Funding and Preparedness: Why Ghana Needs a Public Health Emergency Fund

Ghana, like many other African nations, has repeatedly faced the devastating consequences of public health emergencies. From the Ebola scare in 2014 to the COVID-19 pandemic and recurring cholera and meningitis outbreaks, the country’s response has often been reactive rather than proactive.

Health facilities become overwhelmed, essential medical supplies run out, and many preventable deaths occur due to inadequate preparedness.

The COVID-19 pandemic exposed critical weaknesses in Ghana’s health system, including its dependence on donor funding, limited healthcare infrastructure, and inadequate disease surveillance mechanisms.

Today, as Ghana battles yet another cholera, and meningitis, the familiar cycle of scrambling for emergency funds and resources continues. These crises highlight the urgent need a dedicated financial resource that ensures rapid and effective responses to outbreaks, reducing human and economic losses.

Unfulfilled Promises and a History of Unpreparedness

Public health experts have long emphasized the need for sustained investment in epidemic preparedness. In his inaugural address, President John Mahama stressed the importance of a robust public health system, acknowledging that epidemics threaten national stability. Despite such commitments, successive governments have struggled to allocate sustained funding for epidemic preparedness.

Ghana’s experience during COVID-19 underscored this reality. The Auditor-General’s report indicates that from March 2020 to June 2022, the government mobilized approximately GH¢21.8 billion to mitigate the pandemic’s impact.

However, nearly 50% of these funds were allocated for budgetary support rather than direct COVID-19 interventions. This allocation underscores the need for a dedicated Public Health Emergency Fund to ensure that resources are available for health emergencies without diverting essential funds from other critical areas.

Despite this, the country relied heavily on donor support for vaccine procurement, personal protective equipment (PPE), and medical supplies. This external dependency left Ghana vulnerable when global demand for resources surged, forcing delays in vaccine access and straining healthcare systems.

Similarly, the country’s ongoing struggle with cholera highlights the structural weaknesses in its health system. Poor sanitation, inadequate access to clean water, and limited hospital capacity has all exacerbated the crisis. Cholera, a disease that should be preventable with proper infrastructure and sanitation, continues to claim lives in Ghana. The government’s response to such outbreaks is often delayed, as funds must be redirected from other areas of the national budget an inefficient and unsustainable approach.

Why Emergency Preparedness Matters

Investing in preparedness is more cost-effective than scrambling for funds during a crisis. Studies show that every dollar spent on epidemic prevention saves multiple times that amount in response and recovery costs. A dedicated Public Health Emergency Fund would ensure that Ghana can:

• Maintain a stockpile of essential medical supplies.
• Strengthen disease surveillance and early warning systems.
• Rapidly deploy healthcare workers and resources to affected areas.
• Establish emergency treatment centers before outbreaks escalate.

Recently, the Country Director of SEND Ghana, Harriet Nuamah Agyemang, during the SEND Ghana’s National Dialogue on Public Health Emergency Financing urged the government to establish public health emergency funds at the local and national levels to better prepare the country for unforeseen health catastrophes.

She believes the move is important as donor support for health emergencies continues to decline.

“In recent times, we do not have donors wanting to give us as much as they used to or at all. We should begin to look within. That is the message of our advocacy since 2021, asking our government to use domestic resources to fund public health emergencies.”

Mrs. Nuamah Agyemang further urged the Ministry of Health to incorporate a public health emergency fund into the revised Public Health Act, which being currently reviewed.

“We have called on the Ministry of Health to include a health emergency fund so that when the Act goes back to Parliament, the fund aspect will also be passed. That way, we will have a dedicated source of funding to implement the Public Health Act,” she said.

Without a proactive funding mechanism, the nation remains trapped in a cycle of preventable health disasters.

Lessons from Other Countries

Several countries have successfully implemented sustainable public health emergency funds, demonstrating that preparedness saves lives and money.

• Rwanda has built a strong epidemic preparedness system through sustained local investment. Its public health emergency operations center, supported by a government-led emergency fund, allows for rapid responses to outbreaks. This proactive approach helped the country respond effectively to COVID-19 and other health emergencies.

Nigeria’s Basic Health Care Provision Fund, implemented through the Nigeria Centre for Disease Control (NCDC), has strengthened its healthcare system by ensuring continuous funding for epidemic preparedness.

Additionally, the Kano State Emergency Fund in Nigeria serves as a crucial example of how localized funding mechanisms can support rapid responses to health crises. This initiative has provided timely financial resources to manage disease outbreaks, demonstrating the effectiveness of decentralized epidemic preparedness models.

