Humanitarian aid organisation Direct Relief is set to help boost the global medical oxygen supply crisis induced by the ongoing Covid-19 pandemic with a $5m (£3.7m) commitment to supply healthcare providers in under-resourced communities with much-needed oxygen systems.

The commitment adds to more than $15m (£11m) already invested by the organisation for the mitigation of global oxygen shortages, realised through schemes such as its provision of more than 33,000 oxygen concentrators for international healthcare providers. 

As seen in other sectors, the need for medical-grade oxygen and related equipment throughout the pandemic exposed pre-existing weaknesses that were not adequately addressed, such as the scarcity of medical oxygen caused by supply chain logistics. 

These concerns were addressed in ‘unprecedented’ agreements entered into by industrial and medical gas giants Air Liquide and Linde, which aim to provide increased access to medical oxygen in low and middle-income countries. 

Leith Greenslade, Founder and CEO of JustActions and Coordinator of the Every Breath Counts Coalition, spoke to gasworld last year (2021) and commented on the new agreements put in place. 

“A basic pre-requisite during a pandemic is that you have an ongoing dialogue with industry on one of the main solutions for reducing deaths,“ she said. 

“This is the first tangible example of a direct partnership with the oxygen industry, for what the WHO (World Health Organisation) now calls the most essential medicine to treat Covid-19 – oxygen.” 

”…it’s appalling when you put it that way”

“It’s appalling when you put it that way,” she added, “that we went into this pandemic without any kind of partnerships for the essential medicine to treat Covid patients – oxygen.” 

With persistent supply chain disruption causing major issues when it comes to the import of medical oxygen and supplies, a more direct and sustainable route exists in pressure swing adsorption (PSA) plants, which separate oxygen from other gases onsite at hospitals. 

In addition to being non-reliant on a solid import infrastructure, PSA systems can also reduce the initial capital required compared to the cryogenic production of oxygen. 

Conventionally produced centrally at the air separation units (ASUs) before being distributed in either liquid form or as a gas via cylinders, medical oxygen generated using the cryogenic production method has been joined by PSA oxygen concentrators as an increasingly popular method of oxygen generation. 

Linde's PSA plant

Linde’s PSA plant

Source: Linde

Capable of conforming to the requirements of the oxygen 93% monograph, onsite oxygen generators also provide a more sustainable alternative to the large-scale import of medical oxygen by minimising the visits of trucks for oxygen delivery, eliminating the corresponding carbon dioxide (CO2) emissions. 

With no onsite bulk storage requirements, PSA systems also reduce the footprint of physical space and safety considerations. 

Such systems have been introduced at permanent oxygen-generating plants at hospitals funded by Direct Relief in several low to middle-income countries. Further commitments have been made following the organisation joining forces with Every Breath Counts, a public-private coalition comprising UN agencies, businesses, and academic institutions and Build Health International, to build and restore PSA plants. 

The amount of oxygen required in the countries that need it most often means that PSA plants require repair, an example being Dhulikhel Hospital in Nepal last year, which needed 150-200 oxygen cylinders every 24 hours to care for patients in its 136 Covid-19 beds. 

The plant, not operating at full capacity, was only generating 60 cylinders per day, resulting in a joint effort from Direct Relief and Build Health International to diagnose and fix the problem. 

Source: Direct Relief

A collaboration between Direct Relief and Every Breath Counts has helped estimate the need for oxygen in low and middle-income countries. Known as the ‘Find & Fix Map’, the partners collect data and represent it using a map and data dashboard.