SEND GHANA, Other Actors charge government to consider immunization and epidemic issues into budgeting

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SEND Ghana
SEND Ghana

Ghana has developed a well-costed NAPHS. However, implementation has long been a challenge due to limited or no dedicated funding. This however, costs a country less to prepare for health emergencies than to deal with their impacts.

More so, continuous investment in epidemic preparedness helps safeguard a country’s health security and protect the well-being of its citizens.

Ghana regularly experiences disease outbreaks such as cholera, influenza, meningitis, and measles, in addition to the ongoing COVID-19 pandemic, posing a major public health challenge.

Disease outbreaks lead to increased morbidity and mortality, affect the livelihoods of individuals and households, and collapse businesses. Besides the fatalities, unpredictable disease outbreaks often expose vulnerabilities in the health sector, stall economic growth, and worsen poverty and inequality.

The COVID-19 pandemic as we all know is already impacting Ghana severely. Economic development is curtailed, with GDP growth falling from 6.5% in 2019 to 1.1% in 2020 due to significant shortfalls in tax revenue and increased unplanned social and health expenditures, including the cost of preparedness and mitigation strategies.

Looking at current trends, there is no better time to invest in epidemic preparedness through our national budget with all urgency than now. With strong political will, strategic intervention, and fiscal discipline, this can become a reality for Ghanaians.

On the backdrop of this, SEND GHANA in partnership with the African Population and Health Research Centre (APHRC), organized a one-day, high-level forum on the theme “Sustaining Domestic Financing for Immunization and Epidemic Preparedness in Ghana: The Role of National and Local Government in the 2022 Budget and Beyond.”

The objective was to discuss strategies to ensure sustained and increased annual domestic financing for immunization and epidemic preparedness in Ghana’s annual national budget statement and economic policies.

SEND GHANA in a press release copied to News Ghana, enumerated many important keys that will enure to the benefit of Ghana’s epidemic preparedness. Read the original release below;

PRESS RELEASE

November 4, 2021

SEND GHANA, civic actors call on government to prioritize immunization, epidemic preparedness financing in 2022 national budget
In partnership with the African Population and Health Research Centre (APHRC), SEND GHANA organized a one-day, high-level forum on the theme “Sustaining Domestic Financing for Immunization and Epidemic Preparedness in Ghana: The Role of National and Local Government in the 2022 Budget and Beyond.”
The forum was attended by members of civil society organizations, academia, the Parliamentary Select Committee on Health and Local Government, Metropolitan, Municipal, and District Assemblies, District Health Management Teams, Traditional Authorities, Religious Leaders, and the media. The objective was to discuss strategies to ensure sustained and increased annual domestic financing for immunization and epidemic preparedness in Ghana’s annual national budget statement and economic policies.
Ghana regularly experiences disease outbreaks such as cholera, influenza, meningitis, and measles, in addition to the ongoing COVID-19 pandemic, posing a major public health challenge. Disease outbreaks lead to increased morbidity and mortality, affect the livelihoods of individuals and households, and collapse businesses. Besides the fatalities, unpredictable disease outbreaks often expose vulnerabilities in the health sector, stall economic growth, and worsen poverty and inequality.
Case in point: Ghana recorded 1,164 cases of Cerebrospinal Meningitis and 128 deaths in 2010, 153 cases and 33 deaths in 2016, and in April 2020, a total of 409 cases and over 40 deaths in five of the 16 administrative regions of Ghana. In 2014, the country recorded a total of 28,975 cases of cholera with 243 deaths in 130 districts across all administrative regions, with the last major outbreak occurring in 2016 in the Central Region, where 787 cases were recorded. Recently, on 29th October 2021, the Ghana Health Services (GHS) reported that they received interim laboratory results of an unusual disease, suspected to be yellow fever, from the Savannah Region that has led to the deaths of eight people. It is worth adding that Ghana’s geographic location, population size, and role as a trade and travel hub make it increasingly vulnerable to disease spreads.
The COVID-19 pandemic is already impacting Ghana severely. Economic development is curtailed, with GDP growth falling from 6.5% in 2019 to 1.1% in 2020 due to significant shortfalls in tax revenue and increased unplanned social and health expenditures, including the cost of preparedness and mitigation strategies. According to the Ghana Statistical Service, 77.4% of households in Ghana experienced a decrease in income, and every other household (52.1%) reduced food consumption at the peak of the pandemic. Notably, children suffer a great deal during moments of epidemic outbreak. Their education, nutritional requirements, and health care, including routine immunization, are disrupted.
The weaknesses in this country’s health security, such as inadequate cold chain at the sub-district level, erratic supply of reagents for testing at the referral laboratories, delays in sample transportation to referral laboratories, low level of clinician involvement in disease surveillance activities, and low dedication to the co-financing agreement on immunization with the Global Alliance for Vaccines and Immunization (GAVI)—further exposed by the ongoing COVID-19 pandemic—result from a limited financial commitment to the health sector in general, and epidemic preparedness and immunizations in particular, through the annual national budget.

