Oxygen is a lifesaving medicine with no substitute—it is essential across ages, countries, and diseases. Prioritizing access to medical oxygen and pulse oximetry is vital to ensure every patient receives the appropriate respiratory care at the right time.
Just over a year ago, all 164 Member States adopted the World Health Organization (WHO) resolution on increasing access to medical oxygen during the 76th World Health Assembly. And now, just a few weeks ago, 63 Member States and other partner organizations came together at the first-ever WHO National Oxygen Scale-Up Framework Meeting: Road to Oxygen Access, in Dakar, Senegal, to review and agree on a comprehensive framework for national oxygen plans or strategies that is adaptable to country context.
Both milestones demonstrate global and country commitment to improving sustainable oxygen ecosystems, but more needs to be done. Listed below are a few key reflections from the meeting and what should remain at the top of the global oxygen agenda.
1. Meet countries “where they are at” with scaling oxygen
This meeting highlighted that countries are at different phases in their oxygen scale-up efforts and that each requires a mix of interventions to achieve reliable oxygen access. Some countries may primarily rely on oxygen concentrators or cylinders at tertiary hospitals, whereas other countries may use liquid oxygen or oxygen generation plants for supply throughout the health system. This means activities to improve oxygen access will look different for each country. For example, when calculating the oxygen need gap, the process will be different for a country doing it for the first time versus a country that is leveraging an established equipment management system and oxygen progress indicators.
This also means that different countries will require diverse support as well as a variety of adaptable tools to advance oxygen access. It is encouraging that so many such tools exist, from WHO’s new Oxygen Systems Applications to UNICEF’s Oxygen System Planning Tool to PATH’s Oxygen Delivery Toolkit. However, it is unlikely that one tool or guidance document would be “one-size-fits-all” and fully applicable or adaptable to all country contexts. Countries need to be met where they are at in order to most effectively identify their specific needs, characterize them, and then quickly mobilize resources to provide the best support. This new template is an encouraging step, providing a structured yet adaptable framework—but any support or guidance given to countries must be tailored to their needs and context.
PATH staff peruse the poster showcase at the National Oxygen Scale-Up Framework Meeting, learning about different partners’ activities in scaling oxygen access. Photo: World Health Organization; MLD Design.
2. Amplify advocacy and sustainable financing to improve oxygen access
While the meeting demonstrated a shared commitment and motivation across countries to improve access to medical oxygen, there was a general recognition that sustainable financing is a challenge. As external oxygen financing opportunities wane alongside the pandemic response, countries are at risk of falling behind in the commitments laid out in last year’s oxygen resolution. It may take multiple approaches to meet the gap of any funding shortfall before countries can realize the priorities laid out in their national oxygen plans.
First, countries must allocate their own domestic funding and resources to develop a national oxygen ecosystem, particularly building from any previous donor-funded pandemic efforts, for maximum impact. Countries can also leverage other grant mechanisms—through the Pandemic Fund, the Global Fund, or the Global Financing Facility, for example—for additional funding needs. And where necessary, countries should take initiative to request funding directly from donors to support scaling oxygen and ensure continued donor commitment for improving oxygen access.
Prioritizing this issue will be the key to its success. Ministries of health and civil society must continue to advocate for the inclusion of both medical oxygen and pulse oximetry in national budgets. For all these efforts, a national oxygen plan can provide a roadmap for meeting funding needs in a sustainable way.
3. Reinforce cross-country collaboration and partner engagement around oxygen access
The meeting brought together new and old stakeholders in the oxygen community, including governments, nongovernmental and multilateral organizations, donors, and civil society, allowing for a mix of fresh insights and long-held expertise around scaling up oxygen access. Ultimately, bringing together diverse stakeholders from different country contexts to develop this framework ensured that it was both comprehensive and inclusive.
Having so many countries and partners in the same room together also reenergized shared commitment to improving oxygen access for all. Efforts to continue these critical conversations—to network, collaborate, and learn from one another as countries pursue oxygen scale-up efforts—will be an important tactic. The previous Accelerating Access to Oxygen convening is one such example.
Such convenings would encourage dialogue between countries at different stages of oxygen ecosystem development or between countries who have received varying types of support, and they would allow for deeper conversations on technical topics. Existing platforms via the Global Oxygen Alliance and the Lancet Global Health Commission on Medical Oxygen Security offer that opportunity to engage and collaborate. At the core of this process, governments need to be a key player in partner engagement for the most effective and sustainable outcome.
Inutu Kanyama, PATH oxygen country lead in Zambia, highlights the key takeaways from the breakout sessions on effective partnerships at the National Oxygen Scale-Up Framework Meeting. Photo: World Health Organization; MLD Design.
WHO’s Road to Oxygen Access meeting was a significant milestone in the history of increasing access to medical oxygen and an actionable step in country efforts to meet the WHO resolution on the topic. Closing the oxygen gap will require a shift in national health systems—including improved coordination and policy, increased domestic funding, a skilled workforce, a strong monitoring, quality assurance, and evaluation system, improved equipment procurement and management, and advocacy—to ensure safe and scalable delivery to the patient. The new National Oxygen Scale-Up template will provide a framework for countries to do just this; but governments, donors, implementers, and civil society all must play their part to ensure that universal oxygen access becomes a reality.
Other statements and articles on the WHO Road to Oxygen Access meeting:
- Global Oxygen Alliance. After landmark meeting, leading health organizations reinforce their support for countries to integrate medical oxygen into health system planning.
- Every Breath Counts Coalition and Unitaid NGOs. Calling on all world health organization Member States to develop and finance medical oxygen roadmaps by 2025.
- The Lancet Global Health Commission on Medical Oxygen Security. Milestone medical oxygen meeting an opportunity for countries to make rapid progress on access.
- Réunion sur "le cadre national de développement de l'oxygénothérapie : vers l'accès à l'oxygène." https://fb.watch/ss9Td6Azmk
- Seneplus. Access a l’oxygene dans les structures sanitaires : Un gap à combler.
- Sud Quotidien. Développement de l’oxygénothérapie : l’Oms vers un nouveau modèle.