9789240100770-eng

National oxygen scale-up
framework – Road to
oxygen access
Meeting report
Dakar, Senegal
14–16 May 2024
National oxygen scale-up
framework – Road to
oxygen access
Meeting report
Dakar, Senegal
14–16 May 2024
National oxygen scale-up framework - Road to oxygen access: meeting report, Dakar, Senegal, 14-16 May 2024
ISBN 978-92-4-010077-0 (electronic version)

ISBN 978-92-4-010078-7 (print version)
© World Health Organization 2024
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Photo credits:
Cover page: A health worker uses a finger pulse oximeter to measure levels of oxygen saturation in the blood of a patient at
De Martini Hospital, Banaadir, Somalia © WHO/Ismail Taxta/2020 and WHO’s Dr Simon Ssentamu verifies the oxygen cylinder
supply at a health facility in Kutupalang refugee camp, Cox’s Bazar, Bangladesh © WHO / Blink Media - Fabeha Monir/2020.
All report photos are © WHO/MLD/2024 except page 29: © WHO/July Viry/2024.
Contents
Acknowledgements .................................................................................................................. ii
Abbreviations and acronyms .................................................................................................... iv
Meeting purpose and overview .................................................................................................. 1
Background ..............................................................................................................................................................1
Objectives of the National Oxygen Scale-Up Framework Meeting ........................................................................1
Development of the zero-draft oxygen roadmap template ...................................................................................1
Venue...................................................................................................................................... 2
Meeting participants ................................................................................................................ 2
Languages ................................................................................................................................................................3
Meeting agenda ....................................................................................................................... 5
Day 1: 14 May 2024 ...................................................................................................................................................7
Day 2: 15 May 2024 .................................................................................................................................................12
Day 3: 16 May 2024 .................................................................................................................................................18
Polling process and results ...................................................................................................... 23
Delphi consensus process to formalize a national oxygen roadmap template ..................................................23
Poster showcase .................................................................................................................... 24
Partner booths...................................................................................................................... 27
Global Oxygen Alliance (GO2AL) ............................................................................................................................27
Lancet Global Health Commission on Medical Oxygen Security .......................................................................27
Outcomes .............................................................................................................................. 29
Conclusions ............................................................................................................................................................29
Next steps for furthering the National Oxygen Scale-Up template .....................................................................30
Post-meeting survey ..............................................................................................................................................30
References ............................................................................................................................ 33
Annexes ................................................................................................................................ 34
Annex 1: Technical Working Group .......................................................................................................................35
Annex 2: Zero-draft National Oxygen Scale-Up template ....................................................................................36
Annex 3: In-person attendees and affiliations ......................................................................................................40
Annex 4: Speaker, moderator and support staff biographies ..............................................................................45
Annex 5: Detailed agenda for National Oxygen Scale-Up Framework Meeting...................................................57
Annex 6: Breakout session notes ...........................................................................................................................64
Annex 7: Delphi process brief ................................................................................................................................70
Annex 8: Instructions provided during meeting and sample survey ...................................................................72
Annex 9: Summary of polling results.....................................................................................................................88
Annex 10: Media coverage of the meeting ............................................................................................................96
i
WHO National oxygen scale-up framework – Road to oxygen access
Acknowledgements
The World Health Organization (WHO) had the honour to convene 133 participants in person from 64
Member States and 69 partners across 24 organizations at the first National Oxygen Scale-Up Framework
Meeting from 14–16 May 2024 in Dakar, Senegal. In addition to in-person attendance, WHO acknowledges
the over 200 participants who joined us virtually.
The Clinical Management Unit of the Country Readiness Strengthening Department of WHO’s Health
Emergencies Programme would like to acknowledge that this meeting would not have been possible
without the efforts of many. Firstly, we would like to thank Dr Michael Ryan, Executive Director, WHO
Health Emergencies Programme and WHO Deputy General-Director and Dr Nedret Emiroglu, Director,
Country Readiness Strengthening Department, for championing WHO’s efforts on oxygen scale-up.
We would like to thank the core planning and support team for this event: John Appiah, Antoine Chaillon,
Tsira Gabedava, Martha Gartley, Mousse Gningue, Carrie Hemminger, Connie McDonough-Thayer, Steve
McGloughlin, Filiz Onalan, Jamie Rylance, Laura Alejandra Velez Ruiz Gaitan and Varun Venkatesh
Purushotham. Many thanks are also extended to Adriana Velazquez Berumen, Team Lead on Medical
Devices and In vitro Diagnostics, WHO, for her steadfast support and overall technical guidance.
We would also like to thank our colleagues at Partners In Health (PIH): Jessica Cook, Dr Marta Lado, Molly
McGovern, Anne Moller, Dr Shada Rouhani and Dr Paul Sonenthal – for conducting the scoping review of
existing national oxygen scale-up plans and developing the subsequent zero-draft of the National Oxygen
Scale-Up template, and for their support to the core team in the planning of this meeting and on-the-
ground support.
For all the global logistics and travel, thanks are extended to the team from WHO Tunis: Sameh Abassi,
Emna Hamdi, Meriem Meddeb and Kitty Liff Eza Rasmussen; and to our colleagues who hosted us in
Senegal and facilitated all in-country logistics and support: Ndeye Ngom Diaw, Ousmane Drame, Helen
Faye, Pierre Vincent Boly Faye, Moustapha Gningue, Jeff Kabinda Maotela, Louis Bavon Loukakou, Guy
Bertrand N’Jambong, Aïssata Sall, Ndeye Sall, Adji Fatou Sow and Jean Marie Vianny Yameogo.
For enhanced access for both in-person and virtual attendees, we want to thank the WHO interpretation
team: Ghada Chadarevian Boulakovski, Matthew Cole, Elisabeth Kouaovi, Martine Roubeyrie and Eva-
Marie Widmer for interpretation services; and Arlette Ossere Okopoue for offering technical support for
virtual conferencing.
A thank you is also due to the WHO communications team: Nyka Alexander, Tatenda Chimbwanda and
Shagun Khare, for supporting with material development; and to the web team: Alison Ruth Brunier,
Oxana Gourlin, Adam Ungstad and Winnie Wagniers, for building and maintaining our event page.
Final reporting of the event was done by Jessica Cook (PIH), Martha Gartley, Carrie Hemminger and Anne
Moller (PIH). A special thanks goes to Carrie Hemminger for the branding and graphic design for the event.
We would also like to thank the WHO regional and country offices worldwide for supporting nominations
and registration, specifically in helping facilitate attendance for all Member States.
We want to share our gratitude to all the moderators, panellists, speakers and facilitators. We would not
have been able to have such deep and productive discussions without your thoughtful and knowledgeable
contributions.
ii
Last, but certainly not least, we extend our gratitude to all Member States’ representatives and other
oxygen partners for making the effort to attend this meeting. Because you have shared your learnings and
experience, asked your thought-provoking questions and provided invaluable insights, all the while
staying committed to scaling up oxygen within your own countries and across the globe, we had the
reason to convene together in Dakar, Senegal.
The road to achieving universal oxygen access may seem long; however, each action taken matters
because it shows intent, and each action taken will be a step further towards realizing this vision.
We look forward to publishing the final National Oxygen Scale-Up template as an outcome of this meeting
– with the hope it that it will truly set the foundation for strong and sustainable oxygen systems
everywhere.
Dr Janet Diaz
Lead, Clinical Management and Operations Unit, Country Readiness Strengthening,
WHO Health Emergencies Programme, World Health Organization
iii
Abbreviations and acronyms

ACT-A Access to COVID-19 Tools Accelerator
ALIMA Alliance for International Medical Action
CAPEX capital expenditure
CHAI Clinton Health Access Initiative
ESICM European Society of Intensive Care Medicine
GO2AL Global Oxygen Alliance
IFMBE International Federation of Medical and Biological Engineering
LMICs low- and middle-income countries
M&E monitoring and evaluation
MSF Médecins Sans Frontières
OPEX operating expenditure
PAHO Pan American Health Organization
PIH Partners In Health
PSA pressure swing adsorption
RMNCAH reproductive, maternal, newborn, child and adolescent health
TWG Technical Working Group
UNICEF United Nations International Children’s Fund
UNOPS United Nations Office for Project Services
USAID United States Agency for International Development
WHA World Health Assembly
WHO World Health Organization
iv
Meeting purpose and overview
Background
Oxygen is a life-saving medicine which is included in the WHO Model List of Essential Medicines (1) and
used to treat many acute and chronic conditions, including COVID-19 and severe pneumonia. Medical
oxygen is also an essential component of operative care. It is estimated that deaths from childhood
pneumonia could be reduced by 20–40% by providing oxygen where it is not currently available (2). But
despite this, medical oxygen remains a limited resource in low- and middle-income countries (LMICs).
Fewer than half of LMICs have access to a reliable supply (3), a shortage which has been highlighted and
exacerbated by the COVID-19 pandemic. Under the Access to COVID-19 Tools Accelerator (ACT-A)
Therapeutics Pillar, Unitaid convened the Oxygen Emergency Task Force to advocate for, and coordinate,
expansion of access to oxygen (4). This established as a key priority support for countries to identify needs
and develop strategic national oxygen roadmaps. In 2023, this objective was formalized within World
Health Assembly (WHA) resolution 76.3: Increasing access to medical oxygen, which calls on WHO Member
States “to develop, as appropriate, costed national plans to increase access to quality assured, affordable
medical oxygen systems and personnel to meet the identified needs of all patients in the context of
national achievement of the health-related Sustainable Development Goals and universal health
coverage” (5).
The National Oxygen Scale-Up Framework Meeting: Road to Oxygen Access convened Member States
and partners to work towards finalizing a template that could support the development of costed national
medical oxygen plans. The meeting intended to leverage existing experience from countries with oxygen
roadmaps or policy documents and promote understanding, discussion and, ultimately, reach consensus
about the necessary components when planning for costed national oxygen scale-up.
Objectives of the National Oxygen Scale-Up Framework Meeting

• To explore and reach consensus on the necessary components for national oxygen scale-up efforts
in the form of a template, which could be adapted to country context and support in the
development of costed national medical oxygen scale-up plans.
• To facilitate knowledge exchange, highlight best practices, lessons learned and resource
availability and gaps from current national scale-up efforts.
Development of the zero-draft oxygen roadmap template

WHO engaged Partners In Health (PIH) to conduct a scoping review of existing national oxygen roadmaps
and policy documents in LMICs. This detailed data-driven review provided the foundation for the oxygen
roadmap template development through identification of key components in the review documents.
A data extraction tool was used for the scoping review analysis, designed from a literature review of
existing guidelines, tools and publications and supported by a Technical Working Group (TWG) (see Annex
1 for details) of global oxygen stakeholders established to support meeting activities. Ultimately, 65 items
were developed to extract data on roadmap characteristics.
1
Following screening of 54 roadmaps and policy documents, 21 documents met the inclusion and exclusion
criteria. These documents originated from 18 of 135 LMICs, with the WHO African, Eastern Mediterranean
and Western Pacific regions represented. The full text of these identified documents was assessed in detail
against the inclusion criteria by two independent screeners. The item response structure for the analytic
framework used a scale of 0 to 2: with 0 indicating not mentioned; 1 mentioned, with limited detail or
incomplete approach; and 2 mentioned, with details and complete approach.
There was wide variation in the content and completeness of the analysed roadmaps and policy
documents. This highlighted the need for a consensus set of core items that should be included in all
oxygen roadmaps (i.e. a “roadmap template”).
A zero-draft template was created using the scoping review, the text of World Health Assembly (WHA)
resolution 76.3, the WHO Strategy for the National Action Plan for Health Security, and with expert review
from the TWG and WHO technical staff. The zero-draft template included 56 items organized into six
sections and was shared with all participants prior to the meeting in six languages (see Annex 2).
Venue
WHO convened the National Oxygen Scale-Up Framework Meeting: Road to Oxygen Access meeting in
Dakar, Senegal, from 14–16 May 2024. The meeting was hosted at the King Fahd Palace Hotel, offering a
large plenary room, six smaller meeting rooms to accommodate breakout sessions, two prayer rooms
(male and female), an open area for poster presentations and booth displays, and outdoor space for
meeting.
Meeting participants
Participants included representatives of Member States from LMICs and selected Small Island Developing
States, global oxygen stakeholders, including nongovernment organizations (NGOs), donor agencies,
United Nations agencies and civil society organizations.
In-person participation was by invitation only. Virtual participation was available during plenary sessions.
The breakdown of participants is outlined in Table 1 and their geographic representation in Fig. 1. A list of
all in-person participants and their affiliations can be found in Annex 3.
Biographies and photos for all participants who also contributed as moderators, panellists, speakers,
facilitators and support staff can be found in Annex 4.
2
Table 1. The National Oxygen Scale-Up Framework Meeting: Road to Oxygen Access – participation summary
Category Number
Total in-person participants 133
Member State ministry of health nominees 64
Partner participants 45
WHO participants 24
Virtual participants 217
Partner organizations represented 24
All in-person participants outside the King Fahd Palace Hotel conference centre. © WHO/MLD Design/2024
Languages
The meeting was conducted in English with simultaneous interpretation for plenary sessions in Arabic,
French, Russian and Spanish. Interpretation was available for all virtual attendees.
All breakout sessions were offered with French interpretation; four of the seven breakout sessions were
also interpreted in Arabic, Russian and Spanish.
3
Fig. 1. Geographic representation of attendees
In-person Member State ministry of health nominees All in-person attendees
All in-person and virtual attendees
Partners who attended represented 24 organizations including:
✓ Assist International ✓ Management Sciences for ✓ Lancet Global Health

✓ Bill & Melinda Gates Health (MSH) MTaPS program Commission on Medial
Foundation ✓ Médecins Sans Frontières Oxygen Security
✓ Clinton Health Access (MSF) ✓ Unitaid
Initiative (CHAI) ✓ MedGlobal ✓ United Nations Children’s
✓ DAK Foundation ✓ One Health Trust Fund (UNICEF)
✓ European Society of Intensive ✓ Oxygen CoLab ✓ United Nations Office for
Care Medicine (ESICM) ✓ Partners In Health (PIH) Project Services (UNOPS)
✓ FHI 360 ✓ PATH ✓ University of Ibadan (Nigeria)/
✓ International Federation of ✓ Save the Children Oxygen for Life Initiative
Medical and Biological ✓ Alliance for International ✓ University of Rwanda
Engineering (IFMBE) Medical Action (ALIMA) ✓ World Health Organization
✓ Karolinska Institutet
4
Meeting agenda
The meeting opened with remarks by
Dr Michael Ryan (Executive Director/
Deputy Director-General, WHO), followed
by Dr Jeff Kabinda Maotela, WHO Senegal
Representative, officer-in-charge (OIC)
and Dr Fatou Mbaye Sylla as the official
representative for the Ministère de la
Santé et de l’Action sociale, République
du Sénégal.
Dr Diaz, Dr Kabinda and Dr Sylla after providing opening remarks
Professor Adegoke Falade (University of on Day 1. © WHO/MLD Design/2024
Ibadan, Nigeria) followed with the keynote
address, and Dr Janet Diaz (WHO) reinforced all of the welcome remarks and set the stage with regard to
meeting objectives.
After which, the event comprised plenary and breakout sessions (see Fig. 2 and Annex 5 for agenda
details).
▪ Day 1 focused on the draft template and the components needed to develop a national oxygen
scale-up plan. This was achieved through information sessions led by technical experts and
interactive panel sessions with representatives from Member States and implementing partners.
▪ Day 2 continued with the interactive plenary sessions followed by breakout sessions facilitated by
thematic experts to build and refine each component of the template through consensus-seeking
discussion.
▪ Day 3 concluded with a cross-cutting plenary session, an updated draft template, next steps for its
finalization and commencement of planning for its use and implementation.
Active participation was facilitated through breakout discussions, which, combined with key topic plenary
sessions, examined and discussed medical oxygen scale-up. A modified Delphi consensus process
addressed the primary meeting objective – deciding the necessary template components for developing
costed national oxygen scale-up plans.
Participants were encouraged to bring posters for display at the event to showcase specific tools,
resources, case studies and/or entity-specific materials. Exhibition booths were displayed by the Global
Oxygen Alliance (GO2AL) and the Lancet Global Health Commission on medical oxygen security.
5
Fig. 2. Meeting agenda, short format
The following sections provide an overview of the plenary and breakout sessions as well as key takeaways.
Note: Due to timing of the opening session, the agenda was adjusted and plenary session 2 was
rescheduled to take place in the afternoon after plenary session 3.
6
Day 1: 14 May 2024
Day 1 Opening session
1. Welcome and 1. Dr Michael Ryan, Executive Director, WHO Health Emergencies Programme;
opening Deputy Director-General, WHO (virtual)
2. Press point Dr Jeff Kabinda Maotela, WHO Representative, OIC, Senegal
3. Keynote speaker Dr Fatou Mbaye Sylla, Ministère de la Santé et de l’Action sociale, République du
4. Setting the stage Sénégal
5. Meeting agenda 2. Press point
3. Professor Adegoke Falade, Professor of Clinical Science, College of Medicine,
University of Ibadan, Nigeria
4. Dr Janet Diaz, Lead, Clinical Management and Operations Unit, Country Readiness
Strengthening, WHO Health Emergencies Programme, WHO
5. Dr Marta Lado, Director, Clinical Programs and Health Policy, Sierra Leone, PIH
Professor Adegoke Falade (Oxygen for Life Initiative/

University of Ibadan, Nigeria) gives the keynote
address. Dr Janet Diaz (WHO) sets the stage for the
meeting.
© WHO/MLD Design/2024
The recording for the welcome and opening is available here and the keynote and setting the stage here.
Plenary session 1: Existing oxygen roadmap highlights
The Moderator introduced the concept of Moderator: Dr Habtamu Seyoum Tola, Health Specialist, Access to
planning for oxygen scale-up, outlining Essential Child Health and Medicines, UNICEF
requirements, who to involve and how Panellists:
scale-up plans can be used. • Dr Khamsay Detleuxay, Director-General, Department of Healthcare
and Rehabilitation, Ministry of Health, Lao People’s Democratic
Panel discussions included: Republic
• Initiating a roadmap • Noelia Solares Muralles, Pharmaceutical Specialist, Ministry of
• Successes and challenges Health, Guatemala
• What the future holds. • Dr Olfa Challouf, Deputy Director of the Organization of Hospital
Activities, Ministry of Health, Tunisia
Open floor: Q&A and participant sharing. • Dr Prakash Budhathoki, Chief, Health Emergency and Disaster
Management Unit, Ministry of Health and Population, Nepal
• Dr Damira Sharabidinovna Begmatova, Director, Kara Suu District
Hospital, Kyrgyzstan
7
Key takeaways
✓ Situation analysis – Know your

need, know your gap and plan
strategically across services and
programmes to ensure the
sustainability of existing
investments and scale-up for
further needs.
✓ Identify and coordinate key
stakeholders and engage them
as early as possible, including
internal (ministries of health and
of finance, regulatory), external The Moderator and panellists for Plenary session 1. © WHO/MLD
stakeholders and all relevant Design/2024
workforce cadres, including
clinical, technical, infrastructure specialists, energy specialists, administrators and others.
✓ Sustainable financing is a critical shared challenge. It is necessary to design strategies to mobilize
financial resources.
✓ Though there are various entry points for increasing oxygen access – e.g. through a specific health
programme like COVID-19 or children’s health – ensure that oxygen scale-up is not a vertical
programme, but rather an integrated health system intervention.
✓ Key roadmap components include ensuring an adequate and resilient oxygen supply from existing
and planned oxygen production, storage, distribution and maintenance systems, with consideration
of location, distance, accessibility and risk mitigation; ensuring rational and safe clinical use;
monitoring and evaluation (M&E) systems for tracking progress, achievements and challenges; and the
need for regulatory policies across the oxygen ecosystem.
The recording for this session is available here.
Plenary session 3: Oxygen scale-up deep dives (Part 1) –

Effective partnerships
Part 1: Effective partnerships for Moderator: Dr Chizoba Fashanu, Deputy Program Director, Malaria
development and implementation of and Essential Medicines, Clinton Health Access Initiative
oxygen scale-up activities
Panellists:
The Moderator discussed partnerships across • Robert Matiru, Director of Programmes, Unitaid; Co-chair of the
all levels, sectors and cadres. Global Oxygen Alliance (virtual)
• Dr Nicholas Adjabu, Head, Biomedical Engineering Unit, Ministry
Panel discussions included: of Health, Ghana
• Multistakeholder engagement: • Maurine Murenga, Focal Point Special, Community Delegation to
government, NGOs, donors, private sector The Global Fund (virtual)
• Multidisciplinary engagement: technical, • Dr Nahreen H Ahmed, Medical Director, MedGlobal
clinical, administrative, logistics, • Dr Elvis Temfack, Senior Research Officer, Africa Centres for
architects, procurement Disease Control and Prevention (virtual)
• Collaborations in vulnerable or fragile • Dr Muhammad Mudassar, Medical Officer, Ministry of Health,
contexts. Pakistan
Open floor: Q&A and participant sharing.
8
Key takeaways
✓ The ACT-A Oxygen Emergency

Taskforce, established to help
expand access oxygen during the
COVID-19 pandemic, illustrates
the opportunities for
partnerships to play an impactful
role in oxygen ecosystems, from
strengthening supply logistics, to
brokering agreements with
oxygen suppliers and advising on
development of national
The Moderator and panellists for the plenary session on effective
strategies. partnerships. © WHO/MLD Design/2024
✓ Coordination of partnerships,
informed by an intentional
mapping of country need and partnership capacity, is important to ensure synergy and avoid
duplication of effort.
✓ Partnerships should consider context-specific needs – approaches to oxygen ecosystem
strengthening must be responsive across multiple contextual dimensions including extent of health
system centralization and the presence of conflict.

Costing and sustainable financing
Part 2: Costing and sustainable financing of Moderator: Dr Gwenael Dhaene, Health Systems Adviser, WHO
oxygen ecosystems
Panellists:
The Moderator provided an overview of the • Dr David Lowrance, Senior Advisor, Pandemic
financing framework required for oxygen scale-up Preparedness and Response, The Global Fund (virtual)
costing and sustainable financing for assurance of • Scott Pendergast, Director for Strategy, Programmes and
system continuity. Partnerships, WHO Health Emergencies Programme, WHO
• Ankara Alejandra Reichle Collier, Biomedical Engineer,
Panel discussions included: Ministry of Health, Honduras
• Financial planning (costing resources and • Dr Rose Lavado, Technical Officer, Financial Protection,
activities, prioritization, e.g. universal health Equity and Poverty, WHO (virtual)
coverage, Pandemic Fund)
• Budget cycles/timing, decision-makers
• Integration into broader health system
financing, including financing mechanisms
(insurance schemes, innovative cost recovery
modalities)
• Gaps in financing for continued operations for
safe, quality sustainable outputs.
9
Key takeaways
✓ Importance of a progressive and holistic

approach that factors in broader health
system needs specific to context (as
oxygen systems are a function within these
broader ecosystem).
✓ Costing exercises should consider both
capital investments and recurring costs
that countries will face. The capital assets
costing should look at granular unit costs
and data pertaining to public and private
health stakeholders. And operational Dr Dhaene moderates the plenary session on sustainable
costs, which are often overlooked, must financing. © WHO/MLD Design/2024
include staff, supplies and maintenance
costs, that countries need to enable system functionality.
✓ Potential sources of financing beside budgetary allocation for capital investment include grants,
concessional or investment loans from international investors such as bi/multilateral development
banks, blended finance, or market instruments (such as private investment)
✓ Domestic financing is essential, particularly to demonstrate commitment as well as capacity to cover
operational expenditure.

