Bangladesh is set to declare medical oxygen an essential drug in a bid to ensure equitable, safe, and affordable access nationwide, as the government works to close a critical gap in oxygen infrastructure.
Despite growing demand, 70% of patients in Bangladesh still lack access to medical oxygen.
Currently, only 29 oxygen plants are operational across the country, while nearly 70 remain inactive—a disparity that poses serious risks to public health.
The announcement was made at the Bangladesh Oxygen Summit 2025, held yesterday in Dhaka under the theme “National Roadmap to Safe, Affordable and Reliable Medical Oxygen for All.”
The summit was organized by icddr,b and brought together policymakers, scientists, development partners, private sector leaders, and government officials to chart a unified strategy for universal oxygen access.
An icddr,b study presented at the summit assessed the country’s oxygen ecosystem, noting that while PSA, VSA, and VIE plants have expanded production capacity, systemic weaknesses in maintenance, staffing, and governance continue to undermine reliability.
The study called for a resilient, mixed-supply model and urged recognition of oxygen as a core public health service.
Why most plants are inactive
During the Covid-19 pandemic, the government installed 99 oxygen generator plants in hospitals across the country to address acute shortages of medical oxygen.
These installations were carried out under the Covid-19 Emergency Response and Pandemic Preparedness (ERPP) project, which expired in December last year.
According to the Directorate General of Health Services (DGHS), of the 99 plants, 40 were funded directly by the government at a cost of Tk926 million.
An additional 29 plants were installed using Tk513 million from the Covid-19 support fund through the Asian Development Bank (ADB), while 30 plants were funded by the United Nations at a cost of Tk975 million.
Despite the scale of investment, many of these plants remain non-functional due to a lack of technical capacity and maintenance infrastructure.
Dr Ahmed Ehsanur Rahman, a scientist in the Department of Maternal and Child Health at the icddr,b, and a member of the executive committee of the Lancet Commission on Medical Oxygen Safety, told media: “The government is investing in the oxygen sector, but there is very little investment in bio-engineering. We need biomedical engineers and technically skilled workers to operate and maintain these machines, but there is a severe shortage in Bangladesh.”
He also pointed to critical gaps in planning and infrastructure.
“There is no clear plan for how electricity will be supplied to these oxygen plants. In many cases, the plants pose safety risks. If not used properly, accidents can occur. The operational costs are also high, which discourages usage. As a result, many of the plants installed in hospitals are lying abandoned.”
Most in Bangladesh lack oxygen
Global data from The Lancet Global Health Commission on Medical Oxygen Security, established by icddr,b in 2022, estimates that 373 million people worldwide require medical oxygen annually, with over 80% living in low- and middle-income countries.
Yet, only a fraction of patients in these regions receive oxygen when needed.
In Bangladesh, 70% of those in need remain without access.
Speaking as chief guest, Professor Dr Md Sayedur Rahman, special assistant (health) to the chief adviser, said the move to classify oxygen as an essential drug would standardize supply and pricing, strengthen delivery from Upazila-level hospitals to tertiary care centres, and bolster national health security.
“Currently, 29 oxygen plants are operational in the country, while nearly 70 remain non-functional. National initiatives are underway to bring these plants online,” he said.
“Oxygen prices vary across hospitals, but declaring it an essential drug will help standardize both supply and pricing. Safe oxygen management requires not only oxygen itself but also the quality and safety of devices and the entire delivery system.”
He added that the government is also promoting domestic production of vaccines, antivenoms, and antirabies treatments, with the goal of delivering safe oxygen to Bangladesh’s 180 million citizens.
Dr Rahman emphasized that achieving these goals requires a national roadmap, improved technical maintenance, biomedical training, and decentralized repair facilities to ensure the safety and efficiency of oxygen systems.
He noted that lessons from the Covid-19 pandemic continue to inform the government’s strategy.
“We know from experience that oxygen can be the difference between life and death. Some measures taken during Covid could not be sustained, but we are now addressing those gaps,” he said.
Dr Tahmeed Ahmed, executive director of icddr,b and chair of the summit, stressed the importance of strong governance, coordination, and sustained investment to ensure reliable oxygen supply.
“Bangladesh has made remarkable progress, but much more remains to be done,” he said.
Director General of Health Services Prof Dr Md Abu Zafar echoed the sentiment, saying: “Oxygen is not just a commodity; it is a public service. The contributions of icddr,b scientists have been instrumental in shaping both national and global oxygen policies.”
Director General of Health Education Professor Dr Md Nazmul Hossain, along with other experts, emphasized that oxygen access is central to achieving eight Sustainable Development Goals (SDGs), including reductions in maternal, neonatal, and child mortality; control of communicable and non-communicable diseases; mental health and substance abuse treatment; road traffic injury response; universal health coverage; and environmental health.
The summit featured four scientific sessions focused on oxygen demand and supply, production and delivery mechanisms, policy and investment priorities, and local innovation.
Locally developed technologies—including Bubble CPAP, OxyJet, Nishshash ventilators, and low-cost concentrators—were showcased as examples of homegrown solutions for respiratory care in low-resource settings.
Experts from DGHS, BBS, Unicef, UNOPS, World Bank, ADB, and the private sector reiterated that oxygen access is fundamental to achieving the SDGs and building a resilient health system.
The summit concluded with a collective call to recognize medical oxygen as both a human right and a national priority, underscoring its critical role in Bangladesh’s preparedness for future health emergencies.
