More than two decades ago cholera visited the shores of Ghana, several thousands of people where affected, and hundreds died. The cholera outbreak resurfaced again in 2014 to the early parts of 2015, this time round, the disease was widespread to 130 out of 216 districts across 10 regions, over 28 thousand people were affected, hundreds of people died again. Fast forwards to 2020, Ghana, like other countries was not spared during the COVID-19 pandemic, about 172,075 infections and 1,462 deaths were recorded as of April 2024. Within the COVID-19 pandemic to February this year, Ghana experienced other infectious disease outbreaks concurrently. While containing the COVID-19 pandemic, the country had to respond to cases of Yellow Fever (YF), and an outbreak of Marburg virus. This year, 2024 started with cases of Cerebrospinal Meningitis (CSM) in the upper west region, four lives were lost. The incidences above show how the country has witnessed a number of disease outbreaks caused by emerging and re-emergin g diseases over decades, yet Ghana has no dedicated funding to respond to such unplanned public health emergencies. Ghana Health Service's Director for Public Health, Dr Franklin Asiedu-Bekoe, recounts how the country had to mobilise funding on the spot and implement ad hoc measures to respond to such health emergencies. He states that there is no assigned budget for public health emergency, explaining that resources are only mobilised when necessary. With reports of outbreaks of diseases like Measles in Kenya, Cholera in Tanzania and Ebola, dengue fever, anthrax, plague, monkeypox, all over Africa, it is evident that epidemic prone diseases have constituted the greatest threat to public health security and disruptions of social and economic developments in countries and Ghana has not been spared. According to Dr Asiedu- Bekoe, in Ghana, usually when there is a small case of disease infection at the district level, the district, without any funds set aside, is expected to mobilise its own resources to han dle and report the situation to the national level. He explains that the intensity of the health emergency determines where the country will get its resources. He states that for health emergencies of public health concern at the national level, Ghana liaises with international partners like the World Health Organization (WHO) for support and that has been the approach over the years. For Dr Asiedu-Bekoe, it is necessary for Ghana to have a ring-fenced funding for public health emergencies, this will make it easy for funds to be mobilised when there are disease outbreaks and other public health emergencies. He said it is a gap that the country does not have a dedicated funding for public health emergencies and Ghana must act on this without delay. In a report dubbed 'No Time to Gamble', Ellen Johnson Sirleaf, a Former Co-Chair of the Independent Panel for Pandemic Preparedness and Response, opines that a pandemic threat can emerge at any time, in any country and that leaders need to prepare. She narrate s how dangerous disease outbreaks are occurring around the globe citing how avian influenza A (H5N1) for instance is infecting more mammals, including domestic cattle. 'A deadlier new form of mpox has led to a child death in the Democratic Republic of Congo, where there is no access to vaccine, a new pandemic threat, 'Disease X,' could emerge at any time, and countries need to prepare,' she said. For her, every day that preparation for a new threat is delayed, it is a dangerous gamble. Dr, Sirleaf believes that pandemic preparedness and response is not for public health experts alone, it remains an essential role for political leaders at the highest level. 'For leaders, the overriding lesson must be this - the cost of responding to a pandemic is enormously greater than the cost of preventing and preparing for one,' she says. Dr Sirleaf says political leadership for public health emergency funding and response is essential for two reasons - first, it engenders momentum for preparedness and maintains focus on addressing the gaps that make countries vulnerable to future threats. Secondly, it ensures that there is a structure for cooperation at a time of an emerging pathogen to seek effective international collaboration to limit the spread and impact of disease. According to Sirleaf, only political leadership can break the cycle of panic and neglect now associated with outbreaks and pandemics, after many decades of such cycles. Actors in Ghana's health sector like the Ghana Medical Association, Coalition of NGOs in health and the Ghana Association of Medical Laboratory Scientists believe that a Public Health Emergency Fund (PHEF) will help Ghana with the needed resources to respond promptly and effectively to disease outbreaks. This will enable the government to establish and maintain effective disease surveillance systems, which are essential for early detection and swift responses. They say a well-funded public health emergency system will strengthen Ghana's disease surveillance system for early case detec tion and effective case management. Dr Justic Yankson, Vice President of the Ghana Medical Association and a practicing doctor, says occasionally when Ghana experienced epidemics, the inadequacies of the health sector were exposed depending on the level or magnitude of the disease outbreak. 'Epidemic preparedness is not solely about saving or mobilizing funds, it involves building the capacity of health workers and health institutions to man the unplanned health needs of the people,' he says. For Dr Yankson, Ghana needs to constantly build the capacity of the health workforce and upgrade health infrastructure as a way of preparing for epidemics. In Nigeria, Ghana's Neighbouring country, Kano State, one of its populous states, in February 2023 launched the Kano State Action Plan for Health Security (KSAPHS) as a significant step towards enhancing the health security of Kano State and Nigeria as a whole. The plan provides a roadmap for strengthening the core capacities required to prevent, detect and respo nd to public health threats and emergencies. Kano State improved its ability to prevent, detect and respond to disease outbreaks by establishing a budget line for epidemic preparedness and response (EPR) after civil society organizations (CSOs) made the case for increased and sustained funding Establishing a Public Health Emergency Fund is essential to the nation's stability. The importance of such a fund cannot be overemphasised in responses to future health treats because pathogens have wings and can emerge anytime and anywhere, without notice. Source: Ghana News Agency