Importance of the workforce
Part 3: Importance of the workforce for oxygen Moderator: Dr John Appiah, Consultant, Clinical Management
ecosystems and roadmap development and Operations Unit, Country Readiness Strengthening, WHO
Health Emergencies Programme, WHO
The Moderator underscored the need for
multidisciplinary human resources for health Panellists:
systems, at all levels, to advocate for, plan, • Tazeen Saeed Bukhari, Board Member, IFMBE Clinical
implement, use and sustain medical oxygen Engineering Division
systems. • Dr Gilbert Shetak, National Oxygen Desk Director,
Department of Hospital Services, Federal Ministry of Health
Panellists showcased persistent needs and and Social Welfare, Nigeria
challenges: • Professor Mervyn Mer, Faculty of Health Sciences, University
• Training and education (in-service, pre- of the Witwatersrand, Johannesburg, South Africa
service), expanding and supporting diverse • Dr Dora Lenturut-Katal, Acting Deputy Secretary, National
occupational groups (clinical, technical, Health Services Standards, National Department of Health,
administrative, logistics, architects, Papua New Guinea
procurement)
• Facility organizational structure, delineating
all roles (highlighting skills mix), identification
of persistent shortages
• Labour markets (dynamics; need, demand
and shortages, recruitment and retention).
10
Key takeaways
✓ Workforce challenges include global shortages of

health workers and limited access to regular
training programmes. This can lead to negative
impacts for patient care, including medical device
failures.
✓ The oxygen health workforce is multi-
disciplinary, and staff outside of the clinical setting
should be considered. This includes technical
personnel (engineers, technicians, energy and
infrastructure specialists), procurement and Dr Gilbert Shetak (left, Ministry of Health, Nigeria) and Dr
supply personnel, and regulatory and compliance John Appiah (right, Moderator, WHO) during the plenary
officers and administrators. session on workforce. © WHO/MLD Design/2024.
✓ Key roadmap components include a
commitment to workforce training; strategies for retention of staff; monitoring progress during
workforce development; and adapting approaches based on lessons learned.
Due to technical difficulties, only the Q&A portion of this session was recorded, which is available here.
Plenary session 2: The National Oxygen Scale-Up template
Foundational requirements of oxygen scale-up Adriana Velazquez Berumen, Team Lead on Medical Devices and
In vitro Diagnostics, WHO
Overview of existing oxygen roadmaps, results Anne Moller, Associate Director for Public Health and Emergency
from scoping review. Systems, PIH
Overview of zero draft of the National Oxygen Jessica Cook, Senior Analyst, Universal Health Coverage
Scale-Up template Financing, PIH
• What is meant by “template”?
• How was it developed?
• Template contents
• Intended users, how it can be used.
Plenary session 4: Template polling – introduction
Introduction to the Delphi methodology • Anne Moller, Associate Director for Public Health and
Emergency Systems, PIH
How we will apply the process to the National • Dr Jamie Rylance, Subject Matter Expert, Clinical
Oxygen Scale-Up template zero draft Management and Operations Unit, Country Readiness
Demonstration of polling feature (to take place at
the end of Day 2)
Closing remarks
Day 1 wrap-up, looking to Day 2 and closing Dr Marta Lado, Director, Clinical Programs and Health Policy,
remarks Sierra Leone, PIH
11
Day 2: 15 May 2024
Brief welcome and overview of Day 2 agenda Alfonso Rosales, Technical Officer, Medical Devices and
In vitro Diagnostics, PAHO/WHO

Finding the need-gap
Part 4: Finding the need-gap: assessment and Moderator: Lisa Smith, Program Leader, Market Dynamics,
quantification for oxygen scale-up PATH
The Moderator provided overview and summary of Panellists:

unmet needs within the oxygen ecosystem, including • Martha Gabriela Chiguano Curicho, Biomedical
recognition that these needs will constantly evolve. Engineer, Ministry of Public Health, Ecuador
• Dr Beverly Bradley, Technical Specialist, Oxygen
Panellists discussed their experiences of assessing and Therapy, Supply Division, UNICEF
meeting needs: • Vusumuzi Sibusiso Dlamini, Biomedical Engineer,
• Examples of challenges faced Ministry of Health, Eswatini
• How they have prioritized unmet needs • Dr Chiori Kodama, Medical Officer, WHO Health
• Tools that have assisted in improving performance Emergencies Programme, WHO Regional Office for the
• Pandemic and surge preparedness. Eastern Mediterranean
• Dr Varun Manhas, Associate Director of Public Health
Open floor: Q&A and participant sharing. Programs, One Health Trust
Key takeaways
✓ Estimating oxygen needs is complex:

o Medical oxygen is necessary for a
broad spectrum of clinical conditions
and surgery with varying oxygen
requirements.
o Oxygen needs fluctuate at patient,
facility and country levels due to
disease burden, epidemiological
trends and delivery pathway (i.e. nasal The Moderator and panellists during the plenary session on
finding the need-gap. © WHO/MLD Design/2024
cannula oxygen vs mechanical
ventilation).
o Oxygen access is hard to measure due to a wide range of equipment and resources, including
trained staff, multiple metrics used to measure access, and inconsistencies in available data.
✓ Countries are piloting different approaches to tracking oxygen access, leveraging various
modalities such as public and private sector monitoring.
12
✓ Engaging and organizing
stakeholders are essential to
successful outcomes. Effective
stakeholder involvement requires
government-led coordination,
including assignment of clear
roles and responsibilities.
✓ Supporting real-time tracking is
important to ensuring that
oxygen is available. Threshold
The Moderator and panellists during the plenary session on measuring
alarms and tracking oxygen
impact and outcomes. © WHO/MLD Design/2024
availability, especially in variable
supply settings, are critical for ensuring an uninterrupted supply.

Measuring impact and outcomes
Part 5: Measuring impact and outcomes for timely action Moderator: Dr Carina King, Associate Professor of
toward evidence-informed decision-making along the Global Health, Karolinska Institutet, Sweden
oxygen ecosystem
Panellists:
The Moderator provided an overview of the challenges of • Dr Janet Diaz, Lead, Clinical Management and
acquiring, analysing and utilizing data to measure outcomes Operations Unit, Country Readiness
for the safe, effective treatment of patients, for quality-assured Strengthening, WHO Health Emergencies
oxygen systems, and for global investments and governance. Programme, WHO
• Dr Erasto Sylvanus Odindo, Health Disaster
Panellists discussed the importance of evidence-informed Management Specialist, Ministry of Health,
decision-making and the application of relevant and United Republic of Tanzania
appropriate data systems and timely analysis of indicators for • Dr Jean-Paul de Bruyne Mushenvula,
evaluation within the oxygen ecosystem: Programme Medical Manager, ALIMA
• Use of data for evidence-informed decision-making for • Dr Freddy Kitutu, Dean, School of Health
policy and governance at all levels of the health system Sciences; Senior Lecturer, Health System
• Using data to illustrate improved outcomes and identify Pharmacy, Makerere University, Uganda
gaps for advocacy • Dr Jeanine Condo, Managing Director, CIIC-HIN;
• Measuring patient-centred clinical care outcomes Adjunct Associate Professor, University of
• Ongoing M&E of operational activities for: Rwanda
- Accountability and learning regarding
implementation and utilization
- Ensuring safe, optimal performance of oxygen system
equipment
- Improving national coverage through
decentralization of services.
13
Key takeaways
✓ Leverage routine clinical data collection by considering how existing databases can be used to
generate quality measures and key performance indicators.
✓ Data from clinical research, including observational studies (e.g. O2CoV2) and clinical trials, provide
important insights that can inform future interventions and policies.
✓ Available resources include the WHO key performance indicators for the medical oxygen ecosystem
and the Lancet Global Health Commission on Oxygen Security’s ATMO2S (access to medical oxygen
scorecard).
✓ Recognize the importance of not just collecting but applying learnings – with the need to include
decision-makers in the set-up of these systems and empower health care workers and data staff with
feedback loops.
Breakout sessions
Semi-structured, thematically organized breakout sessions allowed participants to connect and share
ideas in smaller groups. This enabled in-depth information exchange, and encouraged discussions of
challenges, successes and questions of clarity on the draft template. Participants chose four out of seven
breakout groups to attend. Each session lasted 60 minutes. Live translation services were provided at least
once for every topic.
The following section provides an overview of key takeaways from the breakout sessions. Detailed notes
can be found in Annex 6.
Facilitation team:
Oxygen ecosystem quantification, including
1 Lisa Smith (PATH), Florestan Boualame (WHO),
surge scenarios
Mostafa Othman (WHO)
Key takeaways
✓ Quantification and gap analyses underpin many aspects of a roadmap template.
✓ Use metrics including but not limited to average flow rate, ratio of severe to non-severe patients, occupancy rate,
WHO guidelines, number of technicians per oxygen plant, oxygen system management and oxygen cylinder
management to determine broader system needs.
✓ Utilize national standards around the number of staff per level of care, number of devices per ward and
consumables and accessories to meet minimum needs.
✓ Various approaches to oxygen estimation exist; consider the level of maturity of the analysis to determine which
tools are appropriate.
Facilitation team:
Technical aspects of oxygen systems: Jim Stunkel (Assist International), Dmytro Osin (WHO),
2 source, storage, distribution, operations, Gabriela Jimenez Moyao (UNOPS), Noelia Solares Murales
maintenance and associated infrastructure (Ministry of Health Guatemala), Ankara Alejandra Reichle
Collier (Ministry of Health Honduras)
Key takeaways
✓ Quality assurance for oxygen is necessary to ensure safety and end-user confidence.
✓ Safety practices, such as fire safety planning, safe cylinder handling and hydrostatic (pressure) testing, must be
included in oxygen system planning to protect people and facilities.
14
✓ To ensure an uninterrupted oxygen supply, plan for surge scenarios, including redundant systems and secondary
and tertiary oxygen sources.
✓ Assess and ensure the adequacy of the physical environment where oxygen is produced and delivered to
guarantee oxygen systems' reliability, safety and efficacy.
✓ Clean and reliable power supplies are necessary for sustainable systems.
Facilitation team:
Financing and sustainable investment in
3 Dr Gwenael Dhaene (WHO), Dr Immaculee Mukankubito
oxygen ecosystems
(WHO), Jessica Cook (PIH)
Key takeaways
✓ Needs and gaps analyses are the investment drivers. The analysis should examine the theory of change and
whole-of-life system costing, and implementation planning. It should always consider current and forecast
epidemiological needs.
✓ Evidence-based data and real-world documented experience are needed to bolster solutions and to sketch out
contextual solutions.
✓ Investment in oxygen systems requires a multisectoral, system-wide approach to ensure sustainability, including
qualified workforce, energy, infrastructure, high-grade water, waste management and other ancillary services.
✓ Legal frameworks (legislation and regulations) should be assessed to enable capital projects and
implementation.
✓ Consider financing beyond capital expenditure (CAPEX) and ensure that operating expenditure (OPEX)
projections include realistic budget line items, in particular for maintenance and considering building local
capacity and environmental constraints.
✓ A national health investment plan comprising of oxygen-related targets is required to align with donors and
funders and assess market capacities and appetite for investment. Building an investment case demonstrating
the oxygen value chain and showing value for money is essential for promoting further investment.
✓ The private providers and contractors for equipment or infrastructure should be involved and share
accountability for know-how and technology transfer.
✓ Optimize and seek out public-private collaborations.
✓ Regional or national agreements could also be developed between public entities to pool resources, leverage
capital goods acquisition or negotiate prices.
Facilitation team:
Workforce and competencies needed for
4 Dr John Appiah (WHO), Alfonso Rosales (WHO),
sustained oxygen ecosystems
Dr Jerry-Jonas Mbasha (WHO)
Key takeaways
✓ Engage a multidisciplinary approach to unify clinical and non-clinical health workforce around a common goal.
✓ To increase equitable access to service delivery, ensure comprehensive clinical training reaches all health care
workers, especially those in remote and underserved areas.
✓ Establish regulatory bodies and mechanisms that develop, enforce and monitor regulations for the technical
aspects of oxygen production and delivery to ensure quality, safety and reliability across all health care settings.
✓ Focus on strengthening training of health care workers to fill the existing knowledge and skills gap.
✓ Establish accurate data collection systems to allow robust monitoring of regulatory policy standards for the
technical aspects of oxygen production and delivery, ensuring quality, safety and reliability across all health care
settings.
✓ Develop specialized training modules for biomedical engineers to establish accessible national expertise.
✓ Establish platforms and initiatives that facilitate regional exchange of experiences and best practices to improve
knowledge sharing.
Facilitation team:
Measuring impact and outcomes of oxygen
5 Dr Carina King (Karolinska Institutet), Dr Steven McGloughlin
ecosystems
(WHO), Dr Marta Lado (PIH)
15
Key takeaways
✓ Use burden of disease estimates and individual patient-level data to quantify oxygen needs.
✓ Integrate medical oxygen indicators into HMIS systems (e.g. DHIS2) to ensure maximal availability and
consistency of health informatics.
✓ Establish systems for monitoring oxygen systems from production to patient delivery to evaluate inefficiencies
and oxygen wastage, including data from industry, biomedical engineering and finance departments.
✓ Ensure quality or management teams at the facility level to include oxygen monitoring.
Facilitation team:
Policy, regulations and guidelines for safe,
6 Laura Alejandra Velez Ruiz Gaitan (WHO), Dr Jinho Shin
quality-assured oxygen systems
(WHO), Samriddha Rana (WHO)
Key takeaways
✓ Policies should focus on community needs, acceptance and understanding to ensure engagement with
implementation for equitable access to oxygen therapy.
✓ Ensure local capacity to absorb various technologies and clinical programmes.
✓ Ensure a multistakeholder approach for planning, implementation and evaluation to assess impact
comprehensively.
✓ Create regional or international mechanisms to share lists of prequalified manufacturers and authorized
distributors to increase access to trusted quality oxygen systems.
✓ Promote multisectoral collaboration (from the private and public sectors) to increase access to standards,
training and technical documentation in different languages.
✓ Drive accountability at all levels once roles and responsibilities have been clearly defined to promote good
governance.
Facilitation team:
Partnerships and engagement for oxygen
7 Inutu Kanyama (PATH), Dr Jamie Rylance (WHO),
scale-up
Anne Moller (PIH)
Key takeaways
✓ Partnerships should be explicit, understood by all parties and driven by the needs of nation-states (rather than
the presence of available partners).
✓ Patient perspectives should inform the identification of nation-states' needs; patient outcomes should inform
stakeholder relationships.
✓ Regional/multilateral partnerships could be a powerful source for improving oxygen access, such as through
expanded funding opportunities.
✓ Stakeholder relationships should be monitored and evaluated, with a possible role for civil society to ensure
accountability.
✓ Communication with partners should be active and focused on reducing inefficiency.
✓ Community engagement must carefully define "which community" to promote effective communication and
partnerships.
✓ Powerful partnerships with the private sector begin with well-communicated predictability of legislation and
taxation policies, payment methods for oxygen (e.g. medical insurance schemes) and technical specifications.
✓ Careful consideration is required to integrate oxygen scale-up efforts into broader sexual, reproductive,
maternal, newborn, child and adolescent health, and universal health coverage programmes and platforms.
16
Participants during the breakout sessions on Day 2. © WHO/MLD Design/2024
Plenary session 6: Template polling – Round 1 and Closing remarks
Electronic voting on National Oxygen Jessica Cook, Senior Analyst, Universal Health Coverage Financing, PIH
Scale-Up template revised draft
Brief closing remarks Alfonso Rosales, Technical Officer, Medical Devices and In vitro Diagnostics,
PAHO/WHO
17
Day 3: 16 May 2024
Brief welcome and overview of Day 3 agenda Samriddha Rana, Health Emergency Intervention Officer, WHO
Regional Office for South-East Asia
Overview of consensus on the National • Anne Moller, Associate Director for Public Health and Emergency
Oxygen Scale-Up template zero draft Systems, PIH
• Laura Alejandra Velez Ruiz Gaitan, Technical Officer and Focal
Point for Oxygen Access Initiative, Clinical Management and
Operations Unit, Country Readiness Strengthening, WHO Health
Emergencies Programme, WHO
Plenary session 7: Debriefing discussion on breakout sessions (Part 1)
Part 1: Debriefing discussion on breakout Moderator: Dr Steven McGloughlin, Consultant, Clinical

sessions Management and Operations Unit, Country Readiness Strengthening,
WHO Health Emergencies Programme, WHO
Additional proposed changes to the National
Panellists, facilitators of breakout sessions 1–3:
Oxygen Scale-Up template zero draft and/or
1. Lisa Smith, Program Leader, Market Dynamics, PATH
remaining gaps/areas of uncertainty.
2. Jim Stunkel, Vice President, Technical Services, Assist
International
1. Oxygen ecosystem quantification,
3. Dr Gwenael Dhaene, Health Systems Adviser, Health
including surge scenarios
Infrastructure Focal Point, WHO
2. Technical aspects of oxygen systems:
source, storage, distribution, operations,
maintenance, associated infrastructure
3. Financing and sustainable investment in
oxygen ecosystems
Facilitators from breakout

sessions 1-3 share
highlights.
18
Plenary session 7: Debriefing discussion on breakout sessions (Part 2)
Part 2: Debriefing discussion on breakout Moderator: Constance McDonough-Thayer, Data Systems

sessions Specialist, Operational Support and Logistics Unit, WHO Health
Additional proposed changes to the National
Oxygen Scale-Up template zero draft and/or Panellists, facilitators of breakout sessions 4–7:
remaining gaps/areas of uncertainty. 4. Dr John Appiah, Consultant, Clinical Management and
4. Workforce and competencies needed for
sustained oxygen ecosystems
5. Dr Carina King, Associate Professor of Global Health, Karolinska
5. Measuring impact and outcomes of
Institutet, Sweden
oxygen ecosystems
6. Laura Alejandra Velez Ruiz Gaitan, Technical Officer and Focal
6. Policy, regulations and guidelines for
safe, quality-assured oxygen systems
7. Partnerships and engagement for oxygen
scale-up
7. Inutu Kanyama, Market Dynamics Officer, PATH
Facilitators from breakout

sessions 4-7 share
highlights.
19
Plenary session 8: Cross-cutting aspects of oxygen ecosystems –

alignment and integration
Alignment and integration of oxygen scale- Moderator: Dr Leah Greenspan, Senior Newborn Advisor and
up activities Neonatologist, Global Health Bureau, United States Agency for
International Development (USAID)
The Moderator provided an overview of health
system priorities, programmes and reliance on Panellists:
multisectoral engagement, all of which must • Dr Rajesh Sreedharan, Team Lead, Country Assessment and
be integrated for successful, sustainable Planning, Health Security Preparedness Department, WHO
oxygen scale-up. Health Emergencies Programme, WHO (virtual)
• Dr Nirmal Kandel, Head, Evidence and Analytics for Health
The panel considered horizontal integration of Security Unit, WHO (virtual)
oxygen systems: • Dr Dennis Marke, Programme Manager, Expanded Programme
• Health system priorities (One Health, on Immunization and Child Health, Ministry of Health and
Sustainable Development Goals, Sanitation, Sierra Leone
universal health coverage, health systems • Professor Didier Mukeba Tshialala, Head of Intersectional
for health security framework, National Medical Platform, MSF International
Action Plans for Health Security and Joint • Dr Sura Wisedsak, Director General, Department of Health
External Evaluations, safe hospitals, Service Support, Ministry of Public Health, Thailand
emergency preparedness, response, • Professor Adegoke Falade, Professor of Clinical Science, College
resilience, etc.) of Medicine, University of Ibadan, Nigeria
• Existing health system programmes • Philip Maina Gatongi, Lead Architect, Technical Services Unit,
(emergency, critical and operative care; UNOPS
noncommunicable diseases; maternal • Dmytro Osin, Biomedical Engineering Officer, Bulgaria, WHO
and child health; tuberculosis; newborn
health; etc.)
• Multisectoral engagement
(infrastructure for health systems, utilities
[electricity, water], transportation,
logistics).
Key takeaways
✓ Oxygen systems must be
integrated into health security
planning and framed within
universal health coverage to
ensure ongoing access, even
when demand surges.
✓ Oxygen must be affordable,
available and quality-assured
and reach the people who most
need it. To achieve this, a cross-
cutting, multidisciplinary
approach, including working with
sectors outside of the clinical
setting, is required.
✓ A multidisciplinary technical The Moderator and panellists during the plenary session on alignment and
working group can facilitate integration. © WHO/MLD Design/2024
20
comprehensive planning and effective data use to achieve health system goals.
✓ Clinical and non-clinical training are critical for the rational, appropriate use of oxygen and safety, including
fire safety.
✓ Practical solutions in the field promote oxygen access where it is otherwise unavailable, such as using
equipment designed to blend oxygen using ambient air to provide safe oxygen to preterm newborns or using
solar energy to operate oxygen concentrators.
✓ Practise interventions and ensure they align with evidence-based practice.
✓ Treatment for hypoxaemia in newborns requires a specially trained workforce and a focus on practising
through the lens of “do no harm”.
✓ There’s a need for multisectoral agreement on the concept of oxygen scale-up initiatives. Planning should
include an assessment and agreement on approach, and data are required to capture key gaps.
Plenary session 9: Template polling – Round 2
Electronic voting on revised National • Anne Moller, Associate Director for Public Health and Emergency
Oxygen Scale-Up template Systems, PIH
• Laura Alejandra Velez Ruiz Gaitan, Technical Officer and Focal
Global Oxygen Alliance showcase
Global Oxygen Alliance showcase Robert Matiru, Director of Programmes, Unitaid; Co-chair of the
Global Oxygen Alliance (virtual)
Open discussion on aspirations and next steps
Next steps for oxygen scale-up • Dr Jamie Rylance, Subject Matter Expert, Clinical Management
• Interactive session: motivations, and Operations Unit, Country Readiness Strengthening, WHO
aspirations, needs Health Emergencies Programme, WHO
• Open forum to share visions, ideas, goals • Adriana Velazquez Berumen, Team Lead on Medical Devices and
• Revisiting foundational requirements: In vitro Diagnostics, WHO
bringing it all together.
21
Dr Janet Diaz, Adriana Berumen and the audience raise their pens to remember their aspirations moving forward
during the last session of Day 3. © WHO/MLD Design/2024
Closing
Meeting wrap-up, closing Dr Janet Diaz, Lead, Clinical Management and Operations Unit, Country
remarks and next steps Readiness Strengthening, WHO Health Emergencies Programme, WHO
22
Polling process and results
Delphi consensus process to formalize a national oxygen roadmap

template
A modified Delphi process was applied to the zero-draft template to finalize the items for inclusion.
Participants were provided with a translated brief of the process before the meeting (see Annex 7) in six
languages. At the end of Day 1, participants were presented again with the Delphi methodology, its
application to the National Oxygen Scale-Up template zero draft and shown a demonstration of the polling
feature that would be used on Day 2 (see Annex 8).
On Day 2, participants completed a survey of all 56 items from the zero-draft template. Participants
received their unique survey link via e-mail and could access it in six languages. They were asked to vote to
"include" or "exclude" each. Participants were offered a third option if they did not have a definitive
opinion, ("I'm not sure"); these responses were not included in the consensus calculation. A free text field
for comments was available after each item and at the end of the survey to suggest new items or
modifications.
Items that reached a predefined 70% threshold of consensus for "include" (as a proportion of definitive
responses) would remain in the template. Similarly, those with a 70% threshold for "exclude" would be
removed from the template.
All items in the first voting round reached at least 87.5% votes for inclusion and were therefore retained. All
free text entries were evaluated by a steering group according to pre-determined criteria. Seven new items
and one item modification were identified. By a show of hands of the participants in plenary, six of the
seven proposals were supported by more than 30%, and therefore included in further voting rounds. A
second round of formal voting was conducted, and all items reached the 70% threshold for inclusion. A
more detailed summary of polling results can be found in Annex 9.
23
Poster showcase
Posters were produced by the following organizations.
Attendees sharing and discussing posters during the event poster showcase. © WHO/MLD Design/2024
Burkina Faso, Ministry of Health and Social Action

