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#Post#: 7--------------------------------------------------
The list of equipment
DIR By: David Peel
Date: January 17, 2018, 5:35 am
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The list of equipment from UNICEF is far too complicated . I
propose the following simple set of equipment which has been
used in several countries and which can easily be maintained .
Pulse oximeter , Lifebox ( 250 USD)
Sensor with 1 year guaranteed life , Lifebox (25 USD)
Oxygen concentrator , AIRSEP Elite with 5 year guarantee (approx
1000 USD)
Spare parts for Elite ,Kit for 10 machines bought with purchase
15 USD/ machine /year i.e 750 USD.
Flow splitter for 5 patients , Longfian , (100USD).Oxygen
analyser
Nasal prongs , Longfian can be disinfected or boiled.
#Post#: 9--------------------------------------------------
Re: The list of equipment
DIR By: David Peel
Date: January 25, 2018, 6:21 am
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Dear All,
On 12th January, a message to TRG members from Bev Bradley
stated that "Given the recent WHO/PATH publication Technical
Specifications for Oxygen Concentrators, specification for
concentrators are considered completed". I have been working
successfully with Mike Dobson and Trevor Duke since 1989 on
projects for WHO which have been aimed at identifying the most
suitable oxygen concentrator for use in the treatment of
pneumonia in children. Numerous papers have been published on
this topic. Therefore I felt obliged to read this document in
detail. This was a difficult task. I was shocked to find that
the WHO/PATH specification hides an important change of policy
which is that the search for an appropriate oxygen concentrator
has been abandoned by WHO/UNICEF and is now considered to be the
responsibility of an unidentified number of National/Regional
organisations who are completely inexperienced in this field.
This denial or responsibility by WHO/UNICEF is completely
unjustified. The only possible way to move forward at the
current time is for WHO/ UNICEF to identify the most suitable
model of concentrator and appropriate accessories and to
distribute them worldwide. In parallel with this, a new
specification should be written and put out to tender so that
for the first time we will be defining a concentrator suitable
for use in low resource situations. According to my knowledge,
the technical specification given in the WHO/PATH document is
not met by any concentrator currently in the market. I will be
pleased if anyone including UNICEF can demonstrate which current
model meets the specification written by WHO /PATH.
In summary I consider that the WHO/PATH document is totally
unfit for purpose and must be withdrawn , it is far from being
complete.
The specification for an oxygen concentrator for use in lower
resource countries is by far the most important specification in
the whole project. It is essential that a concentrator which
works in a tropical climate to produce a minimum concentration
of 82% oxygen at maximum flow in an environment of 40C, 95%RH at
2000 m altitude should be manufactured with a five year warranty
and purchased with a defined set of spare parts. There are very
few manufacturers in the world who are capable of doing this but
they should be enticed to do so by a promise of access to the
world market. Up to now all attempts to pursuade manufacturers
to make a concentrator for low resource countries have been met
by rejection due to lack of a perceived market. WHO/INICEF have
access to this market and should now proceed and to provide and
test the appropriate equipment.
#Post#: 10--------------------------------------------------
Re: The list of equipment
DIR By: bbradley
Date: January 29, 2018, 3:37 am
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David,
We appreciate your engagement on this topic, especially given
your history and experience in this area.
First of all, I’d like to clarify that a specification for
oxygen concentrators was not within the scope of this WHO/UNICEF
project. When I said the concentrator specifications were
complete, I meant that since that document was recently
published we were not funded to cover it as part of this
project. That being said, specifications are never complete!
They should evolve with advancements in technology and with the
changing needs of the settings we serve. David, when you said
"a new specification should be written and put out to tender so
that for the first time we will be defining a concentrator
suitable for use in low resource situations" - what specific
changes to the current spec do you propose are required? We
would like to know. Again, revising the current WHO
specification for oxygen concentrators was not in scope for this
project, but if there are issues with what is currently
available, please let us know what you think those issues are.
We can pass that on to those at UNICEF Supply Division who will
be working on tendering of concentrators.
That brings me to the UNICEF procurement process. Rest assured,
UNICEF has not changed its procurement policy in any way. At
UNICEF, a competitive tendering process is used to find the best
value-for-money and fit-for-purpose products based on
pre-defined specifications. Depending on the tendering cycle
set for any specific product, these specifications are typically
revisited every 2 to 3 years. Again, it is not within the
scope of this project to update or revise what WHO published for
concentrators, but for the products that are being considered
under this grant (i.e., the 12 product specifications circulated
to the TRG, including hand held pulse oximetry) we are moving
forward with creating harmonized specifications. Indeed, one of
the goals here is use UNICEF’s procurement channels to
facilitate access to the world market for appropriate oxygen
products.
Lastly, product testing is not funded under this project phase.
Yet your argument for testing is very compelling and we agree it
is very important. Let's discuss the most efficient way to get
this done including identifying appropriate testing facilities,
a review of the specifications, who should lead this and how to
get it funded. We will make this an agenda item for the next TRG
meeting and raise the issue with our donor.
Again, David, we send our sincere thanks for your constructive
comments, which have caused us to reflect deeply on the task at
hand.
Kind regards,
Bev
#Post#: 12--------------------------------------------------
Re: The list of equipment
DIR By: David Peel
Date: January 30, 2018, 4:01 am
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On the 29th I wrote to Bev making comments sentence by sentence
on her input. However, I find that the forum will not accept my
comments in the format which I send to Bev, I will therefore
have to rewrite them using a different method using a format
that is acceptable to the forum.
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