Time to convert COVID-19 Fund into a public health emergency fund
What started as a mere sore throat and cough later affected his ability to communicate for months until a third hospital he visited confirmed a diagnosis.
This was after all other medications, including herbal treatment, had proved futile and he had begun losing weight and could no longer take in solid foods.
Joel Akom Ntiri, then in his early 30s and a mid-career banker, was finally confirmed to be TB-positive at the Greater Accra Regional Hospital after a series of tests following his dwindling health.
Despite the free diagnosis and treatment of Tuberculosis under Ghana’s National Health Insurance Scheme (NHIS), TB patients incur substantial costs from auxiliary support and care as well as coping strategies, for a full recovery.
According to a 2018 study by Pedrazzoli et al, a TB patient in Ghana spends an average of between US$429.60 and US$659.00, a year, depending on the type of treatment they are put on, either multi-drug resistance (MDR) or non-MDR management.
The high cost of managing infectious diseases like TB, whether borne by the state or individual, has dire socio-economic implications.
These diseases, often caused by organisms such as bacteria, viruses, fungi or parasites, could be passed on from person to person, animals or other environmental factors.
Over the years, Ghana has suffered a complex burden of infectious diseases and outbreaks, including cholera, chickenpox, meningitis, measles, yellow fever, Marburg Virus Disease, Lassa fever, Monkey Pox, and COVID-19 pandemic.
However, response, management and control of these infections have largely been dependent on international donor funding as current health spending remains low of GDP.
This is despite the country being a signatory to conventions and laws like the Abuja Declaration and Ghana’s Public Health Act 2012, which proposes a dedicated funding stream to promote health emergency response and accelerate efforts in achieving universal health coverage (UHC) and the Sustainable Development Goals (SDGs).
The onset of COVID-19, however, brought in a significant turn of events. It gave us lemonade out of lemons and for the first time in history, a special levy was instituted in the country to mobilise funds in fighting a disease.
A ‘whole-of-government’ approach structured around curtailing importation of cases; identifying and containing the outbreak; caring for the sick; cushioning people against the impact of COVID-19 on Ghana’s economic and social life; and boosting domestic production to deepen self-reliance earned Ghana respect as one of the best countries to manage the pandemic in Africa.
Besides, the COVID-19 Health Recovery Levy, 2021, (Act 1068) enacted by Parliament in 2021 to impose a special levy on the supply of goods and services and imports to raise revenue to support COVID–19 expenditures and other related matters, was a feather in the cap in managing the disease.
Not only was the law considered a move to building self-reliance at the peak of the pandemic amidst dwindling donor support but a significant stride towards epidemic response in Ghana.
Within the first eight months of its implementation, data released by the Ministry of Finance (MoF) showed that an amount of GH¢773.93 million had been realised from the COVID-19 Levy.
This had increased to GH¢889 million by the end of 2021 and further to GH¢1.14 billion in 2022 with the government anticipating to collect some GH¢2.5billion from the levy this year (2023)
However, recent developments have put the relevance of the COVID-19 levy in question.
On May 5, 2023, the World Health Organisation (WHO) announced that COVID-19 was no longer a Public Health Emergency of International Concern (PHEIC), which means despite remaining a public health threat, countries could now transition from emergency mode to managing it like any other infectious disease.
In view of that, all restrictions imposed at Ghana’s ports of entry have since been lifted with the Ghana Health Service (GHS) justifying the move by the fact that there has been a sustained decline in COVID-19 cases in the past five months.
“As of May 15, 2023, there were only 18 active cases, none of which is severe or critical. The only COVID-19 death in 2023 was in January,” a statement issued by the GHS said.
The question now is, what becomes of the COVID-19 levy and the related fund? What options are available if we are to keep the fund running? Will it be scrapped?
Already, the levy has proven to have huge potential to rake in the needed resources for the purpose for which it was established. However, the challenge has to do with accountability and the legal framework of the Act, which suggests that when the pandemic is over, the country could cease collecting the levy.
This, health experts believe, is problematic as the COVID-19 levy could be the easiest springboard for getting the country a much-awaited public health emergency fund (PHEF), which would contribute to building a resilient healthcare system to cater for and support investment in health infrastructure, logistics, human resources and risk communication during outbreaks, local manufacturing of vaccines, and medicine and health research.
“This is long overdue as we have always alluded to and I think expanding the COVID-19 fund as it is now into the PHEF is the right thing to do for the country.
The next epidemic may be nearer than we could think of and the lessons of COVID-19 should ginger us to take the necessary steps in establishing this fund as soon as possible,” public health expert, Dr Nii Nortey Hanson-Nortey, stressed in an interview.
The Presidential Advisor on Health, Dr Anthony Nsiah-Asare, in a recent media interview, hinted that the PHEF was something the government was seriously considering to improve response to possible public health epidemics.
This is refreshing to learn because now is the time to act against any future outbreak to spearhead rapid advancement of Ghana’s health care system and the government must remain committed to its word as indicated in the 2022-2025 National Medium Term Development Framework in readiness for future public health threats.
The Government must show strong political commitment to mobilise and protect domestic resources to help achieve its set objectives under UHC and achieve the Sustainable Development Goals, especially SDG 3 which aspires to ensure health and well-being for all.