The world’s first Global Oxygen Strategic Framework and Investment Case calls for US$ 4 billion to expand access to lifesaving medical oxygen in LMICs

The world’s first Global Oxygen Strategic Framework and Investment Case calls for US$ 4 billion to expand access to lifesaving medical oxygen in low- and middle-income countries

• An investment of US$ 4 billion in the most affected countries could increase oxygen access in low- and middle-income countries (LMICs) by 25%, benefiting an additional 24 million patients and saving 860 000 lives, including 331 000 children under five – 89 000 of them newborns.
• Investment in oxygen systems can be highly cost-effective and could deliver significant economic gains – with each dollar invested leading to an estimated return of US$ 21.
• The Global Oxygen Alliance (GO₂AL), a collaborative of 20 leading global health organizations and civil society groups, has commissioned and launched an ambitious new Global Oxygen Strategic Framework and Investment Case to expand access to medical oxygen in low-resource settings.

Berlin – Each year, hypoxaemia (low blood oxygen) directly contributes to the deaths of approximately 9 million people in LMICs, including 1.6 million children under five. On the sidelines of the World Health Summit, GO₂AL has commissioned and launched the Global Oxygen Strategic Framework and Investment Case, aimed at transforming global access to medical oxygen in LMICs. With a proposed funding ask of US$ 4 billion, the investment case outlines a comprehensive pathway for improving access to this essential medicine, which is crucial for treating a wide range of conditions and critical for pandemic preparedness and response.

Medical oxygen is a lifesaving medicine with no substitute. It is used to treat a broad spectrum of illnesses and conditions, including pneumonia, COVID-19, advanced HIV, severe tuberculosis, and malaria, and is vital for maternal and child health services, surgery and critical care. Despite its importance, fewer than 50% of health facilities in many low-income countries have consistent access to oxygen, with the largest gaps found across sub-Saharan Africa and Asia.

“Oxygen is a fundamental medicine no patient should go without,” said Dr Philippe Duneton, Executive Director of Unitaid and Co-Chair of GO₂AL. “During the COVID-19 pandemic, oxygen shortages caused countless deaths, and we still see it daily in countries where the most vulnerable, particularly mothers, children and critical care patients, die because they can’t access this lifesaving treatment. These inequalities cannot continue. Today, we are providing a clear path for governments and the global health community to make the changes and investments needed to strengthen oxygen access in the countries that need it most.”

The Global Oxygen Strategic Framework and Investment Case can guide donors, governments and health organizations in integrating medical oxygen into national health plans and mobilize support from donors and investors for countries and global health agencies to improve access to oxygen. The proposed US$ 4 billion investment over the next six years is expected to increase oxygen access by 25%, benefiting an additional 24 million patients, and is projected to save 860 000 lives – including 331 000 children under five, 89 000 of them newborns – while providing a return on investment of US$ 21 for every US$ 1 spent.

“The window to build on the recent momentum and close the oxygen access gap is now,” said Peter Sands, Executive Director of The Global Fund and Co-Chair of GO₂AL. “We must act decisively to strengthen health systems and ensure oxygen is available to all who need it, especially young children who are among the most vulnerable when oxygen isn’t available. Investing in oxygen systems is key to achieving universal health coverage and building resilient health systems that can protect populations in future crises, leaving no one behind.”

Building on the US$ 1 billion mobilized by global health agencies to strengthen oxygen supplies in over 120 countries during the COVID-19 pandemic, the Global Oxygen Strategic Framework and Investment Case is an outline for maintaining and expanding these vital investments, ensuring they reach even more people in need.

 “Africa CDC fully supports the launch of this vital investment case,” said Jean Kaseya, Director-General of the Africa Centres for Disease Control and Prevention and Vice-Chair of GO₂AL. “It is unacceptable that so many preventable deaths occur due to a lack of access to medical oxygen. This investment case lays out a clear, action-oriented plan to change that. By integrating oxygen into national health plans, we can build stronger, more resilient health systems across the African continent that will save lives.”

The launch comes as GO₂AL marks one year of investments in oxygen by its member organizations, having supported over 50 countries to increase access to pulse oximetry and medical oxygen since its launch at the World Health Assembly in 2023. While GO₂AL celebrates this progress, the alliance recognizes that much more needs to be done to close the oxygen access gap in low-resource settings. The new Global Oxygen Strategic Framework and Investment Case aims to accelerate these efforts, ensuring oxygen reaches even more people in need.

“PAHO supported the development of the Global Oxygen Strategic Framework and Investment Case, recognizing that improving access to high-quality medical oxygen is crucial for improving health outcomes and saving lives, especially in underserved and vulnerable communities,” said Judit Rius, Director, Department of Innovation, Access to Medicines and Health Technologies, PAHO. “By prioritizing investments in oxygen supply infrastructure and training, countries can strengthen health systems and improve the quality of care across the region. PAHO will continue to lead efforts to ensure access to this essential health technology for all.”

For more information, please see the Global Oxygen Strategic Framework and Investment Case 2025-2030.

Partner quotes

“Medical oxygen plays a crucial role in saving the lives of mothers, newborns and children, by treating conditions like pneumonia, which tragically takes the lives of around 700 000 children under five every year,” says UNICEF Deputy Executive Director for Programmes, Omar Abdi. “This investment case shows that, by making oxygen therapy more accessible, we could save the lives of more than 300 000 children by 2030. It’s an essential solution we must support.”

Note to editors:

About GO₂AL

During the COVID-19 pandemic in February 2021, amidst widespread global oxygen shortages, the world’s leading health agencies created the Oxygen Emergency Taskforce as part of the Access to COVID-19 Tools Accelerator (ACT-Accelerator). The taskforce member organizations raised more than US$ 1 billion to boost access to medical oxygen, expand production, negotiate for better pricing and provide technical advice to governments. As the world transitioned from the acute phase of the COVID-19 pandemic and prepares for future health threats, the ACT-Accelerator Oxygen Emergency Taskforce evolved in May 2023 into the Global Oxygen Alliance (GO₂AL), a broader collaborative to expand the work started by the taskforce.

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 hosted 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 Bill & Melinda 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.  

Scope of analysis

This analysis is conservative in several respects. It does not account for enduring benefits beyond 2030, nor does it include the broader benefits to the health system, such as training biomedical engineers or providing oxygen for safe surgery. Additionally, conservative cost assumptions were used to reflect the challenging conditions in low-resource settings. Finally, barriers to quality treatment, as defined by the coverage cascade in the Lancet Global Health Commission on Medical Oxygen Security, were strictly adhered to.