In light of the number of epidemic outbreaks Ghana has faced in recent years, with the current Meningitis and Cholera plagues, the country's commitment to strengthening its epidemic preparedness framework has never been more critical.

The loudest advocacy surrounding the epidemic preparedness and response debate is the calls by civil society organisations and other well-meaning Ghanaians to establish a dedicated fund.
While the calls are in the right direction, another key area that needs attention is how health arms are strengthened to collaborate in epidemic preparedness and response. The health arms include the Ghana Health Service (GHS), Public Health Workers, Laboratory Scientists, Pharmacists, Medics, Frontliners, and others.

Thus, key players in this effort are the Navrongo Health Research Centre (NHRC), located in the Upper East Region of the country, and the National Public Health and Reference Laboratory (NPHRL).

How NHRC contributes to Ghana’s epidemic preparedness plan

In an exclusive interview with Mahmud Mohammed-Nurudeen of Joynews, the Director of Navrongo Health Research Center (NHRC), Dr. Patrick Ansah, mentioned how the center contributes to Ghana's broader epidemic preparedness plan, emphasising the importance of collaboration and the role of the Public Health Emergency Fund (PHEF) in tackling health emergencies.

“We do not have our independent management plan. We work together with the district epidemic management team to manage epidemics at the district and probably regional levels,” explained Dr. Ansah.

The NHRC, known for its advanced laboratories and expertise in public health research, plays a vital role in detecting and reporting outbreaks. However, as Dr. Ansah noted, it is through the coordinated efforts of local health teams and national disease surveillance structures that responses are activated.

The collaboration between NHRC and the Ghana Health Service (GHS) is central to the country's epidemic preparedness. NHRC’s primary role is not outbreak detection, but rather supporting GHS efforts by conducting surveillance studies in epidemic-prone areas.

“We have advanced laboratories and trained personnel. We constantly monitor diseases that are prone to outbreaks in our study areas, which aligns with the detection plans of the Ghana Health Service,” Dr. Ansah stated.

Despite its scientific contributions, NHRC is not solely responsible for the management of epidemics. Dr. Ansah emphasised that epidemic management is a collective responsibility. "We play a role at the district epidemic management team level, which is chaired by the Municipal Chief Executive (MCE). We contribute personnel, logistics, and laboratory support. [However], we are not independent when it comes to epidemic management."

The issue of resources—financial, human, and material—also plays a significant role in epidemic preparedness and response. Dr. Ansah pointed out that while NHRC contributes resources, the mobilisation of these resources largely falls under the jurisdiction of the Ghana Health Service, which is the leading body during an outbreak.

It will bring more independence from external funding and allow us to develop plans which nationally owned by GHS. Right now, the centre cannot start preemptive research unless there is an epidemic around and external funding gives money to start.

Funding challenges faced by the NHRC

Dr. Ansah stated that for about two months during the COVID-19 outbreak, the center was unable to take any action until external funding was received. He mentioned that had the Ghana Health Service (GHS) had had the necessary funds, it would have been able to start research earlier.

"If you have Public Health Emergency Fund institutions being funded, we would always be in readiness. Otherwise, we would wait for the epidemic to be a problem and external funding would come to our aid," Dr. Ansah added.

Without proper funding, rapid response, which includes epidemic detection and research become challenging, especially in remote areas. He said PHEF would help to bridge the gap in resource mobilisation, enabling a quicker, more coordinated response all year round.

Other partnerships

Partnerships with other research institutions, universities, and international organisations have been key to strengthening Ghana’s epidemic response. NHRC collaborates with institutions such as the Noguchi Memorial Institute for Medical Research, Kumasi Centre for Collaborative Research, and international bodies like the U.S. Navy’s NAMRU units.

Dr. Ansah noted that these partnerships have enabled the establishment of advanced laboratories and research platforms crucial to detecting and managing epidemics in Ghana. When it comes to lessons learned, Dr. Ansah stressed that the importance of a strong Public Health Emergency Fund cannot be overstated.

"The recent COVID-19 epidemic management in the Kassena-Nankana District (KND) was a test case for us. It highlighted that effective epidemic management requires pooling scarce resources together and acting in a coordinated manner."

Dr. Ansah’s reflections underscore the role of collaboration, both at the local and national levels, in building an effective epidemic management framework. He also highlighted the need for sustained investment in health systems, particularly in research and resource mobilisation.

"It would allow for the rapid mobilisation of resources, ensuring that we are always ready to act when an epidemic strikes. Having a well-coordinated plan and the resources to back it up is vital for saving lives and protecting communities,” he concluded.

The role of the National Public Health and Reference Laboratory

For his part, Dr. Solomon D.Y. Kwashie, a Medical Laboratory Scientist, in an exclusive interview with Freelance Journalist Emelia Naa Ayeley Aryee, has opened up on the strides made by the agencies responsible for economic preparedness, the lapses, challenges, and possible solutions.

According to Dr. Kwashie, Ghana has a good epidemic preparedness system, mostly coordinated by the GHS, which ensures that the public health division is equipped with the right human resources and infrastructure, including a Public Health Laboratory Network for epidemic response.

He said epidemics are mostly handled by the public health laboratory systems, with the National Public Health and Reference Laboratory (NPHRL) playing a central coordination role. He added that after several years of neglect, it took the COVID-19 pandemic to make the role of NPHRL gain a lot of attention.

