Public health emergency fund: Lessons elsewhere and why Ghana needs one

0

In 2020, the Africa Development Bank (AfDB) supported Ghana’s COVID-19 response programme. A substantial grant was approved in July 2020 for the country’s Emergency Preparedness and Response Plan (EPRP).

Before this, the World Bank, in April 2020, had also provided some $100 million to help the country tackle the pandemic. The fund, according to reports, would be made available in the formof “short, medium and long-term support.”

Similar financial support may have been extended to other countries, however, after the COVID-19 outbreak, manycountries have taken steps to re-strategize and build a more robust health security system to enable them to handle future epidemics more tactfully and proactively.

Ghana has been dealt its blow from COVID-19, but it cannot be stated yet if any robust structures have been put in place to manage other devastating outbreaks in the future effectively.

Proposal

Part of the strategies for handling public health emergencies, according to some experts and health advocates, include the establishment of a Public Health Emergency Fund (PHEF).

Key among the proposals is that proceeds from the COVID-19 Levy, which has been in force for the past three years, should be put into establishing the fund.

Some businesses and individuals in the private sector have lamented how the COVID tax had become a nuisance, and “outlived” its intended purpose. COVID-19 is no longer an epidemic, as indicated by the World Health Organisation.

This, among other things, implies that it is time the government take a second look at the ‘COVID Tax’, which came into force because of the pandemic.

It will appear the government is “reluctant” to scrap the one percent COVID levy, however, if authorities listened to the voices calling for the conversion of the levy into a PHEF in Ghana, we would be in a position to deal with disease outbreaks in the future, as the fund will help address some gaps in the health system.

There have been varied justifications for setting up the PHEF. Though it cannot be said to be a panacea to all health challenges, it would be significant progress in strengthening the country’sepidemic preparedness and response mechanism, due to the lessons learned from the outbreak of COVID-19.

Scenarios

Developments in other countries regarding funding and public health emergency response are lessons we can learn as a country.

In the United States, The Public Health Emergency Fund, established in 1983, is a reserve fund to help Health and Human Services (HHS) agencies, such as the Administration for Strategic Preparedness and Response and the Centers for Disease Control and Prevention (CDC), to “rapidly respond to any kind of public health emergency or threat” such as extreme weather, diseases, and others.

Though the fund has not received appropriation in recent years, according to the United States Government Accountability Office (GOA), efforts are being made to replenish the fund. In addition to this fund mentioned above, there is also the “Infectious Diseases Rapid Response Reserve Fund,”established in 2018, which allows the Centre for Disease Control (CDC) to rapidly respond to infectious disease threats.

According to the GOA, the fund had received“$800 million in appropriations from 2019 through 2023, including $600 millionin 2020 after the beginning of the COVID-19 pandemic.” Other expenditures from the fund are also captured in the GOA August 2023 report to Congressional Committees.  

Clearly, Ghana and the United States are centuries apart in terms of development and we may not be able to commit similar amounts to a PHEF, but we can consider our strengths and situations and set up a similar fund using the COVID Levy.

Beyond the United States, there is also Suriname in North America, where in addition to its pandemic prevention and preparedness mechanisms, efforts are being made to establish a new Public Health Authority.

The Authority in the North American country is expected tocomplement ongoing investments, focusing on national surveillance, Emergency Operations Centers, laboratory support, workforce development, and health communication.”

These scenarios are not to suggest that Ghana is not pulling its weight but the government needs to double its efforts at tackling future health dangers, part of which is the creation of a dedicated fund to make the country’s emergency response systems more vibrant. 

It will be recalled that when there was a shortage of childhood vaccines in Ghana about two years ago, health professionals had to adopt some stop-gap measures to sustain the children until some consignments of the vaccines were procured.

At the time, the government had to mobilise a substantial amount of money to procure the vaccines from suppliers abroad.That was an indication of the recurring financial commitments the government continued to make in the health sector.

That notwithstanding, development partners continue to fund a significant portion of the government’s health expenditure but that support may not be sustainable in the future considering the country’s shift from low-income to middle-income status.

All of this gives credence to the relevance and establishment of Ghana’s Public Health Emergency Fund. As indicated previously, such a dedicated fund would help the country effectively tackle health-related emergencies, and in the long run fund Ghana’s public health care system which relies on external donors.

The government continues to play its part by raising domestic revenue to support the health budget. But to build a more resilient and responsive health system, we would have to look beyond external partners and fast-track the establishment of the PHEF.

Government commitment

Already the government is committed to setting up the fund as stated in the National Medium Term Development Framework (2022-2025), and it is only appropriate it works to meet its targets or deadlines set for 2025.

Thankfully, we may not have to start from scratch; the COVID Fund which continues to accrue some significant revenue can become the starting point if the country is to deliver on it health care delivery mandate to the people of Ghana.

Conclusion

Undoubtedly, Ghana’s PHEF will not solve all health challenges but will, to some extent, minimize the financial shocks often associated with health emergencies, as COVID-19 proved to be a strain on government coffers.

Again, other aspects of emergency response, such as the need to strengthen the capacity of laboratories, procurement of vaccines and other medical supplies, availability of essential health workforce, research, and crisis communication, could be funded when Ghana’s PHEF becomes a reality.

A stronger health system in times of crisis would save many lives. And if lives are to be saved, authorities may want to take inspiration from countries that have already set the pace towards establishing a PHEF.

Writer’s Email: [email protected]

Leave a Reply