Medical oxygen a lifesaving investment: Landmark report launched by The Lancet Global Health Commission

New report reveals wide gaps in access to oxygen, urges major stakeholders to commit to measurable and time bound progress to ensure equitable access and prevent widespread suffering and death.

The Global Oxygen Alliance (GO₂AL) welcomes the release of The Lancet Global Health Commission on Medical Oxygen Security’s report Reducing global inequities in medical oxygen access. The report provides the first-ever estimates of medical oxygen coverage gaps globally and the total cost of closing them, offering a clear set of recommendations to ensure equitable access to this essential, lifesaving medicine with no substitution.

Medical oxygen is critical for treating a wide range of conditions—including respiratory illness, maternal and child health complications, surgery, and critical care. It is essential for managing noncommunicable diseases and infections caused by severe forms of tuberculosis, malaria, and advanced HIV. Yet, despite its necessity, access remains severely inadequate. For example, the report finds that: 

• Five billion people, 60 percent of the world’s population, lack access to safe, quality, affordable medical oxygen, with low- and middle-income countries (LMICs) bearing the greatest burden. 

• 374 million newborns, children, and adults need medical oxygen every year, with 82 percent of these patients living in LMICs, and 68 percent concentrated in South Asia, East Asia and the Pacific, and Sub-Saharan Africa regions.  

• In LMICs, less than one in three people who need oxygen for acute medical or surgical conditions receive it due to gaps in service contact, readiness, provision, and quality. Oxygen coverage gaps stand at 70 percent, exceeding those for HIV/AIDS and tuberculosis treatments. 

• In LMICs, pulse oximetry and medical oxygen are available in just 54 percent and 58 percent respectively of general hospitals, and 83 percent and 86 percent respectively of tertiary hospitals, with the greatest inequities in small, rural, government health facilities.  

• Global costs to close oxygen coverage gaps in LMICs are estimated at US$6.8 billion annually, or a total of US$34 billion between 2025 and 2030.  

Investing in oxygen ecosystems is not only a public health necessity but is highly cost-effective, driving progress on eight of the nine targets for health-related Sustainable Development Goals, including universal health coverage and newborn, child, and maternal health, and strengthening global pandemic preparedness and response. 

The Commission report builds on the momentum from the world’s first Global Oxygen Strategic Framework and Investment Case, launched by GO₂AL in October 2024. The investment case serves as a strategic framework for integrating oxygen into national health plans and mobilizing donor and investor support. It identifies US$4 billion of international and domestic investment over the next six years as a crucial initial step toward increasing oxygen access in the most affected LMICs.  

“As the global health landscape rapidly evolves, the Commission’s findings are more critical than ever,” said Dr. Philippe Duneton, Executive Director of Unitaid and Co-Chair of GO₂AL. “Together with the Global Oxygen Strategic Framework and Investment Case, this report provides the evidence and tools needed to drive real progress in expanding access to medical oxygen, an essential yet often overlooked medicine.” 

Recognizing the urgency of this issue, the Commission calls on national governments to collaborate with GO₂AL on the development of national oxygen plans and urges donors to commit fundings toward the initial $US4 billion resource mobilization target laid out in the GO₂AL investment case. The funding is estimated to increase oxygen access by 25%, benefiting an additional 24 million patients and saving 860,000 lives, including 331,000 children under five—89,000 of them newborns.  

“Medical oxygen is not a luxury—it is a fundamental component of any functioning health system,” said Peter Sands, Executive Director of the Global Fund and Co-Chair of GO₂AL. “Yet, for billions of people, access remains dangerously inadequate. The findings of this Commission make clear that closing this gap is not only urgent but achievable. Investing in medical oxygen is one of the most cost-effective ways to save lives, strengthen health systems, and build resilience against future health threats. Every dollar invested in medical oxygen yields a US$21 return—this is not just a moral imperative, but a smart economic decision that will pay dividends for global health and development.” 

“Not only does this report shine a light on the huge gap in the availability of oxygen across the globe, but it provides concrete and actionable recommendations for all stakeholders. It clearly shows that investing in access to oxygen can save lives,” said Dr. Michael Ryan, Executive Director, WHO Health Emergencies Programme and Deputy Director-General of WHO.  

To accelerate efforts to close the vast gaps in oxygen access, the Commission outlines 52 specific recommendations for governments, industry, global health agencies, academic institutions, and civil society to work together in strengthening health systems and ensuring universal access to medical oxygen. It also introduces new tools to support scale-up, including the Access to Medical Oxygen Scorecard (ATMO₂S), 10 Oxygen Coverage Indicators, and 20 priority areas for oxygen innovation.  

“Despite its importance, access to medical oxygen remains inadequate in many low- and middle-income countries leading to preventable deaths—particularly among newborns and children,” said George Laryea-Adjei, UNICEF Programme Director. “Strengthening oxygen infrastructure, investing in innovative delivery solutions, and training healthcare workers are essential for building resilient health systems and ensuring better pandemic preparedness. Recognizing oxygen as an essential medicine can save millions of lives and improve healthcare equity worldwide.”

GO₂AL and its partners recognize that closing oxygen access gaps in LMICs is a collective commitment. Placing strong national oxygen ecosystems at the forefront of global health is a critical step to advance many health goals simultaneously, achieve universal health coverage, and build resilient health systems that can protect populations now and in future health crises.  

About GO₂AL 

GO₂AL is a multistakeholder collaborative consisting of 20 organizations and delegations that volunteered to join the alliance to collaboratively work towards a collective vision to increase oxygen access in LMICs. It is not a legal entity or funding mechanism. GO₂AL is coordinated by Unitaid, the World Health Organization (WHO) and the United Nations Children’s Fund (UNICEF). It is co-chaired by Unitaid and The Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund) and vice-chaired by the Africa Centres for Disease Control and Prevention (Africa CDC) and the Pan American Health Organization (PAHO). GO₂AL members include the Access to Medicine Foundation, Africa CDC, the Gates Foundation, Build Health International, the Clinton Health Access Initiative, the Every Breath Counts Coalition, PAHO, Partners In Health, PATH, Save the Children, The Global Fund, UNICEF, Unitaid, United Nations Office for Project Services, United States Agency for International Development, WHO, the World Bank and representatives from civil society and affected communities.   

About the Commission on Medical Oxygen Security  

Announced in September 2022, The Lancet Global Health Commission on Medical Oxygen Security provides a thorough exploration of current medical oxygen coverage gaps, with recommendations to ensure that no patient dies for lack of access to this essential medicine, including during public health emergencies like COVID-19. The Commission was led by 18 Commissioners – multi-disciplinary academics with clinical, economic, engineering, epidemiological, and public policy expertise – representing all regions of the world. Forty Advisors representing United Nations and global health agencies, donors, academic institutions, and non-governmental organisations provided guidance to Commissioners. A large global network of Oxygen Access Collaborators provided constant input to the Commission and included representatives from all sectors, including industry and Ministries of Health. In addition, special consultations were conducted with patients, caregivers, and clinicians to ensure that their voices and experiences shaped the Commission’s recommendations. An Executive Committee coordinated the work of the Commission and included representatives from Makerere University, Uganda, International Centre for Diarrheal Disease Research (icddr,b), Bangladesh, Murdoch Children’s Research Institute (MCRI), Australia, Karolinska Institutet, Sweden, and Every Breath Counts Coalition, USA.