“You will realise that the Research laboratories were more equipped for pandemic handling in the Covid-19 era. This was a result of inadequate attention to the Ministry of Health and the Ghana Health Service Laboratory systems.”

“The story has now changed as much attention is currently being paid to the NPHRL and its zonal public health laboratories. There is a need to support the South-Eastern area of the Country with additional public health laboratories,” Dr. Kwashie intimated.

How healthy arms work together

He disclosed that within the ecosystem, there is a significant collaboration between players in human, animal and environmental health in public health emergencies. There is also an inter-agency committee at the policy level that ensures that diseases are reported and investigated timely.

To him, this collaboration was much evident in the COVID-19 era where all laboratory systems were activated using the one health approach to fight the pandemic. The Ghana Field Epidemiology Laboratory Program, he said, trains professionals based on the One Health team approach. These professionals are distributed to various areas of the country where they provide valuable support in outbreak investigation and surveillance.

Dr. Kwashie revealed that the Ghana Health Service has a national management plan in place, which is based on the One Health approach. These plans and strategies demonstrate Ghana's commitment to managing epidemics and improving public health.

“As part of our national management plan, there is the National Infection Prevention and Control Strategy, which aims to prevent, reduce, and control Healthcare-Associated Infections (HAIs) and Antimicrobial Resistance (AMR). This strategy is part of the government's efforts to strengthen the health system and improve patient safety.”

Additionally, Ghana has an Integrated Disease Surveillance and Response system, which outlines procedures for responding to outbreaks and other public health problems. This system includes setting up entities to manage responses, holding regular meetings, and preparing district epidemic response plans,” he explained.

Challenges

Despite these laudable milestones, the health system has undoubtedly been fraught with a number of challenges, and this boils down to a lack of funding.

Dr. Kwashie noted that funding is one basic thing that has hindered how effectively the Public Health Laboratory Network and other health arms and agencies responded to epidemics. He thus rated Ghana’s epidemic preparedness at 7 on a scale of 10, while response garnered 6.

Another challenge, he noted, is the inadequate health infrastructure in hard-to-reach areas, which prevents people in these areas from reporting disease outbreaks on time. He added that the inadequate interface between clinical laboratories and public health laboratories is a significant challenge in Ghana’s laboratory systems.

“For example, clinical laboratories may identify infectious diseases, but the information may not be communicated promptly to public health laboratories, hindering timely outbreak response.
Again, different laboratories may use varying testing protocols and reporting formats, making it difficult to compare and consolidate data,” Dr. Kwashie explained.

He noted that there is also a challenge of inadequate coordination between the public health facilities and private health facilities in Ghana in disease reporting.

A dedicated fund

All said and done, Dr. Kwashie stressed that a dedicated fund for epidemic preparedness is the way to go. He said one of the advocacies surrounding the dedicated fund, which aims at the conversion of the COVID-19 levy into a Public Health Emergency Levy, is appropriate.

This, he said, will serve as seed money and provide a constant funding source for our emergency preparedness.

“There must be a fund which must be managed using the inter-agency approach. There must be stakeholders from the one health team to handle this fund,” he suggested.

He added that the fund would make it possible to build the capacity of people at the local level to identify and report suspect health conditions to authorities for investigation.

“In Ghana today, there are many private organisations, including the media, Civil Service Organisations, who are contributing to healthcare. The public health systems must be re-engineered to leverage the strengths of these organisations and partner with them in areas such as risk communication and public health education programs, and this all involves money which the fund can cater for,” Dr. Kwashie said.

There is also the need to build a strong health system with significant infrastructure across the country. There should be empowerment of the communities in health decision making, there is the need for ensuring strong Public-private partnerships for health.

“All these would be meaningful with the coming into being of the dedicated fund. To ensure that health arms are strengthened to collaborate effectively toward epidemic preparedness and response, there must be adequate funding and capacity building toward the future,” Dr. Kwashie emphasised.

Epidemic numbers and how much is needed

Meanwhile, the numbers keep increasing concerning the Meningitis and Cholera outbreaks.

By the close of February 2025, nearly 1,000 cases of Cholera had been recorded in the Central, Greater Accra, Western, Eastern, and Ashanti Regions, with over 100 deaths and counting.
Again, over 100 cases and 20 deaths of cerebrospinal meningitis had been recorded in the Upper West and other parts of the Northern Region.

In handling these outbreaks and others effectively, it is anticipated that an amount of GHË 19 billion would be needed yearly to tackle epidemics, taking a cue from the expenditure of
COVID-19, according to a March 19, 2021, report sighted on the website of the Finance Ministry.

The Country Director of SEND Ghana, Madam Harriet Nuamah Agyemang, in an earlier interview, intimated that 60% of this amount could be used for epidemic preparedness, while the remaining 40% is used for epidemic response, explaining that if we prepare adequately, we would have less to respond to.

As Ghana continues to face the challenges posed by emerging infectious diseases, the role of institutions like the NHRC, NPHRL, GHS, and the introduction of the Public Health Emergency Fund are essential in ensuring the country is prepared to respond quickly and efficiently.

Effective collaboration across all health arms—government, research institutions, and international partners—will be key to building a resilient public health system capable of managing any future health emergencies.