Respiration is an inevitable process for all living beings. The complexity of the process, beyond the simple explanation of breathing in and out, is least discussed among the general population. But now, oximeters, used for measuring oxygen levels in the blood are common in most households. The necessity of emphasizing the ability to “breathe well” was exposed in its worst condition as the COVID-19 pandemic stretched to its second year. Public and private sector organizations have been trying hard to tackle the challenges in this oxygen supply chain.

Normally, lungs perform the life-sustaining function of gas exchange. The air inhaled through our nose reaches the lungs where oxygen is extracted and transferred to every cell in the body. When we breathe out, carbon dioxide from the cells is collected in the lungs and exhaled through the nose. Oxygen shortage is a situation that occurs when the lungs are not able to meet the optimum oxygen levels necessary for every organ and cell in the body to perform their functions properly, resulting in life-threatening conditions. There are various infections associated with COVID-19. Infections affecting the lungs can cause inflammation or scarring in the lung tissues where the oxygen is passed into the bloodstreams, causing the movement to be difficult. In a healthy person, fully functioning lungs can oxygenate blood up to 95 to 100 percent. A dip to less than 92 percent is a cause of concern for the ideal functioning of the human body. Supplemental oxygen is necessary for these conditions where the individual is provided with an additional oxygen supply from an external source to sustain life. The significance of manufactured oxygen via oxygen supply chain at different levels, comes to play in these situations.

Man in support of additional oxygen supply (Source: iStock)

The Global Oxygen Market

The oxygen supply chain market is expanding with a growth rate of 6.1% since 2015. The market comprises of few large producers contributing to 50% of the total manufactured oxygen, in the world. But the majority of the manufactured oxygen is not used for the health industry but mineral processing applications, automobiles, mining, and other. Currently, medical oxygen makes up just 3% of global production. Since the unprecedented outbreak of the coronavirus, the healthcare segment, which uses medical-grade oxygen is estimated to be the fastest-growing segment in the oxygen market.

Shortage in Medical-grade Oxygen

The supply and demand of medical oxygen follows a seasonal pattern. The accumulated stock during the months with less demand is stored for the busy months. But the COVID-19 pandemic increased the demand for a level beyond the estimated needs of the market which led to a shortage in the medical-grade oxygen generally available.

Considering the critical medical and humanitarian need for medical-grade oxygen, we might arrive at the solution of shipping industrial oxygen for medical needs. But the purity standards are different for both. Medical oxygen has to follow strict regulations and ensure that no other elements contaminate the cylinders. But, to cater to the current situation, some producers are converting their existing industrial oxygen cylinders to medical-grade oxygen, to meet the needs of the current crisis.

Production of Medical-grade Oxygen Cylinders

Oxygen is found in the environment around us, but why is there a critical shortage in the availability of oxygen cylinders for use? To understand this, we need to know more about the steps involved in the process.

The air around us comprises a mix of various gases, including oxygen. The process of cryogenic distillation technique is used to compress atmospheric air into liquid forms. Large manufacturing plants use distillation columns to get the liquid oxygen which is 99.5% pure. This liquid oxygen that is produced, is stored in huge tankers. From there, the transportation of oxygen to different places is carried out by road through cryogenic tankers which look similar to petrol-carrying tankers. These reach the distributors at different areas where the oxygen is converted into a compressed gaseous form and transferred to cylinders to be used in healthcare facilities or, for patients at home. Generally, local suppliers take up the role of middlemen in distributing these cylinders to the market.

Oxygen cylinders (Source: iStock)

Strengthening the Oxygen Supply Chain Management System

Many reasons can be given for the shortage of oxygen supply during these hard times. These cannot be left as justifiable issues but treated as lessons to learn and improve upon. The pandemic has exposed the weak spots of the oxygen supply chain such as production schedules and transportation apart from the infrastructural challenges.

The lack of sufficient manufacturing units is a major issue to counter, to enable enough supply of medical-grade oxygen at the time of need. As we all know, building huge manufacturing units is not an easy task which should comply with many other factors like suitable space, budget, infrastructure etc. Proper planning and scheduling the maintenance of the existing units will help to produce oxygen without any unexpected breaks to avoid any substantial pressure on the supply chain.

Smooth transportation of the liquid oxygen from the production units to different areas is vital for the uninterrupted supply of oxygen. Availability of delivery vehicles and proper maintenance of these trucks will ensure untroubled transportation across various destinations. Streamlining turnaround times and optimizing routes are the key ways of effectively managing logistics.

Truck carrying medical grade oxygen (Source: iStock)

Oxygen cylinders should be maintained to their best quality and the availability of these cylinders should be ensured. A vigilant tracking of the availability of the oxygen cylinders will ensure the effective supply and utilization of the produced oxygen to the end-users.

Empower’s Role in Strengthening Supply Chain Management

Healthcare is an essential need for the entire population. These services are made to be available for everyone at any point in time. To ensure the effective functioning of the health sector, the availability and proper management of equipment, medicine, professionals and essentially a supportive environment are essential. A strong supply chain management system guarantees the establishment of these functionalities in place for any healthcare system, and also upholds the optimal use of resources.

The Empower School of Health, as an active player in the field of health and development, believes in a sustainable solution to ensure a strengthened supply chain management system. Empower has developed and successfully employed its supply chain Competency Assessment Tool (CAT) across three countries in Africa. Various webinars and interactive sessions are being conducted globally with the aim of empowering healthcare professionals and individuals interested in supply chain management to formulate or devise various strategies and novel ideas to frame a sustainable system. Empower has also curated various courses for learners across the globe to build a strong understanding of the procurement and supply chain management systems and how one can effectively employ these skills to strengthen the countries healthcare system.

These hard times have unmasked the vulnerable links in our health system. It is our responsibility to understand and learn from these weak points to build a better system upon them.

About the author:

Amal S works with the Empower School of Health as a Public Health Associate. A development sector and communications professional, he has developed a keen interest in health systems and health communications.