Ghana must set up public health emergency fund

Records by the Ministry of Health and the Ghana Health Service show that within the space of three years (2020 to 2023), Ghana recorded eight major disease outbreaks.

These include the COVID-19 pandemic, Cerebrospinal Meningitis (CSM), Polio, Yellow Fever, Monkeypox (Mpox), Marburg virus disease, Measles, and Lassa fever.  

The country recorded her first two cases of the COVID-19 on March 12, 2020.

Besides its negative impact on the country’s socioeconomic development, statistics by the Ghana Health Service (GHS) show that more than 1,400 deaths were also recorded.

The GHS, on April 15, 2020, reported a total of 409 cases of CSM in five out of the 16 regions. By the second week of April 2020, it had recorded over 40 deaths from that outbreak.

The magnitude of the outbreak was severe and unprecedented in the past decade but the response to it was slow, largely because the national health team was overstretched in the response to the COVID-19 pandemic.

This led to several deaths. In October, 2021, the Savannah Region reported suspected cases of yellow fever, which were later confirmed positive by the National Public Health Reference Laboratory and the Noguchi Memorial Institute for Medical Research.

The disease spread quickly to 13 of the 16 regions of Ghana and more than 40 deaths were recorded.

In 2022, the circulation vaccine-derived poliovirus type 2 (cVDPV2) was confirmed in the country. These were from two acute flaccid paralysis cases; one each from North Gonja District in the Savannah Region and West Mamprusi in the North East Region.  

In July, 2022, the country confirmed three cases of the Marburg virus disease – two were fatal.

Also, in 2022, 116 Mpox cases were confirmed, resulting in four deaths. The country also battled measles, which was recorded in many regions due to the non-availability of vaccines for children.

With Lassa fever two cases were confirmed in February, 2023, with one death. This, in the past three years, put a lot of strain on the country’s health system in terms of her ability to respond to public health emergencies. The subsequent years could even be worse because other major disease outbreaks could be recorded.

In all these, how did the country prepare to face the  situation? 

The last three years have been one of the busiest for all health professionals in Ghana. The resilience of the system to respond to public health emergencies was tested.

It was realised that the country did not have adequate and readily available funds to timeously respond to public health emergencies.

Development partners had to support the country to contain the situation. In the case of the polio outbreak, the Government, with support from the World Health Organization (WHO) and other partners, under the Global Polio Eradication Initiative (GPEI), rolled out a polio vaccination campaign targeting children under-five years across all 16 regions.

The first round of the campaign was held from September 1- 4, 2022, whilst the second round was held from October 6 -9, 2022.

It was to increase the population’s immunity against type-2 poliovirus and break transmission of the disease.

More than six million children across the country were expected to receive the novel Oral Polio Vaccine Type 2 (nOPV2) for each of the rounds.

The WHO and other GPEI partners provided financial, logistical, and technical support to the government to reach and vaccinate all eligible children across the country.

In the case of yellow fever, persons aged nine months to 60 years old (except pregnant women) in the affected regions were injected with the yellow fever vaccine to keep them safe from the disease.

The first phase of the vaccination campaign was held in December, 2021. However, it was realised that pockets of the disease still existed after the campaign, and some new communities also started recording cases.

Therefore, a second phase of the vaccination exercise was held from February 26 to March 2, 2022. That was led by the GHS with support from partners including the United Nations Children’s Fund (UNICEF).

UNICEF worked with the GHS Expanded Programme on Immunization (EPI), providing technical assistance and financial support to help build the capacity of health workers, provide vaccines and logistics and also support the EPI in community mobilisation and sensitisation efforts.

In the case of the COVID-19 pandemic, amongst other support packages, UNICEF, WHO, and the Government of the United States of America supported the procurement of the first set of vaccines under the COVAX Facility, which the Government took delivery of in February, 2021, to begin the first set of vaccinations against the COVID-19 pandemic in the country.

How should Ghana prepare for disease outbreaks in the future?

Disease outbreaks do not only have consequences for the well-being of the population but also affect a country’s economy. If the response is not timeous and adequate, many lives could be lost.

For the past three years, donor partners had been highly supportive of the Government to contain the outbreaks and lessen the impact on the population.

But for the support of the donor partners, not much would have been achieved, and many of the citizens would have been affected.

Government’s challenge had been how to mobilise enough funds to respond to public health emergencies.

Now that donor support is dwindling, there is a need to establish a dedicated fund to support public health emergencies such that the country does not always look to development partners for assistance.

As the Government deemed it necessary to establish the Health Insurance Fund to cater for the clinical aspect of the health sector, it must also establish a dedicated fund for public health emergencies.

Through this, public health emergencies could be better handled to reduce pressure on the clinical aspect of health, thereby reducing the burden on the health budget.

The way forward

Just as disease outbreaks will continue to emerge, the country must also be prepared at all times to adequately respond to such emergencies.

Ghana cannot continue to rely on donor support to respond to public health emergencies especially when such support is dwindling now.

She must establish a Public Health Emergency Fund, as indicated in the National Medium Term Development Policy Framework (2021-2025) to ensure availability of funds to effectively tackle public health emergencies to ensure the safety and well-being of all Ghanaians.

By Albert Futukpor

Source: GNA