Addressing the critical shortage of medical oxygen is essential for saving lives worldwide. Over 5 billion individuals lack access to this vital resource, highlighting an urgent need for comprehensive reforms. The Lancet Global Health Commission on Medical Oxygen Security has identified key challenges and proposed actionable solutions to bridge this gap.

The importance of medical oxygen cannot be overstated. It is as crucial as vaccines in combating life-threatening conditions but remains underfunded and overlooked. This indispensable clinical need spans various acute and chronic illnesses, including surgical procedures. Despite its cost-effectiveness, the global healthcare system faces significant inequities in providing this essential service. The commission emphasizes that medical oxygen should not be viewed merely as a commodity but as a public service requiring coordinated investments in production, distribution, regulation, and financing.

To tackle the global medical oxygen crisis, the commission recommends several strategic measures. Immunization programs, smoking cessation initiatives, air pollution control, nutritional improvements, and climate change mitigation can significantly reduce the demand for oxygen. Public health interventions, such as expanding vaccine coverage for respiratory diseases, can lower infection rates and lessen the need for oxygen therapy. During emergencies like pandemics or natural disasters, the demand for oxygen surges dramatically, often overwhelming healthcare systems in low-resource countries. The coronavirus pandemic highlighted this issue, with millions of patients requiring oxygen support.

Inequities in access to medical oxygen are profound. About 374 million people globally need medical oxygen annually, with 82% residing in low- and middle-income countries (LMICs). In these regions, only 30% of those who require oxygen receive it, and in sub-Saharan Africa, this figure drops to a mere 9%. Key factors contributing to these shortages include inadequate healthcare infrastructure, lack of diagnostic tools like pulse oximeters, insufficient trained personnel, and high costs. Addressing these issues requires substantial investment—estimated at $6.8 billion annually—but is as cost-effective as childhood vaccinations.

Making medical oxygen accessible to all necessitates a multi-faceted approach. Governments must develop national oxygen plans by 2030, integrating oxygen systems into broader healthcare infrastructure. Collaboration between public and private sectors is crucial for ensuring stable production, transparent pricing, and reliable distribution. Pulse oximetry, which measures blood oxygen levels, should be available in all healthcare facilities to diagnose hypoxemia promptly. Ensuring affordability and sustainability involves optimizing operational costs, utilizing mixed-source oxygen supply, and minimizing user fees. Price transparency and alignment with international standards are also vital for maintaining quality and equity.

Ultimately, the commission underscores the importance of equity and sustainability in achieving global medical oxygen security. By prioritizing this essential service, governments and global health agencies can save countless lives, enhance healthcare systems, and contribute to the Sustainable Development Goals. Integrating energy-efficient technologies and local maintenance solutions will further promote long-term sustainability while reducing financial and environmental costs. Ensuring universal access to medical oxygen is not just a moral imperative but a necessary step towards a healthier, more resilient world.