Plan triennal de renforcement de la disponibilité et l’utilisation de l’oxygène médical dans les structures
sanitaires du Burkina Faso, 2024–2026
Georgia, Ministry of Labour, Health and Social Affairs
Ghana, Ministry of Health; USAID

Assessment of the new-born respiratory ecosystem from public health facilities in the Northern and Upper
West Regions in Ghana
Guyana Ministry of Health

Oxygen network in Guyana
Honduras, Ministry of Health

Expanding access to oxygen in Honduras: 6 new PSA oxygen generation plants
Kyrgyzstan, Ministry of Health

Using oxygen scale-up in Kara Suu
Liberia, Ministry of Health and Social Welfare

Improving hypoxaemia diagnosis and clinical oxygen delivery in Liberia
Morocco, Ministry of Health

État des lieux des fluides médicaux au Royaume du Maroc
Nigeria, Ministry of Health; CHAI

Building technical capacity for oxygen use in Nigeria: strengthening the HWF across all levels of care
Palau Ministry of Health and Human Services

Strengthening Palau’s medical oxygen system: a national approach to access reliable and affordable
medical oxygen
24
Thailand, Ministry of Public Health
The medical oxygen gas management on public health crisis in Thailand
Tunisia, Ministry of Public Health

Medical Oxygen Strategic Plan 2024–2028
The UNICEF Oxygen System Planning Tool to build oxygen supply chain in Tunisia
Medical oxygen ecosystem in Tunisia situational analysis
Viet Nam, Ministry of Health

Viet Nam’s strategy for "Enhancing the supply and use of medical oxygen”
BREATH investigators
Hypoxaemia in sub-Saharan Africa: epidemiology, clinical practices and outcomes
ALIMA; Heidelberg Institute of Global Health; Technical Uni Ulm; Politecnico di Torino
Essential critical care and O2-supply in low-resource settings from an energy perspective
Oxygen provision in health emergencies: the role of mobile, rapidly deployable electricity units with
extendable photovoltaic capacity
ALIMA, Guinea and Mali

Decentralized oxygen access: feasibility, acceptability, and implementation challenges in primary health
centres in Guinea and Mali
FHI 360, EpiC project

Strengthening medical oxygen ecosystems in low- and middle-income countries
IFMBE
IFMBE CED and GCEA led support for global clinical engineers in COVID-19
One Health Trust, India

National Medical Oxygen Grid (NMOG)
Oxygen CoLab
Making Better Futures, United Republic of Tanzania
Partners In Health, Lesotho

Lessons learned from Partners In Health’s BRING O2 Project: Lesotho oxygen distribution network
PATH
Our integrated approach to improve access to medical oxygen
UNICEF
Supports the planning of oxygen delivery from source to patient, with a customizable tool for demand
estimation and recommendations
Driving the development of a durable, state of the art oxygen concentrator
Delivering sustainable access to oxygen through UNICEF’s innovative Plant-in-a-Box solution
Sustainable scaleup of access to oxygen in the West and Central African Region-UNICEF
USAID MTaPS project

Quality assurance practices for medical oxygen systems
25
WHO Nepal Country Office

Impact study: Photovoltaic (PV) solution for pressure swing adsorption (PSA) oxygen plant
Development and roll out of biomedical equipment related training in Nepal
SARI treatment facility to strengthen national preparedness for public health emergencies in Nepal
WHO Ukraine Country Office

Ukraine national oxygen scale-up efforts and WHO role
WHO Regional Office for Africa

Scaling-up access to medical oxygen in the WHO African Region
WHO Regional Office for the Eastern Mediterranean

WHO Eastern Mediterranean Region Live Oxygen Platform: Endeavour to support medical oxygen scale-
up
WHO/Pan American Health Organization

The PAHO Oxygen Technical Group – GTO2
WHO Regional Office for the Western Pacific

Oxygen scale-up support in the Western Pacific
Region
WHO headquarters
Development of video-trainings for respiratory
equipment as a response to the COVID-19 pandemic
MeDevIS as a WHO information resource of medical
devices for oxygen systems
WHO-led multinational observational study of
oxygen use in COVID-19
Implementation and impact of PSA oxygen
generation systems
Oxygen systems web-based applications (O2 One of the interpreters perusing the poster showcase.
Applets) © WHO/MLD Design/2024
WHO headquarters; ESICM

Strengthening critical care workforce: WHO and ESICM preparatory course rollout
26
Partner booths
Global Oxygen Alliance (GO2AL)

GO2AL is a multistakeholder partnership designed to support low-and-middle income countries with
technical assistance, financial solutions, capacity building and demand-generation to build upon the
investments made during the pandemic.
Why visit our booth?
1. Get to know how our members work with countries and ministries of health.
2. Share how GO2AL could better support your oxygen work – we truly want to gain your guidance.
3. Join our “Ministry of Health Advisory Group” (July–September 2024). Find out how to become a critical
contributor to the development of GO2AL’s Global Strategy and Investment Case and, in turn, use this
to support your work.
4. Learn from one of our “oxygen specialists” – here to answer questions or share solutions.
5. Sign up to receive updates and invitations to special events.
6. Collect your small “thank you” gift for taking the time to visit us.
About us: GO2AL is hosted by Unitaid, UNICEF and WHO and is co-chaired by Unitaid and The Global
Fund and vice-chaired by PAHO and Africa Centres for Disease Control and Prevention. The taskforce
within GO2AL is its engine, generating technical, advocacy and resource mobilization outputs. In addition
to the leadership, GO2AL members currently include the Access to Medicine Foundation, Bill & Melinda
Gates Foundation, Build Health International, CHAI, Every Breath Counts Coalition, PIH, PATH, Save the
Children, UNOPS, USAID, World Bank and representatives from civil society and affected communities.
New members, particularly representatives from LMICs’ ministries of health, are being invited to join as
GO2AL strives to build a stronger, more diverse and inclusive membership.
Visit: www.globaloxygenalliance.org for more information.
Lancet Global Health Commission on Medical Oxygen Security

The Lancet Global Health Commission on Medical Oxygen Security was announced in September
2022 to take stock of the tragic medical oxygen shortages that occurred during the COVID-19 pandemic
and the continued lack of access to medical oxygen plaguing many health systems, and to recommend
strategies to ensure that no patient dies from lack to access to pulse oximetry or medical oxygen
anywhere.
The Commission’s work focuses on four major areas: quantifying oxygen need, defining and measure
oxygen access, analysing oxygen solutions, and generating the financing and political will to
achieve transformational change. Twenty Commissioners oversee the work of the Commission –
academic experts representing all regions – and 40 Advisors provide guidance to the Commissioners.
To ensure the widest possible access to the work of the Commission, a global network of more than
100 organizations – the Oxygen Access Collaborators – meet regularly. The Commission is co-chaired
by Makerere University in Uganda, icddr,b in Bangladesh, University of Melbourne/Murdoch Children’s
27
Research Institute in Australia and the Karolinska Institutet in Sweden. The Every Breath Counts
Coalition provides support to all parties. Together these organizations form the Executive Committee.
The Commission is on track to publish its report with associated comments in early 2025 and will
undertake a series of regional launches to maximize uptake of its recommendations.
To learn more about the Lancet Global Health Commission on Medical Oxygen Security visit:
https://stoppneumonia.org/latest/lancet-global-health-oxygen-commission/.
To get involved, contact Leith Greenslade: leith@justactions.org.
28
Outcomes
Conclusions
This flagship event brought together a
multidisciplinary group – planners, policy
makers, clinicians, (biomedical) engineers
and technicians, emergency preparedness
specialists – all engaged in the complex
challenge of scaling up access to oxygen
for safe, scalable clinical care.
Through candid discussions and

knowledge exchange, attendees were able
to explore both challenges with and
Participants interact during the meeting reception on
effective approaches to oxygen scale-up Day 2. © WHO/MLD Design/2024
and, as a collective, were able to reach
consensus on the necessary components
for doing so. And thus the primary
objective for co-developing a template for
planning and costing national oxygen
scale-up was met.
The meeting was a recognized success,

not only measured by reaching its
objectives, but also through the
observation of active engagement of all
attendees over the course of the 3 days
together, and through feedback from a
Biomedical engineers expand their network during the
post-event survey.
event reception. © WHO/July Viry/2024
Media coverage
During the opening ceremony, Dr Kabinda, Dr Sylla and Dr Diaz held a question-and-answer session with
members of the press. As a result, the meeting received a sizable amount of media coverage across various
platforms in Senegal, including print media, television and radio. Several examples include:
✓ Agence de Presse Sénégalaise : L’OMS préconise un modèle de déploiement national pour une
disponibilité globale de l’oxygène (https://aps.sn/loms-preconise-un-modele-de-deploiement-
national-pour-une-disponibilite-globale-de-loxygene/).
✓ Sud Quotidien : Développement de l’oxygénothérapie : l’OMS vers un nouveau modèl
(https://www.sudquotidien.sn/developpement-de-loxygenotherapie-loms-vers-un-nouveau-modele/).
✓ Agence de Presse Sénégalaise : Un « effort continu » nécessaire pour la disponibilité de l’oxygène
médical (directrice) (https://aps.sn/un-effort-continu-necessaire-pour-la-disponibilite-de-loxygene-
medical-directrice/).
Press releases were also published by the Global Oxygen Alliance, Every Breath Counts Coalition and the
Lancet Global Health Commission for Medical Oxygen Security. See Annex 10 for media coverage across all
platforms.
29
Next steps for furthering the National Oxygen Scale-Up template

Building on momentum from the meeting and other global oxygen initiatives, WHO will continue this
initiative through 2024 and 2025 (see Fig. 3):
✓ Finalize the template for planning and costing national oxygen scale-up in the summer of 2024.
✓ Work, in collaboration with GO2AL, on industry and private sector engagement in the autumn of 2024.
✓ Host a series of workshops and webinars on deep-dive themes explored during this meeting in autumn
2024.
✓ Engage Member States on status and progress with roadmap/scale-up plan development up to WHA 78
in May 2025 and beyond.
Fig. 3. Road ahead for next steps in finalizing and disseminating the template, as discussed at meeting
Our road ahead…

May 2025
WHA 78…
November 2024
Virtual meeting with Member March 2025
October 2024 States on status of roadmaps Virtual meeting with
Workshops & webinars Member States in
on deep-dives themes advance of WHA 78
from template
May 2024
September 2024 WHA 77
Engage with Today!
private sector End-July 2024 WHO National
Template Oxygen Scale-Up
finalized Framework Meeting
Dakar, Senegal
Post-meeting survey
A post-meeting survey was conducted to solicit feedback from all attendees on the content and format of
the meeting. The purpose was to understand if participant expectations were met and serve to improve
future initiatives. The format was 17 scaled questions and 8 open-ended questions. 49 attendees (37%)
responded, and all responses were anonymous (see Figs 4 and 5).
Plenary session feedback
Respondents were asked to scale the plenary sessions in terms of their utility. Scores were very positive,
with average scores over 80% in terms of utility across all topics.
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Fig. 4. Results of participant feedback on the plenary sessions, per a Likert scale
Existing oxygen roadmap highlights 1111 17 28
Scopiong review and

2 16 31
national oxygen scale-up template
Effective partnerships 3 20 26
Costing and sustainable financing 1 3 2 17 26
Importance of the workforce 16 33
Finding the need gap 1 4 17 27
Measuring impact
2 19 28
and outcomes
Cross-cutting aspects of oxygen systems:
11 23 24
alignment and integration
0% 20% 40% 60% 80% 100%
I don't know/no opinion Neutral Not useful Somewhat useful Useful Very useful
Overarching comments on the plenary were that learning experience from other countries was most
interesting and most helpful. However, there were too many formal presentations and not enough time
allocated for more interactive and fluid conversation.
Breakout session feedback
Respondents were asked to scale the breakout sessions in terms of their utility. Scores were very positive,
with average scores over 75% in terms of utility across all topics. It is likely that the “I don’t know/no
opinion” answers resulted from respondents not attending the breakout in question as participants had to
select four of the seven breakout sessions on offer and thus could only provide input on the four they
attended.
Fig. 5. Results of participant feedback on the breakout sessions, per a Likert scale
Quantification 9 2 1 19 18
Technical aspects 4 2 16 27
Financing and
5 3 1 11 29
sustainable investments
Workforce and competencies 4 18 27
Measuring impact and outcomes 4 2 16 27
Policy and regulations 7 1 18 23
Partnerships and engagement 8 1 18 22
0% 20% 40% 60% 80% 100%
I don't know/no opinion Neutral Not useful Somewhat useful Useful Very useful
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Main themes from general comments were that there was not enough time for breakout group discussions.
Participants would have liked the opportunity to go to all topics as opposed to choosing four (of the
seven), and to have breakouts on all days of the meeting. Additionally, some participants expressed that
they were hoping for defined recommendations for potential action (particularly regarding financing).
It was felt that certain topics were only lightly touched on or missing altogether, such as: transport
(security, reliability, cost), system resilience (technical failure, risk of fraud), decentralized contexts (where
roads do not exist, i.e. highly remote) and oxygen in emergencies (conflict, natural disasters).
Format of the meeting and general experience: open-ended feedback
Five open-ended questions were asked. Below are the most predominant or repeated observations.
1. What were your key takeaways from this meeting?

✓ The ATMO2S scorecard tool will be very helpful in tracking progress toward achieving WHA
resolution 76.3
✓ Value that roadmaps will bring to effective scale-up, and to do so holistically, engaging all
stakeholders
✓ The importance of costed plans and identifying financing to enable sustainable systems
2. Were there any topics related to oxygen scale-up that you thought were missing?
✓ More in-depth practical discussions (technical and clinical) with solutions-based outcomes
✓ Research, innovation, local production
✓ Quality and safety
✓ Engagement with private sector
3. Overall, what do you think went well?

✓ Organization of overall meeting
✓ Utility of meeting: good panels and breakouts
✓ Diversity of attendees in terms of expertise and experience
✓ Interdisciplinary approach to topics and discussion
4. Overall, which aspects of the meeting could have been improved?

✓ Meeting was not long enough – needed more time for sharing, more time for breakouts
✓ Technical: more and deeper dives
✓ Virtual: more engagement
✓ Poster session: more time for presenting
5. Please share any additional feedback.

✓ WHO should remain focal/reference point
✓ [Vetted] repository of tools/resources
✓ Translation of all meeting documents/reports please
✓ Next meeting to be held in Asia.
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References
1. World Health Organization Model List of Essential Medicines – 22nd List. Geneva: World Health Organization; 2021
(https://iris.who.int/handle/10665/345533).
2. Lam F, Stegmuller A, Chou VB, Graham HR. Oxygen systems strengthening as an intervention to prevent childhood
deaths due to pneumonia in low-resource settings: systematic review, meta-analysis and cost-effectiveness. BMJ
Glob Health. 2021;6:e007468 (https://gh.bmj.com/content/bmjgh/6/12/e007468.full.pdf).
3. Ross M, Wendel SK. Oxygen inequity in the COVID-19 pandemic and beyond. Glob Health Sci Pract.
2023;11:e2200360. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9972372/).
4. Access to COVID-19 Tools (ACT) Accelerator. Geneva: World Health Organization; 2024
(https://www.who.int/initiatives/act-accelerator).
5. WHA 76.3 Increasing access to medical oxygen. Geneva: World Health Organization; 2023
(https://apps.who.int/gb/ebwha/pdf_files/WHA76/A76_R3-en.pdf).
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Annexes
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Annex 1: Technical Working Group
A TWG was convened to support the meeting activities comprised of 40 participants from organizations
including WHO, Africa Centres for Disease Control and Prevention, UNICEF, UNOPS, ALIMA, Assist
International, Build Health International, CHAI, FHI360, MSF, PATH, PIH, Every Breath Counts, Bill & Melinda
Gates Foundation, DAK Foundation, The Global Fund, Unitaid and USAID.
The TWG held five meetings starting in May 2023, following the WHA, and concluding in February 2024. The
two primary activities were collaborating on the first draft of the meeting agenda and providing input for
and feedback on the analytic framework used as the data extraction tool for the scoping review. The TWG
also reviewed the zero-draft oxygen roadmap template.
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Annex 2: Zero-draft National Oxygen Scale-Up template
Oxygen roadmap template

Zero draft
SECTION 1: Situation analysis

1.1 Hypoxaemia context: Summarize burden of hypoxaemic disease, hypoxaemia outcome trends,
determinants and causes of hypoxaemia. Provide appropriate level of disaggregation (e.g. by age, sex,
location, ethnicity, socioeconomic status and disability).
1.2 Multisectoral stakeholder landscaping.
1.3 Review of national regulations/standards related to oxygen: Review existing national regulations
and standards covering quality/safety standards for medical oxygen. Mention if oxygen is included in
national essential medications list; mention if medical devices for oxygen therapy are included in a
national list; note programmes with oxygen in their strategic and operational plans, such as
reproductive, maternal, newborn, child and adolescent health (RMNCAH), COVID-19 and surgery.
1.4 Review of existing national health strategies and clinical guidelines relating to medical oxygen:
Include discussions of previous oxygen roadmaps and the results of their implementation.
1.5 Oxygen quantification and gap analysis: Assess the scale of medical oxygen access gaps in the health
system, including at subnational- and local-level health facilities, needed to provide patients with:
• the required amounts of medical oxygen and related diagnostic tools (including pulse oximeters and
patient monitors);
• medical devices that deliver oxygen therapy (including invasive and non-invasive ventilators and
continuous positive airway pressure); and
• qualified staff availability.
1.6 Percentage of health facilities with reliable oxygen supply.
SECTION 2: Goals and objectives

2.1 Context: Provide context for objectives and goals informed by and consistent with internationally
agreed recommendations including universal health coverage, Sustainable Development Goals, Safe
Hospitals and World Health Assembly resolution 76.3; emphasize commitment to equity.
2.2 Impact goals: Describe overall impact goals related to patient outcomes or universal access to oxygen.
2.3 Objectives: List objectives with outcomes that are SMART: specific, measurable, achievable, relevant
and time-bound.
SECTION 3: Governance, management and coordination

3.1 Governance: Describe multisectoral and multistakeholder governance arrangements at both national
and subnational levels that specify management, oversight, coordination, consultation and reporting
mechanisms. Consider specific mechanism for intra-governmental coordination to facilitate a whole-
of-government approach to implementation.
36
3.2 Oxygen task force: Establish or maintain taskforce(s) or technical working group(s) including key
stakeholders and subject matter experts to advise and support implementation of the roadmap.
3.3 Advocacy and communication: Promote engagement of all relevant stakeholders and
implementation of planned actions at national and subnational levels.
3.4 Linkages to other oxygen-relevant sectoral strategies and plans: Recognize the role of oxygen in
emergency preparedness and response by referring to the following national assessments and plans:
Joint External Evaluation (of International Health Regulation capacities) and National Action Plan for
Health Security.
Transparency
3.5 Description of roadmap/policy/strategy development process: Provide details of stakeholder and
technical advisor participation, including which stakeholders from which sectors were involved in the
development process – starting from validation of the situation analysis, as specific to the national
context. Also describe how the consultation process ensures lead by government and effective
participation of all stakeholders at local and national levels, so they can provide input systematically,
with reasonable deadlines and time for consultation, into plan development and in foreseen annual
operational planning.
3.6 Reporting conflicts of interest: Describe the institutional framework needed for identifying and
managing conflicts of interest and how this is linked with other oversight mechanisms.
3.7 Commitment to make roadmap and future progress reports publicly available.
Accountability
3.8 Description of roadmap development process: Provide details of stakeholder and technical advisor
participation, including which stakeholders from which sectors were involved in the development
process – starting from validation of the situation analysis, as specific to the national context. Also
describe how the consultation process ensures lead by the ministry or committee responsible for
implementation that is accountable to the government through accountability mechanisms.
SECTION 4: Implementation plan

Systems for oxygen production, storage and distribution
4.1 Mixed production approach to increase oxygen supply.
4.2 Intra-facility distribution: Distribution methods within facilities (e.g. medical gas piping systems).
4.3 Inter-facility distribution: Safe liquid oxygen and gaseous cylinder distribution networks.
4.4 Contingency planning: Ensure continuous oxygen availability during expected downtime, unexpected
downtime and surges in demand (e.g. pandemic, emergency and disaster planning).
Regulations, guidelines and policies

4.5 Create and/or update regulations related to medical oxygen, respiratory medical devices and
associated equipment.
4.6 Create and/or update protocols/guidance: Include installation, maintenance and repair of oxygen
systems and related infrastructure.
4.7 Create and/or update clinical protocols: Include ensuring appropriate and safe use of oxygen, and
harmonization with existing clinical policies and guidelines.
4.8 Referral processes: Include processes within the health care system for hypoxaemic patients,
including oxygen availability for ambulance/inter-facility patient transfer system.
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Infrastructure
4.9 Integration of medical oxygen and other medical gas systems into the construction of health care
infrastructure.
4.10 Coordination with electrical grid as part of planned oxygen infrastructure development.
4.11 Mechanism(s) for ensuring maintenance of oxygen infrastructure.
4.12 Mechanism(s) for timely procurement and distribution of spare parts for oxygen infrastructure.
Respiratory medical devices

4.13 Mechanism(s) for respiratory medical devices inventory tracking and forecasting.
4.14a Mechanism(s) to assess the different respiratory medical devices required for diagnostics,
monitoring and administration of medical oxygen.
4.14b Mechanism(s) to ensure the procurement and supply of required respiratory medical devices:
Identify needs inclusive of installation, testing, commissioning and training.
4.15 Mechanism(s) for ensuring appropriate disinfection, reuse and disposal: Include decommissioning
of medical devices.
Staff
4.17 Approach that aims to deliver the sustainable supply of the necessary clinical workforce including
hiring and initial and ongoing clinical training in oxygen therapy for health care workers.
4.18 Approach that aims to deliver sustainable supply of the necessary biomedical engineering workforce
including hiring and initial and ongoing training in operation and maintenance of oxygen
equipment/infrastructure for biomedical engineering and technician staff.
4.19 Approach that aims to deliver the sustainable supply of the necessary non-clinical/non-biomedical
engineering workforce including hiring and initial and ongoing training for necessary non-
clinical/non-biomedical engineering workforce (procurement, finance, IT/data management and M&E).
Equity and social support

4.20 Measures to ensure equitable universal oxygen access.
4.21 Measures to mitigate the financial burden of oxygen therapy on patients: Inclusion (or potential
inclusion) of oxygen in insurance schemes.
4.22 Support for home-based oxygen therapy.
SECTION 5: Monitoring, evaluation and operational research

