Epidemic preparedness: Is Ghana ready to fight emergencies?

The recent shortage of some childhood vaccines in the country has concerned me greatly.

This shortage, if not curtailed, will negatively affect Ghana's Childhood Immunisation Programme, which has been recognised as one of the most successful in the world, President Nana Addo Dankwa-Akufo Addo told Parliament on Wednesday, March 08, 2023.

The president, in his seventh State of the Nation Address (SONA), was, however, quick to assure that the government had taken steps to procure and supply the vaccines as a matter of emergency.

His comments followed several media reports on the shortage of routine immunisation vaccines for babies from birth to at least 18 months at various health facilities nationwide, which created fear and panic among mothers.

The vaccines include Bacille Calmette-Guerin (BCG) for tuberculosis; oral polio vaccine 0 (OPV); and those for Measles-Rubella; Meningitis and Diphtheria, tetanus, pertussis (whooping cough).

Already, the northern part of the country has had to deal with an outbreak of measles in children - an acute viral respiratory illness, as a result of the situation.

Some residents, however, called for the closure of schools to reduce the spread of the disease in the Region, a devastating situation.

Dr Patrick Kuma-Aboagye, the Director General of the Ghana Health Service, speaking to the situation, attributed it to, among other factors, the depreciation of cedis.

He assured that there had been arrangements for Ghana to receive some vaccines between two to three weeks from then.

Mr. Kweku Agyemang-Manu, the Minister of Health, responding to queries on the floor of Parliament Thursday, March 09, 2023, corroborated the position of the GHS boss.

He revealed that Ghana had paid some $6.4 million to the United Nations International Children's Emergency Fund (UNICEF) for the supply of three key childhood vaccines.

"We have done all the necessary arrangements, and within two to three weeks, we should get vaccines," he said.

The distress visited on the country by the coronavirus pandemic, coupled with the current situation at hand, reinforces the urgent need for Ghana to stop relying on foreign countries, particularly in times of emergencies.

Fortunately, the Ministry of Health on Saturday, March 11, 2023, received the first consignment vaccines for measles, measles, BCG and Oral Polio distributed across various facilities nationwide.

But when will we honour our annual obligation for vaccine procurement as a country?

GAVI support

In a maximum of four years, Ghana is expected to transition from its co-financing agreement with the Global Alliance for Vaccines and Immunisation (GAVI) programme, which currently supports over 89 per cent of the cost of vaccines and vaccine delivery in the country, to full self-financing where Ghana is expected to bear the full cost of procuring vaccines.

Fortunately, the country appears to be making progress with the passage of the National Vaccine Institute Bill, which intends to coordinate and supervise the research, development, and manufacturing of vaccines and sera in Ghana.

The Institute is expected to ensure that, no matter what happens to the global vaccine supply chain, the country can produce its own vaccines locally.

The World Health Organization (WHO) declared that covid-19 was no more a threat, thus the need to scrap the levy and rename it as a source of funds for epidemics preparedness.

Scrapping of Covid-19 levy

Dr Justice Arthur, the Chairman of the Central Regional Ghana Medical Association, has called on the government to scrap the Covid-19 levy since it was no more threat to the nation.

He said remaining the levy in a fund would help support public health emergencies to position the health systems well for pandemics or epidemics.

The establishment of a covid -19 levy is a prudent move; however, it is now eminent to expand and rename the levy as a source of funding to cater for public health emergencies and to support the country's quest to produce vaccines.

Roland Ataffah, a Public Health Officer, noted that the covid-19 levy was not useful since it's been declared no more threat, adding that a fund to prepare for emergencies was imperative to help the country in such times.

He said accounting for the use of levy was difficult, thus the need to scrap it for funding epidemic and pandemic preparedness.

"We could not account for the use of the Covid-19 levy; why pay again since it's no more threat to the citizenry?"

"Let us establish a fund to prepare the county ahead of emergencies," he added.

The need to rename covid-19 levy as a source of funding for public health emergencies and epidemics

Some members of the Ghana Association of Laboratory Scientists and Public Health Technical Officers have stressed the need for the establishment of a Public Health Emergency Fund (PHEF) to support pandemics and epidemics in the country.

They noted that the public health emergency in Ghana was complex and multifaceted, with challenges ranging from infectious disease outbreaks to chronic diseases and health system constraints, thus the need for a fund to fight such emergencies for strengthened health systems.

In particular, the COVID-19 pandemic had a significant impact on the country, with thousands of confirmed cases and hundreds of deaths which should empower the country to focus on effective ways of dealing with health emergencies.

Thomas Reynolds, a Laboratory Scientist at the Cape Coast Teaching Hospital (CCTH), said it is important to allocate the COVID-19 levy as a source of funding for the pandemic and epidemic prevention and preparedness because it will provide a sustainable funding stream to support public health emergency preparedness and response.

The levy provides an opportunity to build resilience in the health system, improve surveillance and disease detection, and invest in critical infrastructure and supplies necessary for pandemic preparedness.

Ghana, as a developing country, though, has made efforts to invest in quality healthcare and respond to public health emergencies. However, there is much to be done to strengthen the health system and respond to health emergencies.

The government had increased healthcare financing, improved healthcare service delivery, and strengthened disease surveillance and response to support in that regard.

However, Reynolds stated that there were gaps, lapses and challenges that needed to be addressed, including inadequate healthcare infrastructure, low healthcare workforce, inadequate medical supplies and equipment, and limited access to healthcare services, especially in rural areas.

Additionally, allocating the COVID-19 levy as a source of funding for emergency preparedness and response was crucial in Ghana's public health emergency preparedness efforts before another outbreak.

The Laboratory Scientist said Ghana had made significant strides in healthcare investment and response to public health emergencies, but there was still the need to address the existing gaps and challenges to ensure an effective and efficient response to future emergencies.

For her part, Comfort Antwi, a Public Health Nurse with the Ghana Health Service, suggested to the government to make logistics available to the health facilities for quality service delivery.

She said that although Covid-19 affected the country and the economy, other adverse diseases were affecting and taking more lives in the country that needed prompt attention.

Antwi advocated for an emergency fund to help Integrated Disease Surveillance and Response (IDRS) teams in the health sector identify, research and find lasting solutions to diseases rather than waiting for its outbreak before resolutions.

Way Forward

Reynolds advised that the government consider establishing a public health emergency fund to support pandemic preparedness.

He said the Covid-19 levy should be collated into a single fund to serve as a dedicated source of funding for disease outbreaks.