6 days ago
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… Say Global Access To Oxygen, Highly Inequitable, Causing Widespread Suffering, Deaths
… 400 Million Children, Adults Require Medical Oxygen Yearly
… Urge Countries To Develop, Invest In National Medical Oxygen Plans
LAGOS – Nigerian Researcher, Prof. Adegoke Falade and 31 other world scientists have stressed the need for countries to develop National Medical Oxygen Plans to meet universal access to medical oxygen by 2030, according to a new Lancet Journal report.
Prof Falade and other researchers made the call in a new report released by The Lancet Global Health Commission on Medical Oxygen Security decrying wide gaps in access to medical oxygen, saying it continues to cause widespread suffering and death.
The report noted that targets for universal access, national roadmaps, and more affordable and accessible care are vital to help fill the medical oxygen gap affecting more than half of the world’s population.
The report is titled, ‘Reducing global inequities in medical oxygen access: the Lancet Global Health Commission on medical oxygen security,’ The Lancet Global Health.
The Lancet Global Health Commission report details for the first time how future investment in strengthening medical oxygen systems could have a huge impact by saving millions of lives and improving pandemic preparedness.
Almost 400 million children and adults require medical oxygen every year. More than five billion people, 60 percent of the world’s population, do not have access to safe and affordable medical oxygen services.
The Commission, co-chaired by Makerere University in Uganda, the International Centre for Diarrheal Disease Research (icddr,b) in Bangladesh, Murdoch Children’s Research Institute (MCRI) in Australia, Karolinska Institute in Sweden and the Every Breath Counts Coalition in the US was launched in 2022 against the backdrop of the COVID-19 pandemic. The Commission was tasked with submitting actionable recommendations for governments, industry, global health agencies, donors, and the healthcare workforce.
MCRI Dr Hamish Graham said the COVID-19 pandemic had put a spotlight on the longstanding global inequities in accessing medical oxygen.
“Oxygen is required at every level of the healthcare system for children and adults with a wide range of acute and chronic conditions,” he said. Previous efforts, including the major investments in response to the COVID-19 pandemic, largely focused on the delivery of equipment to produce more oxygen, neglecting the supporting systems and people required to ensure it was distributed, maintained, and used safely and effectively.”
Dr Graham said channelling investments into national oxygen plans and bolstering health systems, including wider use of pulse oximeters (a small device that measures how much oxygen is in the blood), would help solve the medical oxygen crisis.
“We urgently need to make high-quality, pulse oximeters more affordable and widely accessible,” he said. Pulse oximeters are available in 54 percent of general and 83 percent of tertiary hospitals in low- and middle-income countries, with frequent shortages and equipment breakdowns.
“Concerningly, in these countries, the devices are performed for only 20 percent of patients presenting to general hospitals and almost never for those at primary healthcare facilities. We see the greatest inequities in small and rural government health facilities and across Sub-Saharan Africa.”
Dr. Graham said the importance of medical oxygen must also be recognised and integrated into broader national strategies and pandemic preparedness and response planning.
“Governments should bring together public and private sector partners with a stake in medical oxygen delivery, including health, education, industry, energy, and transport to design a system and set up a governance structure that supports the new Global Oxygen Alliance (GO2AL) and replenishing The Global Fund with a strong oxygen access mandate,” he said.
Key findings from the report published in The Lancet Global Health include: The global need for medical oxygen is high. Every year, 374 million children and adults need medical oxygen, including 364 million patients with acute medical and surgical conditions and nine million patients with long-term oxygen needs due to chronic obstructive pulmonary disease.
Global access to oxygen is highly inequitable with huge gaps in coverage despite pandemic-related investments. Less than one in three people in low- and middle-income countries like Nigeria who need oxygen for acute medical or surgical conditions receives it.
Costs to fill the oxygen gap are large but represent a highly cost-effective investment that will have wide reaching impacts. Closing the large acute medical and surgical oxygen access gap in low- and middle-income countries requires an additional $US6.8 billion annually.
The report noted that National Medical Oxygen Plans are essential to facilitate investment and effectively coordinate service delivery. However, it said that less than 30 countries have developed National Oxygen Plans to date but all governments are encouraged to have one by 2030.
Oxygen systems must be designed to suit the context, include operational costs, and be affordable to all patients. There is no one-size-fits-all national medical oxygen system. Governments should define priorities and optimise their systems to suit local conditions.
Pulse oximetry is the gateway to safe, quality, affordable oxygen care and needs to be integrated into clinical guidelines, education, and all levels of the healthcare system. Pulse oximetry measures should be routinely assessed in patients at all levels of health care.
A need for closer collaboration between the medical oxygen industry, national governments, and global health agencies. Companies should adopt specific oxygen access targets and publish progress while global health agencies should regularly assess the oxygen industry’s progress similar to how the pharmaceutical industry operates.
Accurate and timely data on oxygen systems is essential for effective decision-making and oxygen service access. New tools such as the 10 Oxygen Coverage Indicators and a national Access to Medical Oxygen Scorecard (ATMO2S) would help governments to both plan their national oxygen systems and report progress implementing the WHO Oxygen Resolution.
The report comes after it was announced MCRI would partner with 12 countries in the Pacific and Southeast Asia under a $10 million initiative to improve child and adolescent health across the region.
The Australian Government has awarded MCRI a strategic grant as part of its Partnerships for a Healthy Region Initiative.
The three-year funding will be used to establish the ReALiSE program – the Regional Alliance for Learning in Systems for Equitable Child and Adolescent Health – which will strengthen resilience in public health systems and engage with youth leaders and local communities to improve the health of all young people.
One of the initiatives includes strengthening local health systems data to improve care and the use of oxygen as an essential medicine in Cambodia, Lao PDR, and Papua New Guinea.
A. G. Falade, a Professor of Paediatric Pulmonology at the College of Medicine, University of Ibadan, and an honourary Consultant Paediatrician to University College Hospital, Ibadan, Nigeria is a seasoned researcher with several scholarly publications.
Other researchers involved in the study are Hamish R Graham PhD & Carina King, Ahmed Ehsanur Rahman, Freddy Eric Kitutu, Leith Greenslade, Masooma Aqeel, Tim Baker, Lucio Flavio de Magalhães Brito, Harry Campbell, Karen Czischke and Mike English.
Others are Patricia J Garcia PhD, Mireia Gil MEng, Stephen M Graham, Amy Z Gray, Stephen RC Howie, Niranjan Tex Kissoon MD, Ramanan Laxminarayan, Inês Li Lin, Michael S Lipnick, Dianne B Lowe, David Lowrance, and Eric D McCollum.
The rest are Tisungane Mvalo, Jacquie Oliwa, Stefan Swartling Peterson, Rediet Shimeles Workneh, Heather J Zar, Shams El Arifeen, and Freddie Ssengooba.
English (US) ·