Medical Oxygen Crisis

Oxygen saves lives – but is still in short supply

COVID-19 caused a massive burden of respiratory infections around the world, pushing health care systems to breaking point and disrupting routine health services. More than 7 million COVID-19 deaths have been reported to the World Health Organization (WHO), but the true death toll could be more than three times higher. WHO-reported COVID-19 deaths increased all-cause pneumonia deaths to a massive 6 million in 2021. No other infection causes anywhere near this burden of death.

A lack of equitable access to vaccines, diagnostics, and medicines is the primary reason the COVID-19 response in low- and middle-income countries (LMICs) lagged so far behind. Nowhere was this disparity more evident than in the case of medical oxygen. Access to medical oxygen had been a serious but neglected challenge in LMICs for decades and most countries entered the pandemic ill-equipped to respond to the massive demand for oxygen.

As the need for medical oxygen surged along with COVID infection rates, hospitals ran out of medical oxygen or came perilously close in every region of the world. Forced to search for oxygen on the private market, families faced high out-of-pocket costs. If they could not find oxygen, which happened in many countries, their loved ones died.

The international effort to help LMICs increase oxygen supplies kicked in during the first quarter of 2021 and was coordinated by the ACT-Accelerator (ACT-A) Oxygen Emergency Taskforce, co-chaired by Unitaid and the Wellcome Trust. Since its establishment, the taskforce has provided around $US 1 billion worth of oxygen supplies to more than 100 countries, including liquid oxygen, oxygen plants, and concentrators. It has brought the largest oxygen suppliers to the table and mobilized a network of non-profit agencies with oxygen expertise to support LMIC health ministries and governments.

The oxygen crisis is far from over. With patients still dying for lack of access to medical oxygen in many countries, and a 66% chance of another respiratory pandemic in the next 25 years, the taskforce will continue its vital work as the Global Oxygen Alliance, led by Unitaid, The Global Fund, PAHO and the Africa CDC. The Global Oxygen Alliance needs to mobilize billions more to continue its work. G20 nations and private philanthropists are well-placed to strengthen the international oxygen response enabling countries to make faster progress to achieving the Sustainable Development Goals for health and fortifying their health systems to be ready for the next pandemic.

Investing in oxygen will save lives now – especially for newborns and children with pneumonia, adults with infectious and chronic conditions, and patients requiring surgery – and better prepare countries for the next pandemic.

COVID-19 Oxygen Needs Tracker

Medical oxygen access has been a long-neglected element of health systems, despite being an essential treatment for a wide range of diseases and conditions. The COVID-19 pandemic exposed the vital role of medical oxygen as a life-saving therapy for patients struggling to breathe when so many health facilities were unequipped to meet the rising demand.

Almost half of all hospitals in low-resource settings have an inconsistent supply of medical oxygen, or lack it entirely, according to WHO. More than ever, timely and robust planning for reliable oxygen delivery is needed to protect and save lives.

Critical questions

During the COVID-19 pandemic, many governments and their national, regional, and international partners struggled to respond to the tidal wave of patients needing respiratory care, and ensure that health systems continued to function for non-COVID patients.

During this period, the Every Breath Counts Coalition met weekly to strategize and mobilize solutions to meet the rising needs across Latin America, Asia, Africa, the Middle East, and parts of Eastern Europe. We invited experts to join us to answer tough questions.

Below is a record of some of the most critical questions and their answers. We thank the many experts who joined us over this intense period to share their expertise and candid views on the many ways health systems need to change to cater to the needs of patients in respiratory distress, no matter the cause.

Q: How to protect maternal, newborn, child and adolescent health and nutrition services in low- and middle-income countries during the COVID-19 pandemic?

Read answer from John Borrazzo, Senior Health Specialist at the Global Financing Facility

Q: How do we prioritize invasive versus less-invasive respiratory therapies in low-resource settings?

Read answer from Tim Baker, critical care doctor affiliated with Karolinska Institutet in Sweden & Muhimbili University of Health & Allied Sciences in Tanzania

Q: How can international actors best support local manufacturing of WHO-recommended COVID-19 technologies, where appropriate and feasible?

Read answer from Dr Paulin Banguti, University of Rwanda, King Faisal Hospital & Rwanda Society of Anesthesiologists

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