What is a national medical oxygen plan?

What the plan covers

The Lancet Global Health Commission on medical oxygen security (17 February 2025) describes national oxygen plans as strategic national policy documents that describe the existing oxygen ecosystem, quantify gaps in current and future needs and outline strategies to strengthen oxygen system capacity and performance. Its recommendations for governments include a costed plan with estimates of the pulse oximeters, medical oxygen and supporting systems needed for neonates, children and adults at all levels of the health system, in routine service and in emergencies, with oxygen part of both national health plans and emergency preparedness plans and progress monitored through core oxygen coverage indicators.

WHO's Foundations of medical oxygen systems (17 February 2023) places policy and country roadmaps within a wider oxygen ecosystem that also takes in health coverage, regulation and quality assurance, human resources from clinicians to engineers and technicians, infrastructure and logistics, the market landscape of suppliers, service level capacities and maintenance, and finance, including the health ministry budget.

What WHA76.3 asks of governments

Resolution WHA76.3, Increasing access to medical oxygen (30 May 2023), urges Member States, taking into account their national contexts, to:

• Develop, as appropriate, costed national plans to increase access to quality assured, affordable medical oxygen systems and personnel.
• Assess the scale of medical oxygen access gaps, including at subnational and local health facilities.
• Provide qualified staff, including engineers, to establish demand and to select, set up, operate and maintain oxygen equipment and infrastructure.
• Set up national and subnational medical oxygen systems, and consider including oxygen systems and personnel in national strategies for pandemic preparedness and response.
• Integrate medical oxygen data into routine health information systems.

Who prepares it

National governments: the Lancet Commission calls them the primary party responsible for ensuring oxygen access, and says that to develop the plan they should bring together public and private sector partners with a stake in medical oxygen delivery, including the health, education, industry, energy and transport sectors. In Nigeria, the Commission reports, an oxygen desk was set up in the federal ministry of health to coordinate the national oxygen strategy, with oxygen desks in each state to support its adaptation at state level. In May 2024 WHO convened a meeting attended by 63 ministries of health to co-create a national oxygen plan template. UNICEF says it helps countries design national oxygen roadmaps covering basic and surge needs, and its Oxygen System Planning Tool assesses, quantifies and costs oxygen supply needs at national, subnational and facility level.

How plans shape investment

According to the Lancet Commission, Ethiopia was the first low- or middle-income country to publish a national medical oxygen and pulse oximetry scale-up roadmap, followed by Nigeria's national strategy, and most countries with published plans are in sub-Saharan Africa. Global Fund guidance on PSA plant sustainability (22 August 2024) says a national strategy for oxygen investment and capacity building should cover all aspects of sustaining medical oxygen production, and the Global Fund's Grant Cycle 8 prioritisation guidance (issued 13 April 2026) asks applicants to align with national strategies. A Global Fund briefing note (23 August 2023) adds that one supply model does not have to be chosen for a whole country, since regions may have different needs; see centralised vs decentralised oxygen supply.