A case study undertaken by social justice organisation Partners In Health (PIH) has revealed the importance of increasing the supply of medical grade oxygen in low and middle income countries (LMICs) to treat diseases such as Covid-19, TB, and other chronic conditions.  

Although most developed nations have little to worry about when it comes to supply of medical oxygen, developing countries are still lacking in medical grade oxygen supply and its associated delivery equipment.  

According to PIH, even prior to the heightened demand for oxygen during the Covid-19 pandemic only 10% of hospitals in LMICs had access to pulse oximetry and oxygen therapy. Even then, just 20% of the patients who needed life-saving oxygen actually received it.  

And it’s not only Covid-19 that has necessitated the need for oxygen; in 2020, the disease accounted for less than 25% of the 38 million patients admitted to LMIC hospitals needing oxygen.  

Conditions such as bacterial pneumonia, TB, heart failure, chronic lung disease, and newborn prematurity can all cause low oxygen levels – or hypoxia.  

Having partnered with the Government of Lesotho in 2006, PIH Lesotho (PIH-L), has helped support the country’s medical oxygen independence.  

Before Covid-19, the country had been entirely reliant on imported oxygen from neighbouring South Africa. With supply chains affected during the first outbreak, the mortality rate among Covid-19 patients admitted to treatment centres within the country reached 43%.  

In December 2020, PIH-L opened Lesotho’s first oxygen plant in the city of Botšabelo, which has since produced enough oxygen to treat nearly 500 Covid-19 patients.  

A look inside the Botšabelo oxygen plant

A look inside the Botšabelo oxygen plant

Source: PIH

“We have got so much support from our partners and our government, and we are going to take the opportunity to make sure that we turn around the health system of Lesotho, and that we build a better healthcare system,” commented Motlatsi Maqelepo, Lesotho Minister of Health.  

Through a new Unitaid-funded project, named Building Reliable Integrated and Next Generation Oxygen Services (BRING O2), PIH-L has helped develop a national oxygen plant maintenance plan which aims to train staff to run and maintain oxygen plants.  

The project, developed in partnership with Build Health International (BHI) and Pivot Health Madagascar, intends to accelerate access to safe, reliable, and quality oxygen in Malawi, Rwanda, Peru, Lesotho, and Madagascar.  

So far BRING O2 has purchased two new oxygen production plants and undertaken over 30 on-site technical assessments of existing oxygen plants set to receive repairs later this year.  

Its short and long term goals include installing piping to deliver oxygen to more than 550 hospital beds, establishing regional networks to deliver oxygen to hospitals without oxygen plants, and hiring, training, and educating biomedical technicians and healthcare workers.  

According to the study, with a one-year budget of $7.8m BRING O2 could secure oxygen therapy for approximately 150,000 patients at a cost per patient of $52.  

For under $3m, piped oxygen systems could be installed in every district hospital in Malawi, demonstrating a relatively affordable method of improving treatment outcomes for millions of people in LMICs.