One year after the launch of the Access to COVID-19 Tools Accelerator (ACT-A) Oxygen Emergency Taskforce, what has been achieved? Has this unprecedented effort by more than 20 United Nations and global health agencies to work together to support low- and middle-income countries (LMICs) to mitigate pandemic-related medical oxygen shortages delivered on its promise? And what remains to be done in 2022?
Against the backdrop of widespread oxygen shortages across Latin America, Asia, Africa, and the Middle East, the ACT-A Oxygen Emergency Taskforce was launched on 25 February 2021. Unitaid and the Wellcome Trust were announced as Co- chairs with membership drawn from the World Health Organization (WHO) and its Biomedical Consortium,[1] UNICEF, UNOPS, The Global Fund to Fight AIDS, Tuberculosis, and Malaria (The Global Fund), the World Bank, USAID, the Clinton Health Access Initiative (CHAI), PATH, Save the Children, the Bill & Melinda Gates Foundation (BMGF), the Access to Medicine Foundation, and the Every Breath Counts (EBC) Coalition.
Later in the year, the Pan American Health Organization (PAHO) and the Africa Centres for Disease Control and Prevention (Africa CDC) joined the Taskforce. As of January 2022, Unitaid is the sole chair.
The first phase (February – October 2021)
The initial focus of the Taskforce was to pursue five key objectives:
During this period, Taskforce members mobilized ~$US700 million in grant financing to help LMICs avert oxygen shortages and ensured that access to oxygen was front and center of the overall ACT-A response.[2]
Between February and October 2021, The Global Fund, supported by several government and private sector donors, provided ~$US475 million in grants to help more than 66 low- and lower-middle income countries purchase oxygen supplies, including Pressure Swing Adsorption (PSA) plants, concentrators, liquid oxygen, ventilators, cylinders, pulse oximeters, and more.
WHO and UNICEF provided direct technical and operational support, procuring $US132 million and delivering $US89 million worth of oxygen supplies to more than 120 countries, including oxygen plants, concentrators, cylinders, advanced respiratory equipment, patient monitors, pulse oximeters, and oxygen delivery consumables, supported by several governments and private sector donors.[3]
Unitaid, the Wellcome Trust, and the BMGF, provided ~$US30 million to the WHO Health Emergencies Programme (WHE) and to NGOs including PATH and CHAI to increase the oxygen support they provide to specific LMIC governments – for procurement as well as maintenance and training.
Over 2021, Unitaid invested an additional $US17 million to NGOs ALIMA, PATH, Partners in Health, The Elizabeth Glaser Pediatric AIDS Foundation (EGPAF), and CHAI, as well as the WHE, for catalytic interventions including rapidly establishing COVID-19 treatment facilities in West Africa, distributing pulse oximeters, and improving the oxygen market by putting up collateral for emergency oxygen access and equipment stockpiling.
And in September 2021 at the Global COVID-19 Summit, the US Government announced $US50 million to increase access to medical oxygen in partner countries and called for a coalition of governments, foundations, NGOs, and companies to mobilize significant additional funding for oxygen access to “Save Lives Now.”
The second phase (October 2021 – present)
On 28 October 2021, the ACT-A released a new Strategic Plan and Budget seeking an additional $US1.4 billion to enable the ACT-A Oxygen Emergency Taskforce to continue to finance and provide oxygen supplies to LMICs in need during 2022.
The new strategy set an immediate goal of supporting the delivery of 110 to 140 million cubic meters of oxygen to LMICs by the end of 2021 and a longer-term goal of meeting the medical oxygen needs of 6 to 8 million severe and critical patients by September 2022.
The majority of the oxygen funding needed is for procurement and delivery and to support the repair, maintenance, and scale up of local medical oxygen production via The Global Fund, UNICEF, Unitaid, and WHO.
To implement the new strategy the Taskforce announced three new objectives:
In December 2021, the US Government announced a further $US75 million for additional support for USAID’s Rapid Response efforts, which includes investment to help strengthen oxygen market systems to improve reliable oxygen production and delivery.
A detailed list of oxygen milestones by Taskforce members to date is outlined below.
What’s next?
As a result of the critical work of the Taskforce in 2021, many LMICs entered 2022 with a far greater capacity to meet the oxygen needs of COVID-19 patients. Despite causing less severe disease, the sheer scale of global transmission of the Omicron variant has driven hospital admissions to record highs in many countries, increasing the need for medical oxygen.
More support is needed to bridge LMIC oxygen gaps during 2022. Oxygen therapy remains the first line of treatment for those with severe and critical COVID-19 in low-resource settings and the ACT-A Oxygen Emergency Taskforce has demonstrated that it can work effectively with LMIC governments and their local partners to increase access to medical oxygen in hospitals, ensure safe oxygen therapy to patients, and support staff to operate and maintain the equipment.
Most of the G20 nations have not yet contributed to ACT-A efforts and to oxygen support. Outreach and coordinated efforts through the ACT-A mechanism continue to mobilize countries and private sector donors with the financial and/or industrial capacity to support LMICs in their national COVID-19 responses, including increased access to oxygen.
Investments made via the Taskforce will not only help countries reduce COVID-19-related deaths but will strengthen health systems for the long term so they can continue delivering oxygen to save lives well beyond the pandemic. This will help countries make progress on many of their Sustainable Development Goal targets, including reducing deaths among newborns, children, women in childbirth, and adults with both communicable and non-communicable diseases.
Investing in medical oxygen will also help countries improve national pandemic preparedness and response, as the risk of respiratory outbreaks where oxygen is a cornerstone of critical care remains high.
[1] Members of the WHO Biomedical Consortium include ALIMA, BMGF, International Medical Corps (IMC), Médecins Sans Frontières (MSF), UN Development Programme (UNDP), UN High Commissioner for Refugees (UNHCR), UNICEF, UNOPS, USAID, and the World Food Programme (WFP).
[2] The World Bank also provided significant loan financing as part of their $US157 billion COVID-19 Crisis Response, which some LMICs have used to improve medical oxygen access. The value of these investments is not included.
[3] This is in addition to the $US96 million of oxygen support that WHO and UNICEF provided to 145 countries in 2020.
Media contact:
Sarah Mascheroni
Communications officer
Email: mascheronisa@who.int
Mobile: +41 79 728 73 11