Monitoring and evaluation
5.1 Develop key performance indicators.
5.2 Standardized procedures for data collection and analysis.
5.3 Data management integrated into routine health information systems.
5.4 Feedback mechanisms to relay data and results to key stakeholders.
Operational research
5.5 Evaluate the impact of policies or interventions implemented.
5.6 Evaluate the cost-effectiveness of specific policies or interventions implemented.
5.7 Establish research priorities.
5.8 Support domestic research agenda.
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SECTION 6: Costing
Costing of plan activities
6.1 Assessment of top-line budget requirements for all planned activities: Include description of the
ownership model (e.g. government owned, public-private partnership, lease), costing methodology
used and budget assumptions.
6.2 Assessment of budget requirements for staff, including recruiting, training and ongoing
mentorship: Include description of the costing methodology and budget assumptions.
6.3 Assessment of budget requirements for infrastructure investments: Include CAPEX and OPEX, and
description of the costing methodology and budget assumptions.
6.4 Assessment of budget requirements for governance, management and coordination activities:
Include description of the costing methodology and budget assumptions.
Sustainable financing
6.5 Estimate of current budget allocations for oxygen spending, financial commitments for plan
implementation, shortfall in funds for implementation and ongoing costs: Include, where
available, ongoing commitments from key stakeholders.
6.6 Prioritization of plan activities based on available funding.
6.7 Consideration of public-private partnerships for oxygen production and maintenance: Include,
where available, details of how public-private partnerships will meet identified gaps or increase
efficiency of plan implementation.
6.8 Commitment to local production and distribution of medical oxygen.
6.9 Consideration of budget requirements for operating expenses beyond the plan’s
implementation phase.
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Annex 3: In-person attendees and affiliations
Title Name Last Name Institution
MOHSP – Morocco | Chef de Division Logistique et Ingénierie, Centre Hospitalo-Universitaire
Ms/Mr Abdelkrim Jabri Mohamed VI
Dr Abdillahi Moussa Farah MOH - Djibouti | Pharmacist, University Hospital of Djibouti
Prof Adegoke Falade University of Ibadan - Oxygen for Life Initiative
Ms/Mr Adriana Velazquez Berumen WHO headquarters
Ms/Mr Alfonso Rosales WHO Regional Office for the Americas
Ms/Mr Álvaro Ariel Lacayo MINSA - Nicaragua | Director de Gestión Logística de Insumos Médicos del Ministerio de Salud
Mr/Ms Amad Diouf MOH - Senegal | Ingénieur biomedical/logisticien de santé
Dr Amadou Sidibe MOH - Mali | Child Survival Officer, National Office for Reproductive Health
Mr/Ms Ankara Alejandra Reichle Collier MOH - Honduras | Ing. Biomedico, Technico del Segundo Nivel De Attencion
Ms/Mr Anne Moller Partners In Health
Ms/Mr Anne Detjen United Nations Children's Fund
MOH - Cabo Verde | Director of the health infrastructure and equipment management and
Ms/Mr António Diamantino Barreto maintenance service
Mr/Ms Arafat Naji al Zindani MOH - Yemen | General Manager of Medical Equipment
MOH - Cabo Verde | Biomedical Engineer, Technical Coordinator of the Project for Installation and
Ms/Mr Artur Jorje Ribeiro Gonçalves Production of Medicinal Oxygen in Central Hospitals
Dr Asadullah Motaqi MOH - Afghanistan | General Directorate of Curative Medicine
MOH - Tunisia | General Director of CETMBH (Centre d'Etudes Techniques de Maintenance
Mr/Ms Ben Hassen Imed Biomédicale et Hospitalière)
Dr Beverly Bradley United Nations Children's Fund
Dr Boukare Kassongo MOH - Burkina Faso | Directeur de la Pharmacie a.i
Mr/Ms Carina King Karolinska Institute - The Lancet Global Health Commission on Medical Oxygen Security
Ms/Mr Carolyn Hemminger WHO headquarters
Mr/Ms Charlotte LaJeune Bill & Melinda Gates Foundation
Dr Chiori Kodama WHO Regional Office for the Eastern Mediterranean
Dr Chizoba Fashanu Clinton Health Access Initiative (CHAI)
Mr/Ms Cisse Souleymane MOH - Côte D'Ivoire
Ms/Mr Connellius Njini MOH - Zambia | Hospital Equipment Engineer
Ms/Mr Constance McDonough-Thayer WHO headquarters
Ms/Mr Cyrille Ouaradague Davy MOH - Central African Republic | Technicien Superieur en Electronique
Dr Damira Sharabidinovna Begmatova MOH - Kyrgyzstan | Director of the Territory Hospital of Kara-Suu district of the Osh region
40
Annex 3: In-person attendees and affiliations

Ms/Mr Darnelle Worswick MOH - Palau | Acting Health Administrator, Bureau of Hospital Services
Ms/Mr David Latchman MOHWE - Saint Vincent and the Grenadines | Health Planner
Dr Dennis Marke MOH - Sierra Leone | Health System Strengthen Manager
Prof Didier Mukeba Tshialala Médecins Sans Frontières (MSF), Head of Intersectional Medical Platform
Mr/Ms Dmytro Osin WHO Regional Office for Europe - WCO Bulgaria
Dr Dora Lenturut-Katal NDOH - Papua New Guinea | Acting Deputy Secretary for Medical Standards and Curative Services
Ms/Mr Elizabeth Amia MHSS - Namibia | Chief Biomedical Engineer
Dr Emad Abu Yaqeen MOH - Jordan | Director of the Hospitals Technical Affairs Administration Directorate
Miss Emna Hamdi WHO Tunis office
Dr Erasto Sylvanus MOH – United Republic of Tanzania | Emergency Preparedness and response officer
Dr Eunice Angcao WHO Philippines, OSL
Dr Fabrice Kankolongo Mikombe MOH - Democratic Republic of the Congo | CE Medical
Ms/Mr Farida Mahgoub WHO Regional Office for the Eastern Mediterranean
Mr/Ms Florestan Boualame WHO Regional Office for the Eastern Mediterranean
Dr Freddy Kitutu The Lancet Global Health Commission on Medical Oxygen Security
Mr/Ms Gabriela Jimenez Moyao United Nations Office for Project Services
Dr Gilbert Shetak MOH – Nigeria | National Oxygen Desk Officer
MOH - Georgia | Deputy Director, Ministry of IDP's Labor, Health and Social Affairs of Georgia -
Mr/Ms Grigol Revazishvili Emergency Situations Coordination and Urgent Assistance Center
Dr Gwenael Dhaene WHO headquarters
Dr Habtamu Seyoum Tolla United Nations Children's Fund, Health Specialist
Dr Hans-Joerg Lang The Alliance for International Medical Action (ALIMA)
Ms/Mr Hemerson N’Zagi da Costa Bandeira MOH - Sao Tome and Principe | Directeur Technique d’appui au diagnostic-thérapeutique
Dr Immaculee Mukankubito WHO Regional Office for Africa
Ms/Mr Inutu Kanyama PATH
MOH - Malaysia | Senior Principal Assistant Director, Hospital Support Services Regulatory Sector,
Ms/Mr Ir. Ts. Mohd Hisam bin Sa'at Engineering Services Division
Ms/Mr Isaac Assaraf The Alliance for International Medical Action (ALIMA)
Ms/Mr James Stunkel Assist International
Dr Jamie Rylance WHO headquarters
Dr Jan De Waele European Society of Intensive Care Medicine (ESICM)
Ms/Mr Jane Briggs Management Sciences for Health (MSH) MTaPS Program
Ms/Mr Jane Tyler Makepeace FHI 360
Dr Janet Diaz WHO headquarters
41

Ms/Mr Jayendra Kasar PATH
Ms/Mr Jean-Baptiste Dusenge MOH - Rwanda | Director of Electronical Unit, RBC
Dr Jeanine Condo University of Rwanda
Dr Jean-Paul Mushenvula The Alliance for International Medical Action (ALIMA)
Dr Jerry-Jonas Mbasha WHO Regional Office for Africa
Ms/Mr Jessica Cook Partners In Health
Dr Jinho Shin WHO Regional Office for the Western Pacific
Dr John Appiah WHO headquarters
Dr Julian Amsterdam MOH - Guyana | Director, Standards & Technical Services
Ms/Mr Julie Viry WHO headquarters
Ms/Mr Kate Kikule Management Sciences for Health (MSH) MTaPS Program
Ms/Mr Katy Huang Unitaid
MOH - Lao People's Democratic Republic | Director General, Department of Healthcare and
Dr Khamsay Detleuxay Rehabilitation
Dr Lal Panapitiya MOH - Sri Lanka | Deputy Director General (Medical Services)
Ms/Mr Laura Alejandra Velez Ruiz Gaitan WHO headquarters
Ms/Mr Lauren Blanchard MOHWEA - Saint Lucia | Health Planner III
Dr Leah Greenspan United States Agency for International Development
Dr Leidis Ana Rosales Bello MINSAP - Cuba
Ms/Mr Lisa Smith PATH
Dr Louis Davidson Casimir MOH - Mauritius | Health Director
Dr Lucy Mapota Masoabi MOH - Lesotho | Director Clinical services
Ms/Mr Luis Osoria MSP - Dominican Republic | Analista de la Dirección de Riesgo
Dr Mark Luke MOH - Liberia | Emergency Medical Service
Ms/Mr Marnie Rickards DAK Foundation
Dr Marta Lado Partners In Health
Ms Martha Mulerwa United Nations Children's Fund
Ms/Mr Martha Gabriela Chiguano Curicho MSP - Ecuador | Directora Nacional de Equipamiento Sanitario, Encargada
Ms/Mr Martha Lauren Gartley WHO headquarters
Ms/Mr Melissa Bochnowicz United States Agency for International Development
Chairperson of the Global Intensive Care Working Group of the European Society of Intensive Care
Prof Mervyn Mer Medicine (ESICM)
Ms/Mr Miranda Dixon Oxygen CoLab
Dr Mirwais Rahimzai FHI 360
42
Annex 3: In-person attendees and affiliations

Mr/Ms Mohamed Mohamud Addow MOH - Somalia | Director of Health Emergencies
Ms/Mr Mostafa Othman WHO Regional Office for the Eastern Mediterranean
Dr Muhammad Mudassar MOH - Pakistan | Medical Officer
Dr Nahreen Ahmed MedGlobal
MOH - Congo | Directrice des équipements et de la maintenance, Ministère de la Sante et de la
Ms/Mr Nandide Akouala Population
Ms/Mr Ndeye Astou Badiane PATH
Ms/Mr Nguyen Thanh Toan MOH - Viet Nam | Technical officer of Department of Infrastructure and Medical Equipment
Dr Nicholas Adjabu MOH - Ghana | Head of Biomedical Engineering Unit
Ms/Mr Noelia Solares Muralles MSPAS - Guatemala | Pharmaceutical Specialist
Dr Nyakoye Gomou MOH - Guinea | Conseiller Charge des Missions
Dr Olfa Challouf MOH - Tunisia | Focal Point Medical Oxygen
Dr Onesphore Nkikumana MOH - Burundi | Chief EOC Operation Support and Logistic
Dr Owen Malema MOH - Malawi | Head of Anaesthesia and Intensive Care Unit
Ms/Mr Pablo Vega Rojas Unitaid
Dr Papys Lame The Alliance for International Medical Action (ALIMA)
Ms/Mr Philip Maina Gatongi United Nations Office for Project Services
Dr Prakash Budhathoky MOH - Nepal | Chief, Heath Emergency Operations Center
Dr Ramarolahy Andriatiaray Rija Niaina MOH - Madagascar | General Director of Healthcare Supplies
Ms/Mr Raphael Kayambankadzanja PATH
Dr Reginald Bahatungire MOH - Uganda | Ag. Commissioner Health Service/Clinical services
Miss Sameh Abbassi WHO Tunis office |
Ms/Mr Samriddha Rana WHO Regional Office for South-East Asia - WCO Nepal
Dr Scotty Kandelyo NDOH - Papua New Guinea | Sr Emergency Physician
Ms/Mr Sean Parham MOH - Jamaica | Director of Projects
Dr Shehata Eissa MoHP - Egypt | Director of Damanhour Chest Hospital
Dr Steven McGloughlin WHO headquarters
Dr Sura Wisedsak MOH - Thailand | Director General, Health Services Support Department
Ms/Mr Tadesse Gamessa FHI 360
Ms/Mr Tawfeek Hasabaa MOH - Syria | Head of Ambulance and Emergency
Ms/Mr Tazeen Saeed Bukhari International Federation of Medical and Biological Engineering (IFMBE)
Ms/Mr Theo Nottage Princess Margaret Hospital - Public Hospital Authority
Ms/Mr Tiyezye Joseph Mphande MOH - Zambia | National Oxygen Coordinator
Ms/Mr Tran Thi Thanh Quy FHI 360
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Ms/Mr Trevor Biransesha Oresty Save the Children
Ms/Mr Ugyen Tashi MOH - Bhutan | Chief Program Officer, Dept of Health Science
Dr Varun Manhas One Health Trust
Ms/Mr Vusimuziv Sibusiso Dlamini MOH - Eswatini | Biomedical Officer
Ms/Mr William Alfredo Hernandez Perez MOH - El Salvador | Técnico Biomédico
MOH - Algeria | Sous Directrice des programmes de soins de la néo-natalité, de l'enfance, de
Ms/Mr Yacef Lamia l'adolescence et de la jeunesse
Ms/Mr Zachary Katz Clinton Health Access Initiative (CHAI)
Ms/Mr Zameera Ibrahim MOH - Maldives | Biomedical Engineer
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Annex 4: Speaker, moderator and support staff
biographies
Sameh Abbassi, Global Conference and Training Centre, WHO
Sameh Abbassi has a bachelor’s degree in English Language Specialty Linguistics from Manouba University in Tunisia.
Since 2018, she has worked for WHO in the Global Conference and Training Centre. She started as Logistics Assistant
handling meetings for different units at WHO headquarters. Now, she is an assistant to the team within the same office. In
2020, she also worked as a human resources assistant with the Universal Health Coverage Life Course department
where she supported the recruitment process for many positions with the team at WHO headquarters. Sameh
provided venue, logistical and travel support for the meeting.
Dr Nicholas Adjabu, Head, Biomedical Engineering Unit, Ministry of Health, Ghana

Dr Nicholas Adjabu is a qualified medical practitioner with specialties in medical engineering and health technologies.
He studied Medicine at the University of Ghana Medical School and Medical Engineering at Queen Mary, University of
London. He is currently Head of the Biomedical Engineering Unit of the Ministry of Health. Previously, he was the Deputy
Director and Head of the Clinical Engineering Department of Ghana Health Service and has also worked with WHO as a
Technical Officer and on Health Technology for WHO Regional Office for Africa and as a member of the Expert Advisory
Group on Health Technology. Dr Adjabu sat on the panel for Plenary session 3: Oxygen scale-up deep dives –
Effective partnerships.
Dr Nahreen H Ahmed, Medical Director, MedGlobal

Dr Nahreen Ahmed is a Pulmonary and Critical Care specialist and the Medical Director for the international NGO
MedGlobal, working in crisis and conflict zones across the globe including Bangladesh, Gaza, Latin America, Lebanon,
Sudan, Syrian Arab Republic, Ukraine and Yemen. Dr Ahmed’s role is to provide technical oversight, working closely with
local partners and respective medical authorities to implement activities with the overarching goal of systems
strengthening through capacity building and infrastructure support in order to build resilience in austere
environments. Dr Ahmed sat on the panel for Plenary session 3: Oxygen scale-up deep dives – Effective
partnerships.
Dr John Appiah, Consultant, Clinical Management and Operations Unit, Country

Readiness Strengthening, WHO Health Emergencies Programme, WHO
Dr John Appiah is a paediatric critical care senior specialist. He is currently a Technical Officer with the Clinical
Management Unit of WHO Health Emergencies Programme. He was Head of the Case Management Team at the WHO
Regional Office for Africa. He has worked as a clinician in low-resource settings, mostly in Ghana, as Head of the
Paediatric Intensive Care Unit, Komfo Anokye Teaching Hospital, Kumasi.
Dr Appiah moderated Plenary session 3: Oxygen scale-up deep dives – Importance of the workforce and
facilitated and reported on the breakout session on the same topic.
Dr Damira Sharabidinovna Begmatova, Director, Kara Suu District Hospital, Ministry of Health, Kyrgyzstan
Dr Sharabidinovna received her Diploma in General Medicine from the Medical Faculty of the Kyrgyz Medical Academy in
Bishkek and completed her residency in the Department of Obstetrics and Gynaecology. She began her career in 2003 in
the Family Medical Centre of the Kara Suu District and became the Director of the Kara Suu District Family Medicine
Centre in 2014. In 2016, she received her PhD in Obstetrics and Gynaecology. Since 2021, she has worked as the
Director at the Kara Suu District Hospital. Dr Sharabidinovna sat on the panel for Plenary session 1: Existing
oxygen roadmap highlights.
Adriana Velazquez Berumen, Team Lead on Medical Devices and In vitro Diagnostics, WHO
She is a passionate biomedical engineer with 40 years’ experience – striving for access to priority medical devices for all
populations in need. She has led the Medical Devices unit at WHO for the last 15 years and has coordinated around 40
WHO publications. Prior to WHO, she was the founder of CENETEC, a health technology centre, in the Mexican Ministry of
Health, and had worked in private and public hospitals. She has a bachelor’s degree in Biomedical Engineering from
Mexico and a master’s in clinical engineering from Case Western Reserve University. Ms Velazquez spoke during
Plenary session 2: The National Oxygen Scale-Up template, facilitated the open discussion on aspirations and
next steps on Day 3, and provided onsite coordination during the event.
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Florestan Boualame, Regional Biomedical Engineer Consultant, WHO Health Emergencies Programme
and WHO Regional Office for the Eastern Mediterranean
Florestan is a biomedical engineer with extensive experience in LMICs to support health care technology
management, from the editing of specifications and the procurement phase to commissioning and installation,
including training, preventive maintenance and management of medical equipment. He previously worked with MSF,
International Committee of the Red Cross and WHO Geneva as a Biomedical Engineer Consultant. Florestan
provided facilitation support during the breakout group on oxygen ecosystem quantification and supported
onsite event logistics.
Dr Beverly Bradley, Technical Specialist, Oxygen Therapy, Supply Division, UNICEF

Dr Beverly Bradley is a Technical Specialist at UNICEF Supply Division in Copenhagen. Since 2020, She has led the
technical team responsible for the selection and procurement of oxygen-related equipment and services for UNICEF.
Between 2017 and 2020, She managed UNICEF’s Oxygen Therapy Project, developing guidance and tools to help
improve access to oxygen globally. She has a PhD from the Centre for Global Engineering at the University of Toronto
with a specialization in Global Health. Bev sat on the panel for Plenary session 5: Oxygen scale-up deep dives –
Finding the need-gap.
Dr Prakash Budhathoki, Spokesperson, Ministry of Health and Population, Nepal

Dr Prakash Budhathoki is the spokesperson of Ministry of Health and Population with over two decades’ experience in
the government health sector, at the Ministry of Health and Population and the Ministry of Home Affairs. He also held the
position of Chief of the Health Emergency Operation Center (HEOC) and one of the teams managing oxygen within Nepal
during the second wave of COVID-19. During the earthquake in November 2023, though the HEOC, he was able to
coordinate with the Office of the Prime Minister and Council of Ministers and Ministry of Home Affairs to rapidly provide
health sector support.
Dr Budhathoki sat on the panel for Plenary session 1: Existing oxygen roadmap highlights.
Tazeen Saeed Bukhari, Board Member, IFMBE Clinical Engineering Division

Ms Tazeen Saeed Bukhari, a Biomedical Engineering Consultant and IFMBE Board member, holds an MEng from Imperial
College London with a year at ETH Zurich. With over a decade of experience in medical device management,
regulation, procurement and planning across government, NGOs and INGOs globally, her major contributions include
developing Pakistan's Biomedical Equipment Resource Centre and conducting a baseline survey to support oxygen
systems with WHO Pakistan, and improving medical equipment availability during and after COVID-19. Ms Bukhari
sat on the panel for Plenary session 3: Oxygen scale-up deep dives – Importance of the workforce.
Dr Olfa Challouf, Deputy Director of the Organization of Hospital Activities, Ministry of Health, Tunisia
Dr Olfa Challouf, Deputy Director of Activity Organization at Tunisia's Ministry of Health since 2010, is a pivotal figure in
health care. Renowned for her crisis management expertise, notably during the COVID-19 pandemic, she spearheads
initiatives in oncology, organ transplants and patient safety. Her leadership, nationally recognized, fortifies health
care systems and elevates standards, ensuring lasting impact.
Dr Challouf sat on the panel for Plenary session 1: Existing oxygen roadmap highlights.
Ankara Alejandra Reichle Collier, Biomedical Engineer, Ministry of Health, Honduras

Ankara Alejandra Reichle Collier studied biomedical engineering in the United States. She currently works with the
Ministry of Health in Honduras focused on biomedical equipment and health infrastructure. Her work contributes
directly to improving the quality and efficiency of medical services in the country. Ankara sat on the panel for Plenary
session 3: Oxygen scale-up deep dives – Costing and sustainable financing, and provided support during the
breakout session on Policy, regulations and guidelines for safe, quality-assured oxygen systems.
Jessica Cook, Senior Analyst, Universal Health Coverage Financing, PIH

Jessica Cook is a Senior Financing Analyst where she provides technical assistance for financing policy and costing
analyses. She has worked across various health domains including primary health care, community health
programmes, tuberculosis, and with The Global Fund. Previously, she provided technical assistance on the design
and costing of the national community health programme in Togo. Jessica holds a Master of Science in Health Policy,
Planning and Financing from the London School of Economics and the London School of Hygiene and Tropical
Medicine. Ms Cook spoke during Plenary session 2: The National Oxygen Scale-Up template and Plenary session
6: Template polling, Round 1, supported the breakout group on Investment and sustainable financing, and
provided onsite coordination during the event.
46
Annex 4: Speaker, moderator and support staff biographies
Dr Jeanine Condo, Managing Director, CIIC-HIN; Adjunct Associate Professor, University of Rwanda
Dr Jeanine Condo is a medical doctor and has a PhD in Public Health. She is an Adjunct Associate Professor at the
University of Rwanda and Tulane University (USA). Since 2021, she has served as the Managing Director of CIIC-HIN
(Center for Impact, Innovation, and Capacity Building for Health Information and Nutrition), a not-for-profit registered in
Rwanda. Previously, she held numerous senior governmental posts at the University of Rwanda and the Ministry of
Health. Dr Condo sat on the panel for Plenary session 5: Oxygen scale-up deep dives – Measuring impact and
outcomes.
Martha Gabriela Chiguano Curicho, Biomedical Engineer and National Director of Health Equipment,
Ministry of Public Health, Ecuador
Engineer Martha Gabriela Chiguano Curicho is a Biomedical Engineer with the Ministry of Public Health in Ecuador. There,
she leads the management of the quality of health equipment in health services through the generation of technical
standards; development of plans, programmes and tools for equipment maintenance; management of catalogue and
acquisition of health care equipment; management of preventive and corrective maintenance; and compliance with
quality standards. Martha sat on the panel for Plenary session 5: Oxygen scale-up deep dives – Finding the need-
gap.
Dr Khamsay Detleuxay, Director-General, Department of Healthcare and Rehabilitation, Ministry of Health,

Lao People’s Democratic Republic
Dr Khamsay Detleuxay brings over 20 years’ invaluable experience to his current role. Initially serving as the head ICU
doctor for nearly two decades at Mahosot Hospital, one of the country's largest central hospitals, he ascended to the
position of Deputy Director. Later, he transitioned to the Ministry of Health, assuming the role of Deputy Director at the
Department of Healthcare and Rehabilitation. Presently, he leads efforts to enhance health care, with a particular focus on
improving oxygen provision, through collaboration with various partners within and outside the Ministry of Health. Dr
Detleuxay sat on the panel for Plenary session 1: Existing oxygen roadmap highlights.
Dr Gwenael Dhaene, Health Systems Adviser, WHO

