Building Resilient Local Markets that Deliver for Patients
We are building healthcare markets that deliver oxygen reliably to patients.
Dr Abdu Mukhtar, National Coordinator, PVAC Nigeria
“You can produce as much oxygen as you want, but if it doesn't get to the patient at the bedside, it's of no consequence. The ultimate goal is for it to reach the patient.”
We now have evidence that local respiratory care businesses can reliably connect oxygen to patients. To build resilient local markets for these businesses, they need backing by the right investment, and the right conditions to grow.
Moving from proven pilots to resilient healthcare markets requires coordinated action across four areas.
Turning fragmented need into investable demand
Most health systems procure oxygen as a commodity, buying cylinders or equipment in one-off transactions. But reliable oxygen depends on supply, maintenance, consumables, and training working together. When procurement can't account for that, purchasing fragments, supply becomes unreliable, and value for money drops.
Oxygen CoLab works with governments to shift procurement from buying products to contracting for outcomes. This includes developing Target Service Profiles that define what reliable oxygen service looks like, and supporting approaches like sub-national procurement consortia that give suppliers the predictable demand they need to invest.
When suppliers have confidence in demand, they scale. When facilities contract for outcomes, patients get oxygen.
Shaping Regulation for Market Growth
Regulation plays a critical role in shaping oxygen markets but in many countries, regulatory frameworks for medical oxygen remain fragmented, unclear, or misaligned with how oxygen is actually delivered. These barriers slow market growth even where demand is high. Responsible businesses that want to operate can't navigate the pathway in, and investors can't assess the risk.
Through our work in Uganda and Nigeria, Oxygen CoLab has mapped these regulatory barriers and identified approaches to address them including tiered frameworks based on provider capacity, strengthened testing and enforcement infrastructure, and clearer guidance for manufacturers and distributors.
When regulation enables rather than blocks market entry, the businesses patients depend on can reach them.
In some markets, oxygen equipment and oxygen as a pharmaceutical face separate regulatory pathways, creating confusion and cost that discourage new providers from entering
Backing the businesses that bridge the gap
Local small and medium-sized enterprises are the Missing Middle - the businesses that connect oxygen production to patient access. Oxygen CoLab has backed five of these businesses across four countries, and the results are clear.
But most oxygen SMEs struggle to grow. Demand is uncertain, contracts are short-term, and access to capital is limited. Our supplier mapping in Nigeria found that fewer than one in three are reliably profitable, and nearly two-thirds cannot access outside financing.
Growing this layer of the market requires flexible capital, technical and commercial support, and new market entrants. Oxygen CoLab works to de-risk these businesses for investors by demonstrating viable service models, connecting SMEs with blended finance, and identifying oxygen-adjacent companies that could expand into service delivery.
Oxygen use increased 50–70% once supply became reliable, with more than 20,000 patients having been treated through these models.
Following the money and making it work harder
Oxygen financing is often invisible. Spending is buried within broader essential medicines budgets, fragmented across funding streams, and difficult to track. Facilities lack visibility into what's available. Revenue from oxygen is pooled centrally and can't be reinvested locally. This results in no one in the system having a clear picture of what oxygen costs, what's being spent, or where the gaps are.
Oxygen CoLab is working to change this, generating the data and insight needed to make oxygen spending visible across the system, and exploring financing approaches, from revolving funds to insurance reimbursements to blended-finance structures, that coordinate what's already being spent so it goes further, and give suppliers the revenue predictability they need to invest.
We need to fund what lasts - local businesses and the conditions that let them deliver reliably long after the grant cycle ends: fit-for-purpose regulation and tariffs, smarter procurement, and processes that make smaller investments feasible.
Without clarity on financing, oxygen markets remain difficult to invest in. Suppliers can't plan. DFIs can't assess risk. Governments can't allocate effectively.
Logos
Click on logos below to open the image file which you can copy and paste for use in your documents. Avoid changing the logo in any way by stretching, altering colours, or adding words.
FCDO Logos
Click on logos below to open the image file which you can copy and paste for use in your documents. Avoid changing the logo in any way by stretching, altering colours, or adding words.
Partner Logos
These are the grantees and partners we’re working with. Include their logos where appropriate. Click on logos below to open the image file which you can copy and paste for use in your documents.
Icons
Templates
Our templates are in Google docs. Please do not edit the template but instead make a copy before editing. If you have issues with permission please contact someone from Brink.
Brand guidelines
These guidelines are for the whole Better Futures CoLab, not just oxygen. They give greater detail on the brand and are useful for briefing external creatives.
