Author: Emelia Naa Ayeley Aryee || Freelance Journalist
In the wake of several public health crises, including the recent outbreak of cholera, cerebrospinal meningitis, monkey-pox, and others in some parts of Ghana, health and civil society experts have intensified the call on the government to establish the much-touted dedicated fund for emergency health financing.
As of Wednesday, February 12, 2025, over 500 cases of Cholera had been recorded in the Central Region, with 13 deaths and counting in the Effutu Constituency.
Again, by Thursday, February 6, 2025, over 60 cases, and 14 deaths of cerebrospinal meningitis had been recorded in the Upper West Region alone.
This worrying trend has raised concerns among ordinary Ghanaians, medical doctors, civil society experts, and the legislature. It must be noted, also that this is not the first time we are having such outbreaks. And this is one of the reasons experts believe that if there should be a dedicated public fund for health emergency financing, it would go a long way to possibly forestall the outbreaks.
In a news programme monitored by this journalist on TV3 on Thursday, February 6, 2025, the MP for Daffiama Bussie Issa, Dr. Sebastian Sandare, called on the Speaker of Parliament, Rt. Hon. Alban Bagbin, to as a matter of urgency, intervene by directing the Ghana Health Service (GHS) to act swiftly save the situation and avert more deaths from Meningitis
In his response, the First Deputy Speaker of Parliament, Bernard Ahiafor, directed the GHS to take immediate action to control the situation and curb the disease from further spreading. But, have there been enough assurances from past and current governments concerning the timeline for the establishment of the fund?
Also, what pointers are there to drum home the importance of establishing the Public Health Emergency Fund as enshrined in the national Medium Term Development Plan (2022-2025)?
Epidemic preparedness
On the back of the incessant calls, the Medical Director of St. Anthony’s Catholic Hospital, Dzodze, Volta Region, Dr. Neville Kaba Kelugu, has explained how the country and citizens as a whole stand to benefit if government paid heed to the calls and established the fund.
Dr. Kelugu was speaking in an exclusive interview with freelance journalist Emelia Naa Ayeley Aryee in Accra.
In his opinion, Ghana has made strides, compared with how health crises were managed 10 years ago. However, a lot more areas are begging for attention. It is on this basis that he scored the country’s emergency health preparedness 4 on a scale of 10.
Why such a dismal score? Dr. Kelugu noted that there are what he termed “fearful loopholes”, as there is lack of resources spanning manpower, infrastructure, doctor-to-patient ratio, and the inability to detect outbreaks at the borders before they occur, adding that with our current level of preparedness, it will be very difficult to handle an outbreak if there should be a new one.
“We are struggling, we lack infrastructure. As you may be aware, during COVID, some school buildings were converted into quarantine centers. Canopies were mounted to cater for the situation, few ICUs and still few. How many health officers do we have working at a facility as against the number of patients recorded? The next outbreak will be difficult to handle if nothing is done now,” Dr. Kelugu intimated.
He also questioned how far we have gone as a country with regards to the manufacturing of our own vaccines so that even before there is an outbreak, the populace would be vaccinated in a bid to control the outbreak when it occurs, or, better still prevent it.
Epidemic prevention
Dr. Kelugu rated Ghana’s level of prevention two out of 10. He explained that sanitation management has been done poorly in recent times compared to when we had officers from the Town Council visiting homes unannounced and fining those whose households were found dirty.
He added that though the country has policies regarding sanitation and hygiene, they are not being enforced.
“We need good water sources. We need the policies surrounding our hygiene and sanitation enforced. They are there. We have them written in books, but that is not enough, they need to be enforced,” Dr. Kelugu said.
The doctor also questioned the functionality of the health promotion unit of the Ghana Health Service, stressing that “as we speak, there is a Cholera outbreak. There is a meningitis outbreak and we are not hearing any health education about them on the TV and radio.”
Epidemic response
According to Dr. Kelugu, our response to epidemic outbreak has not been as timely as it should be. He cited the m-pox outbreak as an example, saying that if we had vaccines for m-pox, as soon as Ghana learnt of the outbreak in the Democratic Republic of Congo (DRC), it would have, as a preventive measure, vaccinated citizens without first waiting for the epidemic to hit us before taking action.
He added that the government should be willing to train individuals in certain specific areas of health, while training and retraining workers already in the health sector, so they can be capable enough to handle epidemics and their dynamics.
Why setting up the fund is critical
Setting up the dedicated fund will help cater for all the lapses in the aforementioned areas of epidemic management and save lives. It will also help manage health situation better, as the country cannot rely on donor support all the time, said Dr. Kelugu.
His views were corroborated by the Country Director of Send Ghana, Ms Harriet Nuamah Agyemang, who, in an interview, expressed the belief that the fund will largely help in preventing outbreaks and keep citizens alive.
She noted that establishing the dedicated fund is crucial for Ghana to be able to prepare, respond, and be self-reliant whenever there is an epidemic.
The fund, she added, will better equip us to find the root cause of an epidemic and solve it in a timely and more capable manner.
“By setting up the fund, a lot of lives could be saved, translating into government getting more revenue from taxes because the citizen will be healthy to work and be able to pay taxes,” she said.
Madam Harriet added that effective response, such as having medications, enough staff, and volunteers to help with contact tracing, logistics, and the immediate release of logistics in times of an outbreak means we are prepared adequately as a country, and this can be made possible only by means of the dedicated fund.
She said the lack of action on the part of GHS to raise awareness, educate, and sensitize the public on disease outbreaks could be largely attributed to lack of funds.
However, if the dedicated fund was in place, it could be used to pursue that goal so people know how to carry themselves so as not to get infected.
How much is needed?
Taking a cue from the expenditure on the COVID-19 pandemic, it is anticipated that an amount of GHË 19 billion could be needed yearly to tackle an epidemic.
According to a March 19, 2021 report sighted by this journalist on the website of the Finance Ministry, the government spent that amount on managing the pandemic.
Of this amount, Madam Harriet says 60% could be used for epidemic preparedness, while the remaining 40% is used for epidemic response; as she explained that if we prepare adequately, we will have less to respond to.
Sources and management of the fund
Currently, the primary source of funding for the health sector is government’s budgetary allocation, taxes, and the national health insurance scheme. Other sources include donor support, international aid, and out-of-pocket payment.
On the sources of funding for the dedicated fund, Madam Harriet is of the opinion that the government should maintain the COVID levy, but rename and use it as seed money to establish the fund, while topping up with other sources.
Both Dr. Kelugu and Madam Harriet opined that a legal framework is needed to effectively manage the fund, while independent people are employed based on their expertise to manage the fund.
This, they said, will enhance transparency and accountability, which will in turn boost the public’s confidence to contribute to the fund.
“Just as people at the end of the month give one-tenth of their money to the church, individuals, when they see that the fund is managed well, would want to make consistent contributions as well,” Dr. Kelegu said.
On the role the public plays in epidemic prevention, Madam Harriet cautioned individuals to take care of themselves because life is everything.
“Eat right, keep your environment clean, maintain good personal hygiene, wash your hands after using the restrooms. Failure to do all of these shows you are being self-centered which could also affect other people. Your children’s education can also be affected because you won’t be healthy to work and pay the fees,” Madam Harriet advised.
She also called on food vendors to get screened to obtain the needed certificate clearing them to ply their trade; and suggested that food show programs on television should also include how to properly clean the food items before cooking and cleaning of environment as part of the show because they have a lot of viewers who must be taught.
Madam Harriet is of the firm belief that prevention of outbreaks is the surest way to save the populace from costs and death. However, since are not totally inevitable, it is necessary to set up the dedicated fund and it must be done now!