Ghana signed the Abuja Declaration to commit a minimum of 15% of its total expenditure to the health sector year on year. However, after more than 20 years of signing the agreement, the country still struggles to meet half of its target. Indeed, budget allocation to the health sector declined from 8.2% in 2019 to 7.5% in 2021, notwithstanding the prevalence of the COVID-19 pandemic and the role of government in mitigating its impacts. Our national budget statement and economic policy over the years has no specific budget line for epidemic preparedness. The high case fatalities from disease outbreaks underscore a clear need for the government to prioritize domestic financing for immunization and epidemic preparedness in the budget statement and economic policy for 2022 and beyond.

Accordingly, we demand the government to consider implementing the following as the 2022 national budget process is underway.
• Set aside a dedicated budget in line with international benchmarks through the annual national budget to finance immunization and Epidemic Preparedness and implementation of the National Action Plan for Health Security (NAPHS), as well as the Ghana Centre for Disease Control to respond to the threat of epidemics.
• Find the fiscal space to sustain an increase in budgetary allocation to the health sector, and increase budgetary support for the expanded programme on immunization.
• Broaden the COVID-19 levy to cover all vaccines, including immunization-related services and epidemic response.
• Increase annual epidemic preparedness and response budgets at various government levels to fully fund NAPHS implementation.
• Earmark one percent of the District Assemblies Common Fund to support immunization and epidemic preparedness at the MMDAs level to inspire local level preparedness and response.
• Empower relevant government entities to track and regularly report on NAPHS implementation progress and spending.
• Revitalize Community-Based Surveillance Systems through community health volunteers. Strengthening these groups through capacity building on disease surveillance and early detection at the community level and adequately supporting them with logistics could help prevent disease outbreaks or mitigate escalation.

Prospects for domestic revenue mobilization for immunization and epidemic financing
We believe that Ghana has the brighter prospects for domestic revenue mobilization to fund immunization and prepare adequately against any future outbreaks. A few of the viable prospects which could be considered by the government include;
• Allocating agreed percentages of internally generated funds from hospitals within all districts for immunization and epidemic preparedness programs paid into a centralized district fund, and managed by the district hospital/Regional Health Directorate on behalf of the Ministry of Health.
• Resource Local pharmaceutical companies to respond to country’s immunization needs and future pandemics through local vaccine manufacturing and development programs; this could also be a revenue source for the country, while eliminating costs associated with procurement and importation (i.e., vaccine and injection supplies).
• Encourage and support local businesses through policies aimed at offering competitive advantages both locally and internationally. Such businesses must in turn, be committed to helping capitalize on the National Trust Fund, which should specify allocations for immunization and epidemic preparedness programmes, among others.
• Support the National Lottery Authority with a legislation to use earmarked lottery earnings to fund immunization and contribute to the National Trust Fund. Funds from one “draw” of the national lottery on designated month(s) of the year could be dedicated to vaccines, after the lottery winnings and operating costs are deducted.
• Encourage the private sector to annually increase support to the health sector through the Ghana COVID-19 Private Sector Fund to provide a prompt response to future health crises.
Conclusion: Ghana has developed a well-costed NAPHS. However, implementation has long been a challenge due to limited or no dedicated funding. In our view, it costs a country less to prepare for health emergencies than to deal with their impacts. Continuous investment in epidemic preparedness helps safeguard a country’s health security and protect the well-being of its citizens. There is no better time than now to invest in epidemic preparedness through our national budget. We believe that with strong political will, strategic intervention, and fiscal discipline, this can become a reality for Ghanaians.

Signed

Dr. Emmanuel Ayifah
Deputy Country Director, SEND GHANA

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