Addressing the Global Oxygen Access Gap in South-East Asia
Oxygen is a life-saving essential medicine with no substitute. The complexity of industrial production processes creates significant challenges in ensuring its availability, quality, affordability, and safe distribution. Around five billion people worldwide lack access to safe, quality, and affordable medical oxygen. This issue is particularly critical in South-East Asia and East Asia, where the oxygen service coverage gap is as high as 78% and 74%, respectively.
Challenges in Oxygen Access
Several systemic barriers hinder the availability of medical oxygen, preventing its integration into healthcare systems. One major issue is the shortage of equipment. Only 54% of hospitals in low- and middle-income countries (LMICs) have pulse oximeters, and 58% have access to medical oxygen. This lack of basic monitoring and supply infrastructure leads to delayed diagnoses, inadequate treatment, and preventable fatalities, especially during severe respiratory outbreaks and pandemics.
However, the issue extends beyond equipment availability. The financial burden of increasing oxygen access remains a major obstacle. Bridging the global oxygen gap requires $6.8 billion, with South Asia alone needing $2.6 billion. Many LMICs face competing healthcare priorities, making it difficult to allocate substantial funding toward oxygen infrastructure. Without sustainable financing mechanisms, efforts to improve oxygen access risk being short-lived.
Compounding the challenge is the acute shortage of trained biomedical engineers and technicians. Even when oxygen plants and concentrators are available, a lack of skilled professionals to install, maintain, and repair them can lead to frequent breakdowns. These deficiencies exacerbate disparities in access, especially in rural and underserved communities, where alternative solutions are often unavailable.
A long-term, multi-pronged approach that integrates innovation, investment, and policy action is essential. Transparency, data-driven decision-making, and a strong policy framework will be crucial. The WHO Access to Medical Oxygen Scorecard is a key tool in tracking progress and ensuring accountability. The resolution calls for reporting progress in the implementation of this resolution to the Health Assembly in 2026, 2028, and 2030.
National governments should develop medical oxygen scale-up plans with support from WHO to strengthen oxygen ecosystems, allocate resources effectively, and address infrastructure gaps. Tailoring these strategies to healthcare needs can create sustainable, resilient oxygen delivery models.
Insufficient Infrastructure
Ensuring a stable oxygen supply requires strong partnerships between governments, the private sector, and international organizations. WHO emphasizes local manufacturing to reduce import dependence, cut costs, and improve accessibility. Decentralized production can address supply imbalances and enhance last-mile delivery.
Innovations such as portable oxygen concentrators, solar-powered generators, booster pumps, and community-based hubs can bridge accessibility gaps, especially in remote areas. Integrating these solutions into healthcare plans can ensure that life-saving oxygen reaches every patient.
Power disruptions in South-East Asia, as in many LMICs, hinder oxygen production. Solar-powered oxygen systems are a cost-effective and low-maintenance innovation that ensures uninterrupted supply, lower costs, and reduced grid dependence. Ethiopia and Nigeria have successfully implemented solar-powered oxygen delivery systems in remote healthcare facilities, improving access and saving lives. The South-East Asia region should promote and invest in the solarization of oxygen plants to ensure a stable supply amid energy insecurity and health crises.
Strengthening Oxygen Ecosystems
Bridging the oxygen gap requires a unified, multi-stakeholder approach. Governments should lead by integrating oxygen access into universal health coverage and emergency preparedness plans. A clear regulatory framework should be established to ensure the quality and safety of medical oxygen, along with standardized protocols for storage, transportation, and distribution. These measures will be essential for sustaining long-term availability of quality medical oxygen.
The private sector must also invest in local production and supply chain optimization. Industry players have a crucial role in developing cost-effective, scalable solutions tailored to the specific needs of LMICs. Furthermore, global health agencies must ensure that oxygen access remains a funding priority, facilitating financial support for infrastructure development, equipment procurement, and workforce training.
Academia and research institutions can contribute by focusing on low-cost, innovative oxygen solutions tailored for LMICs. Prioritizing affordability, efficiency, and adaptability will be key. Using digital technologies for real-time monitoring, predictive demand analytics, and supply chain management can further enhance the efficiency of oxygen delivery systems.
The oxygen crisis is a solvable problem that demands coordinated action, sustainable financing, and strong political will. Our success in installing PSA oxygen plants in countries demonstrates that strategic investments, cross-border collaboration, and workforce training can yield long-term solutions.
To maximize COVID-era investments in PSA oxygen plants, countries must ensure operational readiness. Ideally, donors who have already shown support for these initiatives during the pandemic should continue to support ongoing efforts. Surplus capacity should be distributed to peripheral facilities using booster pumps. WHO stands ready to provide technical support.
Access to medical oxygen is not just a health issue but also a matter of equity and human rights. Oxygen should never be a privilege but rather a fundamental right for all. Instead of crisis-driven approaches, sustainable investments in oxygen infrastructure can – and must – be made, ensuring that no one is left behind in their moment of need.