19 Nov Open Letter to The Global Fund Board: Access to medical oxygen
Dear Global Fund Board,
The Global Fund must continue its vital work helping eligible countries close the massive gaps in access to medical oxygen that are stymying efforts to achieve the Sustainable Development Goals (SDGs) and prepare for the next pandemic.
Oxygen is an essential medicine with no substitute. The world saw just how essential during the COVID-19 pandemic, when hospitals in most countries either ran out or didn’t have any to begin with. But it is also a treatment for a vast array of health conditions, including infections (e.g., pneumonia, tuberculosis, malaria), non-communicable diseases (e.g., COPD, heart disease, stroke), neonatal disorders, and conditions requiring surgery – all together representing eight of the nine health-related SDGs.
Acknowledging The Global Fund’s leadership during COVID-19
We applauded The Global Fund when, in February 2021, the Executive Director, Peter Sands, spoke out, saying “Vaccines alone are not going to do this. We could do a better job in saving lives by providing more of what we can currently deliver. In many places, the constraint is oxygen.” Less than one month later, The Global Fund announced a COVID-19 Response Mechanism (C19RM), which for the first time enabled governments to apply for oxygen supplies.
And they did.
To date, the Global Fund has invested US$564 million to strengthen medical oxygen supplies across 83 countries. This includes hospital-based oxygen plants, mobile oxygen concentrators, liquid oxygen, pulse oximeters, ventilators, patient monitors, masks, consumables, and more. In Kenya alone, The Global Fund’s US$41.7 million transformed oxygen access across all 47 counties with 22 new oxygen plants, 14 liquid oxygen storage tanks, medical oxygen piping, and medical oxygen cylinders. We have highlighted similar transformational Global Fund investments in Ethiopia, Tanzania, Indonesia, and Syria, and there are many more.
Underscoring The Global Fund’s impact on the SDGs
These oxygen investments are continuing to save lives – according to The Global Fund around 520,000 lives between 2024 and 2026 in 14 countries alone. But many more lives could be saved with more investment. The Fund notes that US$1.2 billion in the next two years could close all oxygen access gaps in the 14 countries saving another 556,000 lives. Oxygen investments are estimated to yield returns between four and 34 times the value invested, depending on the country with two-thirds of the net benefits accruing to children under five.
Imagine the impact across the more than 100 countries with medical oxygen access gaps?
This level of investment will accelerate achievement of the SDG goal for HIV/AIDS, tuberculosis, and malaria as medical oxygen is an essential treatment for severe infections during both acute and chronic stages. We are particularly concerned about recent estimates of the 92 million people living with post-tuberculosis lung disease, many with an unmet need for medical oxygen, like this young girl living in hospital in Kenya because she can’t get oxygen at home, and these young men in Lesotho and India, dependent on NGOs for medical oxygen so they can lead productive lives after recovering from tuberculosis. Oxygen investments will also increase The Global Fund’s impact on other SDGs relating to maternal, newborn, and child survival (SDG 3.1, 3.2), non-communicable disease mortality (3.4), deaths from substance abuse and injury (3.5, 3.6), and universal health coverage (3.8).
The Global Fund is well-positioned for greater oxygen impact
As the largest international funder of medical oxygen support to LMICs and co-chair of the Global Oxygen Alliance (GO₂AL), The Global Fund is well-positioned to continue its leading role. We applaud the recent GO₂AL publication of the world’s first Medical Oxygen Investment Case and the call for $US4 billion to implement its recommendations. We call on global health donors – public and private – to ensure that The Global Fund is fully financed during its 8th Replenishment to continue its vital oxygen work.
We envisage a world where eligible countries can continue to work with The Global Fund to provide the most cost-effective and sustainable oxygen solutions, where support is provided in ways that strengthen local oxygen markets, increase industry competition and price transparency, and improve affordability, and where investments in a well-trained clinical and biomedical engineering workforce to fully operationalize and maintain oxygen equipment are prioritized.
Finally, we thank The Global Fund for its strong and consistent leadership on access to medical oxygen since the height of the COVID-19 pandemic in 2021. Your oxygen investments to date have already reduced immeasurable suffering among patients, their families, and healthcare workers in more than 80 countries. But there is much more work to be done to save lives now and prevent further mass fatalities from oxygen shortages when the next respiratory pandemic strikes. Just how much more work will become clear when the Lancet Global Health Oxygen Commission publishes its report in February 2025.
19 November 2024
Published by Every Breath Counts for The Global Fund 52nd Board Meeting, 19-22 November 2024