Reducing global inequities in medical oxygen access – report released by The Lancet Global Health Commission on medical oxygen security

In low- and middle-income countries (LMIC), less than one in three people who need oxygen receive it. Global inequities in access to safe, quality, affordable medical oxygen is contributing to hundreds of thousands of preventable deaths each year and reducing quality of life for millions more, according to the report released by The Lancet Global Health Commission on Medical Oxygen Security.

The report, Reducing global inequities in medical oxygen access, provides the world’s first estimates of the large scale and inequitable distribution of medical oxygen coverage gaps and the cost of closing the gaps. It contains specific recommendations for how governments, industry, global health agencies, academic institutions, and civil society can work together to strengthen health systems to guarantee medical oxygen access for all.

The Commission, announced in September 2022, set out to explore existing medical oxygen coverage gaps, and recommend actions to ensure that no patient dies for lack of access to this essential medicine. The report reveals that oxygen is a highly cost-effective investment to advance global public health that will not only accelerate achievement of most of the Sustainable Development Goals (SDGs) for health by 2030, but will also help countries prepare for the next pandemic to prevent a repeat of the COVID-19 oxygen shortages and the mass fatalities that resulted.

The Commission was led by 18 Commissioners – including RESPIRE Co-Director Harry Campbell – with multi-disciplinary expertise across clinical, economic, engineering, epidemiological, and public policy, representing all regions of the world. Forty Advisors representing United Nations and global health agencies, donors, academic institutions, and non-governmental organisations provided guidance to Commissioners.

A large global network of Oxygen Access Collaborators provided constant input to the Commission and included representatives from all sectors, including industry and Ministries of Health. In addition, special consultations were conducted with patients, caregivers, and clinicians to ensure that their voices and experiences shaped the Commission’s recommendations.

RESPIRE partner, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) is one of two LMIC, with Makerere University, who led much of the work of the Commission. Shams Arifeen and Ahmed Ehsanur Rahman (Ehsanur), based at icddr,b coordinated the work of the Commission through their positions on the Executive Committee.

Oxygen has always been a priority area of research for RESPIRE. Initial studies – including Ehsanur’s PhD Studentship – explored the integration of pulse oximetry into the management of childhood illness, which led to RESPIRE being approached by the Ministry of Health (MOH) in Bangladesh to design and implement a national oxygen security survey. 

More recently, research into oxygen preparedness and security has been extended into a multi-country study, with partners in Bhutan, India and Pakistan working in collaboration with researchers from icddr,b and partners in the Bangladesh MOH. In April 2022, Leith Greenslade, member of the Commission’s Executive Committee and coordinator for the Every Breath Counts Coalition, delivered a presentation on the link between medical oxygen and universal health coverage for RESPIRE’s Knowledge Mobilisation Hub.

In 2023, the Commission helped promote and support the development of, and achievement of the World Health Assembly resolution on medical oxygen. This work evolved directly from the past and ongoing work on medical oxygen in RESPIRE, defining best approaches to build national oxygen security and the related methods, skills and tools involved.