Strengthening Ghana’s epidemics preparedness response through health surveillance 

Maintaining an alertness to surprises is not only relevant in the security agencies but equally important in the health sector. The reason is that when the health sector remains battle-ready to handle any health hazards such as epidemics and pandemics, it makes it easier for the health of the citizens to be well-secured and protected. 

That is why epidemic preparedness and response financing has been identified by many health experts and advocates as one of the surest ways through which Ghana could secure its health sector against disease outbreaks—epidemics.

The reason is that when a dedicated budget is set aside purposely for the management of epidemics, it helps in coordinating remedial efforts in containing such outbreaks—making all the arms of the health sector to function as expected. 

The issue is that when the various arms of the health sector, including the medics, biomedics, health promotion practitioners, researchers and scientists are working together, their combined efforts will pay off in the process of preventing and/or containing any epidemics that may pose health risk to the populace.

It is for this reason that the Head of the Biomedical Science Department of the Navrongo Health Research Centre in Upper East Region, Dr Victor Asoala, has expressed strong conviction that setting aside epidemics preparedness and response fund would go a long way to strengthen health surveillance, a critical component of detecting epidemics early.

For him, “Health surveillance is like putting your eye on the ball and watching things so that when you detect any change or anything that can set or can expose you to risk of getting disease, you would have already known it.”

His reason is that epidemics don’t give signal of their invasion but once there are proactive systems to detect them on early, it would help to profess solutions to them, hence reducing their risk on the population.

He explained that because surveillance could directly measure what was going on in the population, it was useful both measuring the need for interventions and for directly measuring the effects of interventions. 

For Dr Asoala, the purpose of surveillance “is to empower decision makers to lead and manage more effectively” by providing timely and useful evidence.

However, he observed, if the health surveillance arm of the health sector was not well-resourced to perform their function as expected, there would be a gap in providing their critical service, particularly towards controlling and monitoring diseases—including epidemics.

Epidemics and need for surveillance 

The point is that increasingly, top managers in ministries of health and finance in developing countries and donor agencies are recognising that data from effective surveillance systems are useful for targeting resources and evaluating programmes. 

For example, in 2005, China rapidly began to expand its surveillance and response capacity through its Field Epidemiology Training Programme (FETP); Brazil and Argentina chose to use World Bank loans to develop surveillance capacity; and the U.S. Agency for International Development (USAID) redesigned its surveillance strategy to focus on the use of data to improve public health interventions (USAID 2005).

The fact is that humanitarian emergencies increase the risk of transmission of infectious diseases and other health conditions such as severe malnutrition. Hence, an effective disease surveillance system is essential to detecting disease outbreaks quickly before they spread, cost lives and become difficult to control. 

Public health surveillance is the continuous, systematic collection, analysis and interpretation of health-related data. Health surveillance serves as an early warning system for impending outbreaks that could become public health emergencies; enables monitoring and evaluation of the impact of an intervention, helps track progress towards specified goals; and monitors and clarifies the epidemiology of health problems, guiding priority-setting and planning and evaluation public health policy and strategies.

Health Research and epidemics preparedness 

Ghana as a country has a long tradition of medical research dating back to the early 1900s. However, the involvement of policy makers and programme implementers in research became more prominent in the 1980s. Prior to the establishment of the Ghana Health Service (GHS), the Ministry of Health established the Health Research Unit within the Policy Planning Monitoring and Evaluation Division (PPMED). The Health Research Unit was charged with the responsibility of coordinating research for the GHS.

Subsequently, three health research centers in Navrongo, Kintampo and Dodowa were set up in the three ecological zones of the country to undertake complex policy related research.

The creation of a Research and Development Division (RDD) as a stand-alone division from the PPMED became necessary to highlight the importance of Health Research and Development in the overall context of the country’s developmental agenda. 

The main rationale for this is the fact that research is not only essential for policy formulation but also for programme implementation (operational and epidemiological), for service delivery and indeed every aspect of the health sector.

However, over the years, our health research centres across the various zones of the country have consistently raised concerns over lack of funding for their research activities. In fact, many of the research centres rely mainly on donor support to be able to carry out their work. Without donor support, many of our health research centres will not be able to work. What this means is that if they are unable to get funding support from external sources, they will not be able to perform their critical role for the Ghana Health service, which is to help detect diseases, including epidemics on time for early interventions. 

Strengthening health systems

For Dr Asoala, a public health emergency fund would provide Ghana with the resources necessary to respond promptly and effectively to disease outbreaks without waiting for support from international organisations. 

Establishing a public health emergency fund in Ghana is vital to support epidemic preparedness, response, and prevention initiatives, arguing that lack of adequate funding to respond effectively to epidemics could plunge the health of the country into a catastrophe.

He explained that when effective health surveillance are put in place, such systems would help to enhance the country’s capacity and capabilities to handle any disease outbreaks, be it epidemics or pandemic.

“If you put the scientists or the researchers and the medics, and in fact, all the people in the health sector together, they can easily identify outbreaks early,” Dr Asoala noted. 

His reason is that all the various arms of the health sector can provide useful data to guide health action and interventions, saying all health workers collect data and such data can give an idea about how certain conditions should be addressed. 

“Such data give a signal about a particular ailment in a specific district or region. And so, it already signals to them that they should prepare. So, you don’t even think about the pandemic, you will think about other diseases that can cause epidemics,” he explained. 

Dr Asoala believes that “once we set up the surveillance systems that can detect epidemics, ultimately, we will be able to overcome any pandemic.”

For him, any advocacy aiming at putting pressure on duty bearers to set up epidemic preparedness and response fund is “a laudable idea.”

“Provided the fund is used for epidemic preparedness and not wait for the thing to happen. I think it is a very good idea,” Dr Asoala noted. 

For him, what should compel the country to set up its own domestic funding towards epidemics preparedness is the fact that when any disease outbreak of global scale happens, every country would be focused on their people than helping others at their expense of their own. 

“It’s not like waiting for the problem to come and then you go running and screaming. For instance, if it becomes a global thing, every country will be giving its resources to protect its people. It is only if its epidemics in your areas that they will come,” Dr Asoala explained, adding “So if we already have the funds, the next thing is that ….oh what do we do to prevent or to curtail this.”

His worry, however, is that such a dedicated fund should not be used for any other thing aside the reason for which it was set up for.