Global O2ptimization of respiratory support collaboration

Oxygen is a basic human need. Supplemental oxygen is the mainstay of the management of patients with COVID-19 and of other severe acute respiratory tract infections (SARI). Particularly in low- and middle-income countries, SARIs are a major cause of mortality and morbidity. The experience of the COVID-19 pandemic revealed two uncomfortable truths:

  • Medical oxygen is a scarce resource, particularly in times of extraordinary need, and global access to oxygen is inequitable.
  • Far too many questions regarding the optimal delivery and use of medical oxygen remain unanswered, leading to worse outcomes for patients.

WHO is partnering with global research networks in acute care to address these shortcomings as part of the WHO Global O2ptimization of respiratory support collaboration. This work is also building on the international collaborative effort that performed the WHO O2CoV2 study, an observational study of oxygen requirements and approaches to respiratory support in patients with COVID-19 in LMICs.

This research programme will study the optimal approaches to delivering oxygen and providing respiratory support for patients with SARI and hypoxaemic respiratory failure across the globe, in a range of resourced settings, from the most austere to the most privileged.

The collaboration is based upon several core principles:

  • Ownership of the collaboration will be distributed, and primary authorship will be attributed to the group, rather than to individuals.
  • Research governance and leadership will ensure equity, diversity and inclusion, and will include participants from all WHO regions.
  • Research questions will be established through a prioritization process involving multiple stakeholders, including patients and families, and grouped within specific domains. High-priority research questions will be those relevant to the care of patients in resource-constrained settings where the burden of disease is the highest.
  • Investigators will be encouraged to recruit to research questions most relevant to their local needs.
  • The programme will strive to ensure maximal levels of both regional autonomy and global collaboration.

Progress to date

An expression of interest sought for this collaboration resulted in over 100 responses from researchers and clinicians in over 45 countries, including all WHO regions and representing over 50 research networks.

A survey of research involvement and capacity across the collaboration has been completed. Working groups within the collaboration have then developed a governance structure and a research prioritisation methodology. 

Following this work, we are now surveying members of the collaboration as well as clinicians and researchers from around the world on the research priorities for the collaboration to address.

An expression of interest was sought for this collaboration in February 2024 and remains open. If you are interested in joining the collaboration please go to Global O2ptimization of respiratory support collaboration. We encourage research networks/organisations and clinical institutions from LMICs to register their interest as research questions from these settings will be a priority.

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