Ghana was an early adopter of the ideals of the World Health Organisation’s 1978 landmark Alma Ata meeting on primary health care.

Like many low- and middle-income countries, Ghana has made subsequent efforts to strengthen public health, necessary to achieve the conditions so the nation can be both healthy and productive.

The evolution of Ghana’s public health has involved core assessments, policy development and the implementation of interventions to address policy objectives.

The process of strengthening public health policy and interventions over the last half century has hinged on evidence generated through research at both local and international levels.

The importance of this evidence is that it catalyses Ghana’s response to the numerous public health issues which confront successive governments.

Over time, lessons have accrued for the country’s communities to enhance the promotion, restoration and maintenance of health.

This has occurred even as the disease burden has changed from one of infectious and communicable diseases and maternal and child health to an increasingly sophisticated triple burden incorporating non-communicable diseases.

Robust healthcare system

Speaking at his inauguration ceremony on January 7, President Mahama outlined his vision for a robust healthcare system capable of safeguarding Ghanaians’ well-being in the face of emerging global threats.

The President reaffirmed his commitment to strengthening Ghana’s public health systems.

He rightly noted that it is necessary to prepare citizens for future health challenges, including potential pandemics exacerbated by the deepening climate crisis.

The President explained that Ghana’s worsening climate crisis is a catalyst for the resurgence of viruses previously thought to be eradicated.

He reminded Ghanaians that past epidemics – most recently COVID-19 – have taken a terrible toll on families and communities and it is vital to be prepared as far as possible for the next one.

To expedite preparedness, President Mahama pledged that his government will work diligently to strengthen Ghana’s public health systems, while closely monitoring the global health situation so that when the next epidemic or pandemic occurs, the country’s losses will be minimised.

During the previous government of Nana Akufo-Addo, Ghana was compelled to confront the COVID-19 pandemic, of which the first official case was reported in mid-March 2020.

To its credit, the government took swift action to contain the spread of the virus, introducing contact tracing, testing and lockdown measures.

By mid-2023, Ghana had had more than 170,000 confirmed cases of Covid-19 and approaching 1,500 deaths.

However, the consequence of COVID-19-associated emergencies went well beyond health effects, with wide economic, social, education and partnership disruptions.

Ghanaians were, on the whole, largely satisfied with the Akufo-Addo government’s management of COVID-19: three-quarters of Afrobarometer respondents said the government had performed ‘fairly well’ or ‘very well’ in relation to COVID-19 and its effects.

24-hour economy

The Mahama government will have to do at least as well as the previous Akufo-Addo administration if or when the next pandemic appears in Ghana, it wishes to retain Ghanaians’ faith in the capacity of the government to deal well with pandemic-related issues and other major public health concerns.

How might the new government accomplish this?

One of President Mahama’s most high-profile pledges is the aim to build a ‘24-hour economy’ to boost employment and unlock Ghana’s industrial potential.

According to the president, the ‘24-hour economy’ initiative is a deliberate policy to encourage and support businesses and public organisations to operate 24/7 in three shifts of eight hours to boost production, promote productivity and generate well-paying jobs.

The purpose is to transform Ghana into ‘an import substitution and export-led economy’.

This goal, both optimistic and expansive, cannot be achieved without improving Ghana’s public health.

Just like other priority sectors, including education and infrastructure, improved public health will require significant government investment.

Ghana has seen promising improvements in health-related development indicators in recent years.

The National Health Insurance Scheme was introduced in 2003; since then, the proportion of Ghanaians insured publicly or privately has risen to around 69 per cent, although there is considerable variability by region.

There has been a significant drop in child and maternal mortality rates and malnutrition and a rise in life expectancy to 65.17 years in 2024, a 0.36 per cent increase from 2023.

Yet, the accessibility of health care services varies by location; most hospitals and clinics are in urban areas, and those in the countryside are less likely to have modern technology, forcing rural Ghanaians to travel long distances to access care. In other words, it is better to be ill in Accra or Kumasi than in poorer, rural areas, often far away from accessible, modern health care.

To achieve President Mahama’s objective of a ’24-hour economy’ will require more than support from businesses and public organisations alone.

It will also necessitate significant investment in public health and associated developmental objectives while requiring the same intellectual and financial commitments afforded to communicable and infectious diseases such as malaria and HIV/AIDS.

Understanding and responding to the multifaceted roots and consequences of chronic diseases and their impact on Ghana’s public health requires not only interventions and policies informed by multidisciplinary collaborations but also the government’s long-term financial commitment to improve the country’s public health.

The success of the Mahama government will be measured in part by whether Ghanaians enjoy improved health over its four-year term.

The path to progress starts now.

The writer is an Emeritus Professor of Politics, London Metropolitan University, UK.
Email: tsjhayn1@londonmet.ac.uk