Epidemic preparedness: need for National Public Health Fund to address emergency issues

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By Comfort Sena FETRIE

In the past few years, countries around the world – including Ghana – have witnessed outbreaks of deadly diseases such as Ebola, Zika and COVID-19 which have had adverse effects on the people’s socio-economic wellbeing.

These epidemics have highlighted the importance of having a well-prepared national public health emergency fund in place that can adequately and effectively respond to such public health emergencies.

In Ghana, the  COVID-19 pandemic outbreak exposed how vulnerable the country’s health system is and how ill-prepared authorities were to respond to the virus’s dire effects on the citizenry’s socio-economic wellbeing.

Government, as part of efforts to recover from the virus’s devastating impact on the economy, introduced the COVID-19 recovery levy to moblise revenue to aid in getting the economy back on track post COVID-19.

Many have called for government to put in place efficient measures that build the country’s resilience against future epidemics and pandemics, including setting-up a fund as part of preparations toward responding to such public health emergencies.

It is therefore appropriate for government to use the COVID-19 recovery levy as its main source of funds for establishing a National Public Health Emergency Fund (PHEF) that assists in responding to public health threats associated with emergencies such as natural disasters or widespread disease outbreaks in Ghana.

The Fund will support epidemic preparedness, response and preventive initiatives to enhance the quality of health care delivery for the citizenry, while also reducing the country’s socio-economic challenges during public health emergencies.

One of the primary reasons Ghana must prioritise setting up a national health emergency fund is to manage disease outbreaks effectively to save lives and reduce the economic and development challenges during future epidemic outbreaks.

The impact of pandemics on Ghana’s health sector

A study has revealed that during the COVID-19 outbreak, Ghana’s healthcare system was overwhelmed by the number of cases – to the extent of using temporary structures as isolation and treatment centres for the virus.

The lack of adequate funding for effectively responding to the outbreak affected quality healthcare delivery, especially in rural areas.

In Ghana, there were only three public testing centres at the start of the outbreak: namely the Noguchi Memorial Institute for Medical Research; Kumasi Centre for Collaborative Research; and National Public Health Reference Laboratory .

However, there were systems in place to transport samples of suspected cases to these public testing centres; and by June 2020, the number of testing centres had increased to 10.

Dr. Enoch Harvoh, a medical doctor at Tamale Teaching Hospital, in an interview stated that during the COVID-19 pandemic period Ghana’s health system lacked the necessary equipment to create responsive, quality healthcare delivery that was equitable, efficient and accessible.

He therefore urged that stakeholders join the call for government to establish a national public health emergency fund to build necessary structures that resource the healthcare system to effectively respond in future public health emergencies.

Mr. Abubakar Saeed, a farmer at Sang community in the Northern Region’s Karaga district, said the pandemic had a negative effect on families in his community – adding that access to quality healthcare services was severely impaired, giving rise to other health issues like malaria.

“In my view, government should establish a national public health emergency fund that  focuses on preventive activities and strengthening health care systems as a way of preparing for responses to future epidemics,” he said.

 The pandemic’s socio-economic impact on Ghanaians

Economically, the COVID-19 pandemic unleashed immense chaos on global economies in terms of real and potential losses, irrespective of their economic standing – and Ghana’s economy has not been spared the negative ramifications.

Many businesses, public and private, had to close down after the lockdown; and employers inevitably had to lay-off employers, pause salaries, cut remunerations amid losing business to restrictions.

A research conducted in February 2022 by the International Journal of Social Economics revealed that the coronavirus pandemic had negatively impacted on Ghanaian’s socio-economic development.

While an estimated 42,000 people lost their jobs in the first two months of the pandemic in Ghana, the country’s tourism sector alone lost US$171million due to the partial lockdown and closure of tourism and hospitality centres.

An interview conducted with some young girls in the Mion district revealed that many of their male neighbours who saw how vulnerable they were as a result of COVID-19 offered them food, money and other social essentials in exchange of sex – just because most of these vulnerable girls’ parents lost their daily source of livelihood during that period.

Impact of COVID-19  in the educational sector

The COVID-19 pandemic changed the lives of a large number of students, teachers and parents across the country – with millions whose teaching and learning had to be done remotely from home.

School closures not only impacted students, teachers and families, but also had far-reaching economic and societal consequences.

School closures in response to the pandemic have shed light on various social and economic issues; including student debt, digital learning and food insecurity, as well as access to childcare.

The impact was more severe for disadvantaged children and their families, causing interrupted learning, compromised nutrition, childcare problems and consequent economic cost to families who could not go to work due to the school closure because they had to take care of children in their houses.

Statistics from the Ghana Health Service (GHS) say that about 13 teenage pregnancy cases were recorded every day in Ghana in 2020 during the COVID-19 period.

