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 are exploring opportunities to increase access to medical oxygen in low and middle-income countries (LMICs) along with industry, investors, and global health agencies.
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.
The pandemic has exposed the urgent need to expand the Access the Medicine Foundation’s proven model of engaging pharmaceutical companies to the oxygen industry. The big oxygen companies all need robust, long-term access to oxygen strategies, with performance indicators that can highlight best practices and areas where more attention is needed. The Foundation can help oxygen companies increase their impact during the pandemic, and long after the pandemic is over, by strengthening health systems to do a better job of treating tens of millions of hypoxemic patients each year.
Leith Greenslade
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.
Alex Rowe
Nomura Asset Management
10 actions 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
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.
