCD screening and treatment services [101]. A study in Abuja reported a high prevalence of hypertension among the elderly populations, and majority of whom were unaware about their conditions [102]. Other studies have suggested that low levels of knowledge and awareness of hypertension are associated with undiagnosed, severe or complicated, and uncontrolled hypertension [103], lack of patients’ adherence to lifestyle modifications and to medications [104, 105]. Certainly raising awareness particularly on uptake of screening services for most NCDs could be beneficial at both individual and population-levels. And in the context of urban Africa, such efforts could leverage on wide spread mass-media for health promotion. Low levels of NCD awareness or knowledge levels among health workers is also associated with reduced ability for case-finding, treatment and referrals [106].
Urban populations in Africa tend to be very diverse by education, religion, socioeconomic status and culture [5]. As a result, NCD prevention and control policies and programs need to be tailored to cater for variations at population levels [107]. In a review CVD policies in Kenya Asiki et al. (2018) found no standalone policies for CVD management and care but some aspects of CVD policy were covered in general NCD policy document [108]. NCD policies in most African countries suffer the same deficiencies as they do not reflect the typical realities of urban living –pervasive food marketing and complex urban food environments that may offer diversity as well as greater exposure to unhealthy foods [8]. These policies are also not well integrated with policies in other sectors such as spatial planning, infrastructure and housing, transport planning, education policy, access to energy, and water and sanitation policies and interventions [53]. As such minimum intersectoral and multisectoral engagements in policy formulation lead to standalone NCD policies that are not coherent with other policies [90]. Furthermore, national policies and plans for the prevention and control of NCDs often suffer from underfunding [109], and are thus not implemented. In addition, interference from commercial and economic interests of industry for tobacco, alcohol, and food industries makes it difficult to regulate these NCD risk factors as policy makers and law enforcers are often bribed or threatened not to formulate and or implement such policies [110].
Health systems in SSA are characteristically weak and overburdened by the rapidly increasing double burden of communicable diseases and NCDs [17]. With more focus and investment on infectious diseases such as malaria, TB and HIV, very little attention is given to the rising NCD burden in cities [111]. As a consequence, several gaps and missed opportunities exist to offer services for patients and many miss diagnosis, and treatment to when they present to hospitals with other diseases [112]. Inadequate staff and as well as capacity of health staff in most countries, negatively affects NCD prevention and treatment at facilities. For instance, nurses at primary healthcare facilities should have skills to use simple point-of-care equipment such as glucometers for early screening, treatment and referral of individuals with abnormal blood glucose [113]. Frequent stock-outs of medicines and supplies remains a critical barrier to prompt treatment and adherence to these treatments. In Nairobi, Kenya medicines for NCDs are hardly available in public hospitals, and there is lack of integration of NCD services with other chronic diseases such as HIV or TB services [114]. Knowing that interventions targeted against one of the disease burdens will impact the other, it is critical that interventions are conducted jointly instead of competing for limited resources. A study in Malawi reported that the full cost of NCD care is often borne directly by patients through out-of-pocket (OOP) payments individuals [115]. Similarly, a study by Mwai and Muriithi (2016) in Kenya reported that NCDs reduce household income by almost 30%, compared to other general ailments that reduce household income by 13.6%. As a consequence, many people suffering from NCDs in Africa face risks of experiencing catastrophic health expenditures, impoverishment and may be deterred from seeking the care they need [116].
Poverty is common among urban residents in Africa and this plays a fundamental role in the onset, progress and mortality of NCD patients [117]. Studies have suggested that the groups most at risk of NCDs in the next decade will be the urban poor [118]. While NCD epidemiology in high income countries is largely driven by explosion of traditional risk factors in Rwanda, increasing evidence points to a greater contribution of malnutrition, infections, and toxic environments - all exacerbated by poverty [119]. Poverty also limits access to quality NCD care. Majority of the urban poor lack access to health insurance and therefore resort to out-of-pocket payments, consequently leading to catastrophic spending [120]. Research on social and economic implications of NCDs remain scarce in most SSA countries yet such information is important for prioritization of NCDs by all relevant sectors [121].
The rapid urbanization in Africa continues to drive the NCD epidemic, increasing vulnerability of individuals, threatening development and sustainability of African cities. To mitigate this rising threat - effective evidence-informed multi-sectoral policies are needed to address prevention and control of NCD focusing on the major NCD risk factors. While several countries have developed national strategies for NCD prevention following the global WHO NCD prevention strategies, implementation of these policies is still inadequate. Thus there is need for governments to put more effort in strengthening implementation of these policies including allocation of financial and other resources to support implementation. NCD policies need to be integrated into urban planning to address air pollution as well as physical inactivity by designing and developing parks and recreational facilities including pedestrian and cycling tracks, zoning walk-ways where motorized vehicles are not allowed and providing incentives for the non-use of motorized vehicles. Fiscal policies and regulatory measures to restrict unhealthy food environment in urban areas of Africa are also needed to curtail the ever growing food marketing by a burgeoning food industry.
There is need to strengthen health care systems to make them more responsive to NCD prevention and control. This include building capacity of health workforce on prevention and control of NCDs, strengthening infrastructure, providing essential commodities and supplies and strengthen surveillance systems to be able to plan, monitor, and assess the effects of NCDs on population health and monitor the performance of interventions. A good balance of investment is required for the delivery and coordination of both curative and preventive and promotive services to avert the NCD disease burden. Countries need to explore various models of partnership with private sector partners aimed at scaling up their contributions to addressing NCDs directly or indirectly through various multi-sectoral strategies.
There is need to strengthen primary prevention interventions at community-levels. These interventions include early detection, active screening, case finding, referral and treatment and working with at-risk individuals to reduce high risk behavior. Expanding opportunities for early detection at the community and in primary health facilities could yield positive outcomes, especially through deliberate implementation of task shifting and task sharing models, involving community health workers (CHWs), while consistently mentoring and evaluating performance of such a model. Further community interventions include health education and promotion focusing on NCD risk factors including importance of reduced alcohol and tobacco consumption, physical activity and decreased consumption of high-calorie foods and highly processed foods while increasing consumption of fruits and vegetables. Some evidence exist on the potential positive results of such small-scale healthy food interventions utilizing platforms such as school feeding programs and workplaces. While documented community interventions addressing alcohol and tobacco consumption are scarce, interventions to enhance awareness and engagement in physical activity in major cities such as in Rwanda and Cameroon have been shown to work. Above all pro-poor primary health care programs targeting vulnerable and disadvantaged groups in African cities are needed to reduce the equity gap in NCD services.
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