Ghana can learn from these models by creating a sustainable PHEF that is insulated from political interference and ensures rapid mobilization of resources during health emergencies.

The Dangers of Relying on Donor Funding

Ghana’s dependence on external donors for epidemic response poses a serious risk. During global health crises, wealthier nations prioritize their citizens, leading to delays or reductions in international aid. COVID-19 vividly illustrated this issue when wealthier countries hoarded vaccines, leaving African nations struggling for supplies.

Additionally, donor funding often comes with conditions, limiting how Ghana can allocate resources. Over-reliance on external support also means that funds may not be available when they are needed most, forcing the government into a reactive stance rather than a proactive one.

A sustainable Public Health Emergency Fund would ensure Ghana has immediate, unrestricted access to resources, allowing for faster, more effective outbreak responses.

Deputy Director of the Ministry of Local Government, Chieftaincy, and Religious Affairs, Rex Manu Yeboah, has recently acknowledged the importance of structured finance for public health emergencies, supporting the call for a legal framework to regulate financial allocations. He emphasized the importance of the government transitioning from an overreliance on donor-driven finance, which has rendered many public health efforts vulnerable.

“Our health sector has been largely donor-driven, and we have over-relied on external support to the extent that we are not able to organize ourselves to take care of it,” he said, adding, “With USAID funds now withdrawn, it is perhaps a blessing in disguise, pushing us to rethink and find innovative ways to mobilize internal revenue to fund public health emergencies.”

Mr. Yeboah underlined that current legislation, such as the Local Government Act, Public Health and Sanitation Act, and NADMO Act, requires Metropolitan, Municipal, and District Assemblies (MMDAs) to allocate monies for health-related concerns.

He, however, pointed out that many assemblies have struggled to set aside finances for emergencies due to competing priorities. He asked for a policy that necessitates a specific amount of the District Assemblies Common Fund (DACF) be committed to public health emergency preparedness.

“If we should have a fixed percentage of the Common Fund allocated for public health emergencies, it becomes a law that can be enforced. But currently, there is no such standardized percentage, and it is left to the discretion of the assemblies,” he explained.

Economic Implications of Epidemic Unpreparedness

Health emergencies do not only affect individual well-being, they also have far-reaching economic consequences. When Ghana faces a disease outbreak, economic activities slow down, businesses close, and the government is forced to divert resources from development projects to emergency responses.

The COVID-19 pandemic, for example, led to a significant decline in Ghana’s GDP growth rate, increased unemployment, and deepened poverty levels. Ghana’s GDP growth rate during the COVID-19 pandemic was 0.5% in 2020, a sharp decline from 6.5% in 2019. The economy rebounded to 5.4% growth in 2021 as recovery efforts took effect.

A proactive investment in health security could reduce these economic losses. The World Bank estimates that low- and middle-income countries could avoid billions in losses by investing in pandemic preparedness. A dedicated Public Health Emergency Fund would provide the financial stability needed to mitigate the economic impact of health crises, ensuring that resources are available to sustain businesses, keep schools open, and protect livelihoods.

How Ghana Can Establish a Public Health Emergency Fund

1. Dedicated Annual Budget Allocations

The government should mandate a fixed percentage of the national budget for epidemic preparedness. This ensures consistent funding without waiting for donor pledges.

2. Innovative Financing Mechanisms

There is the need to advocate for the government to use Covid-19 levy to fund Public Health Emergency Funding.

Challenges and Roadblocks

While establishing a Public Health Emergency Fund is essential, it is not without challenges. Ensuring citizens including those in the Diaspora, the private sector, require a lot education and trust building will get them to contribute funds to Public Health Emergencies.

Additionally, securing political commitment remains a challenge. Policymakers often prioritize short-term projects with visible results over long-term investments in epidemic preparedness. Advocacy from healthcare professionals, researchers, and the media will be essential in keeping epidemic preparedness high on the national agenda.

A Call to Action

Ghana cannot afford to continue its cycle of reacting to health crises instead of preventing them. Establishing a Public Health Emergency Fund is not just an option it is a necessity. The government must prioritize epidemic preparedness by allocating sustainable funding, strengthening infrastructure, and reducing dependency on external donors.

Policymakers, health professionals, and civil society must push for immediate action to safeguard Ghana’s public health future. Without decisive steps now, the country risks facing even greater health disasters in the years to come. The time to act is now.

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