Devex CheckUp: A breath of fresh air for Africa’s medical oxygen supply

Most of the conversations about regional health manufacturing focus on vaccines and treatments. But lately there are other efforts, such as the one underway in Kenya and Tanzania to build a regional supply of liquid oxygen.

Under the new initiative, dubbed the East African Program on Oxygen, three local oxygen manufacturers will receive support to expand their production of liquid oxygen. This includes new facilities in Mombasa and Dar es Salaam, as well as technical support to usher the products to market. Unitaid is providing $22 million in grants, while MedAccess will support the initiative through volume guarantees, wherein it would ensure a portion of the sales for the product for a period.

Once fully operational, they expect these efforts to increase oxygen production from 750 tons to 2,000 tons per month in the region, and save hundreds of thousands of lives over the next decade. The goal is for the facilities to also supply neighboring countries such as Malawi, Mozambique, Uganda, and Zambia.

Medical oxygen is used to treat a wide range of diseases and conditions, including hypoxemia,  pneumonia, and COVID-19. However, during the COVID-19 pandemic, many low- and middle-income countries saw shortages of this lifesaving tool, with much of the supply concentrated in high-income countries.

Read: Blended finance expands medical oxygen production in East Africa (Pro)

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Slim pickins

The Global Fund to Fight AIDS, Tuberculosis and Malaria provides 76% of the international financing for tuberculosis. But TB advocates want more.

They argued that TB, despite killing more people than HIV and malaria combined, has received the smallest allocation from the multilateral donor since 2013. An independent evaluation commissioned by the fund and published this year also said there’s a need to adjust the disease split to give more to TB.

The Global Fund has consistently allocated 18% for TB, 32% for malaria, and 50% for HIV in its country allocation. In 2021, recognizing TB requires more resources, it decided to provide more funding to the disease. But in total, TB still received the smallest amount at $2.4 billion, compared to $6.5 billion for HIV and $4.2 billion for malaria.

A Global Fund spokesperson tells me that the fund is similarly concerned about TB, but they have other things they consider when deciding on the allocation apart from the death toll. Nevertheless, the spokesperson says the secretariat has proposed an increase for TB in the next allocation period, and the board will decide on that in November.

However, TB advocates argued that the options promising at least 25% of the funding to TB are dependent on high replenishment targets that are unrealistic. They also can’t understand why increasing the allocation for TB had to be based on whether the fund can raise more resources.

In a challenging fundraising environment in which donors are tightening their purse strings across the aid sector, the odds seem stacked against TB. But some experts tell me agencies such as the Global Fund need to rethink the way they do business entirely in these changing times.

Read: The battle for limited Global Fund resources

Switch it up

One suggestion is for organizations such as the Global Fund to rethink their replenishment model, as it’s becoming “outdated,” writes Bright Simons, a social innovator and policy activist, in an opinion piece for Devex.
Donors are starting to show fatigue, and replenishments have failed to crowd in more private sector money — even though they play a significant role in development financing. Organizations reliant on replenishments also mostly fund specific diseases when countries need much broader health financing, he argues.

What does he offer as an alternative? Innovative financing solutions that “harness the power of private capital and concessional loans.”

“Contrary to fears of debt crises in low-income countries, health is an investment that could boost productivity and, with good governance, generate returns that keep debt sustainable,” he writes.

Opinion: How the world funds global health is starting to look outdated

Please, please, please

In her first interview as head of the International Union Against Tuberculosis and Lung Disease, Kelly-Cirino tells me TB is chronically underfunded. But international donations will remain critical to address one of the world’s deadliest infectious diseases. While countries do invest domestically in their TB programs, it simply isn’t enough, she says.

But if the worst happens and international funding becomes more limited, “I think we’d have to start to have a lot more conversations about the domestic funding pipeline for countries,” she says. And that could be affected by the prospect of a TB vaccine, which might spur countries to invest in their own inoculation programs.

Read more: New The Union head says eliminating TB ‘doable’ but ‘expensive’ (Pro)

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Third chances

The groups involved in planning and carrying out a polio vaccination campaign in Gaza were forced to postpone the final phase of the campaign that was supposed to begin Wednesday due to “escalating violence, intense bombardment, mass displacement orders, and lack of assured humanitarian pauses across most of northern Gaza,” according to a World Health Organization news release.

The campaign is supposed to administer the second dose of the novel oral polio vaccine type 2 to over 100,000 children across northern Gaza. But according to WHO, ongoing attacks on civilian infrastructure “continue to jeopardize people’s safety and movement” in the region. This means families can’t bring their children for vaccination, and health workers cannot operate in the area.

A delay in the administration of the second dose reduces the impact of the vaccination campaign — and jeopardizes efforts to stop polio transmission in the enclave. That could lead to the virus spreading further in Gaza and neighboring countries. In the statement, WHO and UNICEF reiterated their calls for a ceasefire.

The postponement came days after WHO said Israel barred six medical NGOs that had been operating in Gaza from entering the area, without any explanation for the order. The U.N. health agency expressed concerns about the impact of this denial of entry on Gaza’s already strained health care system.

ICYMI: Inside Gaza’s polio campaign

What we’re reading

Global health organizations are looking to Gulf states for funding as aid budgets decline among traditional donor governments. [Bloomberg]

Japanese startups focus on AI-powered medical services in countries with a doctor shortage, such as Thailand and Brazil. [Nikkei]

Germany detects its first case of the new mpox variant clade 1b, which is fueling the current outbreak in the Democratic Republic of Congo. [Reuters]