Hamish Graham
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hamishgraham.bsky.social
Hamish Graham
@hamishgraham.bsky.social
37 followers 64 following 36 posts
Kids doctor, oxygen-lover, health researcher, implementation scientist, critical optimist.
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hamishgraham.bsky.social
Conduct of clinical trials is grossly inequitable:
👉Only 10% of trials included children.
👉Only 9% were conducted in low-income and middle-income countries (LMICs), 1% in low-income countries
thelancet.com/journals/lan...
March 27, 2025 at 10:49 PM
hamishgraham.bsky.social
New guidance from @thelancet.bsky.social
is charting a new direction for clinical trials.
thelancet.com/series/clini...
March 27, 2025 at 10:49 PM
hamishgraham.bsky.social
What is up with PubMed?

It's looking weird from Australia. Hoping this is not more idiotic destruction of core health infrastructure by USG!?! But sadly would not be surprised 😯
March 2, 2025 at 9:04 AM
hamishgraham.bsky.social
But oxygen for all needs action - so we make 52 recommendations for governments, the oxygen industry, global health actors, advocacy groups, academics, and professional bodies to work towards by 2030...

Read more and find out what you can do 🫵
www.thelancet.com/commissions/...
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
Solution 5 - harness data for decision making with standardised oxygen coverage indicators, ATMOS policy scorecard, fostering a learning health system to continually generate and translate new learning into practice...
#data #impact #monitoring
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
Solution 4 - foster fair markets and regulation with transparent tendering and pricing, representation from LMICs, regulation that allows multiple oxygen production sources and makes devices fit for purpose...
Photo of liquid oxygen tank. Photo credit: Brian Otieno/ The Global Fund
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
Solution 3 - coordinate oxygen system management with a national oxygen plan, stakeholder involvement across vertical programs, funding to match need and gaps...
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
Solution 2 - build resilient oxygen supply systems with context-appropriate solutions that build on what exists, biomedical support and essential infrastructure (especially power), planning for total cost of ownership...
Photo of health worker with oxygen concentrator in hospital ward. Photo credit: PATH/Ragul Krishnan
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
Solution 1 - link patients to care with routine pulse oximetry, SpO2 a vital sign, capable and supported frontline health workers, and evidence-based expansion of pulse oximetry to smaller facilities...
#oximetry #vitalsign #oxygen
Photo of health worker with pulse oximeter probes. Photo credit: Isabeau Walker/Lifebox
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
We identified 5 priority areas for action to ensure equitable access to oxygen...
#solutions
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
Getting oxygen to patients requires a systems approach. Might not sound sexy but it is sooo important...
#healthsystems #oxygen
Image showing the many components that go into getting oxygen to patients. Starting with the production to patient level - we need care seeking, early diagnosis, uninterrupted oxygen availability, health worker and technician expertise. Next, ensuring this complex system functions relies on effective management and planning, including costed maintenance and repair plans. Data on these steps is glaringly absent and prohibits effective planning by facility managers and district health staff, meaning stock-outs are common and unpredictable. Given the need for medical oxygen and pulse oximetry across all levels of the health system and multiple patient groups, oxygen is often without a clear “home” among government ministries and has too often been left out of policies, programmes, and data collection systems. At the national level, different parts of the oxygen system often sit with different ministries and public agencies, and oversight of procurement and quality control of oxygen fragmented and subject to inefficiencies. This is partly a result of absent coordinating structures that bring all national and sub-national actors and regional and international stakeholders together. And then, these failures in oxygen supply, quality control, and system inefficiencies are linked to how the global oxygen market functions, and deficiencies in regulations, standards and financing. Therefore, solutions need to consider how technological innovations, workforce capacity, market dynamics, and political systems intersect, considering each solution as one piece of a bigger puzzle. Many of the solutions we present are also not limited to oxygen systems – oxygen is part of the wider health system, and therefore solutions need to take a broader systems perspective.
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
There should be no question as to whether investment in oxygen-system strengthening is value for money. Rather, the focus should be on how much funding is needed and how this money would be most effectively spent...
#investinoxygen
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
Oxygen access is poorer in rural areas, smaller facilities, and poorer communities, with people in Sub-Saharan Africa, South Asia, and East Asia and the Pacific facing the biggest oxygen access gaps...
#equity #rural #oxygen
Figure showing lower oxygen access in Sub-Saharan Africa, South Asia, and East Asia and Pacific compared to other parts of the world.
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
The oxygen coverage gap is due to: not seeking care; lack of oxygen equipment; lack of blood oxygen screening (pulse oximetry); difficulties providing oxygen correctly (quality of care); cost barriers. This won't be solved by simply shipping in more equipment...
#systems #barriers
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
However, in low-income and middle-income countries, less than 1 in 3 people who need oxygen for acute medical or surgical conditions receives it. This 70% coverage gap far exceeds treatment gaps for HIV/AIDS (23%) and tuberculosis (25%)...
#coverage #access #inequity #oxygen
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
Patients young and old can need oxygen, for respiratory and other systemic illnesses, for anaesthesia and surgery, for chronic respiratory failure. And when a patient needs oxygen, they need it now, as this patient testimonial says...
#oxygen #patient #testimonial
Quote: “I remember when I got to the emergency room my saturation was 80%. I had a blackout in front of my eyes. I thought I would die. I was sweating. I felt like there was no life in my hands or feet. I felt much better when I got on oxygen and my symptoms got better and I thought I would come out of it. It gave me hope,” Young patient in respiratory failure, Pakistan
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
Each year, 374 million people need medical oxygen: 306 million (82%) live in low-income and middle-income countries. During emergencies, the need for oxygen can rise exponentially, putting enormous pressure on health systems (as we saw in COVID)...
#oxygen #GBD #covid
Map of the world showing where the greatest need for oxygen is - South Asia, East Asia and Pacific, Sub-Saharan Africa
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
The COVID-19 pandemic was a big wake-up call for oxygen. But the problems with oxygen access have been around for a long time...
#covid #oxygen #pandemic #healthaccess
Dr Tedros Ghebreyesus, World Health Organization head, on video explaining that oxygen in an essential medicine that is not available to so many of the world's people in their time of need.
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
Let's start with the basics - oxygen is a life-saving essential medicine that we will almost all need sometime in our life...
#oxygen #medicine #globalhealth
Quote from the report: Oxygen therapy is life-saving for people with acute illness, life-sustaining for people undergoing anaesthesia and surgical care, and life-enhancing for people with chronic respiratory failure. Oxygen is an essential medicine, an essential service for all levels of healthcare, requiring a systems approach.
February 27, 2025 at 4:38 AM
hamishgraham.bsky.social
The @thelancet.bsky.social #Oxygen Commission report is officially launched providing a roadmap towards oxygen access for all. Stay posted for more... thelancet.com/commissions/...
#InvestinOxygen #GlobalOxygenAlliance #SDGs #Pandemic2025
February 20, 2025 at 2:54 AM