Page 13 - GHES-2-3

Global Health Economics and
Sustainability
Medical oxygen during COVID-19 pandemic

by May 13, 2021 (Ministry of Health and Family Welfare, The Indian government provided assistance to states/UTs
2021a). This feat was achieved by maximizing production by establishing and operationalizing 1,225 PSA units under
in steel plants and other LMO facilities, establishing a real- the PM CARES initiative. Furthermore, an additional 336
time monitoring system for production and distribution, PSA units were established through government-owned
and even imposing temporary restrictions on industrial public sector undertakings and other channels (Ministry
oxygen use (Ministry of Commerce & Industry, 2021; of Finance, 2023). Moreover, the PSA facilities established
Ministry of Health and Family Welfare, 2021g). To swiftly under PM CARES have been enhanced with Internet of
address the pressing need, India secured 1,385 MT of LMO Things (IoT) devices (Prime Minister’s Office, 2021) by
through multiple imports from the United Arab Emirates, DRDO with the National Informatics Centre. On July 6,
Bahrain, Kuwait, Qatar, Singapore, and other sources 2021, the MoHFW formulated and distributed guidelines
(Ministry of Health and Family Welfare, 2021a). The to states outlining suggested standards for establishing
availability of tankers and ISO containers was augmented oxygen production units in healthcare facilities. At present,
through the conversion of existing nitrogen and argon a total of 2,574 PSA oxygen plants are being established
tankers, as well as imports and domestic manufacturing. using funds from both state resources and corporate social
Logistical support for transporting LMO tankers was responsibility (CSR) contributions (Ministry of Finance,
provided with support from the Indian Air Force and 2023).
Railways (Ministry of Commerce & Industry, 2021). India’s fight against oxygen scarcity received a major
A collaborative and transparent framework (Ministry boost with a multi-pronged approach. Ample resources
of Health and Family Welfare, 2021h) was established were allocated to crucial equipment and infrastructure:
for medical oxygen allocation. This framework involved (i) PSA plants: 4,127 units installed by December 2022,
consultation with states, UTs, and stakeholders, including generating 4,852 MT of oxygen daily (Ministry of
relevant ministries and oxygen manufacturers/suppliers. Finance, 2023).
Allocation was primarily based on active COVID-19 cases (ii) Oxygen concentrators: 114,000 units distributed
in each state/UT, with additional factors like case doubling to states under PM CARES and ECRP-II schemes
rate and available medical infrastructure also considered. (Ministry of Health and Family Welfare, 2021b).
The framework remained dynamic, adapting to changes (iii) Ventilators, oxygen cylinders, LMO tanks, and
in the pandemic’s burden. The initial allocation of medical MGPS: Ongoing initiatives to bridge the gap between
oxygen, issued on April 15, 2021, was subsequently revised existing equipment and needed systems.
based on fluctuations in active COVID-19 cases and oxygen (iv) Daily monitoring and collaboration: Close
supply availability. As of May 28, 2021, a cumulative total coordination with agencies such as DRDO, HITES,
of 10,250 MT had been allocated to 26 states identified and CMSS ensures the smooth operationalization of
as having a high disease burden (PTI, 2021c). Under the this infrastructure.
Emergency COVID Package-Part-II (ECRP-II), more than This comprehensive strategy addresses the issue
930 LMO tanks, along with 1,359 medical gas pipeline from multiple angles, aiming to eliminate potential
systems (MGPS), were set up across the country at a cost oxygen shortages and prepare health-care facilities for
of INR 8 million, aiming to increase storage capacity in all future challenges. Equipment availability, technology,
37 states/UTs. and financial aid for PSA plants, ventilators, oxygen
concentrators and cylinders, LMO, and MGPS are being
3.6. PSA plant
closely monitored. The GoI has directed that the status
PSA technology, a well-established method for localized of these modalities should be monitored on a daily basis
oxygen generation, is being implemented in hospitals, to ensure that the gap between equipment and systems is
particularly in remote regions. This technology reduced to zero. In addition, coordination with DRDO,
empowers hospitals to generate their own oxygen supply, HITES, and CMSS for the operationalization of medical
decreasing the strain on the nationwide medical oxygen oxygen infrastructure is essential. As of December 28, 2022,
supply network. As of April 25, 2023, more than 4,135 4,127 PSA plants have been installed and commissioned,
PSA plants have been established and installed in India with an oxygen capacity of 4,852 MT (Ministry of Finance,
(Ministry of Finance, 2023; Ministry of Health and 2023). Under PM CARES and ECRP-II funds, 114,000
Family Welfare, 2021f). As of October 2021, a total of oxygen concentrators were provided to states/UTs. In
1,225 PSA oxygen plants had been funded through PM addition, 958 LMO storage tanks and MGPS in 1,374
CARES, with more than 1,100 plants commissioned hospitals have been sanctioned under ECRP-II (Ministry
(Prime Minister’s Office, 2021). of Health and Family Welfare, 2021b).

Volume 2 Issue 3 (2024) 5 https://doi.org/10.36922/ghes.2023