An international health organization, The Lancet Global Health Commission, has reported that five billion people, representing 60 per cent of the world’s population, currently lack access to safe, quality, affordable medical oxygen, with the greatest inequities in low- and middle-income countries (LMICs).

The organization revealed this in its new report during the launch of the Lancet Global Health Commission on Medical Oxygen on Tuesday in the United States of America, virtually.

A member of the commission, Leith Greenslade, made the report available to The Guardian in Ibadan on behalf of the Executive Committee of the Lancet Global Health Commission on Medical Oxygen Security. Professor Adegoke Falade from the Faculty of Clinical Sciences, College of Medicine, University of Ibadan, and others were part of the committee.

The report had the theme: “Reducing Global Inequities in Medical Oxygen Access: The Lancet Global Health Commission on Medical Oxygen Security.”

The commission lamented that the wide gaps in access to medical oxygen continue to cause widespread suffering and death.
The report stated that six out of every ten people in the world lack access to safe, quality, affordable medical oxygen, contributing to hundreds of thousands of preventable deaths each year and reducing the quality of life for millions more.

The Lancet Commission stated that, globally, access to medical oxygen is highly inequitable. The need for medical oxygen is high and concentrated in LMICs, while oxygen coverage rates are unacceptably low. In LMICs, pulse oximeters and oxygen are available in just 54 per cent and 58 per cent of general hospitals, respectively.

The report, which provided the world’s first estimates of the large-scale and inequitable distribution of medical oxygen coverage gaps and the cost of closing them, noted that global quantities of oxygen needed are large and rising. It called on governments to collaborate with the Global Oxygen Alliance (GO2AL) to develop national plans to close medical oxygen coverage gaps.

The commission, therefore, urged that pulse oximetry and medical oxygen coverage should be routine indicators in UN databases. It also recommended collaboration to increase investment in 20 priority areas for oxygen innovation and new tools to measure and evaluate Oxygen Coverage Indicators, among other things.

The report said: “Five billion people, 60 per cent of the world’s population, do not currently have access to safe, quality, affordable medical oxygen, with the greatest inequities in low- and middle-income countries (LMICs).

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“Each year, 374 million newborns, 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 (COPD).

“Less than one in three (30 per cent) people who need oxygen for acute medical or surgical conditions receive it due to gaps in service contact, readiness, provision, and quality. Coverage gaps are even higher in Sub-Saharan Africa (91 per cent), South Asia (78 per cent), East Asia and the Pacific (74 per cent).

“Pulse oximeters and oxygen are available in just 54 per cent and 58 per cent of LMIC general hospitals and in 83 per cent and 86 per cent of tertiary hospitals, respectively, with frequent shortages and equipment breakdowns. They are practically non-existent in primary healthcare facilities.

“Even when available, pulse oximetry is provided infrequently to unwell patients attending LMIC general hospitals (19 per cent) or tertiary hospitals (54 per cent), and only 45 per cent of patients with hypoxemia in general hospitals and 79 per cent in tertiary hospitals receive oxygen therapy.

“Pulse oximetry is the gateway to safe, quality, affordable oxygen care and needs to be integrated into clinical guidelines and education, and routinely used to assess patients at all levels of healthcare.

“Global quantities of oxygen needed are large and rising. Patients with acute medical and surgical needs require a minimum of 1.2 billion cubic meters (Nm³) of medical oxygen annually, while the need for long-term oxygen therapy (COPD) is 3.2 billion cubic meters.

“Global costs to fill oxygen coverage gaps are large. An additional $6.8 billion is needed annually to close oxygen coverage gaps in LMICs, equating to $34 billion between 2025 and 2030. This does not include the substantial cost to meet the additional oxygen needed for pandemics.

“Oxygen represents a highly cost-effective investment. The case for investing in medical oxygen is strong—it is as cost-effective as routine childhood immunization. It will accelerate progress on eight of the nine health-related Sustainable Development Goals (SDGs) and strengthen pandemic preparedness and response.”

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The Lancet Global Health Commission on Medical Oxygen Security provides a thorough exploration of current medical oxygen coverage gaps, with recommendations to ensure that no patient dies due to a lack of access to this essential medicine, including during public health emergencies like COVID-19.

The commission was led by 18 commissioners—multidisciplinary academics with clinical, economic, engineering, epidemiological, and public policy expertise—representing all regions of the world. Forty advisors representing the United Nations and global health agencies, donors, academic institutions, and non-governmental organizations provided guidance to the 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.

An Executive Committee coordinated the work of the commission and included representatives from Makerere University, Uganda; the International Centre for Diarrheal Disease Research, Bangladesh; Murdoch Children’s Research Institute (MCRI), Australia; Karolinska Institutet, Sweden; and the Every Breath Counts Coalition.