Open Letter to Leaders of Global Coronavirus Response on Access to Medical Oxygen

Open Letter to Leaders of Global Coronavirus Response on Access to Medical Oxygen

Photo credit: Newborn Foundation

8 May 2020

Dear Leaders,

The Every Breath Counts Coalition applauds your efforts to rally an effective global response to the COVID-19 pandemic and welcomes the announcement of the Access to COVID-19 Tools (ACT) Accelerator and the €7.4 billion pledged to “accelerate equitable global access to safe, quality, effective, and affordable COVID-19 vaccines, diagnostics, and therapeutics”.

While it is vital that new vaccines, diagnostics, and therapeutics for COVID-19 are developed, it is access to medical oxygen and related technologies (e.g., pulse oximetry) that will be critical to mitigate the impact of COVID-19 in low- and middle-income countries (LMICs). 

Accordingly, the Every Breath Counts Coalition calls on the governments and global health agencies* who are supporting the ACT Accelerator to invest in robust, cross-cutting health system strengthening efforts that accelerate access to medical oxygen and related technologies in LMICs. 

These investments should ensure that the tools recommended by the World Health Organization (WHO) in the COVID-19 disease commodity package (e.g., pulse oximeters, oxygen concentrators, CPAP/BiPAP, ventilators, laryngoscopes, endotracheal tubes, resuscitators etc) are available at all facilities caring for patients with COVID-19 and that health workers are trained to use them safely.  

If these technologies are deployed with training and support, not only will COVID-19 mortality be substantially reduced, but as the pandemic subsides deaths from the many other causes that require oxygen therapy will also fall, including from pneumonia, which remains the leading cause of death in many LMICs.

Decades of underinvestment in access to medical oxygen in LMICS have rendered health systems extremely vulnerable to a respiratory pandemic like COVID-19. A recent study in Nigeria found extremely low levels of access to functioning pulse oximeters and oxygen in hospitals, and inadequate care practices even where equipment was available. The study concluded that lack of access to oxygen contributes to substantial excess mortality.

The need to equip health systems in LMICs to provide oxygen therapies effectively could not be more urgent.

COVID-19 is spreading rapidly in LMICs. In the month of April, confirmed cases rose twelvefold in Southeast Asia, from 4,115 to 54,021, and sixfold in Africa, from 3,786 to 24,713, according to WHO. While the world waits for new vaccines and medicines that can prevent and treat COVID-19 (hopefully not for long), these countries will rely on oxygen therapies to keep people alive.

Our Coalition is committed to working in solidarity with global, regional and national actors to minimize the impact of COVID-19 in LMICs and to ensure that the global coronavirus response benefits the world’s most vulnerable populations in ways that strengthen health systems for the long-term.


*European Union, Canada, France, Germany, Italy (incoming G20 presidency), Japan, the Kingdom of Saudi Arabia (holding the G20 presidency), Norway, Spain and the United Kingdom, and the Bill & Melinda Gates Foundation, the Coalition for Epidemic Preparedness Innovations (CEPI), the Developing Countries Vaccine Manufacturers Network (DCVMN), Gavi, Global Fund, the International Federation of Pharmaceutical Manufacturers & Associations (IFPMA), the International Generic and Biosimilar Medicines Association (IGBA), Unitaid, Wellcome Trust, and WHO.