Source: Shutterstock
Source: Shutterstock

Oxygen access need ‘not ended with pandemic’

Continued investment and technical support for the expansion, operation and maintenance of oxygen infrastructure are still urgently needed to improve overall health outcomes and achieve universal health coverage, according to Unitaid.

In a joint opinion editorial from Executive Director Philippe Duneton, Takeshi Akahori, Ambassador and Assistant Minister for Global Issues in the Ministry of Foreign Affairs of Japan, and Patrick Amoth, Acting Director General for Health of Kenya, the trio underline why the issue of oxygen access – which received much prominence during COVID-19 – remains after the pandemic.

An enduring reality is that, in many health facilities around the world, access to lifesaving medical oxygen is often unavailable and underfunded.

“Medical oxygen is essential for surgery as well as emergency and critical care, and for treating severe respiratory illnesses, including COVID-19 and pneumonia, the leading cause of death of children under five,” the article states.

“It is also critical for treating pregnant women with complications, newborns in respiratory distress and people with severe malaria, advanced HIV and tuberculosis, among other critical health issues.”

The strengthening of oxygen systems worldwide could cut hospital-based pneumonia deaths among children by half and overall hospital deaths of under fives by a quarter. This would make it possible to achieve the global infant mortality rate target of fewer than 25 deaths per 1,000 live births.

Even before the pandemic put oxygen in the headlines, severe shortages of medical oxygen had been a problem for decades. Fewer than half of health facilities in low- and middle-income countries had uninterrupted access.

Of the 7.2 million children who typically had a critical need for medical oxygen each year to treat pneumonia in low- and middle-income countries, only one in five received it, the article notes.

COVID-19 made these problems much worse.

Within a matter of weeks, the number of people needing medical oxygen to live increased tenfold. Many hospitals ran out of supplies, leading to countless preventable deaths.

While it is unknown how many of the 25 million deaths as a result of the COVID-19 pandemic were due to a lack of oxygen, studies have shown that hypoxemia, or low levels of oxygen in the blood, was a major cause of death from COVID-19 in low-resource settings.

The need for medical oxygen suddenly became painfully clear, and the world scrambled to respond.

Taskforce response

Health institutions, co-led by Unitaid, launched the Oxygen Emergency Taskforce as part of a ground-breaking collaboration with the Global Fund to Fight AIDS, Tuberculosis and Malaria and the World Health Organisation (WHO) to ensure equitable access to COVID-19 vaccines, treatments and diagnostics.

The task force raised more than $1bn to boost access to medical oxygen, secured price reductions from two major suppliers (Air Liquide and Linde) of approximately 22% for liquid oxygen and 43% for cylinders and cylinder filling, and helped more than 100 countries upgrade their treatment facilities.

To promote long-term equitable access and sustainability, the task force also supported more than 120 countries to assess their oxygen needs and to prioritize medical oxygen in their national health plans.

Japan, which has long invested in strengthening health systems across Africa and Asia in support of universal health coverage, immediately delivered oxygen concentrators and provided training for the hardest-hit countries.

Kenya, with funding from Unitaid, repaired and installed oxygen plants, tanks and piping in medical facilities, trained biomedical engineers and health care workers, and became one of the first countries to expand the use of bulk liquid oxygen to reach more patients.

At last year’s World Health Assembly, all 194 WHO member states backed the Increasing Access to Medical Oxygen Resolution. At the Group of Seven summit in Hiroshima, Japan, last May, leaders emphasised their commitment to achieving more resilient, equitable and sustainable universal coverage through strengthening health systems, and to promoting health innovation, including enhancing equitable access to medical countermeasures.

In May, the Oxygen Emergency Taskforce evolved into the Global Oxygen Alliance, a broader and more inclusive partnership that includes about 20 health partners and representatives from civil society and affected communities.

Co-led by Unitaid and the Global Fund to Fight AIDS, Tuberculosis and Malaria, the new alliance is supporting countries to expand equitable and sustainable access to affordable oxygen, particularly in Africa, Latin America and Asia.

This includes establishing public-private partnerships to provide broader technology transfers, capacity-building, new equipment and quality control help from countries like Japan for manufacturers in low- and middle-income countries to strengthen regional production and sustainability.

With disease forecasters saying there is a 30% chance of another respiratory-based pandemic within the next decade, strengthening access and supplies of medical oxygen for everyone, everywhere, is imperative.

For the millions of people in need of lifesaving oxygen today, from premature babies struggling to breathe to children with pneumonia to people with severe tuberculosis, the solution is obvious. With oxygen, they will live.

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