 The causes

Most of the pregnancies were due to the lockdown instituted by government as a preventive measure to stop the infection and spread of COVID-19.

The causes of teenage pregnancies included: loss of livelihood for parents, poverty, parental neglect, sexual exploitation and abuse, defilement or rape, curiosity and adventurous adolescent behaviour, as well as the lack of adolescent and reproductive health education in most communities.

All these factors contributed to the phenomenon’s rise during the COVID-19 period.

This compromised their education and other development opportunities, and made them vulnerable to poverty, violence, crime and social exclusion.

Hajia Alima Sagito Saeed, Executive Director-Savannah Women Integrated Development Agency (SWIDA), said COVID-19 increased the school drop-out situation particularly among girls in rural communities across the country.

She said most girls in urban areas were also forced to work by trading on the streets or engage in head-portering (Kayaye) to earn income for their households.

According to her, economic hardship as a result of the pandemic forced parents to give  their children for early marriages as an alternative source of income for the family.

Scenarios

In an interview with some of the girls who were victimised, a 14-year-old student (name withheld) from Karaga Junior High School (JHS) in the Northern Region said she became pregnant as result of her school’s closure during the COVID-19 period.

She said after delivering her parents forced her into marriage – to the detriment of her education – and her 36-year-old husband has not been supportive economically. So, the circumstances compelled her to sell foodstuff at Nanton Market to care for her child.

A 12-year-old primary schoolgirl (name withheld) from Bimbila Primary in the Northern Region also shared her experience, saying she became pregnant during the lockdown period.

She said her parents were facing financial challenges to take care of her and five other siblings.

“I had no option than to be having sex with a 35-year-old man without protection, just to make some money to feed myself.

“l became pregnant and gave birth before schools reopened during the pandemic period, which affected my ability to go back to school,” she added.

The sad reality is that many, most especially the girl-child, remain exposed to such exploitations as the global pandemic continued to wreak mayhem on the lives of ordinary Ghanaians.

Professor Mohammed Muniru Iddrisu, Principal for the Nyankpala Campus of University for Development Studies, in an interview recommended that government should establish a Public Health Emergency Fund – which would be a very significant step toward mitigating all the adverse effects of future pandemics in the education sector.

Dr Paul Achonga Kabah Kwode, Senior Lecturer at Tamale Technical University, in an interview appealed for government to establish a public health emergency fund to support tertiary institutions with the tools needed for both students and lecturers to undertake distance teaching and learning during pandemics.

Government needs to use the COVID-19 recovery levy for financing the establishment of a National Public Health Emergency Fund

A public health emergency fund will provide Ghana with the resources necessary for responding promptly and effectively to disease outbreaks without waiting for support from international organisations.

With a ready source of finance – the COVID-19 recovery levy –  government must make conscious efforts to utilise revenue mobilised to establish the fund.

The fund will enable government to establish and maintain effective disease surveillance systems, which are essential for early detection and swift responses.

In addition to managing disease outbreaks, a public health emergency fund will support the development of robust and comprehensive public health infrastructure.

The infrastructure will provide necessary resources to address various environmental and public health concerns that increase the risk of disease outbreaks.

A well-funded public health emergency system will enable Ghana to prevent epidemic outbreaks through vaccination campaigns, public health campaigns and community health education programmes.

Prevention is more cost-effective than controlling an outbreak. Thus, the establishment of a public health emergency fund will help to minimise the economic cost of disease outbreaks.

The establishment of a public health emergency fund in Ghana will improve government support toward local manufacturing of personal protective equipment – such as antiviral hand sanitisers – to help meet the nation’s demands .

Moreover, a public health emergency fund will ensure the country’s public health system’s sustainability and ensure that resources are available to support various public health initiatives in the long-term.

For instance, funding could be used to develop health education programmes, health research and health infrastructure that will be sustainable over the long run.

Recommendations     

Establishing a public health emergency fund is crucial for Ghana’s health security. This fund will provide the necessary resources to manage disease outbreaks, develop comprehensive public health infrastructure and prevent future epidemics.

Government must ensure there is a legal framework to guide operations of the fund and that there are effective communication channels to create awareness; and effective monitoring measures must put in place to ensure transparency and accountability.

Government can use the media, health fairs and community outreach programmes to create awareness and educate the public on the fund’s importance.

It must have effective measures to track use of the funds and ensure they are used for their intended purpose. Government can involve civil society organisations and the public in monitoring the funds’ use.

In conclusion, establishing a public health emergency fund is crucial for Ghana’s health security.

This fund will provide the necessary resources to manage disease outbreaks, develop comprehensive public health infrastructure and prevent future epidemics.

It is therefore imperative that the state uses the COVID-19 recovery levy to establish the fund.

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