Intended for healthcare professionals


Covid-19: Oxygen shortages two years into pandemic highlight pre-covid failures, says WHO

BMJ 2022; 376 doi: (Published 29 March 2022) Cite this as: BMJ 2022;376:o829
  1. Elisabeth Mahase
  1. The BMJ

Two years into the covid-19 pandemic, access to oxygen is still a major problem in low and middle income countries, health leaders have warned.

The shortages have highlighted the “abject failure” of the global community to develop and build up primary healthcare and universal health coverage over the past 20 years, said Michael Ryan, the World Health Organization’s health emergencies programme executive director.

“Covid didn’t cause this, covid uncovered this. Covid laid bare, tore away the bandages from, some very, very old wounds,” Ryan told an Access to Covid-19 Tools (ACT) Accelerator briefing. “No one was interested in oxygen,” he said, despite it being vital for the treatment of patients with covid-19 in the early stages of the pandemic.

“I went to meeting after meeting and I spoke about oxygen, and nobody was listening because oxygen wasn’t sexy. It wasn’t new. It wasn’t some technological advance that could be delivered to the world. Oxygen was boring, oxygen was old,” Ryan said.

But even now—a year after the ACT-Accelerator Oxygen Emergency Taskforce was launched to tackle critical oxygen gaps—supply is still a problem.

Speaking at the event, Leith Greenslade, coordinator for the Every Breath Counts Coalition, which campaigns to end pneumonia, said, “Not one month has gone by without some low and middle income countries experiencing oxygen shortages and related deaths. And when you layer in other disasters like the war in Ukraine, you get oxygen shortages not just affecting patients with covid-19, but mothers in childbirth, newborns, the injured, and the elderly with chronic conditions.”

Global health agency Unitaid has said 75% of patients admitted to hospital with covid-19 can be treated with oxygen alone. At the briefing, Unitaid announced it has pledged $56m in investment to increase and enhance access to medical oxygen. The money directly supports the work of the Oxygen Taskforce by ensuring countries have access to adequate, affordable oxygen solutions such as bulk liquid oxygen, oxygen generation systems, and other important equipment.

A $1bn funding gap for the taskforce’s work remains, however. Taskforce chair and Unitaid director of programmes, Robert Matiru, said, “Many countries continue to face high rates of hospital admissions, and equitable access to medical oxygen remains critical. As we speak, more than 20 countries have surging covid-19 oxygen needs, particularly now in south Asia, and who knows what it will look like in four to five months time?

“Time and time again in the past two years we’ve been caught off guard by not investing in advance and preparing systems to respond effectively.”

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