Ghana must establish Public Health Emergency Fund using COVID-19 Levy

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 socio-economic wellbeing of the people.

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

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

The government, as part of efforts to recover from the devastating impact on the economy, introduced the COVID-19 Recovery Levy to mobilise revenue to aid in getting the economy back on track post-pandemic.

Many have called on the Government to put in place efficient measures to build the country’s resilience against future epidemics/pandemics including setting up a fund to respond to public health emergencies.

It is, therefore, appropriate for the Government to use the COVID-19 Recovery Levy to establish a National Public Health Emergency Fund (PHEF) to assist in responding to threats of natural disasters or uncontrolled disease outbreaks.

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

Impact of pandemics on Ghana’s health sector

During the COVID-19 pandemic the country’s health care system was overwhelmed by the number of cases to the extent of making use of temporary structures as isolation and treatment centres of the virus.

The lack of adequate funding to effectively respond to the pandemic affected quality health-care service delivery, especially in rural areas.

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

However, systems were 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 the Tamale Teaching Hospital, told the Ghana News Agency in an interview that the COVI-19 pandemic brought to light the lack of adequate equipment in Ghana’s medical facilities to ensure equitable, efficient, accessible, and responsive health-care service delivery.

He said it was, therefore, important to have a national public health emergency fund to build the required structures and resource the healthcare system to effectively respond to emergencies.

Mr Abubakar Saeed, a farmer at Sang in Karaga District of the Northern Region, told the GNA that families in his community were not spared the negative impact of the COVID-19 pandemic and the inaccessibility of quality health care services gave rise to other health issues.

“In my view, the Government should establish the fund to aid in preventive measures and strengthen the health care systems to better respond to epidemics,” he said.

 Socio-economic implications of COVID-19 on Ghanaians

Economically, the COVID-19 pandemic had a huge negative impact on global economies, with Ghana not an exception.

Most government organisations and private businesses were forced to shut down due to the lockdown restrictions and employers inevitably had to lay off workers, pause salaries in some cases, and cut remunerations amid losing livelihoods.

Research conducted in February 2022 by the International Journal of Social Economics revealed that the pandemic greatly impacted the socio-economic growth of Ghana.

While an estimated 42,000 people lost their jobs in the first two months of the pandemic, the tourism sector alone lost $171 million due to the partial lockdown.

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

Impact on the education sector

The COVID-19 pandemic has changed the lives of many students, teachers, and parents across the country with millions having to teach and learn remotely from home.

School closures impacted not only students, teachers, and families but also had far-reaching consequences on the academic calendar and progression.

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 to enable them take care of their children at home.

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

Causes

Most of the pregnancies came due to the lockdown restrictions to stop the spread of the infection.

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

All these factors contributed to the rise in the phenomenon 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, the Executive Director of Savannah Women Integrated Development Agency (SWIDA), said COVID-19 increased the school dropout situation, particularly among girls in rural communities.

According to her, the economic hardship forced parents to send their girl-children into early marriages as an alternative source of income for the family.

Scenarios

A 14-year-old student (name withheld) of the Karaga Junior High School (JHS) in the Northern Region told the GNA that she became pregnant as result of the closure of schools during the COVID-19 period.

She said after delivery, her parents forced her into marriage to the detriment of her education and her 36-year-old husband had not been supportive economically, so the circumstances compelled her to sell foodstuffs at the Nanton Market to cater for her child and herself.

Another 12-year-old primary school girl from Bimbilla Primary in the Northern Region, also sharing her experience, said she became pregnant during the lockdown period.

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

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

“l became pregnant and gave birth before the restrictions were lifted and schools reopened, which affected my ability to go back to school.”

The sad reality is that many, especially the girl-child, are the ones who bear the brunt when such pandemics strike.

In the above instances, they were exposed to exploitations as the global pandemic wreaked havoc on their families, hence the need for measures to cater for such emergencies when the need arises.

Professor Mohammed Muniru Iddrisu, the Principal, Nyankpala Campus, University for Development Studies, recommended the establishment of the fund as a significant step towards mitigating all the adverse effects of future pandemics, specifically in the education sector.

Dr Paul Achonga Kabah Kwode, Senior Lecturer, Tamale Technical University, reiterated the importance of a public health emergency fund to support tertiary institutions with logistics to undertake distance teaching and learning during pandemics.

Need to use COVID -19 recovery levy to finance the Public Health Emergency Fund

A public health emergency fund will provide Ghana with the resources necessary to respond promptly and effectively to disease outbreaks without waiting for support from international organisations. Thus, the government must make conscious efforts to divert revenue mobilised under the levy to establish the fund.

A well-funded and resourced public health system will enable Ghana to prevent epidemic outbreaks through vaccination and community health sensitisation programmes.

Since prevention is more cost-effective than controlling an outbreak, the fund will help to minimise the economic cost of bringing disease outbreaks under control.

It will also support the local manufacturing of personal protective equipment to minimise exposure to a variety of hazards such as facemasks, antiviral hand sanitizers, gloves, hard hats, respirators and full body suits to meet the demands of the nation.

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 a comprehensive public health infrastructure, and prevent future epidemics.

The government must ensure that there is a legal framework to guide the operation of the fund with effective communication channels to create awareness and involvement of the public, including civil society organisations, to generate the necessary feedback.

The government could use the media, health fairs, and community outreach programmes to create awareness and educate the public on the importance of the fund.

There should also be effective monitoring measures to ensure transparency and accountability.

By Comfort Sena

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