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PUBLIC HEALTH EMERGENCY PREPAREDNESS: A PANACEA TO FUTURE EPIDEMICS

• Dr Emmanuel Ayifah — Deputy Country Manager of SEND Ghana

Over GH¢10 billion had been expended on Ghana’s COVID-19 response by June 2021, a news report carried by Accra-based Joy FM on Thursday, October 14, 2021 had indicated.

It purports that, “in the last eight months of 2020, Ghana’s COVID-19 expenditure summed up to GH¢8.1 billion and from January to June this year, an additional GHc 2.3billion was spent on the fight against the pandemic.”

Following the 2021 budget presented to parliament this year, the Ministry of Finance and Economic Planning (MOFEP) had explained in a statement dated March 19, 2021 that the country’s COVID-19 related expenditures mainly covered interventions under the COVID-19 Alleviation Programme 1 and 2 (CAP1) and COVID-19 Emergency Preparedness and Response Plan (EPRP), provision of health infrastructure and seed fund for the capitalisation of Development Bank.

Sources of funding these projects principally came from the International Monetary Fund (IMF), World Bank, African Development Bank (AfDB), European Union and the Bank of Ghana (BOG) COVID-19 Bonds.

The US Center for Disease Control and Prevention (CDC), explains the difference between an epidemic and a pandemic as; epidemic- a sudden outbreak of a disease in a certain geographical area while pandemic, is an outbreak of a disease that has spread across several countries or continents.

According to health experts, epidemics are inevitable in a rapidly changing world and at least, within every five to six years, nations are likely to experience a disease outbreak often leaving devastating consequences on their population.

Prior to COVID-19, Ghana had experienced epidemic outbreaks such as cholera, cerebrospinal meningitis, influenza type A, among others in parts of the country, claiming and maiming many lives.

What broke out in Wuhan in the Hubei province of central China in 2019, had become a full-blown pandemic spreading across the globe by early 2020.

By October 15, 2021, figures on the Ghana Health Service (GHS) dashboard points out that the virus had infected a total of 129,058 people with 126,085 recovered since Ghana recorded its first two cases in March 2020.

Over 1,000 casualties have been recorded with the Greater Accra region leading the infection rate, accounting for nearly 54 percent of total case count.

It is the potential of disease epidemics to derail socio-economic gains that necessitated the drafting of the Global Health Security Agenda (GHSA) by the WHO to strengthen countries’ capacity to prevent, detect, and respond to emerging public health threats in a manner that aligns with International Health Regulations requirements.

In furtherance of that, Ghana in 2018 developed a National Action Plan for Health Security (NAPHS) to adequately prepare and effectively respond to epidemics.

The plan, drafted based on a Joint External Evaluation (JEE) report in 2017 on Ghana’s health security capacity and gaps, provides a comprehensively costed, multi-sectoral, collaborative and a time framed strategy to strengthen the health system’s capacity to prevent, detect and respond to all hazards of health emergencies to minimize its consequences.

The absence of adequate funding to execute the plan has however become a major setback for strengthening health security in Ghana.

 A public health specialist, Dr. Gilbert Buckle, in an interview fears, plans like the NAPHS could be rendered ‘useless’ in the face of emerging infectious diseases if there is no ‘discipline’ to dedicate resources to it.

“We need to anticipate the possible types of epidemics and begin preparing for it but at the end of the day, it is about resources. It is not enough to set up an epidemic fund but the discipline to ensure that it is physically present and that, there is flow of funds into it and not used for other purposes,” he said.

Dr. Buckle insisted that public health security should be a national security issue and that budgetary allocation to maintaining Ghana’s security should encompass health.

“Such budget must sit under national security and not even the Ministry of Health (MOH). The Ministry’s role is to provide epidemiological projections and advice on the public health threats.

Issues like flying in of logistics, imposition of curfews, ensuring compliance during epidemics are a national security matter and as we budget for security agencies, public health security must be a factor if we are to prepare for such emergencies.”

Checks at the Disease Surveillance Unit of the Ghana Health Service (GHS) indicates that Ghananeeds an estimated GH¢433.7 million to fully implement the reviewed NAPHS (2019-2023).

Drawing on lessons from the COVID-19 pandemic, the reviewed plan prioritises investment into real time surveillance, strengthening laboratory systems, workforce development, immunisation and emergency response operations, among other action points to effectively manage future epidemics.

 “Resolve to Save Lives”, a global health organization, in a recently published article cautions countries to take epidemic preparedness seriously.

It warns that “unless preparedness improves, epidemics are inevitable and will be costly.” 

“Epidemics impact all aspects of a country’s economy and reverse years of growth and development. Not investing in preparedness is a high-risk economic and political gamble.”

Already, the WHO says a fourth wave of COVID-19 in Africa was imminent in the face of low vaccination rates and fatigue in following preventive protocols especially as the year draws to a close.

To quote its Director-General, Dr. Tedros Adhanom; “COVID-19 has shown that when health is at risk, everything is at risk but when health is protected and promoted it creates a platform for individuals, families, communities, economies and nations to thrive.”

“Health is not a luxury item or simply an outcome of development, it is a fundamental human right, the means to development and the foundation of social, economic and political stability and security,” he maintains.

As government begins the processes of developing the 2022-2025 Budget Statement and Economic Policy, and expected to present to Parliament the first leg of it in coming days, we hope to see clear cut actions at financing emergency preparedness (EP) in the country.

In the face of dwindling donor support, government must make EP a topmost agenda and commit to mobilising the needed resources to fund it annually from the national budget to save the country from debilitating impact of future epidemics.

BY ABIGAIL ANNOH

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