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A growing health crisis is claiming lives around the world, with six out of ten people unable to access safe, affordable medical oxygen.
A newly released report by The Lancet Global Health Commission on Medical Oxygen Security, co-authored by the University of Auckland, underscores the urgent need for global intervention to stop the preventable deaths spiralling from this inequity.
A Crisis of Global Scale
A report published on 18 February highlights a staggering global shortage of medical oxygen, with more than five billion people—mostly in low- and middle-income countries—lacking reliable access to this life-saving resource.
The impact is profound, affecting vulnerable groups such as children with pneumonia, adults with chronic lung conditions, and those in need of emergency care. Associate Professor Stephen Howie, a child health researcher and co-author, has witnessed the devastating consequences of oxygen shortages during his two decades of work in Africa and the Pacific,
“It is such an obvious need. I saw it at the hospitals I worked at in Africa where needless death from diseases like pneumonia happened because oxygen supplies were short, and this hit families and staff very hard,” Howie recalls.
The COVID-19 pandemic further exposed these gaps, with countries like Fiji facing critical shortages and healthcare workers in rural areas forced to ration oxygen supplies, making agonising decisions about who would receive treatment.
A Firsthand Account from Fiji’s COVID-19 Crisis
Dr. Sainimere Boladuadua, a public health medicine specialist and Lancet Commission ambassador, saw firsthand the devastating impact of oxygen shortages while working in Fiji during the pandemic.
Rural health facilities often faced the heartbreaking task of rationing oxygen supplies, leaving healthcare workers to make gut-wrenching decisions, “The reality was rural health facilities sometimes had to ration the oxygen… You have to prioritise who gets it, who doesn’t. Which is just so heartbreaking,” Boladuadua said.
The Fiji Oxygen Project—an initiative involving the Fiji Ministry of Health, the University of Auckland, Cure Kids, and Fiji National University—sought to close the gap, ensuring more hospitals had access to this life-saving resource. Many experts worry that without sustained investment, despite the progress, the momentum for lasting change could falter.
Why the Oxygen Shortage Persists
Oxygen remains out of reach for billions due to several systemic barriers:
- Lack of infrastructure: Many hospitals in low-resource settings lack the necessary equipment to produce, store, and administer medical oxygen.
- High costs: The price of oxygen therapy remains prohibitively expensive for many patients and governments.
- Insufficient training: A lack of trained healthcare workers limits the safe and effective use of oxygen therapy.
- Limited global data: Without comprehensive tracking of oxygen supply and demand, policymakers struggle to implement targeted solutions.
The Lancet report estimates that $6.8 billion annually is needed to address these gaps and ensure adequate oxygen access in low- and middle-income countries.
Building Solutions for the Future
The Lancet Global Health Commission on Medical Oxygen Security, launched in 2022, is urging governments to include oxygen supply in their national health strategies. The report stresses the importance of investing in production, distribution, and oversight to avoid future shortages.
Professor Stephen Howie, a co-author of the report, underscores the necessity of a long-term commitment, “No child should die for lack of oxygen, and this applies to adults too.”
At the same time, Dr. Sainimere Boladuadua, now a doctoral student at the University of Auckland, is leveraging her experiences in Fiji to enhance care for children with respiratory infections. Drawing inspiration from Indigenous health systems, such as those of the Navajo and White Mountain Apache communities, she seeks to blend traditional and modern medical practices,
“I wanted to see how you can use traditional knowledge and practices with Western knowledge… They’re just doing it so beautifully here,” she said.
A Call for Global Action
The oxygen shortage is more than a supply chain issue—it’s a critical matter of global health equity. Experts warn that without sustained action, future health crises will only magnify the vulnerabilities in healthcare systems worldwide.