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A stitch in time saves nine – A case for public health financing in Ghana

It was 11: 30 pm in the middle of a rainy night when young Alhassan who lives with his family at Kpatinga, a village in Gushegu in the Northern region started experiencing a high fever with a runny nose.

Fatima, the mother of Alhassan gave his four-year-old boy paracetamol and placed a wet towel on his son’s forehead and feet hoping to keep the fever under control but the situation worsened as the clock ticked.

As time went by, deep into the night, Alhassan’s body became extremely hot, he began to cough, and his eyes became watery as he coughed severely.

Let us rush him to the hospital, Alhassan’s father exclaimed in a faint voice while his wife Famita gazed at his son helplessly.

At a high speed, Alhassan’s father drove him to the Gushegu District hospital. After several tests and examinations by the doctor, Alhassan was diagnosed with measles.

Four-year-old Alhassan was due to take a second shot of his measles vaccine in January 2023 but a nurse on duty says there was a shortage of measles vaccines and other vaccines for childhood immunization in the hospital in the last six months.

Like young Alhassan, many children are left to their fate when there is a shortage of vaccines for routine childhood immunizations.

The situation often leads to disease outbreaks and public health emergencies when there are no timely interventions.

In 2022 for instance, the shortage of the Measles-Rubella (MR) vaccine for almost six months in public health facilities across the country lead to an outbreak of measles in some parts of the Northern Region where about 120 children were affected.

Ghana has over the years experienced vaccine shortages intermittently its inability to fulfil its financial obligations for the procurement of vaccines, late placement, and payment of vaccine orders due to financial constraints and the absence of a dedicated source of funding for public health issues of such nature.

The nation would not have to rely on development partners for help to attend to internal outbreaks if there is a designated fund for unplanned outbreaks.

In the wake of the vaccine shortage in 2022 which extended to February this year, a source from the Global Alliance for Vaccines and Immunization (GAVI) told the Ghana News Agency (GNA) that Ghana could not fulfil its co-financing obligations for 2022 covering all vaccine needs until February 2023.

Stakeholders in the health sector admit that Ghana’s delay in fulfilling its financial obligations to GAVI also contributed to the shortage of vaccines.

GAVI said Ghana has been encouraged to meet its financial obligations for 2023 on time early in the year by July 2023 to avoid delays in the delivery of the vaccines for this year.

Dr Anthony Nsiah Asare, Presidential Advisor on Health in an interview with the GNA explains that vaccine shortage happens when the country is unable to pay for its vaccines on time.

To him, it is time Ghana gets a fund to fall on in cases of an emergency like the shortage of vaccines and the COVID-19 pandemic.

‘We were all caught unaware when the pandemic struck and setting up an emergency preparedness fund is a requirement by the International Health Regulations (IHR) that we need to fulfil as a country,’ he said.

The Presidential Advisor on Health says the government is considering the establishment of a Public Health Emergency Fund (PHEF) to solicit inflows from companies and organisations with much focus on the extractive industries.

‘This will ensure that we have a system in place which we can easily fall on before we start going to ask for loans and support from other places during pandemics or epidemics,’ he indicated.

Article 851 of the Public Health Act 2012 entreats Ghana to establish, operate and maintain a national public health emergency response plan.

Dr Nsiah- Asare suggests that the COVID-19 Trust Fund be converted into a Public Health Emergency Fund.

He called on individuals, organisations, government, and corporate institutions to donate money into the fund when established, saying, ‘If we do this, we will not have to rush to the International Monetary Fund and the World Bank to address the situations next we are faced with unforeseen disease outbreaks.’

Betty Nana Efua Krosby Mensah Member of Parliament for Afram Plains North and a member of the Parliamentary Select Committee on Health says the establishment of a Public Health Emergency Fund was long overdue.

‘As a country, not too long ago, we experienced an Ebola scare where our leaders had to rush around looking for funding to establish isolation centres to prepare,’ she said.

Madam Mensah said Ghana needed a Public Health Emergency Fund, not to only fund pandemics, but also to prepare for other health emergencies.

She said her constituency, Afram Plain North, for instance, had a tough time looking for a place to admit people who got infected during the outbreak of the COVID-19 pandemic.

‘The government should be able to mount a robust response to fight public health epidemics quickly,’ she said.

Ghana’s 2022-2025 Medium Term Development Plan calls for the enforcement of the Public Health Act, ensuring the establishment of a Health Emergency Fund; and strengthening the Ghana Centre for Diseases Control and other disease control centres across the country.

The plan also calls for the Passage of the Health bill, which includes the emergency preparedness and response plan into law and made operational by 2023.

Ghana needs to urgently establish a Public Health Emergency Fund to increase the country’s readiness and preparedness in responding to disease outbreaks.

A PHEF, when established, would serve as a source of funding for the health sector and could contribute to quality healthcare delivery for every Ghanaian.

Source: Ghana News Agency