Article Impact Level: HIGH Data Quality: STRONG Summary of The Lancet Global Health, 13(3), e528–e584. https://doi.org/10.1016/S2214-109X(24)00496-0 Dr. Hamish R. Graham et al.
Points
- Over 5 billion people worldwide lack access to safe, affordable medical oxygen, with a 70% coverage gap in low- and middle-income countries (LMICs), particularly in sub-Saharan Africa.
- Closing the oxygen coverage gap in LMICs requires an estimated $6.8 billion annually, but investing in medical oxygen is cost-effective, reduces mortality, and supports the Sustainable Development Goals (SDG 3).
- Despite the World Health Organization’s 2023 resolution, fewer than 30 countries have developed national medical oxygen plans, highlighting a need for stronger governance and coordination between public and private sectors.
- Only 54% of general hospitals and 83% of tertiary hospitals in LMICs have pulse oximeters, and just 19% of general hospital patients undergo pulse oximetry testing, which limits effective oxygen therapy.
- The report calls for integrating oxygen systems into national health and pandemic preparedness plans, improving local maintenance and repair efforts, and ensuring equitable access to oxygen therapy, especially in rural areas.
Summary
This report emphasizes the critical importance of medical oxygen as an essential health service, particularly in low- and middle-income countries (LMICs). The COVID-19 pandemic exposed significant global disparities in oxygen access, with over 5 billion people—60% of the world’s population—lacking access to safe, quality, and affordable medical oxygen services. The study highlights that in LMICs, only 30% of individuals who need oxygen for acute medical or surgical conditions receive adequate therapy, with the greatest access gaps found in sub-Saharan Africa. The report identifies a 70% oxygen coverage gap in LMICs, a figure far exceeding the coverage gaps for HIV/AIDS and tuberculosis treatments. This disparity is exacerbated by the lack of pulse oximeters, with only 54% of general hospitals and 83% of tertiary hospitals in LMICs having pulse oximeters and only 58% of general hospitals and 86% of tertiary hospitals providing oxygen therapy.
The cost of addressing this coverage gap is substantial, with an estimated $6.8 billion annually required to close the gap for acute medical and surgical oxygen needs in LMICs. However, the report stresses that investing in medical oxygen is highly cost-effective, offering potential reductions in deaths during future pandemics and advancing the achievement of Sustainable Development Goals (SDGs), particularly SDG 3, which focuses on ensuring healthy lives and promoting well-being for all at all ages. The report also highlights the need for national medical oxygen plans, with fewer than 30 countries having developed such plans, as required by the World Health Organization’s resolution in 2023. Effective coordination between the public and private sectors is essential to address medical oxygen delivery, governance, and funding gaps.
Additionally, the report underscores the importance of pulse oximetry in ensuring safe, affordable oxygen care at all levels of health care. Only 19% of people presenting to general hospitals in LMICs undergo pulse oximetry testing. The report calls for increased affordability and availability of pulse oximeters and their inclusion in clinical guidelines and health curriculums. This, along with increased investment in local maintenance and repair, would significantly improve the sustainability of oxygen systems, especially in rural areas while promoting universal health coverage. The findings emphasize the need to integrate oxygen systems into broader national health and pandemic preparedness plans, ensuring equitable access for all populations.
Link to the article: https://www.thelancet.com/journals/langlo/article/PIIS2214-109X(24)00496-0/fulltext
References Graham, H. R., King, C., Rahman, A. E., Kitutu, F. E., Greenslade, L., Aqeel, M., Baker, T., Brito, L. F. D. M., Campbell, H., Czischke, K., English, M., Falade, A. G., Garcia, P. J., Gil, M., Graham, S. M., Gray, A. Z., Howie, S. R. C., Kissoon, N., Laxminarayan, R., … Ssengooba, F. (2025). Reducing global inequities in medical oxygen access: The Lancet Global Health Commission on medical oxygen security. The Lancet Global Health, 13(3), e528–e584. https://doi.org/10.1016/S2214-109X(24)00496-0