Dr Gwenael Dhaene works at WHO as a Health Systems Adviser in capital investment and health assets. He is the Health
Infrastructure Focal Point for the Universal Health and Life Course Division and works across the three levels to help
decision-makers optimize their health capital goods projects. A public and health law specialist, his expertise spans
contracting and public-private partnerships, infrastructure feasibility studies and lifecycle management for health assets
(facilities, laboratories, warehouses, energy and supplies, ancillary services, value for money). Gwen moderated Plenary
session 3: Oxygen scale-up deep dives – Costing and sustainable financing and facilitated and reported on the
breakout session on the same topic.
Dr Janet Diaz, Lead, Clinical Management and Operations Unit, Country Readiness Strengthening, WHO
Dr Janet Diaz is a specialist in intensive care and pulmonary medicine with rich expertise in clinical medicine, medical
education and quality improvement. For the past 7 years, she has been leading the clinical management readiness and
response to infectious disease threats and other health emergencies at WHO and, since the pandemic, leading the WHO
oxygen scale-up initiative. She completed her internal medicine residency and pulmonary and critical care fellowship
at UC San Francisco. Dr Diaz provided background for the meeting during the Day 1 opening session, sat on the
panel for Plenary session 5: Oxygen scale-up deep dives – Measuring impact and outcomes, and provided
closing remarks.
Vusumuzi Sibusiso Dlamini, Biomedical Engineer, Ministry of Health, Eswatini

Vusumuzi Dlamini is a biomedical engineer from the Kingdom of Eswatini. He currently leads the National Biomedical
Engineering Unit under the Ministry of Health. He has over 5 years’ experience in maintenance, management and
procurement of medical and non-medical equipment for health care. He has experience of medical gases, including
PSA plants and liquid oxygen set up. He is an engineer who believes in positivity and teamwork and that good resource
management and good communication yields satisfying results. Vusumuzi sat on the panel for Plenary session 5:
Oxygen scale-up deep dives – Finding the need-gap.
47
Professor Adegoke G Falade, Professor of Clinical Science, College of Medicine, University of Ibadan
Professor Adegoke Falade is a Professor of Paediatric Pulmonology at the University of Ibadan, Nigeria, bringing
understanding to the challenges of addressing hypoxaemia at both local and global levels. He has a long track record in
translating research into policy and practice, including using evidence and participating in national stakeholder
meetings to develop and revise national oxygen policies, clinical guidelines and new oxygen strategies in Nigeria and
leading training of health care workers in all six geopolitical regions of Nigeria. Dr Falade provided the keynote address
during the opening session on Day 1 and sat on the panel for Plenary session 8: Cross-cutting aspects of oxygen
systems – alignment and integration.
Dr Chizoba Fashanu, Deputy Program Director, Essential Medicines and Malaria, CHAI
Dr Chizoba Fashanu has over 20 years’ experience leading health projects in Nigeria across international development
and public health programmes. She has worked on HIV, malaria, child and maternal/ reproductive health programmes.
In her current role as Director, Essential Medicines/ Malaria and NTDs projects in Nigeria, she oversees implementation
of impactful and innovative programmes to improve access to care for children and their families, including heading
CHAI’s national oxygen programme. Dr Fashanu moderated Plenary session 3: Oxygen scale-up deep dives –
Effective partnerships.
Laura Alejandra Velez Ruiz Gaitan, Technical Officer and Focal Point for Oxygen Access Initiative,
Clinical Management and Operations Unit, Country Readiness Strengthening,
WHO Health Emergencies Programme, WHO
Laura Alejandra has 18 years’ experience working as a biomedical engineer in different sectors (UN, NGO, public, private)
and settings (mainly in developing countries and emergency contexts). She can assess the whole life cycle of health
technology, including medical devices planning, procurement, implementation and maintenance. Laura facilitated
and reported on the breakout session on Policy, regulations and guidelines for safe, quality-assured oxygen
systems and presented Round 1 polling results on Day 3.
Martha Lauren Gartley, Consultant, Clinical Management and Operations Unit, Country Readiness
Martha is an engineer (P Eng, M Eng Sc) with almost 20 years’ international experience in the NGO, multilateral, private
and academic sectors. Since 2016, her focus has been on the scale-up of medical oxygen in LMICs, managing
multisectoral coordination and facilitating planning and implementation. She has served as a technical advisor to
programmes, governments and manufacturers working on safe, appropriate, quality medical oxygen equipment,
systems and “global public good” resources. Prior to this, Martha worked for 6 years with MSF as a WASH coordinator.
Martha supported event planning and logistics, project management and onsite coordination.
Philip Maina Gatongi, Lead Architect, Technical Services Unit, UNOPS

Philip Gatongi is a registered and practising architect in Kenya and holds a bachelor's degree in Architecture from the
University of Nairobi. He has 16 years’ experience in the construction industry: 3 years in the private sector and 13 years
with UNOPS. He is the Lead Architect in the Technical Service Unit of the Kenya Multicountry Office and oversees and
coordinates various design teams and consultants. He has designed and overseen the construction of health care
buildings in 14 African countries. Philip sat on the panel for Plenary session 8: Cross-cutting aspects of oxygen
systems – alignment and integration.
Dr Leah Greenspan, Senior Newborn Advisor and Neonatologist, Global Health Bureau, USAID
Dr Leah Greenspan is a board-certified paediatrician and neonatologist and has extensive experience working in global
health with a focus on newborn health in sub-Saharan Africa and Asia. Dr Greenspan has developed, trained and
implemented programmes both in rural and urban settings – teaching life- saving skills in maternal, newborn and child
health to medical professionals. She is on staff at two community hospitals in the greater Washington, DC area. She
currently serves as the Senior Newborn Advisor at USAID Global Health where she focuses on advancing small and sick
newborn care globally. Dr Greenspan moderated Plenary session 8: Cross-cutting aspects of oxygen systems –
alignment and integration.
Emna Hamdi, Office Assistant, Meeting Department, Global Conference and Training Centre, WHO, Tunisia
Emna Hamdi holds a master's in Accounting and a license in Management. Currently, she serves as an Office Assistant in the
Meeting Department at WHO Global Conference and Training Centre in Tunisia. She brings a wealth of experience in
organizing meetings for WHO across various locations, including South Africa, Kigali, Switzerland and more. Emna
provided venue, logistical and travel support for the meeting.
48
Carrie Hemminger, Senior Communications Officer, PATH

Carrie Hemminger has over 15 years’ experience working in global public health, with expertise in advocacy,
communications, knowledge management and event logistics. She currently works as a Senior Communications
Officer at PATH supporting communications and advocacy activities for the Strengthening Oxygen Utilization and
Respiratory Care Ecosystem project. Before joining PATH, she worked as Knowledge Management Specialist for
University Research Co., LLC and as Training and Event Specialist for USAID Global Health. She holds a bachelor’s in
International Health from Georgetown University and a master’s in Public Health from The George Washington
University. She provided event planning, communications support and onsite coordination.
Inutu Kanyama, Market Dynamics Officer, PATH

Inutu Kanyama is a Market Dynamics Officer at PATH and the country lead for Zambia's implementation of the
Strengthening Oxygen Utilization and Respiratory Care Ecosystems (SOURCE) project. Inutu's areas of expertise
include advisory services to government departments, where she has led several programme evaluations with
governments in Malawi, Nigeria, Uganda and Zambia. Inutu also developed phone surveys on knowledge, attitudes
and practices related to COVID-19 and conducted quantitative policy research for a variety of actors, including the
Ministry of Health in Zambia and the Ministry of Disability, Gender and Social Welfare in Malawi. Inutu facilitated and
reported on the breakout session on Partnerships and engagement for oxygen scale-up.
Dr Nirmal Kandel, Head, Evidence and Analytics for Health Security Unit, WHO
Dr Nirmal Kandel is Head of WHO’s Evidence and Analytics for Health Security Unit, managing analytics, preparedness
economics, benchmarks for emergency capacities, research and health systems for health security. Previously, he led the
development of various international health regulations assessment and planning tools, guidelines and frameworks.
He worked in WHO offices in Nepal and Indonesia, managing international health regulations, pandemic
preparedness and emergency programmes in health systems in the WHO Regional Office for South-East Asia. He is a
medical doctor with master’s in Anthropology and Public Health and an MBA and was a medical officer for surgery in
Nepal. Dr Kandel sat on the panel for Plenary session 8: Cross-cutting aspects of oxygen systems – alignment and
integration.
Dr Carina King, Associate Professor of Global Health, Karolinska Institutet, Sweden

Dr Carina King is an Associate Professor of Global Health at Karolinska Institutet in Sweden and trained as an infectious
disease epidemiologist. Her research work has focused on paediatric pneumonia diagnosis and case management,
which led her into the field of pulse oximetry and medical oxygen where she leads the political economy of oxygen
research theme for the Lancet Global Health Commission on Medical Oxygen Security. She has methodological
expertise in pragmatic trials, mixed-methods evaluation and data systems. Dr King moderated Plenary session 5:
Oxygen scale-up deep dives – Measuring impact and outcomes and facilitated and reported on the breakout
session on the same topic.
Dr Freddy Kitutu, Dean, School of Health Sciences; Senior Lecturer, Health System Pharmacy, Makerere
University, Uganda
Dr Freddy Kitutu is a senior lecturer, health systems pharmacist and researcher at Makerere University in Uganda, and
served as the Dean of the School of Health Sciences. His work focuses on implementing complex health interventions
to enhance access to essential health technologies in low-income countries. Dr Kitutu has provided invaluable advice
to international and national organizations, including WHO and the Uganda Ministry of Health. He has a doctoral
degree in Medical Science (public health, global health, social medicine and epidemiology) from Uppsala University,
Sweden. Dr Kitutu sat on the panel for Plenary session 5: Oxygen scale-up deep dives – Measuring impact and
outcomes.
Dr Chiori Kodama, Medical Officer, WHO Health Emergencies Programme and WHO Regional Office for the
Eastern Mediterranean
Dr Kodama has diverse experience in health emergencies and humanitarian response in various complex settings and
has worked in multiple locations and countries. Her professional career began as a physician specialized in infectious
diseases and health emergencies, reinforced by epidemiology training. She currently serves at the WHO Regional Office
for the Eastern Mediterranean as a medical officer and lead for case management and clinical operations, including
oxygen scale-up, as well as high-threat pathogens and emerging vector-borne and zoonotic diseases in the WHO
Health Emergencies Programme. Dr Kodama sat on the panel for Plenary session 5: Oxygen scale-up deep dives –
Finding the need-gap.
49
Dr Marta Lado, Director, Clinical Programs and Health Policy, Sierra Leone, PIH
Dr Marta Lado is an internal medicine and infectious diseases physician specialized in health emergencies, such as
viral haemorrhagic fever, and the design, planning and implementation of health programmes: RMNCAH,
noncommunicable diseases, mental health, surgery, emergency and critical care, internal medicine and infectious
diseases. She is the Director of Clinical Programs and Health Policy for PIH Sierra Leone. She collaborates with WHO,
NGOs, academia and ministries of health in case management and training in infectious diseases, pandemic
preparedness and response, critical care and medical oxygen. Dr Lado was the primary facilitator for Day 1 and
provided support for the breakout group on Measuring impact and outcomes for oxygen ecosystems
Dr Rose Lavado, Technical Officer, Financial Protection, Equity and Poverty, WHO
Dr Lavado is a Technical Officer at WHO where she designed the model survey for collecting out-of-pocket payments for
financial protection, and jointly with the World Bank, supports the production of the bi-annual Global Monitoring Report
for Universal Health Coverage. Prior this this role, she worked for the Asian Development Bank as a Senior Health Specialist
and Health Economist for the World Bank. She holds a master’s in Public Policy and a PhD in Public Policy and Health
Economics. Dr Lavado sat on the panel for Plenary session 3: Oxygen scale-up deep dives – Costing and
sustainable financing.
Dr Dora Lenturut-Katal, Acting Deputy Health Secretary, National Health Services Standards, National
Department of Health, Papua New Guinea
Dr Lenturut-Katal currently serves as Papua New Guinea’s Deputy Health Secretary of the National Department of Health
Compliance and Regulations. In addition to this role, she serves as the National Chief Radiologist, provides expert
consultant services at Port Moresby General Hospital, and teaches doctors and other health workforce professionals in
radiology. Dr Lenturat-Katal sat on the panel for Plenary session 3: Oxygen scale-up deep dives – Importance of
the workforce.
Dr David Lowrance, Senior Advisor, Pandemic Preparedness and Response, The Global Fund
David joined The Global Fund in 2020 following many years at WHO and at United States Centers for Disease Control and
Prevention, where he served as Country Director in Namibia, Haiti and the United Republic of Tanzania. With over 22 years
of public health experience, he has lived and worked in five of six WHO regions. He obtained his MD and master’s in
Public Health from Tufts University, a diploma in tropical medicine from the London School of Hygiene and Tropic
Medicine, trained in internal medicine at the University of Colorado, and completed the Epidemic Intelligence Service
Fellowship at the United States Centers for Disease Control and Prevention. Dr Lowrance sat on the panel for Plenary
session 3: Oxygen scale-up deep dives – Costing and sustainable financing.
Dr Jeff Kabinda Maotela, WHO Representative (OIC), Senegal

Dr Kabinda serves as the Health Policy Coordinator for WHO in Senegal where he supports the Ministry of Health in
policy planning and health systems strengthening. He also serves as Senegal’s WHO Representative (OIC). Prior to
this, he served as a Country Director for the National Centre for Blood Transfusions and a Professor at the National
Pedagogical University. He holds a master’s in Public Health from Johns Hopkins University and a PhD in Public
Health from the Free University in Brussels.
Dr Kabinda provided the welcome remarks during the opening session on Day 1.
Dr Varun Manhas, Associate Director of Public Health Programs, One Health Trust
Dr Varun Manhas is the Associate Director of Public Health Programs at One Health Trust based in Bangalore, India. He
leads the implementation of the Bill & Melinda Gates Foundation-funded National Medical Oxygen Grid Project in India and
beyond along with contributing to antimicrobial resistance and One Health research. He has previously worked at
PATH and CHAI in India. He has an MSc in Biomedical Engineering from Oxford University; an MPhil in Biotechnology
from Cambridge University and a PhD in Biomechanical Engineering from KU Leuven, Belgium. His other interests
include digital health and health technology assessment. Dr Manhas sat on the panel for Plenary session 5: Oxygen
scale-up deep dives – Finding the need-gap.
50
Dr Dennis Marke, Programme Manager, Expanded Programme on Immunization and Child Health, Ministry
of Health and Sanitation, Sierra Leone
Dr Marke is a medical practitioner and public health professional. Previously, he worked as a clinician in public and faith-
based hospitals and as District Medical Officer and Programme Manager for Child Health/ Expanded Programme on
Immunization. He is currently the Programme Manager of the Health System Strengthening Programme. In 2023, he
was acting Programme Manager for the National Malaria Control Programme. He is a member of the Sierra Leone
College of Physicians and Surgeons. Dr Marke sat on the panel for Plenary session 8: Cross-cutting aspects of
oxygen systems – alignment and integration.
Robert Matiru, Director, Programme Division, Unitaid; Co-chair of the Global Oxygen Alliance
With over 20 years’ experience in international development, Robert currently leads the Programme Division at Unitaid
as Director, and is responsible for planning, developing and implementing a complex portfolio of health product
innovation investments valued at US$ 1.3 billion. Before joining Unitaid in 2012, he served as Head of Operations and
Vaccine Deployment for WHO’s H1N1 Pandemic Response and as Chief Operating Officer of the Global TB Drug Facility.
Robert holds a bachelor’s in International Relations, a master’s in International Development and a postgraduate
diploma in Leadership. Robert sat on the panel for Plenary session 3: Oxygen scale-up deep dives – Effective
partnerships and presented the Global Oxygen Alliance showcase on Day 3.
Dr Jerry-Jonas Mbasha, Operational Partnership Officer, WHO Regional Office for Africa
Dr Jerry-Jonas holds a master's and doctorate in Public Health, and has over 16 years’ experience in development and
humanitarian work. He has worked for health programmes in over 10 countries in Africa, starting his career in health
ministries before moving on to UN agencies, bilateral partners and NGOs. In 2021, he joined the WHO Regional Office
for Africa as the Team Lead of Technical and Operational Partnerships. He is also an Associate Professor at the Official
University of Bukavu, Democratic Republic of the Congo, supporting research methodology, biostatistics and
epidemiology. He supported the breakout session on Workforce and competencies needed for sustained oxygen
ecosystems.
Constance McDonough-Thayer, Data Systems Specialist, Operational Support and Logistics Unit, WHO
Connie McDonough-Thayer came to WHO headquarters in March 2020 to support forecasting efforts for critical COVID-19
supplies. She works in data, mostly around using quantitative information to inform and support operations and
highlight where efforts are or are not working and to create meaningful and impactful metrics and indicators. She’s had
the opportunity to apply this to WHO’s oxygen scale-up initiative, both through the development of key performance
indicators and through the development of information management systems for both oxygen production and
infrastructure. Connie moderated Plenary session 7: Debriefing discussion on breakout sessions (Part 2) and
supported event planning and onsite coordination.
Dr Steven McGloughlin, Consultant, Clinical Management and Operations Unit, Country Readiness
With over 20 years’ experience in the health sector, Dr McGloughlin has worked in management, clinical care and public
health. He has a master’s in Public Health and an International Masters of Health Leadership. He is Program Director of
the Alfred Intensive Care Unit, and Professor at Monash University, Australia. He has worked as a Technical Officer in the
Clinical Management team of the WHO Health Emergencies Programme, supporting guideline work which improves
patient outcomes from various diseases. Dr McGloughlin provided facilitation support for the breakout group on
Measuring impact and outcomes for oxygen ecosystems and moderated Plenary session 7: Debriefing
discussion on breakout sessions (Part 1).
Professor Mervyn Mer, Professor, Faculty of Health Sciences, University of the Witwatersrand,
Johannesburg, South Africa
Mervyn Mer is based in the Department of Medicine, Divisions of Critical Care and Pulmonology, at Charlotte Maxeke
Johannesburg Academic Hospital, University of the Witwatersrand. He also serves as Clinical Head of the Adult
Multidisciplinary Intensive Care Unit and is Academic Head of Critical Care. He is the current Chair of the Global Intensive
Care Group of ESICM. Mervyn is a hands-on clinician with a deep love of teaching and research and a passion to improve
the lives and outcomes for all globally, and with a particular interest in developing countries. Professor Mer sat on the
panel for Plenary session 3: Oxygen scale-up deep dives – Importance of the workforce.
51
Anne Moller, Associate Director for Public Health and Emergency Systems, PIH
Anne Moller is the Associate Director for Public Health and Emergency Systems at PIH. Anne’s career in public health began
during Massachusetts’s COVID-19 response, leading a major programme for the Community Tracing Collaborative, a
partnership between PIH and the Commonwealth of Massachusetts. Anne holds an MBA from New York University’s
Leonard N. Stern School of Business. In her earlier career, Anne led operations and programme management in the private
sector. Anne spoke during Plenary session 2: The National Oxygen Scale-Up template; Plenary session 4:
Template polling introduction; and Plenary session 9: Template polling, Round 2; supported the breakout
group on Partnerships and engagement for oxygen scale-up, and event planning and onsite coordination.
Gabriela Jimenez Moyao, Lead Biomedical Engineer, UNOPS West Africa

Gaby has over a decade of experience as a biomedical engineer, with a track record of successful implementation of health
technology projects in various countries. She is passionate about enhancing worldwide access to safe, affordable and
suitable health technologies and infrastructure. She has previously served as Quality Assurance Specialist for Medical
Equipment and Oxygen for United Nationals Development Programme. She also previously worked with PAHO, Swiss
Tropical and Public Health Institute, WHO and MSF. Gaby provided facilitation support and reported on the
breakout session on Technical aspects of oxygen systems.
Dr Muhammad Mudassar, Medical Officer, National Institute of Health, Pakistan

Dr Muhammad Mudassar is a medical officer at the National Institute of Health (NIH). He is the lead of the Dengue
Surveillance team and Focal Person at national level where he plays a crucial role in its prevention and control. He
was also the Focal Person for oxygen scale-up since the outbreak of COVID-19 – coordinating efforts to increase the
accessibility of oxygen in health care facilities. He completed his medical degree in nephrology, a Field Epidemiology
Training Programme and a Fellowship in Public Health Emergency from the United States Centers for Disease Control
and Prevention. Dr Mudassar sat on the panel for Plenary session 2: Oxygen scale-up deep dives – Effective
partnerships.
Dr Immaculee Mukankubito, Technical Officer, Essential Medicines and Health Technologies, WHO
Dr Immaculee is Technical Officer for Essential Medicines and Health Technologies at the WHO. She is a senior
pharmacist with a master's in Quality Assurance and Quality Control of Medical Products. She has more than 20
years’ experience in supply plans and supply chain management as well as in regulations, quality assurance and
quality control of medical products. She is always passionate to provide a quality service aiming to meaningfully
improve public health. In her life, she values trust, teamwork and reliability, and is always keen to upskill herself by
learning new things. She provided facilitation support during the breakout group on Investment and
sustainable financing.
Noelia Solares Muralles, Pharmaceutical Specialist, Ministry of Health, Guatemala

Noelia Solares graduated from the University of San Carlos de Guatemala with a degree in Pharmaceutical Chemistry.
She is a professional with comprehensive skills in health, drug manufacturing, quality control, research and
development of drugs and public health. Since 2020, she has worked in the Ministry of Public Health and Social
Assistance of Guatemala, in the Technical Assistance Department, where she works as a pharmaceutical technical
assistant for the hospitals of the national network. Noelia sat on the panel for Plenary session 1: Existing oxygen
roadmap highlights and supported the breakout session on Technical aspects of oxygen systems.
Maurine Murenga, Focal Point Special, Community Delegation to The Global Fund
Maurine Murenga is a passionate advocate for the health, development and human rights of women and children. With a
background in programme management and community development, she is a two-time award winner for her work
with women and children. Maurine is currently the coordinator of TB Women Global as well as a board member of
Unitaid, Friends of the Global Fight and EGPAF Kenya. In Kenya, Maurine is a member of The Global Fund Country
Coordinating Mechanism and Elimination of Mother-to-Child Transmission of HIV Committee of Experts. Maurine sat
on the panel for Plenary session 3: Oxygen scale-up deep dives – Effective partnerships.
52
Dr Jean-Paul de Bruyne Mushenvula, Programme Medical Manager, Alliance for International Medical
Action (ALIMA)
Dr Jean-Paul de Bruyne Mushenvula currently leads ALIMA’s programmes in Nigeria. Before joining ALIMA, he worked
for 5 years in the Democratic Republic of the Congo Ministry of Health and for 4 years in the Medical Coordination Unit of
MSF. Since joining ALIMA in 2014, Dr Jean-Paul has held the positions of Medical Officer, Project Coordinator, Medical
Coordinator and Head of Mission in countries including Mali, Central African Republic and Nigeria. He is a graduate of
the University of Kinshasa. Dr Jean-Paul sat on the panel for Plenary session 5: Oxygen scale-up deep dives –
Measuring impact and outcomes
Dmytro Osin, Biomedical Engineering Officer, Bulgaria, WHO

