Bridging the gap in access to oxygen: Foundation coordinates on key actions for industry
Oxygen is critical in the treatment of pneumonia, which claims the lives of more than 672,000 children under 5 every year. Further, one in five COVID-19 patients will each need access to oxygen in vast quantities. The Access to Medicine Foundation and the Every Breath Counts Coalition is exploring opportunities to increase access to medical oxygen in low and middle-income countries (LMICs) along with industry, investors, and global health agencies.
Note: This article is updated on a continuous basis to reflect new developments. Please scroll to the end for the latest news announcements.
The issue of access to medical oxygen is urgent and chronic. 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), including issues of affordability and sufficient supply.
To close these gaps, efforts must be coordinated among numerous actors. Closing access to oxygen gaps will not only reduce the death toll from the COVID-19 pandemic, but also help to prevent early deaths from many other causes.
"COVID-19 has revealed that oxygen is an essential medicine in name only for the majority of patients who need it in low and middle-income countries. That’s why the Every Breath Counts Coalition is joining forces with the Access to Medicine Foundation to engage companies, corporate investors and global health agencies to work closely together to increase access to oxygen. These efforts will also reduce deaths from the many other conditions (e.g., neonatal, childhood pneumonia, childbirth, communicable and non-communicable diseases, and injuries) where oxygen can mean the difference between life and death."
Coordinator, Every Breath Counts Coalition
First-of-kind roundtable builds trust
On 25 September 2020, the Every Breath Counts Coalition and the Access to Medicine Foundation co-hosted a first-of-its-kind virtual roundtable to explore opportunities to increase access to medical oxygen in LMICs.
The main objective of the first roundtable was to share perspectives of the different actors and begin the process of building trust. Many have not engaged in shared value partnerships on this issue before. The Access to Medicine Foundation brought its experience of engaging directly with pharmaceutical companies on access to medicine issues, to foster an understanding of how to identify and develop solutions.
The session focused on the work that medical oxygen producers including multinational and local players, investors and global health agencies are already doing to increase access to oxygen, in the context of COVID-19 and the broader achievement of the Sustainable Development Goals (SDGs).
This first roundtable led to a list of ten ideas for how to work together to close oxygen gaps in LMICs during COVID-19 and beyond. Working groups have also been formed between participants to focus on specific gaps. A follow-up meeting is planned to review their progress.
The Access to Medical Oxygen roundtable brought together representatives from nine medical gas companies, five corporate investors, and eight global health agencies to present their perspective on the access to medical oxygen challenge.
“Nomura Asset Management was pleased to play a role in helping to identify key opportunities in the first-of-its-kind, multi-stakeholder effort convened by the Access to Medicine Foundation and Every Breath Counts Coalition for increasing access to medical oxygen in low- and middle- income countries. The Foundation’s model of company engagement proved successful in bringing major gas companies to the table to discuss tangible solutions for this critical issue now and in the future, particularly in light of COVID-19 and the achievement of Sustainable Development Goal 3.”
Nomura Asset Management
Together, the participants identified 10 key action items required 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
Fortune: Gasping for breath: Covid-19 exposes medical oxygen crisis and need for industry action
In this viewpoint for Fortune Magazine, Access to Medicine Foundation Executive Director Jayasree K. Iyer addresses the urgent need for medical oxygen in low- and middle-income countries (LMICs), examining the role of pharmaceutical companies and how existing needs amplified due to COVID-19.
Roundtables focused on solutions
The roundtables follow a unique model of engagement developed by the Access to Medicine Foundation through its 15+ years working to stimulate and guide the pharmaceutical industry to do more for people living in low- and middle-income countries. The model combines engagement with industry and the influence of many other global health stakeholders to foster partnerships on access issues.
"Lack of access to medical oxygen has been an issue for years, particularly for children with pneumonia. The COVID-19 pandemic is bringing the life-saving power of oxygen to greater attention. It is a critical moment to combine the Foundation's network and model for spurring change with the mandate and experience of the Every Breath Counts coalition, and create a unique opportunity for discussion." Jayasree K. Iyer, Executive Director, Access to Medicine Foundation.
Addressing access to medical oxygen is a key pillar of the work of the Every Breath Counts Coalition. The Coalition supports LMICs to reduce deaths from pneumonia, especially among children and including from COVID-19. The Coalition is committed to engaging the world’s leading suppliers of medical oxygen in the access to oxygen agenda in the context of COVID-19 and the UN's Sustainable Development Goals. It is a public-private partnership representing United Nations and multilateral health agencies, donor governments and foundations, companies, non-government organisations (NGOs) and academic institutions.
The roundtable was hosted under the Chatham House Rule and the meeting report is available to download here, including a list of participating organisations, details on each key action and examples of current practices that may need scaling up.
Update January 2021:
Second roundtable session held in December
On 9 December 2020, the Every Breath Counts Coalition and the Access to Medicine Foundation co-hosted a second virtual roundtable 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.
The organizations in attendance included representatives from leading medical gas companies, corporate investors, multilateral development banks, donor governments and UN agencies and NGOs.
The objectives of the second roundtable were to introduce new stakeholders to the conversation and to discuss a proposal for partnership in select LMICs presented by a subset of stakeholders who attended the first roundtable. Following the first roundtable, this group engaged in a series of bilateral discussions to further advance the conversation and agreed to work together to close medical oxygen gaps in health facilities in a group of LMICs with high and rising confirmed COVID-19 cases counts and corresponding needs for medical oxygen.
During the second dialogue, three major requirements for effective public-private partnerships that were identified in the partnership proposal were explored, including the need for:
- accurate and timely data on gaps in access to medical oxygen by LMIC health facility;
- financing and other support for national and sub-national LMIC ministries of health as oxygen “buyers”; and
- risk-reduction strategies to increase the supply of affordable medical oxygen from medical gas companies.
Participants agreed to continue the conversation in the coming months and to report back at a third dialogue, which will be held in February 2021, and which will include decision-makers from national and regional health and development authorities in LMICs.
The full report from the second session is available to download here.
Update May 2021:
An urgent call for G7 leaders to take action
The Every Breath Counts Coalition and the Access to Medicine Foundation call on G7 leaders to take immediate action to ensure that low- and middle-income countries (LMICs) have the medical oxygen they need to treat all patients during the pandemic.
The call urges G7 leaders to finance the existing Access to COVID-19 Tools-Accelerator (ACT-A) Oxygen Emergency Taskforce* — a global and coordinated response to secure oxygen supplies — 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.
Such emergency financing must have the flexibility to procure bulk liquid oxygen, oxygen plants, concentrators, and related technologies and support governments to supply trained healthcare workers and biomedical engineers to use and maintain the equipment safely.
Read the full call to action here.
*Co-chaired by Unitaid and Wellcome Trust