by At the height of the COVID-19 Pandemie, millions of people in poor countries literally died to breath, even in hospitals. What they were missing was medical oxygen, which is scarce in a large part of the world.
On Monday, a panel of experts published an extensive report on the deficit. Every year the report noted that more than 370 million people worldwide need oxygen as part of their medical care, but less than 1 in 3 receive it, so that the health and lives of those who do not endanger that. Access to safe and affordable medical oxygen is mainly limited in countries with low and middle income.
“The need is very urgent,” said Dr. Hamish Graham, a pediatrician and a main author of the report. “We know that there will be more epidemics, and there will be a different pandemic, probably like Covid, within the next 15 to 20 years.”
The report, published in the Lancet Global Health, is frozen only a few weeks after the Trump administration administration is frozen, including some who can improve access to oxygen.
Stimulating the availability of medical oxygen would require an investment of approximately $ 6.8 billion, the report noted. “Within the current climate, that is clearly a bit more a challenge,” says Carina King, an epidemiologist of infectious diseases at the Karolinska Institute and a main author of the report.
Yet, she said, governments and financing organizations must give priority to medical oxygen because of its importance in health care. People of all ages may need oxygen for pneumonia and other airway disorders, for serious infections, including malaria and sepsis, for operations and for chronic lung conditions.
“We do not place oxygen against other priorities, but rather that it must be embedded within all those programs and within those priorities,” said Dr. King. “It is completely fundamental for a functioning health system.”
Medical oxygen has been used for more than 100 years, often for the treatment of patients with pneumonia. But it was only added to the essential drug list of the World Health Organization in 2017.
At the start of the COVID-19 Pandemie, every breathing, a coalition of more than 50 organizations, insisted on increased access to medical oxygen. Towards the end of 2022, a Task Force Emergency had mobilized more than $ 1 billion in medical oxygen equipment and supplies at more than 100 countries.
A country that has made a substantial investment in improving access to the oxygen, who had taken steps in that direction, even before Covid.
Nigeria has set up around 20 cost -effective factories for generating oxygen on site for hospitals, and investigates liquid oxygen plants that can supply large parts of urban areas, Dr. Muhammad Ali Pate, the Minister of Health and Social Welfare of the country.
Many hospitals have no systems that can reliably deliver oxygen, “so that is a kind of design and a legacy problem we are dealing with,” he said. “There is more to be done.”
Changing hospital systems to deliver oxygen can cause engineering and market problems, and the supply of oxygen requires infrastructure that can transport heavy oxygen tanks for long distances.
Even as soon as the oxygen supply is insured, the equipment to deliver the oxygen directly to patients must be routinely maintained and cleaned and spare parts can last months to be delivered. Healthcare staff must be trained to effectively use the equipment.
“We have seen so many investments in equipment, but very few investments in how that equipment can be operationalized sustainably,” Dr. King.
Healthcare institutions also require pulse oximeters to screen and monitor blood oxygen levels during treatment. But in countries with low and middle income, pulse oximetry is used in less than 1 in 5 patients in general hospitals, and it is almost never used in primary health care, according to the report.
The panel included testimonials of patients, families and health workers who have struggled with the oxygen deficiency. In Sierra Leone, before the COVID-19 Pandemie, only one public hospital had a functioning oxygen plant throughout the country, which resulted in thousands of avoidable deaths. In Pakistan, a man with a chronic lung disease said he stayed inside and avoided kicks to prevent his lungs from cracking under the tension. He had to borrow money from friends and family to pay the $ 18,000 costs of treatment at home.
In Ethiopia a doctor was forced to remove oxygen from one patient to treat another who was more desperately sicker. “It was very heartbreaking to decide who lives and who dies,” he said.
