No one would hesitate to agree that without the availability of medical oxygen, the recent Covid-19 pandemic would have been a catastrophe beyond our imagination, despite the global scientific triumph in vaccination. While medical oxygen did get urgent attention during the Covid-19 crisis, with our pandemic memory slowly fading, the neglect of medical oxygen as essential medicine is yet again putting our health security preparedness at high risk.
As routine health care delivery including healthy aging, accident emergencies, surgeries, trauma, heart failure, asthma, pneumonia, and maternal and childcare, also banks on the availability of adequate medical oxygen supply, it is critical to recognise that medical oxygen therapy is a life-saving intervention, be it in crises or peacetime.
Recent research estimates that improved oxygen delivery systems could reduce childhood pneumonia deaths by 35%, and up to 400,000 newborns could be saved annually with antibiotics and supportive care, including oxygen therapy. The economic case for investing in medical oxygen is also compelling. The cost-benefit analysis of oxygen therapy, especially when paired with pulse oximetry can amplify the impact of other well-established interventions such as vaccines in reducing mortality from pneumonia.
In most countries, there is an urgent need to focus on ramping up medical oxygen production. A resolution adopted by 164 World Health Organization (WHO) member States during the pandemic led to surge investments by governments and multilaterals towards increasing access to medical oxygen but an estimated $1 billion global funding gap remains. The cylinders, concentrators, bulk storage tanks and oxygen production plants established during the pandemic need consistent maintenance and specially trained health workers need repeat training and regular re-certification.
While the need cannot be emphasised enough, the real problem, especially in the Global South, has always been access. It is also important to recognize that countries in the Global South are at different stages in enabling oxygen access. Some, such as island and archipelago nations like Indonesia, Fiji, and Papua New Guinea, face geographical challenges that require tailored interventions.
Fragmented funding and global market dynamics, coupled with inadequate planning within health systems, complicate access to continuous oxygen for routine peacetime needs. Insufficient data, the perception of high costs, and a lack of understanding of integrating and maintaining medical oxygen within health systems compound the issue. To add to this, there is a shortage of trained health care workers and engineers, and infrastructure issues such as unreliable electricity and poor logistical framework lead to difficulties in maintaining a steady oxygen supply. Therefore, we must view medical oxygen as part of a broader ecosystem that encompasses production, distribution, infrastructure, and workforce capacity.
There is an urgent need to map oxygen demand and supply and provide technical support to develop country-specific costed oxygen roadmaps for medical oxygen. Existing tools such as the WHO’s Oxygen Systems Applications and PATH’s Oxygen Delivery Toolkit are helpful, but no single tool fits all. Countries should be supported based on their specific context and needs, ensuring rapid and relevant resource mobilisation. At the same time, cross-country discussions especially south-south collaborations are vital for sharing knowledge and strategies for oxygen scale-up.
Experts predict a 66% chance of another respiratory pandemic, that could result in over 10 million deaths in the next 25 years. A strong response strategy would require more than just access to medical oxygen. It demands a supportive environment where policy frameworks, financing, leadership, and data management work together. The short-term emergency response efforts to boost oxygen access must now be transformed into integrated, long-term strategies.
It is important to acknowledge that global pandemic-related external funding is on the decline. It is time that countries allocate domestic resources and health aid funding to bridge funding gaps. Investing in oxygen infrastructure, be it liquid oxygen supplies, expanding technical capacity, or ensuring safe use, will pay off in lives saved. Oxygen access must be prioritised from a future pandemic preparedness perspective as well as in managing current health challenges across multiple disease conditions. Isn’t it time that we imminently paid attention to how we would build a strengthened health system where essential medicines like medical oxygen are readily available to serve us equally well in peace today and crisis tomorrow?
For more information on PATH’s work on medical oxygen, click here.
This article is authored by Jayendra Kasar, senior programme officer and Ankur Mutreja, director of strategy, partnerships, and communications, PATH.
