COVID-19 oxygen emergency impacting more than half a million people in low- and middle-income countries every day, as demand surges

February 25, 2021 -

Since the start of the pandemic, affordable and sustainable access to oxygen has been a growing challenge in low- and middle-income countries.

COVID-19 has put huge pressure on health systems, with hospitals in many LMICs running out of oxygen, resulting in preventable deaths and families of hospitalised patients paying a premium for scarce oxygen supplies.

Oxygen is an essential medicine, and despite being vital for the effective treatment of hospitalised COVID-19 patients, access in LMICs is limited due to cost, infrastructure and logistical barriers. Health facilities often cannot access the oxygen they require, resulting in the unnecessary loss of lives.

Recognising the central importance of sustainable oxygen supply – alongside therapeutic products such as dexamethasone – for the treatment of COVID-19, the Access to COVID Tools Accelerator Therapeutics pillar (co-led by Unitaid and Wellcome), is taking a new role to coordinate and advocate for increased supply of oxygen, and, in partnership with a WHO-led consortium[1], is today announcing the launch of a COVID-19 Oxygen Emergency Taskforce.

It is estimated that more than half a million people in LMICs currently need 1.1 million cylinders of oxygen per day[2], with 25 countries currently reporting surges in demand, the majority in Africa. This supply was constrained prior to COVID-19 and has been exacerbated by the pandemic.

Dr Philippe Duneton, Executive Director of Unitaid, said: "This is a global emergency that needs a truly global response, both from international organisations and donors. Many of the countries seeing this demand struggled before the pandemic to meet their daily oxygen needs. Now it’s more vital than ever that we come together to build on the work that has already been done, with a firm commitment to helping the worst-affected countries as quickly as possible."

The taskforce has determined an immediate funding need of US$90 million to address key challenges in oxygen access and delivery in up to 20 countries, including Malawi, Nigeria and Afghanistan. This first set of countries has been identified based on assessments coordinated by WHO’s Health Emergencies Programme, in order to match in-country need with potential financing, such as through the World Bank[3] and the Global Fund. Unitaid and Wellcome will make an immediate contribution of up to US$20 million in total for the emergency response. The urgent, short-term requirements of additional countries will be measured and costed in the coming weeks, with the overall funding need over the next 12 months estimated by ACT-A to be US$1.6 billion - a figure that will be regularly reviewed by the taskforce.

Dr Mike Ryan, Executive Director of the WHO Health Emergencies Programme, said: "Oxygen is life-saving and it is imperative to move faster to scale-up holistically with patient-centred, end-to-end solutions that improve clinical outcomes. WHO has been working through the Biomedical Consortium to bring the technical, clinical and procurement partners together with about US$80 million of biomedical equipment procured for low and middle-income countries. The Oxygen Taskforce will help drive oxygen scale-up through further innovation, financing and capacitation."

Paul Schreier, Chief Operating Officer at Wellcome, said: "We have made critical advances in providing lifesaving clinical care and treatments to COVID-19 patients over the last year. The impact of the combination of oxygen and dexamethasone to treat severely ill patients has, in particular, been incredible. But global access to advances remains unequal. We need to urgently increase access to medical oxygen to ensure patients are benefiting regardless of where they live and ability to pay. International solidarity is the quickest - and only - way out of this pandemic. It is a public health, scientific, economic and moral imperative that all tools are made available globally."

The taskforce brings together key organisations[4] that have been working to improve access to oxygen since the start of the pandemic including Unitaid, Wellcome, WHO, Unicef, the Global Fund, World Bank, the Clinton Health Access Initiative (CHAI), PATH, the Every Breath Counts coalition and Save the Children. Building on these efforts, partners will focus on four key objectives as a part of an emergency response plan: measuring acute and longer-term oxygen needs in LMICs; connecting countries to financing partners for their assessed oxygen requirements; and supporting the procurement and supply of oxygen, along with related products and services. Other areas in the scope of the taskforce include addressing the need for innovative market-shaping interventions, as well as reinforcing advocacy efforts to highlight the importance of oxygen access in the COVID-19 response.

Henrietta Fore, Executive Director of UNICEF, said: "Oxygen is a simple medical intervention that remains in short supply for far too many around the world. The COVID-19 pandemic has taken this acute shortage and made it a full-blown emergency. But addressing the oxygen gap will not only help with COVID-19 treatment in countries that are losing far too many saveable lives. It will also help to improve health systems and health outcomes beyond COVID-19 in the long term, including for the many newborns and children who require oxygen to survive."

Even before COVID-19, pneumonia was the world’s biggest infectious killer of adults and children, claiming the lives of 2.5 million people in 2019. The pandemic has exacerbated this problem, particularly in ‘double-burden’ countries which are contending with high levels of pneumonia and COVID-19. As well as meeting the immediate needs of the pandemic, the taskforce would look to leverage gains in this area to help with long-term pneumonia control.

Unitaid is a global health agency engaged in finding innovative solutions to prevent, diagnose and treat diseases more quickly, cheaply and effectively, in low- and middle-income countries. Its work includes funding initiatives to address major diseases such as HIV/AIDS, malaria and tuberculosis, as well as HIV co-infections and co-morbidities such as cervical cancer and hepatitis C, and cross-cutting areas, such as fever management. Unitaid is now applying its expertise to address challenges in advancing new therapies and diagnostics for the COVID-19 pandemic, serving as a key member of the Access to COVID Tools Accelerator. Unitaid is hosted by the World Health Organization.

Wellcome supports science to solve the urgent health challenges facing everyone. We support discovery research into life, health and wellbeing, and we’re taking on three worldwide health challenges: mental health, global heating and infectious diseases.

The World Health Organization provides global leadership in public health within the United Nations system. Founded in 1948, WHO works with 194 Member States, across six regions and from more than 150 offices, to promote health, keep the world safe and serve the vulnerable. Our goal for 2019-2023 is to ensure that a billion more people have universal health coverage, to protect a billion more people from health emergencies, and provide a further billion people with better health and wellbeing.

The Access to COVID-19 Tools (ACT) Accelerator, is a new global collaboration to accelerate the development, production and equitable access to COVID-19 tests, treatments, and vaccines. It was set up in response to a call from G20 leaders in March 2020 and launched by WHO, the European Commission, France and the Bill & Melinda Gates Foundation in April 2020. The ACT-Accelerator but works to speed up collaborative efforts among existing organizations to end the pandemic. It draws on the experience of leading global health organizations which are tackling the world's toughest health challenges, and who, by working together, can unlock new and more ambitious results against COVID-19. Its members share a commitment to ensure all people have access to all the tools needed to defeat COVID-19 and to work with unprecedented levels of partnership to achieve it. The ACT-Accelerator has four areas of work: diagnostics, therapeutics, vaccines and the health system connector.

As part of the UN COVID-19 Supply Chain System, a technical biomedical procurement consortium was set up under the coordination of WHO, including ALIMA, BMGF, IMC, MSF, UNDP, UNHCR, Unicef, UNOPS, USAID and WFP. Approximately US$150m of oxygen related biomedical products and consumables have been delivered to 149 countries over the last year.

https://www.path.org/programs/market-dynamics/covid-19-oxygen-needs-tracker Governments can apply for financing through the World Bank’s COVID-19 emergency health response Partners joining the taskforce include Unitaid, Wellcome, WHO (and the broader biomedical consortium WHO coordinates), Unicef, The Global Fund, the World Bank, UNOPS, Save the Children, Every Breath Counts (coalition), CHAI and PATH.