Re-Examining the Race to Send Ventilators to Low-Resource Settings

• Published in: Respiratory care Vol. 65; no. 9; pp. 1378 - 1381
• Main Authors: Mantena, Sreekar, Rogo, Khama, Burke, Thomas F
• Format: Journal Article
• Language: English
• Published: United States Daedalus Enterprises, Inc 01.09.2020
• Subjects: Banks (Finance); Coronavirus Infections - epidemiology; Coronavirus Infections - therapy; COVID-19; Critical Care - organization & administration; Developing Countries; Female; Health care costs; Health Resources - economics; Healthcare Disparities - economics; Humans; Intensive Care Units - organization & administration; Male; Medical equipment; Medical personnel; Nigeria; Pandemics - statistics & numerical data; Pneumonia, Viral - epidemiology; Pneumonia, Viral - therapy; Poverty - statistics & numerical data; Public health; Resource allocation; United Nations; Ventilators, Mechanical - economics; Ventilators, Mechanical - statistics & numerical data; World Health Organization; Nigeria; South Africa; Massachusetts; COVID-19; global health; resource allocation; mechanical ventilation; low-resource settings; cost effectiveness
• ISSN: 0020-1324; 1943-3654
• DOI: 10.4187/respcare.08185

COVID-19 is devastating health systems globally and causing severe ventilator shortages. Since the beginning of the outbreak, the provision and use of ventilators has been a key focus of public discourse. Scientists and engineers from leading universities and companies have rushed to develop low-cost ventilators in hopes of supporting critically ill patients in developing countries. Philanthropists have invested millions in shipping ventilators to low-resource settings, and agencies such as the World Health Organization and the World Bank are prioritizing the purchase of ventilators. While we recognize the humanitarian nature of these efforts, merely shipping ventilators to low-resource environments may not improve outcomes of patients and could potentially cause harm. An ecosystem of considerable technological and human resources is required to support the usage of ventilators within intensive care settings. Medical-grade oxygen supplies, reliable electricity, bioengineering support, and consumables are all needed for ventilators to save lives. However, most ICUs in resource-poor settings do not have access to these resources. Patients on ventilators require continuous monitoring from physicians, nurses, and respiratory therapists skilled in critical care. Health care workers in many low-resource settings are already exceedingly overburdened, and pulling these essential human resources away from other critical patient needs could reduce the overall quality of patient care. When deploying medical devices, it is vital to align the technological intervention with the clinical reality. Low-income settings often will not benefit from resource-intensive equipment, but rather from contextually appropriate devices that meet the unique needs of their health systems.