(The Hill) — A new article published this week in The Lancet medical journal found that more than half of the world’s population lacks access to safe and affordable medical oxygen services, and most people outside of high-income countries go without adequate oxygen services for their medical conditions.

As the Lancet Global Health Commission noted in its report on medical oxygen security, about 374 million people need medical oxygen every year, with roughly 9 million people needing long-term oxygen due to chronic illness.

However, there are gaps in coverage in low- and middle-income countries (LMIC).

“We found that more than 5 billion people—ie, more than 60% of the world’s population—do not have access to safe, quality, and affordable medical oxygen services,” the commission wrote. “In LMICs, only 89 million (30%) of the 299 million people who need oxygen for acute medical or surgical conditions receive adequate oxygen therapy, with the lowest access in sub-Saharan Africa.”

They noted that this coverage gap of 70 percent far exceeds that of treatments for HIV/AIDS and tuberculosis.

Common causes contributing to this gap include not being able to reach facilities, facilities not having the capacity for basic oxygen service, failure to identify the need for oxygen services and low-quality oxygen care.

Earlier this month, an elderly Burmese refugee who depended on oxygen died after being discharged from a U.S.-funded hospital. This reportedly occurred after the hospital was closed following President Donald Trump’s order to freeze foreign aid.

The commission estimated it would cost $6 to $8 billion annually to close this coverage gap in LMICs, which they acknowledged was costly while also noting that oxygen services are highly cost-effective.

“The case for investing in medical oxygen is strong: it is as cost-effective as routine childhood immunisation, would enable governments to make progress on eight of the nine [Sustainable Development Goal 3], and could reduce deaths during future pandemics,” they wrote.

To better address this issue, the commission called for more countries to develop national oxygen plans that suit their unique national priorities and conditions. They also called for “high-quality, robust pulse oximeters” to be made more affordable and accessible for small and rural health facilities, noting this essential measure is conducted in only about a fifth of people presenting at general hospitals in LMICs.