Gates Package — page 998

We'll also need to deliver other lifesaving tools that aren't drugs, but help keep patients alive long enough for their bodies to recover. Oxygen is a prime example: According to the WHO, about 15 percent of COVID patients get so sick that they need supplemental oxygen.9 Oxygen is an important component in any health system--it's used in cases of pneumonia and premature birth, among others--and although rich countries have run short of it during COVID, low- and middle-income countries have struggled even more. One survey found that only 15 percent of health facilities in developing countries had any oxygen equipment, and only half of that equipment was functional. Hundreds of thousands of people die every year because they can't get medical oxygen--and this was before the pandemic.10 Bernard Olayo, a health specialist at the World Bank, is trying to do something about it. After graduating from medical school in the mid-2000s, he worked at a rural hospital in his native Kenya, where many of the patients were children with pneumonia who needed oxygen for treatment. But there was never enough oxygen available. Often, several patients had to share a single cylinder of oxygen. When there wasn't enough to go around, Olayo and his colleagues would have to decide who would get it and who would go without--a gut-wrenching choice that often meant one child would live and another would die. Olayo set out to learn why something as seemingly basic as oxygen was so hard to come by in Kenya. One problem, he learned, was that there was only one oxygen supplier for the entire country, and because there was no competition, the supplier could charge exorbitant prices. (At the time, oxygen in Kenya cost about thirteen times more than in the United States [CHECK THIS FACT].) Plus, many Kenyan health facilities are hundreds of miles from the nearest oxygen plant, which caused two other problems: Transportation costs added to the price, and