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This guidance note provides a comprehensive overview of medical oxygen production, distribution, and use in Asia and the Pacific region, and explores how to improve systems over the medium and long term. It explains why surges in medical oxygen demand due to the COVID-19 pandemic have exacerbated deficiencies in oxygen systems. It highlights how greater coordination among stakeholders to plan and procure oxygen on a larger scale, improve equipment, and better train staff can dramatically benefit health systems and improve patient care.