In June, the World Health Organization (WHO) updated its Model List of Essential Medicines and List of Essential Medicines for Children to include an additional indication for oxygen therapy, specifying that it should be used to treat patients with dangerously low levels of oxygen in the blood (hypoxemia). The new indication is the result of a proposal led by my organization, PATH (an international nonprofit organization leading in global health innovation), in collaboration with partners and expert advisers. It helps prioritize oxygen therapy for patients with this dangerous condition.
The decision—and the need for it—may surprise those living in high-resource settings. After all, if you've ever been treated in a hospital in a high-income country, you will find access to oxygen therapy literally everywhere—as common as the air around you. But in low- and middle-income countries, fewer than half of health facilities have uninterrupted access to oxygen therapy, an essential treatment for those who are acutely or chronically oxygen starved.
Having worked for more than 30 years researching and developing vaccines, and ensuring that these lifesaving tools are available and used appropriately where needed most, it is clear that tackling barriers to equitable access to lifesaving treatments is fundamental to achieving optimal public health impact.
Access to a reliable and consistent source of oxygen therapy really can make the difference between life and death, especially for the most vulnerable: newborns, young children, and pregnant women. The expanded indication could have a significant impact on a wide range of medical conditions, including premature birth, obstetric emergencies, and pneumonia, which is the leading worldwide cause of death from infectious disease in children younger than age five.
The impact of this new global guidance could be substantial. Increased access to oxygen therapy could reduce childhood pneumonia-related mortality by at least 35 percent, and save the lives of 122,000 children with hypoxemic pneumonia who die each year. But to actually prevent those deaths, oxygen therapy must be accessible, acceptable, available, and affordable to all who need it. To overcome barriers to access, each and every product-specific and market-specific barrier that stands in the way of sustainable access must be anticipated and proactively addressed. There are no silver bullets for ensuring the successful delivery and use of lifesaving therapies. Even if a set of approaches works in one case, success is not guaranteed in other settings.
That said, awareness is key. The WHO's milestone decision to expand the indication for use of oxygen on the List of Essential Medicines and List of Essential Medicines for Children reinforces the need to align country policies with global guidance. A 2016 review by PATH highlighted an alarming fact: Oxygen was absent from nearly 20 percent of 105 countries' essential medicines lists, and in nearly 50 percent of cases it was listed only for use as an anesthetic. Ensuring oxygen is included as a treatment for hypoxemia in national policies and guidelines, as well as prioritized in budgets, is a critical step toward demonstrating government commitment, catalyzing action, and, ultimately, driving equitable access to lifesaving health care.
Attention to infrastructure is also essential. Health systems will need to build robust oxygen supply chains, coordinate consumables and spare parts when establishing procurement plans for oxygen equipment, and train health care workers in the provision of oxygen therapy and technicians on the maintenance and repair of equipment.
Universal access to oxygen therapy will require sustained and coordinated efforts globally and locally. Encouragingly, there are already notable examples of the work underway: The United4Oxygen alliance, a first-of-its-kind coalition of partners (including PATH), is supporting the government of Ethiopia in its work to expand access to oxygen and pulse oximetry on a national scale.
By calling attention to the need, the WHO took a much-needed step toward improving the availability and use of oxygen for all individuals fighting to breathe. It is imperative that the global community now promotes the importance of oxygen and takes action to ensure equitable, predictable access.
Access to oxygen therapy should not be left to good luck or location.
from Health Affairs BlogHealth Affairs Blog http://ift.tt/2fOQBtY
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