PYQ Relevance:

[UPSC 2024] In a crucial domain like the public healthcare system, the Indian State should play a vital role to contain the adverse impact of marketisation of the system. Suggest some measures through which the State can enhance the reach of public healthcare at the grassroots level.

Linkage: The role of the state in the public healthcare system and asks for measures to enhance the reach of public healthcare, particularly at the grassroots level. The “medical oxygen access gap” is fundamentally a problem of the public healthcare system’s inability to reach everyone with this essential medicine.

What challenges hinder global access to medical oxygen?

• Lack of Equipment: Many hospitals in low- and middle-income countries (LMICs) lack basic tools like pulse oximeters and oxygen supply systems. Eg: Only 54% of hospitals in LMICs have pulse oximeters; 58% have access to medical oxygen.
• High Financial Burden: Expanding oxygen infrastructure requires large investments, which LMICs struggle to afford. Eg: An estimated $6.8 billion is needed globally, with $2.6 billion required in South Asia alone.
• Shortage of Trained Technicians: Lack of biomedical engineers leads to poor maintenance of oxygen plants and frequent equipment failures. Eg: In rural areas, oxygen concentrators remain unused due to absence of trained personnel.
• Power Supply Issues: Unreliable electricity hinders oxygen production, especially in remote or rural regions. Eg: Nigeria and Ethiopia adopted solar-powered oxygen systems to address power disruptions.
• Weak Policy and Regulatory Frameworks: Absence of strong regulations affects the quality, storage, and distribution of medical oxygen. Eg: In Bangladesh, a 2021 health system assessment by PATH and USAID found that lack of national oxygen guidelines and standardised protocols led to irregular supply chains and compromised oxygen quality in many public hospitals, especially in rural areas.

Who is responsible for strengthening oxygen ecosystems?

• Governments: They must integrate oxygen access into universal health coverage and emergency preparedness plans, while ensuring quality standards and regulatory frameworks. Eg: The Indian government scaled up PSA oxygen plants under the PM CARES Fund during the COVID-19 crisis.
• Private Sector: Industry must invest in local manufacturing, supply chain optimisation, and cost-effective technologies. Eg: Indian companies like Inox Air Products ramped up production and collaborated with the government to meet surging oxygen demand.
• Global Health Agencies: Agencies like WHO and UNICEF must provide technical and financial support for infrastructure and workforce training. Eg: WHO supported several LMICs (e.g., Bhutan) in installing and operating oxygen plants through cross-border cooperation.

What has been done by the Indian government in Southeast Asia? 

• Oxygen Supply to Bangladesh: In July 2021, India dispatched 200 metric tonnes of Liquid Medical Oxygen (LMO) to Bangladesh via the ‘Oxygen Express’ train service. This marked the first international deployment of the Oxygen Express, showcasing India’s commitment to assisting neighboring countries in crisis.
• Medical Aid to Vietnam: In August 2021, the Indian Navy’s INS Airavat delivered 100 metric tonnes of LMO and 300 oxygen concentrators to Ho Chi Minh City, Vietnam.