Oxygen giant spreads misinformation in Namibia

24 September 2021 | Health

MADLEN DAVIES and TUYEIMO HAIDULA



LONDON/OSHAKATI

One of the world’s biggest industrial gas companies spread misinformation in an attempt to stop Namibian hospitals from switching to more reliable oxygen supplies as they fought a deadly third wave of Covid-19, a joint investigation by the Bureau of Investigative Journalism and Namibian Sun can reveal.

Afrox, the country’s main supplier, wrongly told private hospitals planning to build onsite oxygen plants that the gas they produced was not safe for use on patients.

Doctors told the Bureau that the 93% oxygen generated by onsite plants is as safe as the 99.95% liquid oxygen made by Afrox.

Leith Greenslade, a coordinator of the Every Breath Counts Coalition, which advocates for medical oxygen access worldwide, said the World Health Organisation (WHO) and medical experts “could not be clearer on this”.

“No company should be seeking to restrict access to medical oxygen for any hospital,” she said. “Every national government has to take a good look inside its borders, and if this is happening, stamp it out.”

Last month, the Bureau revealed similar scare tactics had been used by Mexico’s two biggest medical oxygen suppliers.

Short of breath

Healthcare systems worldwide have struggled to keep pace with the soaring need for medical oxygen vital to treating critically unwell Covid-19 patients. Across Africa, demand more than tripled in the past year, but the continent has the second-lowest production capacity for liquid oxygen globally.

In Namibia, Lady Pohamba Private Hospital in Windhoek and Ongwediva Medipark decided to invest in onsite oxygen plants to plug the gaps after being hit by high costs and late deliveries from Afrox.

These plants are generators built on hospital grounds that turn ambient air into medical oxygen, and they can provide a more reliable and economic supply. But Afrox salespeople tried to deter the hospitals from building the plants, hospital managers told the Bureau.

Linde, Afrox’s parent company, did not address the allegations about its subsidiary in Namibia. It told the Bureau that its Covid-19 response teams had worked tirelessly to deliver medical oxygen during the global crisis.

Afrox has no plant in Namibia and imports liquid oxygen from South Africa. The company charges N$510 to refill a cylinder containing 1 400 litres of oxygen, enough to help a severely ill Covid patient breathe for about two hours.

Hospitals must pay an extra N$226 for cylinder rental and cleaning fees. There is also the cost and time needed to transport the cylinders to and from Afrox’s depot in Windhoek. That round-trip journey covers more than 1 400km for Ongwediva Medipark.

As the need for oxygen increased, managers at Ongwediva Medipark realised it would be unwise to rely solely on cylinders from Afrox.

“As the hospital expanded, the demand exceeded the set-up of using cylinders,” Victoria Shikongo*, a manager at the hospital, said.

“We decided it was not sufficient for the maternity ward and other wards needing oxygen services; the [onsite] plant was the way to go.”

Long game

Despite Afrox’s efforts to deter them, both hospitals went ahead and installed the oxygen generator plants.

“We did our own research and realised that Afrox wanted to hold onto the market. There was nothing wrong with onsite plants,” Shikongo said.

And this experience is not unique. According to an onsite oxygen plant manufacturer, Afrox has spread misinformation about the systems since its introduction in Namibia.

Petrus Johannes*, who distributes plants to mostly private hospitals in the country, told the Bureau that all but one of his 13 clients in the past six years had been lobbied by Afrox representatives, falsely claiming oxygen from onsite generators is not safe for patients.

He said Afrox’s use of the tactic was widespread. “[Hospital managers] told me that when the plants were first installed, Linde put a lot of pressure on them seemingly because we were taking away a big part of the market – the bulk oxygen,” he said.

Afrox representatives persisted in visiting hospitals after oxygen plants were installed, according to the managers. “They were really putting a lot of pressure on them to think that [93%] oxygen purity was not acceptable. And it was not right,” Johannes said. “But these hospital directors had done all their homework and consulted and so forth. And by then, they were confident they had made the right choice.”

‘Needlessly high prices’

Brook Baker, a professor of law at Northeastern University and a civil society representative advising the WHO’s deployment of drugs and oxygen for Covid-19, said “Linde’s 99.95% oxygen is no better therapeutically than self-generated 93% oxygen because both are diluted with air for patient use”.

In his opinion, “the only difference is that Linde can charge needlessly high prices for its proprietary oxygen, cylinders and delivery”.

“It’s not surprising that companies with monopoly positions that allow them to charge high prices would disparage alternative products and cheaper sources of supplies.”

*Not their real names

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