OPEN LETTER to the Access to COVID-19 Tools Accelerator (ACT-A) Facilitation Council

OPEN LETTER to the Access to COVID-19 Tools Accelerator (ACT-A) Facilitation Council


Credit: LifeBank Nigeria

28 September 2020

Dear ACT-A Facilitation Council,

We are writing to underscore the critical role of access to medical oxygen in reducing deaths from COVID-19 across low- and middle-income countries (LMICs), and to appeal to the Access to COVID-19 Tools (ACT) Accelerator Facilitation Council to guarantee significant, additional financial support is provided to help LMIC governments ensure that no COVID-19 patient dies for lack of medical oxygen.

Oxygen is an “essential medicine”, according to the World Health Organization, but it is an essential medicine in name only for far too many. Evidence to date suggests that about 1 in 5 COVID-19 patients will need oxygen – and a lot of it. 

The surge in demand has exposed major cracks in medical oxygen infrastructure across Latin America, Asia and Africa. Since June, we’ve seen credible reports of lack of access to oxygen in Peru, Mexico, Bolivia, Afghanistan, Iraq, Pakistan, Nepal, Nigeria, Guinea, the Democratic Republic of Congo, Somalia, South Africa and most recently India, where the Union government has just stepped in.

To meet the escalating demand for oxygen, governments are expected to equip hospitals with oxygen in record time; companies are being asked to ramp up supply to meet demand; and global health leaders are being called on to help countries by providing oxygen equipment and financial support.

This should not have surprised us. Even before the pandemic there was a growing body of studies that showed large patient populations were not receiving medical oxygen – including newborns, children hospitalized with pneumonia and other conditions, older patients with chronic diseases, patients requiring surgery, and others. These studies documented many reasons for the lack of oxygen. They found no one actor was responsible and concluded that many actors needed to coordinate their efforts to close the gaps.

Last week the Every Breath Counts Coalition and the Access to Medicine Foundation convened leading medical oxygen companies, their investors and global health and development agencies to accelerate coordinated action. There is strong commitment from all parties to collaborate to close the access to oxygen gaps, but financing remains a challenge. The inclusion of oxygen in the Health Systems Connector Pillar of the ACT Accelerator is an opportunity to address oxygen gaps in partnership with LMIC governments. We look forward to working closely with the pillar co-chairs, the World Bank and the Global Fund, to make rapid progress.

We stress that investments in medical oxygen will not only reduce deaths from COVID-19, but from many other causes, enabling countries to accelerate achievement of most of the health-related Sustainable Development Goals by 2030. Oxygen is one of those rare health interventions that can play a part in reducing deaths during childbirth and childhood, from both communicable and non-communicable diseases, and from road traffic accidents.

We are living through one of the most promising periods of medical innovation in history. Scientists, companies and governments are sharing information like never before, and collaborating in unprecedented ways. We urge you to make sure we don’t miss this opportunity to make advances in access to medical oxygen and wish you every success at your meeting on 30 September at the United Nations General Assembly to rally more support for the global coronavirus response – including for oxygen.


Every Breath Counts is a coalition of governments, United Nations and multilateral agencies, companies, foundations, non-government organizations (NGOs) and academic institutions supporting low and middle-income countries to reduce deaths from pneumonia, including from COVID-19.