Answer

The Lancet Global Health Commission on medical oxygen security reveals a pressing challenge: South Asia and East Asia-Pacific face the highest unmet demand for medical oxygen, with service coverage gaps of 78% and 74%, respectively. This alarming disparity underscores the urgent need for decisive action to address this critical healthcare shortfall.

Multi-Dimensional Challenges Hindering Medical Oxygen Access in India

• Inadequate Infrastructure and Equipment: Many public hospitals lack oxygen plants, concentrators, or pulse oximeters.
  Example: WHO estimates that only 58% of hospitals in LMICs (including India) have oxygen access; pulse oximeters are available in just 54% of facilities.
• Funding Constraints and Competing Health Priorities: Despite the need, oxygen infrastructure doesn’t receive sustainable long-term investment.
  Example: The Lancet Global Health Commission highlights a $2.6 billion gap in South Asia’s oxygen infrastructure funding needs.
• Human Resource Deficit: Shortage of trained biomedical engineers hinders the installation, maintenance, and repair of oxygen systems.
  Example: WHO’s training program with Nepal’s National Health Training Centre for Bhutanese engineers shows how skill gaps are being addressed, but such models are rare in India.
• Power Supply Disruptions and Rural Accessibility: Remote areas with poor grid access face challenges in running oxygen plants or concentrators.
  Example: Solar-powered systems in Ethiopia and Nigeria are proven alternatives but underutilized in Indian districts with frequent outages.
• Fragmented Supply Chains and Lack of Data Monitoring: Inefficient logistics and the absence of predictive tools result in delayed or misdirected oxygen supply.
  Example: During the COVID-19 second wave, lack of real-time tracking led to major supply shortages across Delhi, UP, and Maharashtra despite oxygen availability elsewhere.
  

Suggested Comprehensive Policy Framework

Technological Innovation

• Deploy Solar-Powered Oxygen Systems: Promote solar-powered PSA (Pressure Swing Adsorption) plants and concentrators in rural and power-deficit areas to ensure uninterrupted supply.
  Example: Ethiopia’s solar oxygen model can be replicated in Indian tribal and remote districts.
• Adopt IoT and Digital Monitoring Tools: Use real-time data systems, geospatial mapping, and predictive analytics for demand forecasting and supply chain tracking.
  Example: WHO’s Oxygen Scorecard can guide digital dashboards for oxygen distribution at the state and national levels.
• Encourage Low-Cost Innovation: Support startups and research institutions to develop affordable, portable, and energy-efficient concentrators suited to LMIC conditions.
  Example: IIT Kanpur and DRDO have developed indigenous low-cost oxygen concentrators post-COVID.
  

Public-Private Partnerships (PPP)

• Collaborate with Industrial Oxygen Manufacturers: Engage private players like INOX and Linde for bulk production, storage, and rapid deployment of medical-grade oxygen during emergencies.
  Example: These firms supported oxygen supply during India’s COVID-19 second wave.
• Incentivise Local Manufacturing Units: Provide subsidies, tax breaks, and ease-of-business support for MSMEs setting up oxygen equipment manufacturing and maintenance hubs.
• PPP in Training and Maintenance: Partner with the private sector and NGOs to train biomedical engineers and ensure round-the-clock maintenance of oxygen infrastructure.
  

Inter-State Cooperation

• Establish a National Oxygen Grid Framework: Facilitate surplus-deficit balancing across states with buffer stock agreements and transport protocols.
  Example: Tamil Nadu supplied oxygen to Delhi and Maharashtra during COVID through mutual coordination.
• Create Standardised Protocols: Develop centrally approved norms for quality, storage, and emergency oxygen movement between states to avoid regulatory delays.
• Promote Regional Training and Support Hubs: Set up regional centres for training biomedical staff and maintaining oxygen systems under central guidance but shared by neighbouring states.

India’s oxygen access gap reflects a deeper issue of public health equity and human rights. Oxygen must be treated as a guaranteed right, not a privilege. Institutionalising access through a coordinated, technology-driven, and policy-backed framework is essential for inclusive healthcare.