In the wake of several public health crises, including recent outbreaks of cholera, cerebrospinal meningitis, monkeypox, and other diseases in parts of Ghana, health and civil society experts are intensifying calls for the government to establish a dedicated emergency health financing fund.

As of Wednesday, 12 February 2025, over 500 cases of cholera had been recorded in the Central Region, with 13 deaths and counting in the Effutu Constituency. By Thursday, 6 February 2025, more than 60 cases of cerebrospinal meningitis had been recorded in the Upper West Region alone, resulting in 14 deaths.

This alarming trend has raised concerns among citizens, medical professionals, civil society groups, and legislators. Experts argue that a dedicated public fund for health emergencies could help mitigate such outbreaks and provide timely responses.

During a news programme on TV3 on Thursday, 6 February 2025, the MP for Daffiama Bussie Issa, Dr Sebastian Sandare, urged the Speaker of Parliament, Rt Hon. Alban Bagbin, to intervene by directing the Ghana Health Service (GHS) to act swiftly to save lives and curb the spread of meningitis.

In response, the First Deputy Speaker of Parliament, Bernard Ahiafor, instructed the GHS to take immediate action to control the situation. However, questions remain about whether past and present governments have given concrete assurances regarding the timeline for establishing the fund. Additionally, there is a need to emphasise the importance of setting up the Public Health Emergency Fund, as outlined in the National Medium-Term Development Plan (2022-2025).

Epidemic Preparedness

Dr Neville Kaba Kelugu, Medical Director of St Anthony’s Catholic Hospital in Dzodze, Volta Region, highlighted the benefits of establishing the fund in an interview with freelance journalist Emelia Naa Ayeley Aryee in Accra.

Dr Kelugu acknowledged that Ghana has made progress in managing health crises compared to a decade ago but stressed that many areas still require urgent attention. He rated the country’s emergency health preparedness at 4 out of 10.

He attributed this low score to significant gaps in manpower, infrastructure, the doctor-to-patient ratio, and the inability to detect outbreaks at border points. He warned that Ghana’s current level of preparedness would make it difficult to handle a new epidemic effectively.

“We are struggling. We lack infrastructure. During COVID-19, school buildings were converted into quarantine centres, and canopies were erected to manage the situation. We still have few ICUs. How many health officers do we have working at a facility compared to the number of patients recorded? The next outbreak will be difficult to handle if nothing is done now,” he stated.

Dr Kelugu also questioned Ghana’s progress in vaccine production, stressing that the country should aim to manufacture its own vaccines to enable preemptive vaccination and better epidemic control.

Epidemic Prevention

Dr Kelugu rated Ghana’s level of epidemic prevention at just 2 out of 10. He criticised the poor sanitation management in recent years, contrasting it with past practices when Town Council officers conducted unannounced inspections and fined households for unclean environments.

Although Ghana has policies on sanitation and hygiene, he noted that enforcement remains weak.

“We need reliable water sources. Our sanitation and hygiene policies exist, but they must be enforced. Writing policies in books is not enough; they need to be implemented,” Dr Kelugu stated.

He also questioned the effectiveness of the Health Promotion Unit of the Ghana Health Service, noting the lack of public health education on the current outbreaks of cholera and meningitis.

Epidemic Response

Dr Kelugu highlighted Ghana’s slow response to epidemic outbreaks, citing the mpox outbreak as an example. He argued that if Ghana had access to mpox vaccines, authorities could have vaccinated citizens as a preventive measure instead of waiting for the epidemic to arrive before taking action.

He also stressed the need for government investment in specialised health training and the continuous education of health workers to ensure they are adequately equipped to manage epidemics.

Why Establishing the Fund is Critical

The establishment of a dedicated emergency health fund would help address the shortcomings in epidemic preparedness, prevention, and response. Dr Kelugu emphasised that Ghana cannot always rely on donor support and must take steps to manage public health crises independently.

His views were echoed by Harriet Nuamah Agyemang, Country Director of SEND Ghana, who argued that the fund would enhance epidemic prevention efforts and save lives.

She stated that the fund would help Ghana become more self-reliant in managing health crises and enable authorities to identify and address the root causes of epidemics more efficiently.

“By establishing the fund, many lives could be saved, contributing to government revenue through taxes, as healthier citizens can work and pay taxes,” she noted.

Ms Agyemang added that adequate epidemic response measures, such as ensuring the availability of medications, sufficient staff, and logistics for contact tracing, would only be possible if the fund was operational.

She also suggested that the Ghana Health Service’s lack of action in raising awareness and educating the public about disease outbreaks was largely due to financial constraints. A dedicated fund, she argued, could help bridge this gap and support public education campaigns.

Funding and Management of the Fund

Based on the expenditure for managing the COVID-19 pandemic, it is estimated that GH¢19 billion could be required annually to address epidemic outbreaks.

A report from the Finance Ministry dated 19 March 2021 indicated that the government spent this amount during the pandemic. Ms Agyemang suggested that 60% of this funding should be allocated to epidemic preparedness, while 40% should be reserved for epidemic response, noting that adequate preparation would reduce the need for emergency interventions.

Currently, Ghana’s health sector is primarily funded through government budgetary allocations, taxes, the National Health Insurance Scheme, donor support, international aid, and out-of-pocket payments.

Ms Agyemang proposed that the government repurpose the COVID-19 levy as seed money for the emergency fund, supplementing it with additional revenue sources.

Dr Kelugu and Ms Agyemang also stressed the importance of a legal framework to govern the fund’s management. They advocated for independent, qualified professionals to oversee the fund to ensure transparency and accountability, which would encourage public confidence and voluntary contributions.

“Just as people tithe in church, if they see the fund being managed well, they will be willing to contribute regularly,” Dr Kelugu stated.

Public Role in Epidemic Prevention

Ms Agyemang urged individuals to take responsibility for their health and hygiene, warning that failure to do so could have consequences beyond personal well-being.

“Eat well, keep your surroundings clean, maintain personal hygiene, and wash your hands after using the toilet. Neglecting these actions is selfish, as it can affect others. Poor health can also disrupt children’s education if parents fall ill and cannot work to pay fees,” she said.

She also called on food vendors to undergo health screenings and obtain certification before selling food, and she suggested that TV cooking shows should include hygiene demonstrations to educate the public.

Ms Agyemang firmly believes that preventing outbreaks is the best way to protect public health. However, since epidemics are not entirely avoidable, she stressed the urgent need to establish the dedicated health emergency fund without further delay.