Dymtro Osin is a biomedical engineering officer with 15 years’ experience in medical equipment servicing and
procurement – 3.5 years of which have been with the WHO. He is certified in technical maintenance, technical safety
checks of medical equipment and project management, on equipment related to medical gases, oxygen production,
storage, regulation and distribution equipment, infusion systems, portable ventilators, defibrillators and vital signs
monitors, viral and biohazardous protection systems, etc. He is well experienced in providing health care support in
conflict settings in Ukraine. Dymtro provided facilitation support for the breakout group on Technical aspects of
oxygen systems and sat on the panel for Plenary session 8: Cross-cutting aspects of oxygen systems – alignment
and integration.
Mostafa Othman, Epidemiologist, WHO Health Emergencies Programme and WHO Regional Office for the
Eastern Mediterranean
Mostafa Othman is an epidemiologist who supports data collection and monitoring of health care emergencies, such
as disease outbreaks, humanitarian crises, natural disasters and other hazard emergencies, for WHO in the region. He
previously held other positions with WHO as well as the Ministry of Health and Population in Egypt. He holds a
bachelor’s in Pharmaceutical Sciences and a post-graduate diploma in Epidemiology. Mostafa supported the
breakout session on Oxygen ecosystem quantification and supported onsite logistics.
Scott Pendergast, Director, Strategy, Programmes and Partnerships, WHO Health Emergencies
Programme, WHO
Scott Pendergast is the Director for Strategy, Programmes and Partnerships with the WHO Health Emergencies
Programme, responsible for the overall strategy, programme delivery and strategic partner engagement to prepare for,
prevent, detect and respond to global health emergencies and humanitarian crises. Prior to this, he worked for the Food
and Agricultural Organization, International Labour Organization and WHO where he has played lead roles in organization-
wide strategic and operational planning, budgeting and performance assessment. Scott started his career working
with the World Bank in various countries establishing social investment funds. Scott sat on the panel for Plenary
session 3: Oxygen scale-up deep dives – Costing and sustainable financing.
Samriddha Rana, Health Emergency Intervention Officer, WHO Regional Office for South-East Asia
Samriddha Rana is a biomedical engineer serving at the WHO Country Office for Nepal. Instrumental during the COVID-
19 pandemic, he supported critical initiatives in the management of oxygen and biomedical equipment along with the
development of learning resource packages for respiratory equipment and medical oxygen systems, establishment of
a severe acute respiratory infection treatment facility and sustainable solutions to energy deficiency through
photovoltaic systems. Prior to joining WHO in 2020, Samriddha spent 6 years working in various multispecialty hospitals.
Samriddha supported the breakout group on Policy, regulations and guidelines for safe, quality-assured
oxygen systems and was the primary facilitator for Day 3.
53
Alfonso Rosales, Technical Officer, Medical Devices and In vitro Diagnostics, PAHO/WHO
Alfonso Rosales works at PAHO as a Technical Officer specializing in medical devices and in vitro diagnostics within the
Department of Innovation, Access to Medicines and Health Technologies. With a background in biomedical
engineering, he has over 14 years’ experience focusing on health technology assessment, health technology
management, big data analysis, and quality assurance and regulation of medical devices. Throughout the COVID-19
pandemic, he was actively engaged in PAHO's Oxygen Technical Group. Currently, he is a member of the PAHO team
participating in the Global Oxygen Alliance. Alfonso was the primary facilitator for Day 2 and provided facilitation
support for the breakout session on Workforce and competencies needed for sustained oxygen ecosystems.
Dr Jamie Rylance, Subject Matter Expert, Clinical Management and Operations Unit,
Country Readiness Strengthening, WHO Health Emergencies Programme, WHO
Dr Jamie Rylance is a medical doctor specialized in Internal Medicine and Pulmonology. Before joining WHO, he spent
10 years in the United Republic of Tanzania and Malawi as a practising physician and a clinical researcher, driven by a
desire to improve patient outcomes. Working with colleagues in both countries, he supported the introduction of
critical care units and advocated for broader access to oxygen alongside other key life-saving interventions. Jamie
spoke during Plenary session 4: Template polling introduction, provided facilitation support for the breakout
group on Partnerships and engagement for oxygen scale-up and facilitated the Open discussion on aspirations
and next steps on Day 3.
Dr Michael Ryan, Executive Director, WHO Health Emergencies Programme;

Deputy Director- General, WHO
Dr Ryan leads WHO’s response to disease outbreaks, humanitarian crises and other public health emergencies. At the
forefront of managing acute risks to global health for nearly 25 years, Dr Ryan first joined WHO in 1996, within a newly
established unit responding to emerging and epidemic disease threats. He completed his medical training at the National
University of Ireland, Galway, and has a master’s in Public Health from University College, Dublin, Ireland. Dr Ryan
provided formal opening remarks for the meeting on Day 1.
Dr Habtamu Seyoum, Health Specialist, Access to Essential Child Health and Medicines, UNICEF
Dr Seyoum is a medical doctor and public health professional with more than 19 years’ health service management
and health system strengthening experience in public, private and international NGOs in resource-limited settings
across Africa and Asia. Over the last 9 years, Dr Seyoum has been providing technical and strategic support on scale-up
of national and global oxygen systems in RMNCAH and pandemic responses. He has co-authored multiple operational
research and results of innovative interventions related to oxygen and hypoxaemia management. Dr Seyoum
moderated Plenary session 1: Existing oxygen roadmap highlights.
Dr Gilbert Shetak, National Oxygen Desk Director, Department of Hospital Services, Federal Ministry of
Health and Social Welfare, Nigeria
Dr Gilbert Shetak, a distinguished health care professional, graduated from the University of Jos Medical School. Since
2001, he has served as the Principal Medical Officer at the Federal Ministry of Health, contributing significantly to
various initiatives. His leadership roles within medical associations and the Federal Medical Centre Division underscore his
commitment to health care advancement. Appointed as the National Oxygen Desk Officer in 2016, he spearheads medical
oxygen scale-up efforts. Dr Shetak sat on the panel for Plenary session 3: Oxygen scale-up deep dives –
Importance of the workforce.
Dr Jinho Shin, Medical Officer, WHO Regional Office for the Western Pacific
Dr Shin works as a medical officer within the Essential Medicines and Health Technologies team. He supports countries
in strengthening regulatory systems for medical products to ensure their quality, safety and efficacy by promoting the
adoption and implementation of WHO policy, standards and guidelines and providing technical support in scientific
evaluation, manufacturing site inspection, laboratory capacity building, post-approval quality surveillance and
assurance, and safety management. Dr Shin provided facilitation support for the breakout group on Policy,
regulations and guidelines for safe, quality-assured oxygen systems.
54
Lisa Smith, Program Leader, Market Dynamics, PATH

Lisa Smith is the Program Leader of PATH’s Market Dynamics Program and has directed PATH’s work in respiratory
care for nearly a decade. She provides analytical and strategic leadership for PATH projects working to develop
healthy markets for innovative health products and technologies in LMICs. Prior to PATH, she helped develop scalable
and sustainable models for global health delivery and supply chains. Lisa holds an master’s in Public Health, a
certificate in Global Health and a social work master’s in Policy and Evaluation from the University of Michigan. Lisa
moderated Plenary session 5: Oxygen scale-up deep dives – Finding the need-gap and facilitated and reported
on the breakout session on the same topic.
Dr Rajesh Sreedharan, Team Lead, Country Assessment and Planning, Health Security Preparedness
Department, WHO Health Emergencies Programme, WHO
Dr Rajesh Sreedharan is a physician with a master’s in Public Health and over 20 years’ experience in infectious
diseases surveillance, prevention and control and outbreaks investigations and response. Dr Sreedharan is a Team
Lead in the WHO Health Emergencies Programme working within the Health Security Preparedness Department. He is
responsible for the development and implementation of the International Health Regulations States Parties Annual
Reporting and Joint External Evaluation that are part of the International Health Regulations Monitoring and Evaluation
Framework and the National Action Planning for Health Security. Dr Sreedharan sat on the panel for Plenary
session 8: Cross-cutting aspects of oxygen systems – alignment and integration.
Jim Stunkel, Vice President, Technical Services, Assist International

Jim has a passion to save the lives and change the destiny of some of the world's most vulnerable people. He
currently serves as the Vice President for Technical Services at Assist International. With a focus on eastern Europe,
Africa, Asia, Central America and the Middle East, he leads networking and coordinating sponsors and resources to
meet needs as well as fundraising, team building and team leadership to developing countries for building orphan
homes, medical facilities, water and power systems and economic empowerment opportunities. Jim facilitated and
reported on the breakout session on Technical aspects of oxygen systems.
Dr Fatou Mbaye Sylla, Health, General Directorate of Health Establishments, Ministry of Health and Social
Action, Senegal
Dr Sylla is the General Director of Health Establishments – a relatively new department within the Ministry of Health and
Social Action in Senegal that oversees the management of public and private health facilities. She was a champion and
public figure for health care access during the COVID-19 pandemic. She has over a decade of experience as a doctor and
previously served as Chief Doctor for Linguère district and Chief Medical Officer for Youssou Mbargane Diop district of
Rufisque, where she became the hospital administrator. Dr Sylla provided a welcome and opening remarks during the
opening session on Day 1.
Dr Erasto Sylvanus, Health Disaster Management Specialist, Ministry of Health,

United Republic of Tanzania
Dr Erasto Sylvanus is an emergency physician and health emergencies expert. He is currently working as a Head of
Emergency Medical Services at the Emergency Preparedness and Response Unit at the Ministry of Health. He has 12 years’
experience in the provision of emergency medical services through the Case Management Pillar and has led the
provision of care in the designated regional, zonal and national highly infectious disease treatment units for emergency
and critical cases during the COVID-19 pandemic. He holds a master’s in Public Health from University College, Dublin,
Ireland. Dr Sylvanus sat on the panel for Plenary session 5: Oxygen scale-up deep dives – Measuring impact and
outcomes.
Dr Elvis Temfack, Senior Research Officer, Africa Centres for Disease Control and Prevention
Dr Elvis Temfack is a Senior Research Officer at the Africa Centres for Disease Control and Prevention, based in Ethiopia.
He is a medical doctor with over 15 years' clinical and health research experience. He also worked at Epicentre, the
research department of MSF, in Malawi, as Principal Investigator providing technical support through relevant clinical
evidence generation for national policy change for HIV first-line treatment. He is highly experienced in designing and
conducting cohort studies and clinical trials with track records of co-authorship of many peer-reviewed publications
and membership of many collaborative working groups. Dr Temfack sat on the panel for Plenary session 3: Oxygen
scale-up deep dives – Effective partnerships.
55
Professor Didier Mukeba Tshialala, Head of Intersectional Medical Platform, MSF International
Professor Tshialala is the Head of Intersectional Medical Platform with MSF, which coordinates its support needs and
response across West and Central Africa. He is also an Associate Professor at the Faculty of Medicine and a Vice Dean in
charge of Research, Specialization and University Clinics at the University of Mbuji-Mayi in the Democratic Republic of the
Congo. He has many years of experience as a doctor and clinical researcher in surgery, infectious disease and internal
medicine, and epidemiology.
Professor Tshialala sat on the panel for Plenary session 8: Cross-cutting aspects of oxygen systems – alignment
and integration.
Dr Sura Wisedsak, Director-General, Department of Health Service Support, Ministry of Public Health,
Thailand
Dr Sura Wisedsak is the Director-General of the Department of Health Service Support. With extensive experience in
public health, he was equipped to effectively manage the COVID-19 pandemic and provide efficient vaccination services.
He has worked towards building positive motivation and welfare for medical personnel. Dr Wisedsak has also
collaborated with the Medical Innovation, Research and Development Operations Center for the COVID-19 pandemic
to become a leader in the primary health system, village health volunteers, medical engineering structures and health
service support. Dr Wisedsak sat on the panel for Plenary session 8: Cross-cutting aspects of oxygen systems –
alignment and integration.
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Annex 5: Detailed agenda for National Oxygen Scale-Up Framework Meeting
Time Topic Speakers
Day 1 Summary
Orient participants to oxygen scale-up efforts by showcasing prior oxygen roadmap accomplishments and introducing zero draft of the National Oxygen Scale-Up template
Day 1 objectives:
• Demonstrate oxygen scale-up efforts through the application of oxygen roadmaps using country examples
• Share experiences and background on key topics relevant to oxygen scale-up efforts
• Introduce the zero draft of the National Oxygen Scale-Up template
• Solicit participant feedback on the zero draft of the National Oxygen Scale-Up template via electronic polling
10:00-10:45 1. Welcome and opening (3 + 10 + 5 mins) 1. Dr Michael Ryan, Executive Director, Deputy Director-
2. Press Point General WHO (virtual)
3. Keynote speaker Dr Jeff Kabinda Maotela, WHO Representative OIC,
4. Setting the stage (2 mins) Senegal
5. Meeting agenda Dr Fatou Mbaye Sylla, la directrice générale des
établissements de santé, Ministère de la Santé et de
l’Action sociale, République du Sénégal
2. Press Point
3. Professor Adegoke Falade, University of Ibadan,
Nigeria
4. Dr Janet Diaz, WHO
5. Dr Marta Lado, Partners In Health
Plenary session 1: Existing oxygen roadmaps highlights
10:45-12:00 Showcase existing oxygen roadmaps Moderator: Dr Habtamu Seyoum Tola, UNICEF
Moderator to introduce concept of planning for oxygen scale-up, outlining requirements, Panellists:
who to involve and how scale-up plans can be used (5 mins) - Dr Khamsay Detleuxay, Ministry of Health Lao
People’s Democratic Republic
Panel discussion (40 mins):
- Noelia Solares Muralles, Ministry of Health Guatemala
• Initiating a roadmap
- Dr Olfa Challouf, Ministry of Health Tunisia
• Successes and challenges
- Dr Prakash Budhathoki, Ministry of Health Nepal
• What the future holds
- Dr Damira Sharabidinovna Begmatova, Ministry of
Open floor: Q&A and participant sharing (30 mins)
Health Kyrgyzstan
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12:00-13:00 Lunch break

Plenary session 3: Oxygen scale-up topic deep dives
13:00-13:50 Part 1: Effective partnerships for development and implementation of oxygen scale-up Moderator: Dr Chizoba Fashanu, CHAI
activities
Panellists:
Moderator to discuss partnerships across all levels, sectors, cadres (5 mins) - Robert Matiru, Unitaid/GO2AL (virtual)
Panel discussion (25 mins): - Dr Nicholas Adjabu, Ministry of Health Ghana
• Multistakeholder engagement: government, NGOs, donors, private sector - Maurine Murenga, Community Delegation to The
• Multidisciplinary engagement: technical, clinical, administrative, logistics, architects, Global Fund (virtual)
procurement - Dr Nahreen H Ahmed, MedGlobal
• Collaborations in vulnerable or fragile contexts Dr Elvis Temfack, Africa Centres for Disease Control
Open floor: Q&A and participant sharing (20 mins) and Prevention (virtual)
- Dr Muhammad Mudassar, Ministry of Health Pakistan
13:50-14:40 Part 2: Costing and sustainable financing of oxygen ecosystems Moderator: Dr Gwenael Dhaene, WHO
Moderator to provide overview of financing framework, what is required for oxygen scale-up
Panellists:
costing and sustainable financing for assurance of system continuity (5 mins)
- Dr David Lowrance, The Global Fund (virtual)
Panel discussion (25 mins): - Scott Pendergast, WHO (virtual)
• Financial planning (costing resources and activities, prioritization, e.g. universal health - Ankara Alejandra Reichle Collier, Ministry of
coverage, Pandemic Fund) Health Honduras
• Budget cycles/timing, decision-makers - Dr Rose Lavado, WHO (virtual)
• Integration into broader health system financing, including financing mechanisms
(insurance schemes, innovative cost recovery modalities)
• Gaps in financing for continued operations for safe, quality sustainable outputs
14:40-15:00 Coffee and tea break
15:00-16:00 Part 3: Importance of the workforce for oxygen ecosystems and roadmap development Moderator: Dr John Appiah, WHO
Moderator to underscore need for multidisciplinary human resources for health systems, at Panellists:
all levels, to advocate for, plan, implement, use and sustain medical oxygen systems (5 mins) - Tazeen Saeed Bukhari, International Federation for
Medical and Biological Engineering
Panellists to showcase persistent needs and challenges (35 mins):
- Dr Gilbert Shetak, Ministry of Health Nigeria
• Training and education (in-service, pre-service), expanding and supporting diverse
- Dr Dora Lenturut-Katal, National Department of
occupational groups (clinical, technical, administrative, logistics, architects,
Health, Papua New Guinea
procurement)
- Professor Mervyn Mer, Trainer C19_SPACE
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• Facility organizational structure, delineating all roles (highlighting skills mix),

identification of persistent shortages
• Labour markets (dynamics; need, demand and shortages, recruitment and retention)
Plenary session 2: National Oxygen Scale-Up template
16:00-16:05 Foundational requirements of oxygen scale-up Presenter: Adriana Velazquez Berumen, WHO
16:05-16:20 Overview of existing oxygen roadmaps, results from scoping review (15 mins) Presenter: Anne Moller, Partners In Health
16:20-16:30 Overview zero draft of the National Oxygen Scale-Up template (30 mins) Presenter: Jessica Cook, Partners In Health
• What is meant by “template”
• How it was developed
• Template contents
• Intended users, how it can be used
Plenary session 4: Template polling – Introduction
16:30-16:50 Introduction to the Delphi methodology: Dr Jamie Rylance, WHO
• How we will apply the process to the National Oxygen Scale-Up template zero draft Anne Moller, Partners In Health
• Demonstration of polling feature (to take place at the end of Day 2)
16:50-17:00 Day 1 wrap-up, looking to Day 2 and closing remarks Dr Marta Lado, Partners In Health
59
Time Topic Speakers

Day 2 Summary
Continuing topic deep dives and refining the zero draft of the National Oxygen Scale-Up template in breakout sessions
Day 2 objectives:
• Elevate country voices to ensure representation in National Oxygen Scale-Up template
• Facilitate sharing of successes, challenges and lessons between countries
• Move towards agreement for key components of an oxygen roadmap template
8:45-9:00 Brief welcome and overview of Day 2 agenda Alfonso Rosales, WHO PAHO
Plenary session 5: Oxygen scale-up topic deep dives
9:00-10:00 Part 4: Finding the need-gap: assessment and quantification for oxygen scale-up Moderator: Lisa Smith, PATH
Moderator to provide overview and summary of unmet needs within the oxygen ecosystem, Panellists:
including recognition that these needs will constantly evolve (5 mins) - Martha Gabriela Chiguano Curicho, Ministry of Health
Panellists to discuss their experiences of assessing and meeting needs (35 mins): Ecuador
• Examples of challenges faced - Dr Beverly Bradley, UNICEF
• How they have prioritized unmet needs - Vusumuzi Sibusiso Dlamini, Ministry of Health
• Tools that have assisted in improving performance Eswatini
• Pandemic and surge preparedness - Dr Chiori Kodama, WHO Regional Office for the Eastern
Mediterranean
Open floor: Q&A and participant sharing (20 mins) - Dr Varun Manhas, One Health Trust
10:00-11:00 Part 5: Measuring impact and outcomes for timely action toward evidence-informed Moderator: Carina King, Karolinska Institutet
decision-making along the oxygen ecosystem
Moderator to provide an overview of the challenges of acquiring, analysing and utilizing data Panellists:
to measure outcomes for the safe, effective treatment of patients, for quality-assured oxygen - Dr Janet Diaz, WHO
systems, and for global investments and governance - Dr Erasto Sylvanus Odindo, Ministry of Health United
Republic of Tanzania
Panellists to discuss the importance of evidence-informed decision-making and the - Dr Jean-Paul de Bruyne Mushenvula, ALIMA
application of relevant and appropriate data systems and timely analysis of indicators for - Dr Freddy Kitutu, Lancet Global Health Commission on
evaluation within the oxygen ecosystem (35 mins): medical oxygen security, ATMO2S scorecard
• The use of data for evidence-informed decision-making regarding policy and governance - Dr Jeanine Condo, University of Rwanda
at all levels of the health system
• Using data to illustrate improved outcomes and identify gaps for advocacy
• Measuring patient-centred clinical care outcomes
60
• Ongoing M&E of operational activities for:

- Accountability and learning regarding implementation and utilization
- Ensuring safe, optimal performance of oxygen system equipment
- Improving national coverage through decentralization of services
11:00-11:30 Coffee and tea break, poster showcase
11:30-12:30 Breakout sessions: hour-long sessions on 7 themes – participants to choose 4 Lead facilitators (co-facilitator & session support):
12:30-13:30 Facilitators using various modalities facilitate smaller groups 1. Lisa Smith (Florestan Boualame & Mostafa Othman)
Lunch 1. Oxygen ecosystem quantification, including surge scenarios 2. Jim Stunkel (Dmytro Osin, Gaby Jimenez, Noelia
13:30-14:30 2. Technical aspects of oxygen systems: source, storage, distribution, operations, Solares Muralles & Ankara Alejandra Reichle Collier)
maintenance, associated infrastructure 3. Dr Gwenael Dhaene (Dr Immaculee Mukankubito &
14:30-14:45
3. Financing and sustainable investment in oxygen ecosystems Jessica Cook)
Transition
4. Workforce and competencies needed for sustained oxygen ecosystems 4. Dr John Appiah (Alfonso Rosales &
14:45-15:45
5. Measuring impact and outcomes of oxygen ecosystems Dr Jerry-Jonas Mbasha)
15:45-16:00 5. Dr Carina King (Dr Steven McGloughlin &
6. Policy, regulations and guidelines for safe, quality-assured oxygen systems
Tea/ Dr Marta Lado)
7. Partnerships and engagement for oxygen scale-up
Transition 6. Laura Alejandra Velez Ruiz Gaitan (Dr Jinho Shin &
16:00-17:00 Samriddha Rana)
7. Inutu Kanyama (Dr Jamie Rylance & Anne Moller)
17:00-17:10 Break
17:10-17:25 Electronic voting on National Oxygen Scale-Up template revised draft Jessica Cook, Partners In Health
17:25-17:30 Brief closing remarks Alfonso Rosales, WHO PAHO
19:00- Formal meeting reception Dr Janet Diaz, WHO
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Time Topic Speakers

