Persistent inequalities in healthcare have left many health systems in the Global South on the brink of collapse as Covid-19 case numbers climb and vaccinations lag, according to a new study of countries that are lacking oxygen supplies for patients.

The Bureau of Investigative Journalism analyzed data from the Every Breath Counts Coalition, the NGO Path, and the Clinton Health Access Initiative (CHAI) and found that at least 19 countries need more than 13 million liquid gallons of oxygen per day to cope with rising case numbers.

India, Nepal, Argentina, Colombia, Pakistan, South Africa, and Iran are among the countries most at risk, the report showed, with fewer than one in 10 people having been vaccinated and the need for oxygen supplies rising more than 20% since March. 

“We could see the total collapse of health systems, especially in countries with very fragile systems,” said Robert Matiru, chair of the World Health Organization’s Covid-19 Oxygen Emergency Task Force. 

“Medical oxygen has been around for over a century yet countries are struggling to prevent Covid patients from suffocating,” said Dr. Paul Sonenthal, a critical care physician and instructor at Harvard Medical School. “It’s a tragic example of the violence of health inequity and demands action.”

The task force was assembled in February as WHO announced that $90 million was needed immediately to secure oxygen supplies in up to 20 low- and middle-income countries. 

“Medical oxygen has been around for over a century yet countries are struggling to prevent Covid patients from suffocating. It’s a tragic example of the violence of health inequity and demands action.”
—Dr. Paul Sonenthal, Harvard Medical School

At the time, Brazil’s Covid-19 crisis was being called “a warning to the whole world” as it faced an especially contagious variant of the coronavirus and hospitals in the northern state of Amazonas ran out of oxygen, forcing healthcare workers to allow some patients to suffocate while they saved others. 

“The situation last year, and again in January this year in Brazil and Peru, should have been the wake up call,” said Leith Greenslade, coordinator of the Every Breath Counts Coalition. “But the world did not wake up.”