Increasing access to oxygen through normative policy change
PATH is implementing a comprehensive approach to increase access to oxygen in low- and middle-income countries, including supporting normative policy change by the World Health Organization (WHO), helping strengthen markets for oxygen concentrators and pulse oximeters, raising awareness about the importance of oxygen through its HO2PE: Oxygen Gives Life campaign, partnering with the United for Oxygen alliance, and developing materials to help advocates and policymakers drive change at the national level.
Additional listing for oxygen on the WHO EML
In collaboration with partners and expert advisers, PATH petitioned the WHO Model List of Essential Medicines (EML) secretariat to include an additional listing of oxygen as a medical gas, extending its use for the management of hypoxemia. Hypoxemia, or dangerously low levels of oxygen in the blood, can be fatal without oxygen therapy. Without oxygen, it would be next to impossible to treat hypoxemia resulting from conditions such as pneumonia, which is the leading cause of mortality in children under five.
Previously, oxygen was listed only for use as an inhalational medicine in general anesthesia on the EML and EML for Children (EMLc). PATH reviewed the national essential medicines lists of 105 countries and found that approximately a third (31 percent) did not include oxygen and roughly half (48 percent) listed oxygen only by anesthetic indication.
On June 7, 2017, PATH hailed WHO’s landmark decision to include a new indication for oxygen in its EML and EMLc (both lists are available here), identifying oxygen as a medicine essential for the management of hypoxemia. This change clarifies oxygen’s importance as a medical treatment that should be widely available in health facilities everywhere. Ensuring such global endorsement and normative guidance for the broader applications of oxygen may foster a more enabling environment for oxygen delivery at the national level.
PATH is also packaging and disseminating a series of evidence-based advocacy resources (policy primer) to enable country-based advocates to engage national decision-makers and stimulate their support for increased access to oxygen. Resources will include content on global evidence, normative policies and guidance, and communications assets, and will be designed to be adaptable at the national level.
Reliable provision of oxygen therapy and accurate identification of hypoxemia is essential in reducing mortality. Identifying barriers to access and ensuring inclusion of oxygen and pulse oximetry in current normative policies, treatment guidelines, health budgeting, and system infrastructure (e.g. maintenance and supply chain management) are key to improving oxygen availability.
Photo: PATH/Mike Wang