Our work on medical oxygenShare
In the battle against the COVID-19 pandemic, many low- and middle-income countries are facing major medical oxygen shortages. We are working to move the medical gas industry with global health organisations, investors and policy makers to permanently close the gaps in access to this essential medical treatment.
The need for medical oxygen is urgent and chronic
Oxygen is critical in the treatment of pneumonia, which claims the lives of more than 672,000 children under 5 every year. The pandemic has exacerbated an already dire situation with one in five COVID-19 patients needing access to oxygen in vast quantities.
Despite medical oxygen being listed by the World Health Organization (WHO) as an “essential medicine,” wide gaps in access remain in healthcare systems in most low- and middle-income countries (LMICs) such as India and Brazil, including issues of affordability and sufficient supply.
To meet pressing needs and tackle the pandemic, latest estimates show that around 1 million COVID-19 patients in LMICs require a total of over 2 million cylinders of oxygen per day—a number that continues to grow as COVID-19 case counts rise. Almost half of hospitals in LMICs have an inconsistent supply of medical oxygen or lack it entirely. Currently, approximately 50 LMICs are facing spikes in demand.
At the Access to Medicine Foundation, we are working for change with the medical gas industry, drawing on our experience moving the pharmaceutical industry on issues of access to medicines, vaccines and diagnostics.
How we drive change:
- Build consensus on where pharmaceutical companies can and should be taking action to improve access to medicine and curb AMR. Every two years, we translate the stakeholder consensus into clear metrics for measuring company behaviour, which we publish in our methodology reports.
- Stimulate competition by identifying the best performers on access to medicine and AMR and publicly recognising companies’ positive actions. This triggers other companies to join a “race to do well” on priority health targets and topics.
- Share best practices identified through our research, in order to facilitate the wider application of best practices and the development of new approaches to long-standing barriers to access.
Read more about our three-part change-making model.
How we are closing oxygen gaps
We are engaging with different stakeholders to explore concrete opportunities to increase access to medical oxygen in LMICs in the context of COVID-19 and the broader achievement of the SDGs.
In partnership with the Every Breath Counts Coalition, we are bringing medical oxygen companies to the table for the first time with the key stakeholders working on the access issue.
We bring forward our expertise in mobilising industry as a member of the Access to COVID-19 Tools Accelerator (ACT-A) Oxygen Emergency Taskforce, co-chaired by Unitaid and Wellcome Trust.
By coordinating with over 150 investors, we are rallying the strongest support for ACT-A from the global financial community to date.
When called on by global media, we shed light on the supply and infrastructure factors that can lead to a lack of access to medical oxygen, and highlight the actions needed.
Roundtables bring oxygen companies to the table
In response to the access to medical oxygen crisis, the Access to Medicine Foundation and the Every Breath Counts Coalition co-hosted a series of first-of-a-kind virtual roundtables with industry, investors, and global health agencies to explore opportunities to increase access to medical oxygen in LMICs. The roundtables bring together representatives from nine medical gas companies with corporate investors and global health agencies to mobilise on the access to medical oxygen challenge.
The regular roundtables build continuous momentum toward closing medical oxygen gaps in health facilities in LMICs with high and rising COVID-19 cases counts. The first roundtable pooled perspectives for the first time from the different actors and began building up trust. The second introduced new stakeholders to the conversation and created space to discuss specific partnership proposals. The third roundtable marked a milestone for turning words into action, following a series of bilateral discussions between the participants.
The roundtable series produced a list of 10 action items to improve access to medical oxygen.
10 key actions to improve access to medical oxygen:
1. Increase LMIC oxygen demand
2. Signal corporate boards
3. Develop corporate KPIs
4. Quantify oxygen gaps
5. Finance oxygen infrastructure
6. Finance oxygen workforce
7. Stimulate oxygen innovation
8. Strike oxygen partnerships
9. Advocate for oxygen
10. Keep oxygen stakeholders engaged
Priority actions for governments
The Access to Medicine Foundation is a member of the COVID-19 Oxygen Emergency Taskforce, which was launched in February 2021 as part of ACT-A. Within this taskforce, the Foundation works to mobilise action to close oxygen gaps alongside partner organisations including Unitaid, the Wellcome Trust, WHO, Unicef, The Global Fund, USAID, the World Bank, UNOPS, the Every Breath Counts coalition, CHAI, PATH, Save the Children, and The Bill and Melinda Gates Foundation.
In support of this, in May of 2021, the Access to Medicine Foundation and the Every Breath Counts Coalition called on G7 leaders to take immediate action to ensure that LMICs have the medical oxygen they need to treat all patients during the pandemic. The G7 are well-positioned to engage with the leading medical gas companies as they are headquartered in G7 countries, including Air Liquide (France), Messer Group (Germany), SOL Group (Italy), Taiyo Nippon Sanso Corporation (Japan), Linde Group (United Kingdom), and Air Products (USA). G7 engagement with all of the major medical gas companies can ensure coordinated action to help end the oxygen crisis in India and prevent others.
The call urges G7 leaders to engage with medical gas companies and to finance the existing ACT-A Oxygen Emergency Taskforce to respond quickly to requests for more oxygen and resources from LMICs. An initial immediate injection of USD 200 million from the G7 would enable the Taskforce to alleviate imminent medical oxygen shortages and related deaths within days.
