Scaling an innovation during a pandemic

In 2020, the oxygen therapy innovation project set up the groundwork to expand access to oxygen in over 90 countries, placing the organization in a unique, global position to continue to innovate and improve oxygen systems for years to come.

A premature baby is receiving oxygen at the Bafata hospital, Guinea Bissau, in 2020.
08 March 2021

Successful innovation takes time. It involves researching and identifying the need, developing an innovative product or system, testing and improving that product or system and full scale global implementation. Even when a new product or system is developed, it can take years to bolster commitment by partners and donors to ensure it is scaled to reach those who need it most.  

Sometimes it takes an emergency to scale an innovation.   

The notorious coronavirus disease, COVID-19, when severe, can lead to pneumonia where lungs become inflamed and filled with liquid, making it difficult, if not impossible, to breathe.  

But pneumonia isn’t a new emergency; it takes the lives of 2.56 million people each year, including 800,000 children, almost all of which are preventable. Every year, 4.2 million children suffering from severe pneumonia in low- and middle-income countries urgently need medical oxygen to survive. This life-saving gas helps patients breathe when they struggle to do so on their own – whether it be children with pneumonia or hypoxemia, newborns and mothers with birth complications, or patients with severe COVID-19. 

An innovative response established before the pandemic

In 2017 UNICEF Supply Division launched the oxygen therapy innovation project to build new tools to combat pneumonia. With support from the Bill and Melinda Gates Foundation, the project resulted in three key outcomes:  

  1. Development of the inter-agency guidance manual for procuring oxygen devices that helps decision makers understand what types of equipment are necessary for providing oxygen. It was published in partnership with the World Health Organization (WHO) in November 2019.  
  2. Launch of the innovative Oxygen System Planning Tool to help countries map out oxygen equipment needs at health facilities across a country. The tool was officially released in April 2020 during the onset of the pandemic.  
  3. Updating the UNICEF Supply Catalogue to include the full range of oxygen equipment needed to provide oxygen therapy so that UNICEF staff, partners and governments can access a one-stop-shop for oxygen. By March 2020, just before the pandemic was officially announced, over 20 new items were added.

Graphic showing innovation project for oxygen therapy devices

Ready for scale  

With the groundwork in place, UNICEF was uniquely positioned to propel an extensive global oxygen response to meet both the imminent need caused by COVID-19, and, moreover, to address the 800,000 children’s lives that pneumonia takes every year.   

In 2020 alone, 16,795 oxygen concentrators were shipped to 94 countries. These life-saving machines take in air from the environment, remove nitrogen and produce a continuous source of oxygen. In addition, UNICEF distributed over 12,050 oxygen accessories (such as pulse oximeters, flow splitters, oxygen analyzers and humidifier bottles) and 920,575 consumables (such as nasal cannula, face masks and tubing). Altogether, UNICEF and partners invested US$21.9 in scaling up oxygen products in 2020.

 Oxygen concentrators shipment at the UNICEF warehouse in New Delhi, India, September 2020.
Oxygen concentrators shipment at the UNICEF warehouse in New Delhi, India.

UNICEF also supported many governments to initiate plans to install and/or refurbish oxygen plants or provide liquid oxygen to further bolster oxygen scale-up efforts while using the new system planning tool, manual and technical support from the Supply Division in Copenhagen.

This project helped build a basis for the global response to the COVID-19 pandemic. UNICEF, WHO and partners from the COVID-19 Supply Chain System Consortia – formed to expand access to oxygen therapy – were able to use the new tools to help establish a global response, enabling for rapid decision-making during the onset of the emergency.

Where UNICEF supplied oxygen in 2020

The response to oxygen needs during the pandemic has truly been global, rapid and multi-faceted.  

UNICEF has been working with governments and partners to find the best solutions for each unique country context, which in most cases involves a mix of oxygen sources from cylinders, concentrators, plants and liquid oxygen. Some key examples are highlighted in the map below. 

Beyond COVID-19: continued investments for oxygen

This pandemic has taught us one major thing: if innovative solutions are already developed and in place, we have the potential to make a lasting, substantial impact. Over the course of 2020, governments, donors, United Nations agencies and partners started to recognize the importance of medical oxygen for helping treat people from pneumonia, whether COVID-19-induced or not. And UNICEF has been there to help lead the way.  

As we look beyond COVID-19, UNICEF will continue its efforts – either by installing or refurbishing oxygen plants, providing liquid oxygen or distributing oxygen concentrators and equipment. UNICEF is also looking at new ways to improve the work: In late 2020, UNICEF launched an additional oxygen innovation project – the development of the next generation of an oxygen concentrator, specifically designed to work in challenging settings where health facilities face extreme environmental conditions and electricity is in short and/or inconsistent supply.  

UNICEF was there before the pandemic, has been amplifying efforts during the pandemic, and will continue the work after the pandemic to bring life to those fighting for breath.