Where the Medical Oxygen Gap Actually Exists

Where the Medical Oxygen Gap Actually Exists.

Last week I wrote about Decentralized Solar Powered Medical Oxygen. https://lnkd.in/ekpwHRF4 This week I want to discuss the SIZE and the SHAPE of the
hashtag
#OxygenGap and how it impacts product design and innovation.

We often talk about the SIZE of the global medical oxygen problem — and the Lancet Global Health Commission on Medical Oxygen Security did an important service by putting real numbers around that crisis. https://lnkd.in/gPgaTjBb The headline being, “We found that more than 5 billion people—i.e., more than 60% of the world's population—do not have access to safe, quality, and affordable medical oxygen services.”

But after spending the last few years working with national Oxygen Scale-Up Plans, what has struck me just as strongly is the SHAPE of the problem. This chart shows one simple thing: Across multiple low- and middle-income countries, the largest annual medical oxygen shortfall is not at referral hospitals — it is at primary and lower-level health facilities, where most patients first seek care. The data behind this comes from national oxygen plans in Uganda, Kenya, Nigeria, Rwanda, and Liberia. While each country is different, the pattern is remarkably consistent.

At tertiary and specialist hospitals, oxygen investments tend to work. PSA plants are installed, engineers are available, and power is prioritized. But as you move down the health system to district hospitals, health centers, and primary care facilities, oxygen access becomes increasingly fragile:
- Power is unreliable
- Maintenance capacity is thin
- Cylinder logistics are expensive and unpredictable
- Staff are stretched across too many roles

That’s why the annual oxygen gap, measured in millions of standard cylinders, is overwhelmingly concentrated at the Last Mile. And that matters, because this is where care actually happens:
- Where mothers deliver babies
- Where children with pneumonia first present
- Where delays in ox