Day 3 Summary
Refine zero draft of the National Oxygen Scale-Up template and identify next steps
Day 3 objectives:
• Discuss key takeaways from breakout sessions
• Identify and revise essential components of an oxygen roadmap template
• Conclude meeting with the next steps identified and shared
9:00-9:10 Brief welcome and overview of Day 3 agenda Samriddha Rana, WHO Regional Office for South-East Asia
9:10-9:30 Overview of consensus on the National Oxygen Scale-Up template zero draft Jessica Cook, Partners In Health
Laura Alejandra Velez Ruiz Gaitan, WHO
Plenary session 7: Breakout sharing
9:30-10:30 Part 1: Debriefing discussion on breakout sessions Moderator: Dr Steven McGloughlin, WHO
Content, additional proposed changes to the National Oxygen Scale-Up template zero draft,
and/or remaining gaps/areas of uncertainty
1. Lisa Smith, PATH
1. Oxygen ecosystem quantification, including surge scenarios
2. Jim Stunkel, Assist International & Gaby Jimenez
2. Technical aspects of oxygen systems: source, storage, distribution, operations,
Moyao, UNOPS
maintenance, associated infrastructure
3. Dr Gwenael Dhaene, WHO
3. Financing and sustainable investment in oxygen ecosystems
10:30-11:00 Coffee and tea break, poster showcase
11:00-12:00 Part 2: Debriefing discussion on breakout sessions Moderator: Constance McDonough-Thayer, WHO
4. Workforce and competencies needed for sustained oxygen ecosystems
5. Measuring impact and outcomes of oxygen ecosystems
4. Dr John Appiah, WHO
6. Policy, regulations and guidelines for safe, quality-assured oxygen systems
5. Dr Carina King, Karolinska Institutet
6. Laura Alejandra Velez Ruiz Gaitan, WHO
7. Inutu Kanyama, PATH
12:00-13:00 Lunch
Plenary session 8: Cross-cutting aspects of oxygen ecosystems
13:00-14:15 Alignment and integration of oxygen scale-up activities Moderator: Dr Leah Greenspan, USAID
Panellists:
62
Moderator to provide overview of health system priorities, programmes and reliance on - Priorities
multisectoral engagement, all of which must be integrated for successful, sustainable oxygen o Dr Rajesh Sreedharan, WHO (virtual) and
scale-up (5 mins) Dr Nirmal Kandel, WHO (virtual)
o Dr Dennis Marke, Ministry of Health Sierra Leone
Panel to consider horizontal integration of oxygen systems (50 mins): o Professor Didier Mukeba Tshialala, MSF
• Health system priorities (One Health, Sustainable Development Goals, universal health - Programmes
coverage, health systems for health security framework, National Action Plans for o Dr Sura Wisedsak, Ministry of Health Thailand
Health Security and Joint External Evaluations, safe hospitals, emergency preparedness, o Professor Adegoke Falade, University of Ibadan,
response, resilience, etc.) Nigeria
• Existing health system programmes (emergency, critical and operative care; - Multisectoral engagement
noncommunicable diseases; maternal and child health; tuberculosis; newborn health; o Philip Maina Gatongi, UNOPS
etc.) o Dmytro Osin, WHO
• Multisectoral engagement (infrastructure for health systems, utilities [electricity, water],
transportation, logistics)
14:15-14:30 Electronic voting on revised National Oxygen Scale-Up template Anne Moller, Partners In Health
Laura Alejandra Velez Ruiz Gaitan, WHO
14:30-15:00 Coffee and tea break and poster showcase highlights
15:00-15:15 GO2AL showcase Robert Matiru, Unitaid/GO2AL(virtual)
15:15-16:15 Next steps for oxygen scale-up Dr Jamie Rylance, WHO
• Interactive session: motivations, aspirations, needs
• Open forum to share visions, ideas, goals
Revisiting foundational requirements: bringing it all together Adriana Velazquez Berumen, WHO
Closing session
16:15-16:30 Meeting wrap-up, closing remarks and next steps Dr Janet Diaz, WHO
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Annex 6: Breakout session notes
1. Oxygen ecosystem quantification, including surge scenarios

Facilitators
✓ Lisa Smith, Program Leader, Market Dynamics, PATH

✓ Florestan Boualame, Regional Biomedical Engineer Consultant, WHO Health Emergencies
Programme and WHO Regional Office for the Eastern Mediterranean
✓ Mostafa Othman, Epidemiologist, WHO Health Emergencies Programme and WHO Regional Office
for the Eastern Mediterranean
Summary

✓ Use metrics including but not limited to average flow rate, ratio of severe to non-severe patients,
occupancy rate, WHO guidelines, number of technicians per oxygen plant, oxygen plant
management and oxygen cylinder management to determine broader system needs.
✓ Utilize national standards for the number of staff per level of care, number of devices per ward and,
accordingly, consumables and accessories to determine the minimum need.
✓ Build strategies to understand and quantify surge needs: quantification of “typical” need is more
straightforward than estimating surge needs. Natural disasters, global pandemics and seasonality
were all highlighted as events that impact routine oxygen planning.
✓ Various approaches to oxygen estimation exist. Consider the level of maturity of the analysis to
determine which tools are appropriate to use – starting with an initial, first-time assessment and
moving toward real-time tracking with advanced analytics. The tools, resources, and support
needed will vary as approaches become more sophisticated.
2. Technical aspects of oxygen systems: source, storage, distribution,

operations and maintenance, associated infrastructure
Facilitators
✓ Jim Stunkel, Vice President, Technical Services, Assist International

✓ Dmytro Osin, Biomedical Engineering Officer, Bulgaria, WHO
✓ Gabriela Jimenez Moyao, Biomedical Engineer, UNOPS
✓ Noelia Solares Murales, Pharmaceutical Specialist, Ministry of Health Guatemala
✓ Ankara Alejandra Reichle Collier, Biomedical Engineer, Ministry of Health Honduras
Summary
✓ Quality assurance is a cornerstone for delivering high-quality oxygen to patients. Many countries adhered to
international standards (e.g. ISO standards) for their design and practices. In some countries, the regulatory
authorities (United States Food and Drug Administration, etc.) ensure the quality of oxygen.
64
✓ Safety – certain safety standards must be considered to ensure safety and end-use confidence, including fire
safety protocols, educational posters and sensitization programmes, cylinder handling and hydro testing,
proper cylinder labeling and colour coding of the piping system.
✓ Adjustment to surge scenarios is critical. Contingency plans in technical systems and supply
chains are imperative to ensure uninterrupted oxygen delivery. Considerations include:
o Cargo prioritization.
o Implementation of remote monitoring systems.
o Proper calculation of storage tanks.
o Redundant systems in one or several components.
✓ Understanding the surrounding environment is central to oxygen delivery. Factors such as plant
location, adequate ventilation, minimizing vibration, and potential impact of dust and inclement
weather conditions must be meticulously assessed to guarantee the reliability and efficacy of
oxygen systems. Pre-assessments and the provision of dedicated transformers for facilities were
measures discussed to ensure adequate oxygen delivery.
✓ Power supply reliability is key for ensuring an uninterrupted oxygen supply. The power supply
should be clean, reliable and without fluctuations.
3. Financing and sustainable investment in the oxygen ecosystem

Facilitators
✓ Dr Gwenael Dhaene, Health Systems Adviser, Health Infrastructure Focal Point, WHO
✓ Dr Immaculee Mukankubito, Technical Officer, Essential Medicines and Health Technologies,
WHO
✓ Jessica Cook, Senior Analyst, Universal Health Coverage Financing, PIH
Summary
✓ Needs and gap analyses: sustainable financing should rely on a theory of change, whole-of-life
costing, financial analysis, economic analysis and implementation readiness. Epidemiological
needs (current and forecast) should underpin needs assessment to ensure proper quantification of
needs.
✓ Real-world evidence to bolster adequate solutions: the post COVID-19 era should signal the
emergence of options based on granular data and insight such as burden of disease (including
spatial epidemiology), capital item unit cost and existing capabilities. Care models and service
delivery should serve to frame contextual solutions.
✓ System-wide approach: oxygen production, storage and distribution should be understood as part
of a larger ecosystem. Oxygen scale-up requires assessment of investment needs in related
infrastructure, comprising of reliable energy, infrastructure (building) and other ancillary services
development (e.g. storage facilities, distribution infrastructure or transportation).
✓ Building the investment case: demonstrating the oxygen value chain throughout the life cycle of
capital goods is essential for finances ministries, investors and funding partners. Financial viability
and economic return must incorporate precise costing of investment needs as well as forecast of
OPEX, inclusive of staffing, recurring costs and maintenance costs.
65
✓ Beyond CAPEX/OPEX, while CAPEX and recurring costs ought to be clearly delineated in any
investment plan, the need for appropriate allocation of resources for maintenance is required.
Extensions of service provision contracts should be pursued whenever possible and negotiated
with manufacturers and suppliers.
✓ National investment plan: priority investment based on domestic resources and external funding
should respond to a single national investment plan (to avoid fragmentation and ensure system
coherence). Private sector participation should be based on clear performance targets and
accountability.
✓ Optimization through contracting arrangements: contracting arrangements should be assessed as
they can contribute to increasing access to oxygen in a context of limited capital or recurring costs
availability. Agreements could also be developed between public entities or health facilities across
subnational levels to pool resources and consolidate demand.
4. Workforce and competencies needed for sustained oxygen systems

Facilitators
✓ Dr John Appiah, Consultant, Clinical Management and Operations Unit, Country Readiness
✓ Alfonso Rosales, Technical Officer, Medical Devices and In vitro Diagnostics, PAHO/WHO
✓ Dr Jerry-Jonas Mbasha, Operational Partnership Officer, WHO Regional Office for Africa
Summary
✓ Engage a multidisciplinary approach to unify the clinical and non-clinical health workforce and
improve patient access to oxygen, including engaging with supply chain staff and health care
administrators.
✓ Ensure that comprehensive clinical training includes accessibility and utilization of oxygen and
that training programmes reach all health care workers, especially those in remote and
underserved areas, which can be challenging due to logistical and infrastructural constraints.
Having the right capacity of skilled health care workers ensures that oxygen systems are used
effectively and efficiently, leading to better patient care.
✓ High burnout and staff turnover pose a major challenge to health care delivery. Health care
workers in many regions are often overburdened with high patient loads, limiting their ability to
focus on and effectively utilize oxygen systems. Additionally, high turnover rates among health
care workers can lead to losing trained personnel, create capacity gaps and require repeated
training efforts.
✓ Establish regulatory bodies and mechanisms that develop, enforce and monitor standards for the
technical aspects of oxygen production and delivery, ensuring quality, safety and reliability across
all health care settings. These bodies could develop guidelines and protocols for oxygen
production facilities, equipment maintenance and distribution logistics. Regular inspections and
compliance checks will ensure adherence to these standards.
✓ Efforts should focus on strengthening the skills of health care workers. Modalities should include
supportive supervision, mentoring and on-site coaching.
66
✓ Establish robust monitoring mechanisms and accurate data collection systems and conduct
regular reviews to help track and improve the implementation of oxygen therapy.
✓ Develop specialized training modules for biomedical engineers. Create comprehensive training
programmes focused on equipment maintenance, repair and troubleshooting, including changing
oxygen cylinders, maintaining the manifold system and addressing technical issues.
✓ Establish platforms and initiatives that facilitate regional exchange of experiences and best
practices related to oxygen production and delivery to enhance collaboration and knowledge
sharing among health care professionals and institutions.
5. Measuring impact and outcomes of oxygen systems

Facilitators
✓ Dr Carina King, Associate Professor of Global Health, Karolinska Institutet

✓ Dr Steven McGloughlin, Consultant, Clinical Management and Operations Unit, Country
✓ Dr Marta Lado, Director, Clinical Programs and Health Policy, Sierra Leone, PIH
Summary
✓ Recognize and monitor cycles where oxygen use increases, using epidemiology or extenuating
factors, such as conflict, to estimate the burden among groups.
✓ Determine patient groups most likely to benefit from oxygen therapy using patient-level data.
✓ Create smart, collectible and meaningful indicators so that data can inform decision-making at a
system level. Use data to advocate for considering priority groups to improve patient outcomes.
✓ Integrate medical oxygen indicators into DHIS2 to ensure maximal health informatics availability
and consistency.
✓ Establish systems for monitoring inefficiencies/oxygen wastage to reduce costs to health care
systems in clinical use and production.
✓ Establish quality or management teams at the facility level to include oxygen monitoring.
6. Policy, regulations and guidelines for safe, quality-assured oxygen

systems
Facilitators
✓ Laura Alejandra Velez Ruiz Gaitan, Technical Officer, Clinical Management and Operations Unit,
Country Readiness Strengthening, WHO Health Emergencies Programme, WHO
✓ Dr Jinho Shin, Medical Officer, WHO Regional Office for the Western Pacific
✓ Samriddha Rana, Health Emergency Intervention Officer, WHO Regional Office for South-East Asia
Summary
✓ Policies should focus on community needs, understanding and acceptance to ensure patient buy-
in. Ultimately, civil society should agree on the implementation of policies.
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✓ Use a multistakeholder, interministerial and multidisciplinary approach to planning, implementing

and evaluating impact to unify stakeholders around a common goal.
✓ Policies should increase research, academic programmes and incentives for health workers such as
biomedical engineers, health architects, electricians, pharmacists and nurses.
✓ Share lists of prequalified manufacturers and authorized regional and local distributors.
International manufacturers must support their authorized distributors with training, information
sharing and spare parts availability. National mechanisms are needed to ensure qualified/licensed
suppliers are available.
✓ Ensure equitable access to oxygen therapy for all populations in every remote area, regardless of
social, cultural and economic status. It is important to consider the capacity to absorb the
technologies and increase access to information, training and documentation in different
languages.
✓ Once the roles and responsibilities have been clearly defined, drive accountability at all levels,
including an accountability framework along the supply chain. Lawyers should be included in the
multidisciplinary team.
✓ Increase awareness for all stakeholders, including donors, the private sector and governments, of
the importance of cost impact and feasibility studies.

Facilitators
✓ Inutu Kanyama, Market Dynamics Officer, PATH

✓ Dr Jamie Rylance, Subject Matter Expert, Clinical Management and Operations Unit, Country
✓ Anne Moller, Associate Director for Public Health and Emergency Systems, PIH
Summary
✓ A national-level strategic plan should define clear goals for partnerships. Partnership agreements
should be explicit, understood by all parties and driven by the needs of nation-states.
✓ The needs of nation-states should be identified from the perspectives of the end-user (patients). A
needs analysis should start from what is needed and include (but not be driven by) stakeholder
mapping.
✓ Consider financing models to promote prioritization for oxygen in national budgets.
✓ Communication with partners should be active and focused on reducing inefficiency at all levels –
supranational, subnational, with individual sectors, stakeholders, communities, etc.
✓ Community engagement needs to carefully define “which community.” “Everyone” messaging is
dilute, and care-seeking generally offers a common entry point (ties in with fear of oxygen/health
care). Specific influencers may amplify messaging and some demographic groups may have more
influence (e.g. females in caregiving roles).
✓ Powerful partnerships with the private sector begin with well-communicated predictability,
enabling market adaptation to meet the needs with sufficient lead time – “pivot to need.” Tools
would be helpful to support Member States in engaging the private sector, including preferential
68
taxation policies to reduce barriers (e.g. on imported components) and medical insurance schemes
that include medical oxygen therapy.
✓ Stakeholder relationships should be monitored and evaluated. Working groups or task forces
should be considered to organize and support all oxygen activities.
69
Annex 7: Delphi process brief
Development of a template to plan for national oxygen scale-up
Applying a modified Delphi methodology to achieve consensus
The zero-draft template for oxygen scale-up comprises 56 items1 across six areas. These items have been
formulated through the scoping review, the text of WHA resolution 76.3, the WHO Strategy for the National
Action Plan for Health Security, and with expert review from the TWG and WHO technical staff and refined
by the steering group’s two organizations (PIH and WHO). These items are the proposed elements of a
template to plan for oxygen scale-up. They are high-level descriptions which will be then used to structure
and to limit the scope of the final template.
We will apply a modified Delphi process to this draft to finalize these items. This process relies on
developing consensus via survey to determine what items should be included in the template. Discussion
around the feasibility and appropriateness of each item will be provided through panel sessions, breakout
groups and other discussions in the first 2 days of the in-person meeting.
The survey involves reviewing a digital version of the draft template in your choice of language and
selecting “include”, “exclude”, or “don’t know” for each item. Participants will be encouraged to give a
definitive answer (i.e. “include” or “exclude” wherever possible) because questions answered as “don’t
know” will not be included in the calculation of consensus.
✓ Items reaching a 70% threshold for “include” (as a proportion of definitive responses) will be
deemed to have consensus and will therefore remain in the proposed list.
✓ Items reaching a 70% threshold for “exclude” (as a proportion of definitive responses) will be
dropped from the proposed list.
✓ Items where responses fall between 30% and 70% for “include” (as a proportion of definitive
responses) will be considered by the steering group, who will make a definitive decision.
Additional items may be proposed by participants during the first poll. New items proposed will be
considered by the steering group and will be flagged for wider discussion unless they:
✓ Significantly overlap with existing items.

✓ Are outside the remit of the project’s aims.
✓ Represent a significant conflict of interest or compromise the independence of the process.
✓ Are unlikely to be helpful due to issues of, for example, non-universal applicability.
After the first round of polling, a summary of the items which reached consensus, and those which did not
will be presented to participants in the plenary meeting. Each newly proposed item will also be presented.
To be entered into the list, a minimum of 30% of the audience must agree to their addition (by show of
hands).
1
Note: in the original document shared with all participants, the word “domain” was incorrectly used and should
read “item” for the sake of consistency with regard to methodology.
70
Annex 7: Delphi process brief
A second round of polling will take place including any newly proposed items, and the same thresholds
will apply. Items in the final template will be communicated to all participants, including any decisions
taken by the steering group to “include” or “exclude” items whose results were between 30% to 70%.
Further development of the text will be guided by the item selections; generation of more detailed content
will begin after the meeting by the WHO Clinical Management and Operations Unit, Country Readiness
Strengthening Department, WHO Health Emergencies Programme.
71
Annex 8: Instructions provided during meeting and sample
survey
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strategies. A template which guides the scope and high-level content is required.
This survey is being used to develop a consensus on what should be included in the template. The survey has six sections. Each
section details proposed domains.
For each domain, we simply ask you whether it should be included or excluded from the template.
We will repeat the survey to help you and other participants understand the opinions and priorities of the wider group, and to
narrow the selection of domains.
Your responses and opinions will be anonymized.
The survey will take you less than 15 minutes to complete - please do this by the end of the day to ensure that we can keep on
track!
Many thanks for your input - you are critical to ensuring this is a success.
Section A: SECTION 1: Situation analysis
Al. 1.1. Hypoxaemia context: Summarize burden of hypoxaemic disease, hypoxaemia outcome trends, determinants and
causes of hypoxaemia. Provide appropriate level of disaggregation (e.g. by age, sex, location, ethnicity, socioeconomic
status and disability).
Include
0
Exclude
0
I'm not sure 0
A2. 1.2. Multi-sectoral stakeholder landscaping.

Include
0
Exclude
0
I'm not sure 0
A3. 1.3. Review of national regulations/standards related to oxygen: Review existing national regulations and standards
covering quality/safety standards for medical oxygen. Mention if oxygen is included in national essential medications
list; mention if medical devices for oxygen therapy are included in a national list; note programmes with oxygen in
their strategic and operational plans, such as RMNCAH, COVID-19 and surgery.
Include
0
Exclude
0
I'm not sure 0
L _J
72
Annex 8: Instructions provided during meeting and sample survey
111111111111111 II II Ill II
A4. 1.4. Review of existing national health strategies and clinical guidelines relating to medical oxygen: Include
discussions of previous oxygen roadmaps and the results of their implementation.
Include
0
Exclude
0
I'm not sure 0
AS. 1.5. Oxygen quantification and gap analysis: Assess the scale of medical oxygen access gaps in the health system,
including at subnational- and local-level health facilities, needed to provide patients with:
• the required amounts of medical oxygen and related diagnostic tools (including pulse oximeters and patient
monitors);
• medical devices that deliver oxygen therapy (including invasive and non-invasive ventilators and continuous
positive airway pressure); and
• qualified staff availability.
Include
0
Exclude
0
I'm not sure 0
A6. 1.6. Percentage of health facilities with reliable oxygen supply.

Include
0
Exclude
0
I'm not sure 0
Section B: SECTION 2: Goals and objectives
Bl. 2.1. Context: Provide context for objectives and goals informed by and consistent with internationally agreed
recommendations including universal health coverage, Sustainable Development Goals, Safe Hospitals and World
Health Assembly resolution 76.3; emphasize commitment to equity.
Include
0
Exclude
0
I'm not sure 0
L _J
73
111111111111111 II I I 11111
B2. 2,2, Impact goals: Describe overall impact goals related to patient outcomes or universal access to oxygen,
Include
0
Exclude
0
I'mnotsure 0
B3. 2.3. Objectives: List objectives with outcomes that are SMART: specific, measurable, achievable, relevant and time
bound.
Include Q
Exclude
0
I'mnotsure 0
Section C: SECTION 3: Governance, management, and coordination
Cl. 3.1.Governance: Description of multi-sectoral and multi-stakeholder governance arrangements at both national and
sub-national levels that specify management, oversight, coordination, consultation and reporting mechanisms.
Consider specific mechanism for intra-governmental coordination to facilitate a whole-of-government approach to
implementation.
Include
0
Exclude
0
I'm not sure 0
C2. 3.2. Oxygen task force: Establish or maintain taskforce(s) or technical working group(s) including key stakeholders
and subject matter experts to advise and support implementation of the roadmap.
Include
0
Exclude
0
I'mnotsure 0
_J
74
r. Advocacy and communication: Promote engagement of all relevant stakeholders and implementation of planned
tions at national and subnational levels.
Include
[J 7
111111111111111 II Ill II II
Exclude
0
I'mnotsure 0
C4. 3.4. Linkages to other oxygen-relevant sectoral strategies and plans: Recognize the role of oxygen in emergency
preparedness and response by refening to the following national assessments and plans: Joint External Evaluation
(of International Health Regulation capacities) and National Action Plan for Health Security.
Include
[J
Exclude
0
I'm not sure 0
cs. Transparency
3.5. Description of roadmap/policy/strategy development process: Provide details of stakeholder and technical advisor
participation, including which stakeholders from which sectors were involved in the development process - starting
from validation of the situation analysis, as specific to the national context. Also describe how the consultation
process ensures lead by government and effective participation of all stakeholders at local and national levels, so they
can provide input systematically, with reasonable deadlines and time for consultation, into plan development and in
foreseen annual operational planning.
Include
[J
Exclude
0
I'm not sure 0
C6. Transparency
3.6. Reporting conflicts of interest: The Describeroadmap describes the institutional framework that should be in
placeneeded for identifying and managing Conflict conflicts of Interest interest (Col) and how it this is linked with
other oversight mechanisms.
Include
[J
Exclude
0
I'm not sure 0
L _J
75
111111111111111 II I II IIII
7
pansparency
I 3.7. Commitment to make roadmap and future progress reports publicly available.
�.-. 0
Exclude
0
I'mnotsure Q
CS. Accountability
3.8. Description of roadmap development process: Provide details of stakeholder and technical advisor participation,
including which stakeholders from which sectors were involved in the development process - starting from validation
of the situation analysis, as specific to the national context. Also describe how the consultation process ensures lead by
the ministry or committee responsible for implementation that is accountable to the government through
accountability mechanisms.
Include
0
Exclude
0
I'mnotsure 0
Section D: SECTION 4: Implementation plan
D1. Systems for oxygen production, storage and distribution
4.1. Mixed production approach to increase oxygen supply.

Include
0
Exclude
0
l'mnot sure 0
4.2. Intra-facility distribution: Distribution methods within facilities (e.g. medical gas piping systems).
Include
0
Exclude
0
I'mnot sure 0
L _J
76
111111111111111 II II I IIII
7
�stems for oxygen production, storage and distribution
I 4.3. Inter-facility distribution: Safe liquid oxygen and gaseous cylinder distribution networks.
�.-. 0
Exclude
0
I'mnotsure Q
4.4. Contingency planning: Ensure continuous oxygen availability during expected downtime, unexpected downtime
and surges in demand (e.g. pandemic, emergency and disaster planning).
Include
0
Exclude
0
I'mnotsure 0
DS. Regulations, guidelines, and policies
4.5. Create and/or update regulations related to medical oxygen, respiratory medical devices and associated
equipment.
Include
0
Exclude
0
I'mnotsure 0
D6. Regulations, guidelines, and policies
4.6. Create and/or update protocols/guidance: Include installation, maintenance and repair of oxygen systems and
related infrastructure.
Include
0
Exclude
0
I'mnotsure 0
L _J
77
78
111 11111111 1111 II I Ill Ill
D12. Infrastructure
4.12, Mechanism(s) for timely procurement and distribution of spare parts for oxygen infrastructure,
Include
0
Exclude
0
I'm not sure 0
D13. Respiratory medical devices
4.13. Mechanism(s) for respiratory medical devices inventory tracking and forecasting.
Include
0
Exclude
0
I'm not sure 0
4.14a. Mechanism(s) to assess the different respiratory medical devices required for diagnostics, monitoring and
administration of medical oxygen
Include
0
Exclude
0
I'm not sure 0
4.14h. Mechanism(s) to ensure the procurement and supply of required respiratory medical devices: Identify needs
inclusive of installation, testing, commissioning and training.
Include
0
Exclude
0
I'm not sure 0
- - - - �
- _J
79
111111111111111 II II II Ill
espiratory medical devices
15. Mechanism(s) for ensuring appropriate disinfection, reuse and disposal: decommissioning Include
a
decommissioning of medical devices.
Include
Exclude
0
I'm not sure 0
D17. Staff
4.16. Approach that aims to deliver the sustainable supply of the necessary clinical workforce including hiring and
initial and ongoing clinical training in oxygen therapy for health care workers.
Include
a
Exclude
0
I'm not sure 0
D18. Staff
4.17. Approach that aims to deliver sustainable supply of the necessary biomedical engineering workforce including
hiring and initial and ongoing training in operation and maintenance of oxygen equipment/infrastructure for
biomedical engineering and technician staff.
Include
a
Exclude
0
I'm not sure 0
D19. Staff
4.18. Approach that aims to deliver the sustainable supply of the necessary non-clinical/non-biomedical engineering
workforce including hiring and initial and ongoing training for necessary non-clinicaVnon-biomedical engineering
workforce (procurement, finance, IT/data management, and monitoring and evaluation).
Include
a
Exclude
0
I'm not sure 0
L _J
80
111 11111111 1111 II Ill I Ill
7
�uity and social support
I 4.19. Measures to ensure equitable universal oxygen access.
�.-. 0
Exclude
0
I'mnotsure Q
D21. Equity and social support
4.20. Measures to mitigate the financial burden of oxygen therapy on patients: Inclusion (or potential inclusion) of
oxygen in insurance schemes.
Include
0
Exclude
0
I'mnotsure 0
D22. Equity and social support
4.21. Support for home-based oxygen therapy.

