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Ghana in 2023- The 18th century all over again?

Voice of America article published on February 27, 2023 read “Child Immunization Vaccine Shortage Hits Ghana.” In this article, author Kent Mensah, reported that 10 of Ghana’s 16 regions were experiencing vaccine shortages as a result of the Cedi’s depreciation. Consequently, at least 120 unvaccinated Ghanaian children had contracted measles. Measles, a viral disease that causes about 140,000 annual deaths worldwide, has no specific treatment.

Fortunately, our understanding of the disease has considerably evolved since the 1600s.  The brightest chapter of science was the discovery of vaccines.. In 1798, Dr Jenner demonstrated that using a milder form of the cowpox virus could confer immunity against the deadly smallpox virus. The first vaccine was born and people did not have to die unnecessarily from this disease. Subsequently, numerous vaccines were created including the measles vaccine which was created by John Enders in 1963. Measles vaccination has since improved mortality outcomes worldwide as vaccination rates have increased. In 2018, the World Health Organization estimated that more than 86% of children worldwide receive their first measles vaccine – up from 72% in 2000. During this 18-year span, the high measles vaccination rate is thought to have prevented 23.2 million deaths. Five years after the World Health Organization report one would expect the upward trend has been maintained. However, as Kent Mensah noted in his article, the upward trend has been disrupted in Ghana. In effect, the shortage of paediatric vaccines across Ghana has taken us back to the pre-vaccination era (i.e., 18th century).

As a medical school graduate, I joked about the amount of information we had to learn. I did not understand why I had to study certain diseases. Naively, I thought I would never encounter them because vaccines had rendered them obsolete. One of the things I joked the most about were Koplik spots. These are white spots in the mouth of measles patients. During medical school, I saw a few measles patients and they didn’t have these spots because, being vaccinated, they had milder forms of the disease. Yet, every test we took insisted on testing the unique but arcane concept of Koplik spots. Given the current situation in Ghana, I am glad that these concepts were tested but sad that it has come to this.

Prior to the current vaccine shortage, vaccine uptake rates in Ghana had been consistently high ranging between 90 and 95%. These figures were not achieved overnight, but through the hard work of healthcare workers and citizens who built trust in their healthcare system. Sadly, in 2023, after so much progress, our country lacks certain childhood vaccines. Unfortunately, some of our leaders do not grasp the urgency of this situation. Death is considered the only negative outcome-so if there are no deaths, then it seems ok.

To avoid circumstances like these; the government must set up an emergency fund for procurement of childhood vaccines. Policy makers can also work with the GAVI vaccine alliance to help avert situations like these.

Our nation’s future is predicated on the health of our little ones or the future leaders as we call them. As previously discussed, vaccines have significantly improved health outcomes over the past centuries. Some may argue that our country’s current economic situation prevents investments in vaccines. However, I believe that investing in vaccines will benefit our country’s economy because our children are future tax payers and will contribute to the country’s economic productivity. As such, if we must pay our nation’s debt, then we must keep the children healthy and alive. Further arguments may be  that the Ghana Vaccine Institute is in the works, but I must say, children born today and this year cannot wait for that to be built as diseases won’t wait.

The shortage of vaccines should be everyone’s concern- Leaders, healthcare workers, parents, teachers and society as a whole.

The children, as we say, are our future. We must act now to protect that future.

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