Lancet Global Health Commission on Medical Oxygen Security​ - Over 5 billion people lack medical oxygen access: urgent action needed

Each year, 374 million people need medical oxygen, yet in low- and middle-income countries (LMICs), only 30% of those in need for acute medical or surgical conditions receive adequate oxygen therapy. This leaves a stark 70% coverage gap, driven by several factors: limited access to healthcare facilities, facilities lacking basic oxygen service capacity, lack of pulse oximetry for timely identification of oxygen need, inconsistent or unsafe oxygen supply, high costs for patients, and interrupted, unsafe, or otherwise low-quality oxygen care. Situation is even worse in sub-Saharan Africa, where only 9% of patients with acute medical conditions have reliable access to medical oxygen.

A Life-saving but Overlooked Medicine 

Medical oxygen has been an essential medicine for over a century, yet health systems continue to struggle with access. The COVID-19 pandemic exposed the deadly consequences of weak oxygen systems, but as this report highlights, shortages existed long before—and persist long after—the crisis. 

Oxygen is needed at all levels of healthcare, from emergency rooms to operating theatres and neonatal care units. However, fragmented supply chains, high costs, lack of financing, and poor infrastructure make it difficult for hospitals in LMICs to ensure an uninterrupted supply. 

A $6.8 Billion Investment to Close the Gap 

The Lancet Commission calls for urgent investment, estimating that $6.8 billion per year is needed to close the acute medical and surgical oxygen coverage gap in LMICs. This estimate excludes the costs of long-term oxygen therapy and the additional demand that future pandemics could cause. While this is a significant amount, the report highlights that investing in oxygen is highly cost-effective—comparable to childhood immunization in its global health impact. Moreover, it would help governments advance progress on eight of the nine SDG 3 targets. To achieve this, the Commission recommends that all governments develop and implement National Medical Oxygen Plans, integrating oxygen supply into broader health strategies. 

Industry Must Step Up 

A comment published alongside the Lancet report—co-authored by Jayasree K. Iyer, CEO of the Access to Medicine Foundation, who also served as an advisor to the Commission—emphasizes the crucial role of the medical oxygen industry in solving this crisis. The authors note that despite the urgency, the market for medical oxygen remains fundamentally broken, dominated by a few gas companies that prioritize industrial production over medical supply.  

The authors outline key steps the industry must take, including: 

• Establish access strategies and accountability: Develop an access-to-medical-oxygen strategy with key performance indicators, an internal access team, and public progress reporting. 

• Ensure affordability: Implement equitable pricing, pooled procurement, and innovative finance mechanisms to make oxygen accessible across different populations and health systems. 

• Secure a sustainable supply: Expand manufacturing in LMICs, maintain buffer stocks, strengthen distribution, and ensure reliable spare part supply chains. Report publicly on plans. 

• Strengthen partnerships: Build long-term collaborations with LMIC governments, regional authorities, global health organizations, and industry partners to improve oxygen access. 

• Support installation, maintenance, and training: Provide technical support for healthcare facilities and staff, develop more durable oxygen equipment, and enhance training programs. 

• Prepare for future emergencies: Establish robust emergency plans and foster relationships with key stakeholders. 

A Turning Point for Global Health

The Lancet Commission report provides a clear roadmap to address the oxygen crisis. With a combination of government action, industry leadership, and sustained investment, millions of lives can be saved each year. 

The Access to Medicine Foundation calls on governments, donors, and industry leaders to act now to ensure that no patient is denied the oxygen they need to survive.