Include
0
Exclude
0
l'mnot sure 0
Section E: SECTION 5: Monitoring, evaluation, and operational research
El. Monitoring and evaluation
5.1. Develop key performance indicators.

Include
0
Exclude
0
I'mnot sure 0
L _J
81
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7
ronitoring and evaluation
I 5.2. Standardized procedures for data collection and analysis.
�.-. 0
Exclude
0
I'mnotsure Q
E3. Monitoring and evaluation
5.3. Data management integrated into routine health information systems.

Include
0
Exclude
0
I'mnotsure 0
E4, Monitoring and evaluation
5.4. Feedback mechanisms to relay data and results to key stakeholders.

Include
0
Exclude
0
I'mnotsure 0
ES. Operational research
5.5. Evaluate the impact of policies or interventions implemented.

Include
0
Exclude
0
I'mnotsure 0
E6. Operational research
5.6. Evaluate the cost-effectiveness of specific policies or interventions implemented.

Include
0
Exclude
0
L
0
_J
I'mnotsure
82
83
111111111111111 II I I 11111
F3. Costing of plan activities
6.3. Assessment of budget requirements for infrastructure investments: Include CAPEX and OPEX, and description
of tbe costing metbodology and budget assumptions.
Include
0
Exclude
0
I'm not sure 0
F4. Costing of plan activities
6.4. Assessment of budget requirements for governance, management and coordination activities: Include description
of tbe costing metbodology and budget assumptions.
Include
0
Exclude
0
I'm not sure 0
FS. Sustainable financing
6.5. Estimate of current budget allocations for oxygen spending, financial commitments for plan implementation,
shortfall in funds for implementation and ongoing costs: Include, where available, ongoing commitments from key
stakeholders.
Include
0
Exclude
0
I'm not sure 0
F6. Sustainable financing
6.6. Prioritization of plan activities based on available funding.

Include
0
Exclude
0
I'm nol sure 0
L _J
84
111111111111111 II Ill II II
F7, Sustainable financing
6.7, Consideration of public-private partnerships for oxygen production and maintenance: Include, where available,
details of how public-private partnerships will meet identified gaps or increase efficiency of plan implementation.
Include
0
Exclude
0
I'm not sure 0
FS. Sustainable financing
6.8. Commitment to local production and distribution of medical oxygen.

Include
0
Exclude
0
I'm not sure 0
F9. Sustainable financing
6.9. Consideration of budget requirements for operating expenses beyond the plan's implementation phase.
Include
0
Exclude
0
I'm not sure 0
Section G: Additional comments
Gl. Please enter any additional comments here:
L
Thank you for completing the survey.
_J
85
Survey from the second round of polling

111 111111111 111 Ill llll II
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I
is ,o-d�lopi•� wilh Membc, State, aod p,rtoe.-s, a•=•"' foe plwmi,g aod oostiog ,aOO,aI """" �le-up
strategies. A template which guides the scope and high-level content is required.
This survey is being used to develop a consensus on what should be included in the template. The survey has six sections. Each
section details proposed domains.
For each domain, we simply ask you whether it should be included or excluded from the template.
We will repeat the survey to help you and other participants understand the opinions and priorities of the wider group, and to
narrow the selection of domains.
Your responses and opinions will be anonymized.
The survey will take you less than 5 minutes to complete - please do this by the end of the day to ensure that we can keep on
track!
Many thanks for your input - you are critical to ensuring this is a success.
Section A: Additional proposed domains
a
Al. Commitments to climate resilience and environmental sustainability:
Include
Exclude
0
l'mnotsure 0
a
A2. Planning for quality assurance
Include
Exclude
0
rmnot sure 0
a
A3. Application of safety practices
Include
Exclude
0
rmnotsure 0
L _J
86
87
Annex 9: Summary of polling results
Results from Polling Session One: 15 May 2024
Item Include Exclude Uncertain Total % % Exclude
Section Item
# (N) (N) (N) (N) Include Exclude (Y/N)
Situation 1.1 Hypoxaemia context: Summarize burden of hypoxaemic disease, hypoxaemia 78 4 2 84 95% 5% No
analysis outcome trends, determinants and causes of hypoxaemia. Provide appropriate
level of disaggregation (e.g. by age, sex, location, ethnicity, socioeconomic
status and disability).
Situation 1.2 Multisectoral stakeholder landscaping. 79 2 3 84 98% 2% No
analysis
Situation 1.3 Review of national regulations/standards related to oxygen: Review 80 2 2 84 98% 2% No
analysis existing national regulations and standards covering existence of
quality/safety standards for medical oxygen. Mention if oxygen is included in
national essential medications list; mention if medical devices for oxygen
therapy are included in a national list; note programmes with oxygen in their
strategic and operational plans, such as RMNCAH, COVID-19 and surgery.
Situation 1.4 Review of existing national health strategies and clinical guidelines 80 1 3 84 99% 1% No
analysis relating to medical oxygen: Include discussions of previous oxygen
roadmaps and the results of their implementation.
Situation 1.5 Oxygen quantification and gap analysis: Assess the scale of medical oxygen 83 1 0 84 99% 1% No
analysis access gaps in the health system, including at subnational- and local-level
health facilities, in order needed to provide patients with: (a) the required
amounts of medical oxygen and related diagnostic tools (including pulse
oximeters and patient monitors); (b) medical devices that deliver oxygen
therapy (including invasive and non-invasive ventilators and continuous
positive airway pressure); and (c) and the availability of qualified staff
availability.
Situation 1.6 Percentage of health facilities with reliable oxygen supply. 78 3 3 84 96% 4% No
analysis
88

Section Item
Goals and 2.1 Context: Provide context for objectives and goals that is informed by and 78 2 4 84 98% 3% No
objectives consistent with internationally agreed recommendations including universal
health coverage, Sustainable Development Goals, Safe Hospitals and World
Health Assembly resolution 76.3; and emphasizes a commitment to equity.
Goals and 2.2 Impact goals: Describe overall impact goals related to patient outcomes or 79 2 3 84 98% 2% No
objectives universal access to oxygen.
Goals and 2.3 Objectives: List of objectives with outcomes that are SMART: specific, 79 2 3 84 98% 2% No
objectives measurable, achievable, relevant and time-bound.
Governance, 3.1 Governance: Description of multisectoral and multistakeholder governance 79 2 3 84 98% 2% No
management, arrangements at both national and subnational levels that specify
and coordination management, oversight, coordination, consultation and reporting
mechanisms. Consider specific mechanism for intra-governmental
coordination to facilitate a whole-of-government approach to
implementation.
Governance, 3.2 Oxygen task force: Establish or maintain task force(s) or technical working 78 5 1 84 94% 6% No
management, group(s) including key stakeholders and subject matter experts to advise and
and coordination support implementation of the roadmap.
Governance, 3.3 Advocacy and communication: Promote engagement of all relevant 75 5 4 84 94% 6% No
management, stakeholders and implementation of planned actions at national and
and coordination subnational levels.
Governance, 3.4 Linkages to other oxygen-relevant sectoral strategies and plans: 82 1 1 84 99% 1% No
management, Recognize the role of oxygen in pandemic prevention, emergency
and coordination preparedness and response by referring to the following national
assessments and plans: Joint External Evaluation (of International Health
Regulation capacities) and National Action Plan for Health Security.
89

Section Item
Governance, 3.5 Description of roadmap/policy/strategy development process: Provide 77 4 3 84 95% 5% No
management, details of stakeholder and technical advisor participation, including which
and coordination stakeholders from which sectors were involved in the development process –
starting from the validation of the situation analysis, as specific to the
national context. Also describe how the consultation process ensures lead by
government and effective participation of all stakeholders at local and
national levels, so that they can provide input systematically, with reasonable
deadlines and time for consultation, into plan development and in foreseen
annual operational planning.
Governance, 3.6 Reporting conflicts of interest: The roadmap describes the institutional 68 10 6 84 87% 13% No
management, framework that should be in place for identifying and managing conflicts of
and coordination interest and how it this is linked with other oversight mechanisms.
Governance, 3.7 Public availability: Commitment to make roadmap and future progress 76 8 0 84 90% 10% No
management, reports publicly available.
and coordination
Governance, 3.8 Description of roadmap development process: Provide details of 70 9 5 84 89% 11% No
management, stakeholder and technical advisor participation, including which stakeholders
and coordination from which sectors were involved in the development process – starting from
validation of the situation analysis, as specific to the national context. Also
describe how the consultation process ensures lead by the ministry or
committee responsible for implementation that is accountable to the
government through accountability mechanisms.
Implementation 4.1 Mixed production approach to increase oxygen supply. 81 2 1 84 98% 2% No
plan
Implementation 4.2 Intra-facility distribution: Distribution methods within facilities (e.g. 80 4 0 84 95% 5% No
plan medical gas piping systems).
Implementation 4.3 Inter-facility distribution: Safe liquid oxygen and gaseous cylinder 80 3 1 84 96% 4% No
plan distribution networks.
Implementation 4.4 Contingency planning: Ensure continuous oxygen availability during 84 0 0 84 100% 0% No
plan expected downtime, unexpected downtime and surges in demand (e.g.
pandemic, emergency and disaster planning).
90

Section Item
Implementation 4.5 Regulations: Create and/or update regulations related to medical oxygen, 82 1 1 84 99% 1% No
plan respiratory medical devices and associated equipment.
Implementation 4.6 Guidance: Create and/or update protocols/guidance, including for 80 2 2 84 98% 2% No
plan installation, maintenance, and repair of oxygen systems and related
infrastructure.
Implementation 4.7 Clinical protocols: Create and/or update clinical protocols, including 78 4 2 84 95% 5% No
plan ensuring appropriate and safe use of oxygen and harmonization with existing
clinical policies and guidelines.
Implementation 4.8 Referral processes: Include processes within the health care system for 75 4 5 84 95% 5% No
plan hypoxaemic patients, including oxygen availability for ambulance/inter-
facility patient transfer system.
Implementation 4.9 Health care infrastructure: Integration of medical oxygen and other medical 81 2 1 84 98% 2% No
plan gas systems into the construction of health care infrastructure.
Implementation 4.1 Electricity supply: Coordination with electrical grid as part of planned 80 2 2 84 98% 2% No
plan oxygen infrastructure development.
Implementation 4.11 Maintenance: Mechanism(s) for ensuring maintenance of oxygen 82 2 0 84 98% 2% No
plan infrastructure.
Implementation 4.12 Spare parts: Mechanism(s) for timely procurement and distribution of spare 78 5 1 84 94% 6% No
plan parts for oxygen infrastructure.
Implementation 4.13 Medical devises inventory: Mechanism(s) for respiratory medical devices 73 6 5 84 92% 8% No
plan inventory tracking and forecasting.
Implementation 4.14 Medical devices: Mechanism(s) to assess the different respiratory medical 72 4 8 84 95% 5% No
plan a devices required for diagnostics, monitoring and administration of medical
oxygen.
Implementation 4.14 Medical devices procurement: Mechanism(s) to ensure the procurement 72 5 7 84 94% 6% No
plan b and supply of required respiratory medical devices: Identify needs inclusive
of installation, testing, commissioning and training.
Implementation 4.15 Disinfection, reuse and disposal: Mechanism(s) for ensuring appropriate 72 7 5 84 91% 9% No
plan disinfection, reuse and disposal, include decommissioning of medical
devices.
91

Section Item
Implementation 4.17 Clinical workforce: Approach that aims to deliver the sustainable supply of 84 0 0 84 100% 0% No
plan the necessary clinical workforce including hiring and initial and ongoing
clinical training in oxygen therapy for health care workers.
Implementation 4.18 Biomedical engineering workforce: Approach that aims to deliver the 83 1 0 84 99% 1% No
plan sustainable supply of the necessary biomedical engineering workforce
including hiring and initial and ongoing training in operation and
maintenance of oxygen equipment/
infrastructure for biomedical engineering and technician staff.
Implementation 4.19 Non-clinical workforce: Approach that aims to deliver the sustainable 77 3 4 84 96% 4% No
plan supply of the necessary non-clinical/non-biomedical engineering workforce
including hiring and initial and ongoing training for necessary non-
clinical/non-biomedical engineering workforce (procurement, finance,
IT/data management and M&E).
Implementation 4.20 Measures to ensure equitable universal oxygen access. 79 2 3 84 98% 2% No
plan
Implementation 4.21 Measures to mitigate the financial burden of oxygen therapy on patients: 75 7 2 84 91% 9% No
Plan Inclusion (or potential inclusion) of oxygen in insurance schemes.
Implementation 4.22 Support for home-based oxygen therapy. 66 5 13 84 93% 7% No
Plan
Monitoring, 5.1 Develop key performance indicators. 81 1 2 84 99% 1% No
evaluation and
operational
research
Monitoring, 5.2 Standardized procedures for data collection and analysis. 81 2 1 84 98% 2% No
evaluation and
operational
research
Monitoring, 5.3 Data management integrated into routine health information systems. 80 3 1 84 96% 4% No
evaluation and
operational
research
92

Section Item
Monitoring, 5.4 Feedback mechanisms to relay data and results to key stakeholders. 77 5 2 84 94% 6% No
evaluation and
operational
research
Monitoring, 5.5 Evaluate the impact of policies or interventions implemented. 78 2 4 84 98% 3% No
evaluation and
operational
research
Monitoring, 5.6 Evaluate the cost-effectiveness of specific policies or interventions 76 5 3 84 94% 6% No
evaluation and implemented.
operational
research
Monitoring, 5.7 Establish research priorities. 69 7 8 84 91% 9% No
evaluation and
operational
research
Monitoring, 5.8 Support domestic research agenda. 61 7 16 84 90% 10% No
evaluation and
operational
research
Costing 6.1 Assessment of top-line budget requirements for all planned activities: 81 1 2 84 99% 1% No
Include a description of the ownership model (e.g. government owned,
public-private partnership, lease), costing methodology used and budget
assumptions.
Costing 6.2 Assessment of budget requirements for staff: Include recruiting, training 82 2 0 84 98% 2% No
and ongoing mentorship: Include a description of the costing methodology
and budget assumptions.
Costing 6.3 Assessment of budget requirements for infrastructure investment: 76 1 7 84 99% 1% No
Include CAPEX and OPEX and a description of the costing methodology and
budget assumptions.
93

Section Item
Costing 6.4 Assessment of budget requirements for governance, management, and 77 3 4 84 96% 4% No
coordination activities: Include a description of the costing methodology
and budget assumptions.
Costing 6.5 Estimate of current budget allocations for oxygen spending, financial 81 2 1 84 98% 2% No
commitments for plan implementation, and shortfall in funds gaps for
implementation and ongoing costs: Include, where available, ongoing
commitments from key stakeholders.
Costing 6.6 Prioritization of plan activities based on available funding. 75 7 2 84 91% 9% No
Costing 6.7 Consideration for of public-private partnerships for oxygen production 74 7 3 84 91% 9% No
and maintenance: Include, where available, details of how public-private
partnerships will meet identified gaps or increase efficiency of plan
implementation.
Costing 6.8 Commitment to local production and distribution of medical oxygen. 71 8 5 84 90% 10% No
Costing 6.9 Consideration of budget requirements for operating expenses beyond the 76 3 5 84 96% 4% No
plan’s implementation phase.
Proposed new items

Commitments to climate resilience and environmental sustainability
Planning for quality assurance
Application of safety practices
Inclusion of an appendix of available planning tools
Consideration for expanding scope for broader medical gas systems
* Clinical guidelines for at-risk patients: For example, newborns, children under 5, pregnant, older and displaced persons
** Consider disease prevention and control measures for communicable and noncommunicable diseases appropriate for the local context. Examples include reduction of air
pollution, vaccination and smoking cessation.
Adaptation
Planning for continuous, reliable, quality power supply (replacing Coordination with electrical grid)
* New sub-item
** Did not reach the 30% consensus to advance to voting for template inclusion
94
Results from Polling Session Two: 16 May 2024

Include Exclude Uncertain Total % % Exclude
Section Proposed item
(N) (N) (N) (N) Include Exclude (Y/N)
Additional proposed Commitments to climate resilience and environmental sustainability. 78 12 5 95 87% 13% No
items
Additional proposed Planning for quality assurance. 90 4 1 95 96% 4% No
items
Additional proposed Application of safety practices. 88 4 3 95 96% 4% No
items
Additional proposed Inclusion of an appendix of available planning tools. 84 7 4 95 92% 8% No
items
Additional proposed Consideration for expanding scope for broader medical gas systems. 65 14 16 95 82% 18% No
items
Additional proposed Clinical guidelines for at-risk patients: For example, newborns, 81 7 7 95 92% 8% No
items children under 5, pregnant, older and displaced persons.
Additional proposed Adaptation: Planning for continuous, reliable, quality power supply 91 1 3 95 99% 1% No
items (replacing Coordination with electrical grid).
95
Annex 10: Media coverage of the meeting
PRESS RELEASES
✓ Global Oxygen Alliance. After landmark meeting, leading health organizations reinforce their
support for countries to integrate medical oxygen into health system planning.
✓ Every Breath Counts Coalition and Unitaid NGOs. Calling on all world health organization
Member States to develop and finance medical oxygen roadmaps by 2025.
✓ The Lancet Global Health Commission on Medical Oxygen Security. Milestone medical oxygen
meeting an opportunity for countries to make rapid progress on access.
PRINT MEDIA
✓ Agence de Presse Sénégalaise, L’OMS préconise un modèle de déploiement national pour une
disponibilité globale de l’oxygène. https://aps.sn/loms-preconise-un-modele-de-deploiement-
national-pour-une-disponibilite-globale-de-loxygene/
✓ Sud Quotidien, Développement de l’oxygénothérapie : l’Oms vers un nouveau modèl.
https://www.sudquotidien.sn/developpement-de- loxygenotherapie-loms-vers-un-nouveau-
modele/
✓ Agence de Presse Sénégalaise, Un ”effort continu” nécessaire pour la disponibilité de l’oxygène
médical (directrice). https://aps.sn/un-effort-continu-necessaire-pour-la-disponibilite-de-
loxygene-medical-directrice/
✓ Lii Quotidien, Oxygénation des établissements de santé publics. « La situation est assez
satisfaisante au Sénégal », dixit Dr Fatou Mbaye Sylla.
✓ Sud Quotidien, Développement de l’oxygénothérapie. « L’OMS vers un nouveau modèle ».
✓ Rewmi Quotidien, Accès à l’oxygène. « L’OMS mise sur l’élaboration et la mise en œuvre de plans
nationaux ».
✓ L’AS Quotidien, Accès à l’oxygène dans les structures sanitaires. « Un gap à combler ».
✓ Le Soleil, Médicament essential. « Vers l’élaboration de plans nationaux pour un accès équitable
des patients à l’oxygène ».
TELEVISION
✓ JT 7 TV, Accès équitable a l’oxygène: L’OMS au chevet du Sénégal.
✓ JT RTS and SNEIPS TV
✓ Live Sante TV
RADIO
✓ SudFM Sen Radio “Sud Sante”
✓ Oxygen Scale Santé FM
✓ Oxygen Scale Santé FM Wolof
96
For more information, please contact:
Clinical Management and Operations Unit
Health Emergencies Programme
World Health Organization
Avenue Appia 20
CH-1211 Geneva 27
Switzerland
Email: oxygen@who.int
www.who.int/initiatives/oxygen-access-scale-up

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National oxygen scale-up

ISBN 978-92-4-010077-0 (electronic version)

© World Health Organization 2024

Cataloguing-in-Publication (CIP) data. CIP data are available at https://iris.who.int/.

Abbreviations and acronyms

Objectives of the National Oxygen Scale-Up Framework Meeting

Development of the zero-draft oxygen roadmap template

Fig. 1. Geographic representation of attendees

In-person Member State ministry of health nominees All in-person attendees

All in-person and virtual attendees

Partners who attended represented 24 organizations including:

✓ Assist International ✓ Management Sciences for ✓ Lancet Global Health

Fig. 2. Meeting agenda, short format

Day 1 Opening session

Professor Adegoke Falade (Oxygen for Life Initiative/

Plenary session 1: Existing oxygen roadmap highlights

✓ Situation analysis – Know your

The recording for this session is available here.

Plenary session 3: Oxygen scale-up deep dives (Part 1) –

Open floor: Q&A and participant sharing.

✓ The ACT-A Oxygen Emergency

The recording for this session is available here.

Plenary session 3: Oxygen scale-up deep dives (Part 2) –

Open floor: Q&A and participant sharing.

✓ Importance of a progressive and holistic

The recording for this session is available here.

Plenary session 3: Oxygen scale-up deep dives (Part 3) –

Open floor: Q&A and participant sharing.

✓ Workforce challenges include global shortages of

Plenary session 2: The National Oxygen Scale-Up template

The recording for this session is available here.

Plenary session 4: Template polling – introduction

Day 2: 15 May 2024

Day 2 Opening session

Plenary session 5: Oxygen scale-up deep dives (Part 4) –

The Moderator provided overview and summary of Panellists:

✓ Estimating oxygen needs is complex:

The recording for this session is available here.

Plenary session 5: Oxygen scale-up deep dives (Part 5) –

Open floor: Q&A and participant sharing.

The recording for this session is available here.

Plenary session 6: Template polling – Round 1 and Closing remarks

Day 3: 16 May 2024

Day 3 Opening session

Plenary session 7: Debriefing discussion on breakout sessions (Part 1)

Part 1: Debriefing discussion on breakout Moderator: Dr Steven McGloughlin, Consultant, Clinical

The recording for this session is available here.

Facilitators from breakout

Part 2: Debriefing discussion on breakout Moderator: Constance McDonough-Thayer, Data Systems

The recording for this session is available here.

Facilitators from breakout

Plenary session 8: Cross-cutting aspects of oxygen ecosystems –

Open floor: Q&A and participant sharing.

The recording for this session is available here.

Plenary session 9: Template polling – Round 2

Global Oxygen Alliance showcase

The recording for this session is available here.

Open discussion on aspirations and next steps

The recording for this session is available here.

The recording for this session is available here.