Read the full call to action here.
Inclusion of medical oxygen in ACT-A response to COVID-19, supported by 150+ leading investors
Investors around the globe use the Access to Medicine Index to improve their knowledge of how medical oxygen companies manage risks and opportunities related to access-to-medicine and antimicrobial resistance (AMR). As part of the Foundation's pandemic response, we coordinated a COVID-centered investor statement calling for fair and equitable access to COVID-19 vaccines and treatments.
Among the demands in the statement: full funding of the ACT-A initiative. The WHO recently called for US$90 million in immediate funding to address shortages in 20 countries and a total of US$1.6 billion over the next 12 months as part of the ACT-A initiative. Medical oxygen, along with vaccines, therapeutics, diagnostics, and personal protective equipment (PPE) – are among the tools named in the initiative.
What are the investors calling for?
In the statement, the signatories set out three actions to mitigate risks posed by new virus strains and by the funding shortfalls and production gaps that prevent billions of people from receiving COVID-19 tools:
- Finance the ACT Accelerator in full: The signatories encourage world leaders in the G7, G20 and ACT Accelerator Facilitation Council to finance the ACT Accelerator in full and deploy adequate funding to ensure fair and equitable access to COVID-19 tools globally;
- Stimulate investee companies to do more: The signatories also pledge to work with the Access to Medicine Foundation and engage with investee healthcare companies to support the ACT Accelerator, for example through cross-industry partnerships to accelerate R&D and expand production, equitable pricing strategies, and voluntary licensing agreements; and
- Explore innovative finance mechanisms: The third action is for governments and international organisations. They are called on to explore the feasibility of innovative finance mechanisms for national and global COVID-19 responses, similar to new vaccine bonds or social bonds being issued for COVID-19 programmes.
Investors issue urgent call for “fair and equitable” global response to COVID-19
Almost 150 institutional investors have issued a joint call for a fair and equitable global response to the pandemic, including through fully financing the ACT Accelerator partnership dedicated to developing, producing and ensuring equitable access to COVID-19 tools.
By engaging media outlets on the topic of medical oxygen, the Access to Medicine Foundation aims to highlight critical access gaps, motivate industry to respond accordingly to emergency needs, and help secure further funding for ACT-A's Oxygen Emergency Taskforce to support the global response.
Click below to see a selection of media coverage on our work surrounding access to medical oxygen.
- In a viewpoint for Fortune Magazine, Access to Medicine Foundation Executive Director Jayasree K. Iyer addresses the urgent need for medical oxygen in LMICs, examining the role of pharmaceutical companies and how existing needs amplified due to COVID-19. Click to read the full article.
- In this episode of the BBC World Service, Jayasree K. Iyer joins host Julian Worricker 34 minutes in to discuss the worldwide shortage of medical oxygen, how the pandemic has exasperated existing oxygen shortages, and the logistical problems of supply and delivery in many LMICs. Click to listen to the full interview.
- The Economist's 'Daily Chart' covers the dwindling supply of medical oxygen available in low- and middle-income countries. The article quotes Jayasree K. Iyer about specific actions governments and others can take to improve access to medical oxygen. Click to read the full article.
- Lianna Matt McLemon for CIDRAP writes about the shortage of medical oxygen that has been exacerbated by COVD-19, especially for those in LMICs. Addressing how the shortage is being handled, the author refers to a February editorial in Fortune Magazine written by Jayasree K. Iyer in which Jayasree makes a specific call to action for medical oxygen manufacturers to ramp up access to this essential medicine where it is needed most. Click to read the full article.
- Dean Kirby for inews.co.uk examines the worldwide oxygen shortage that has most impacted LMICs during the pandemic. Margo Warren, Government Engagement and Policy Manager for the Access to Medicine Foundation, explains the reasons behind the shortage, including "overburdened rural clinics requiring equipment and skills to keep oxygen flowing, and a lack of consistent supplies." Click to read the full article.
- Cecilia Barría for BBC Mundo investigates the grave shortage of medical oxygen in LMICs, focusing on the current crises in India and Latin America. The author examines the reasons for the shortage — including the complicated production, transportation, and distribution of the essential medicine — and the fact that only three companies produce nearly 70% of the world's medical oxygen. Jayasree K. Iyer is quoted in the article. Click to read the full article.
- In this episode of BBC Newshour, the daily current affairs programme on the BBC World Service, Margo Warren, Government Engagement and Policy Manager joins host Julian Marshall to discuss the pressing medical oxygen crisis in India and many LMICs. Click to listen to the full interview.
- In this episode of CBC's Canada Tonight, Margo Warren joins host Asha Tomlinson to discuss medical oxygen shortages in India and other LMICs. Click to watch the full interview.
Following the third Access to Medical Oxygen Roundtable, an agreement brokered by Unitaid and CHAI under the ACT-A Oxygen Emergency Taskforce was announced with two of the world’s largest medical oxygen suppliers. Two memoranda of understanding, one with Air Liquide and another with Linde, pave the way for increased oxygen supply in the context of COVID-19.
The Foundation is exploring long-term approaches to measuring and incentivising ongoing and sustainable industry responses to meet identified medical oxygen needs in LMICs.
Our work to improve access to medicial oxygen in low- and middle-income countries is part of our 3-part change-making model. Click here to read more about how we work every day to improve access to medicine around the globe.