On a visit to a health facility at Doryumu, a remote area in the Shai Osudoku District of the Greater Accra Region, Catherine Aku Klutse meets a man lying breathless while a nurse looks on helplessly.
Ms. Aku Klutse, who is the Deputy Director of Nursing, Shai Osudoku, laments the helpless state of the nurse, whose only strength lies in an empty emergency tray.
“…This was in the first week of April 2024 and as a Senior Nursing Officer on monitoring, I had to improvise to nebulize and refer the patient,” Ms. Aku Klutse tells the Ghana News Agency, saying, after series of tests and examinations, the patient tested positive to COVID-19 and was managed thereafter.
An emergency tray is a set of trays on wheels used in hospitals for the transportation and dispensing of emergency medication for life support protocols potentially to save a patient’s life.
Unfortunately, the trays in many district health facilities nationwide are usually empty due to inadequate funding and less attention paid to public health Emergency Preparedness in remote areas and some urban centers.
The ‘Empty Emergency Tray Phenomenon’ reflects the level of Ghana’s preparation for Public Health Emergencies from the lower level – districts – to the highest level of health care provision.
The importance of Epidemic Preparedness has been very evident in the catastrophic COVID-19 pandemic, with many lives lost, livelihoods disrupted, and economies shuttered.
In Ghana, infectious disease outbreaks occur almost every year, however, it seems the country is not doing much in preparedness for such occurrences.
Lessons from the COVID-19 experience
The Osudoku Health Directorate struggles to manage infectious diseases with inadequate skilled staff, tools to test and collect samples to respond promptly and even Personal Protective Equipment (PPE) for health workers with the situation being dire during the COVID-19 period.
The only resource it had was one vehicle, which the Directorate used to monitor the district and to transport patients to referral facilities.
Though the Directorate prepares a budget for Epidermic Preparedness together with the District Assembly every year, it has never received funding in preparation for future health emergencies.
The future is now and the fear is that, with no preparedness hundreds and thousands of people can lose their lives tomorrow should there be any public health emergency.
Converting the COVID -19 Levy to PHEF
In 2021, the COVID-19 Health Recovery Levy Act was enacted to impose a special tax on the supply of goods, services and imports to raise revenue to support COVID-19 expenditures and to provide for related matters.
In May 2023, the COVID-19 Pandemic was declared by the World Health Organization as a Public Health Disease of no international concern.
Ghana as a result eased restrictions and relaxed adherence to COVID protocols, but the levy is still being charged.
Madam Sophia Osei Bonsu, a Disease Control Officer, at the Shai Osu Doku Health Directorate, strongly advocates that the COVID-19 levy created for the containment of the disease be converted into a Public Health Emergency Fund to bolster pandemic prevention, preparedness, and response in Ghana.
According to the International Health Regulations (IHR) by the WHO, preparing for epidemics entails strengthening disease surveillance, equipping the health workforce, laboratory systems, and community engagement, as well as emergency communication, coordination, and management at the country level.
The IHR says a PHEF could also invest in local health systems, support global and regional institutions and provide technical assistance.
“With the lack of an emergency preparedness fund, we do not feel safe as health workers, we need this fund in place, every year we need to set aside funds for Epidermic Preparedness as viral diseases keep reemerging, we need to be alert and keep active surveillance from the district to the national level,” she says.
A Senior Medical Officer and the COVID-19 Response Team Lead at the Greater Accra Regional Hospital, Dr Emmanuel Addipa Adapoe, says Epidermic Preparedness is of critical importance, thus the country needs to be prepared physically, financially and human resource wise.
He says although there are some activities on epidermic preparedness, the country needs to establish a PHEF
This is critical in situations where there are not enough public health specialists in the regions and districts.
Ghana needs to be prepared in the preventive, promotive, curative and rehabilitative aspect of public health emergencies.
Ghana can learn from Yemen
Yemen in April 2024, launched a Pandemic Preparedness and Response Project (PPRP) to better protect its population from pandemic threats.
The PPRP, expected to run for three years, aims to strengthen the country’s ability to prevent, detect and rapidly respond to endemic and pandemic threats.
H.E. Dr Qasem Buhaibeh, the country’s Minister of Public Health and Population, says the PPRP project reflects Yemen’s commitment to improve pandemic preparedness and response.
“Guided by WHO’s International Health Regulations, we are striving to raise our defenses against persistent disease threats, this requires all-of-society action, and I hope everyone here today will join us in this effort.”
The Geneva Global Health Hub (G2H2) report on Financial Justice for Pandemic Prevention, Preparedness and Response in November 2022 highlights how COVID-19 has spared no country.
According to the report, pandemic preparedness and response is never prearranged. It is a constant process that must be routinely maintained and re-interpreted, based on specific outbreaks, health capacities, approaches and emerging priorities in countries where viral events arise.
Relying on high-income countries has not exactly proven to be a formula for success during the COVID-19 pandemic and the risk is that Western aid, once again, will come too little and too late during pandemics.
Ghana needs to establish a Public Health Emergency Fund now. While calls are going to the central government for a national fund, local Assemblies must without delay mobilise resources to establish District specific funds to help in containing outbreaks before seeking assistance from elsewhere.
The time is now!
