At the height of the COVID-19 pandemic, millions of people in poor countries have literally died out of breath, even in hospitals. What was missing was medical oxygen, which has broken down in a large part of the world.
On Monday, a panel of experts published a full report on the shortage. Each year, indicates the report, more than 370 million people in the world need oxygen in the context of their medical care, but less than 1 in 3 receives it, endangering the health and life of those who do not do not do it. Access to safe and affordable medical oxygen is particularly limited in low and intermediate income countries.
“The need is very urgent,” said Dr. Hamish Graham, pediatrician and principal author of the report. “We know that there are more epidemics to come, and there will be another pandemic, probably like Covid, in the next 15 to 20 years.”
The report, published in Lancet Global Health, comes only a few weeks after the Trump administration froze foreign aid programs, including some that could improve access to oxygen.
Improving the availability of medical oxygen would require an investment of around $ 6.8 billion, noted the report. “In the current climate, this will obviously become a little more challenge,” said Carina King, epidemiologist of infectious diseases at the Karolinska Institute and the main report of the report.
However, she said, governments and financing organizations should prioritize medical oxygen because of its importance between health care. People of all ages may need oxygen for pneumonia and other respiratory conditions, for serious infections, including malaria and sepsis, for surgeries and for chronic pulmonary conditions.
“We do not oppose oxygen to other priorities, but rather that it should be integrated into all these programs and these priorities,” said Dr. King. “It is completely fundamental for a functional health system.”
Medical oxygen has been used for over 100 years, often to treat patients with pneumonia. But it was added to the list of essential drugs of the World Health Organization in 2017.
At the start of the coco-19 cocovid pandemic, each breath counts, a coalition of more than 50 organizations, pushed access to medical oxygen. At the end of 2022, an emergency working group had mobilized more than a billion dollars of medical oxygen equipment and supplies to more than 100 countries.
A country that has made substantial investments in improving access to oxygen is Nigeria, which had taken measures in this direction even before Covid.
Nigeria has implemented approximately 20 profitable factories to generate oxygen on site for hospitals, and explores liquid oxygen factories which can provide large expanses of urban areas, said Dr. Muhammad Ali Pate, Minister of the country’s health and social protection.
Many hospitals have no systems that can provide oxygen reliably, “so it’s a kind of design and a inherited problem that we have to face,” he said. “There is no longer to do.”
The modification of hospital systems to provide oxygen can pose engineering and market problems, and the delivery of oxygen requires an infrastructure which can transport heavy oxygen tanks over long distances.
Even once the oxygen supply is ensured, the equipment to deliver oxygen directly to patients should be regularly maintained and cleaned, and spare parts can take months to be delivered. Health workers must be trained to effectively use the equipment.
“We have seen so much investment in the equipment, but very little investment in the way of operationalizing this equipment in a sustainable manner,” said Dr. King.
Health care establishments also require pulse oxymeters to detect and monitor blood oxygen during treatment. But in low and intermediate income countries, pulse oximetry is used in less than 1 in 5 patients in general hospitals, and it is almost never used in primary health care establishments, depending on the report.
The panel included testimonials from patients, families and health workers who fought with the shortage of oxygen. In Sierra Leone, before the Pandemic Covid-19, only one public hospital in the whole country had a functional oxygen factory, causing thousands of avoidable deaths. In Pakistan, a man with a chronic pulmonary condition said that he had stayed inside and avoided the stairs to prevent his lungs from breaking under tension. He had to borrow money from friends and family to pay the treatment cost of $ 18,000 at home.
In Ethiopia, a doctor was forced to remove oxygen from a patient to treat another who was more desperately sick. “It was very heartbreaking to try to decide who lives and dies,” he said.
