EPIDEMIC PREPAREDNESS: FUND EPR IN NEW MEDIUM-TERM NATIONAL DEVELOPMENT POLICY FRAMEWORK

All countries strive for sustainable growth and development. However, for countries to achieve the desired growth and development, efforts are needed to plan, regulate, control and guide the development process in the right direction.
This makes the need for development plans imperative in spearheading sustained growth and development. (Journal of Human Resource and Sustainability Studies > Vol.6 No.1, March 2018)
In 2015, the Sustainable Development Goals (SDGs), also known as the Global Goals, were adopted by the United Nations as a universal call to action to end poverty, protect the planet, and ensure that by 2030 all people enjoy peace and prosperity.
Since then, some 170 UN Member States and territories have continued to develop and review policies as well as build resilience to achieve the SDGs framed around 17 goals and 169 targets.
Ghana is currently implementing a 40-year development plan with the vision of achieving “a just, free and prosperous society by 2057.
Adopted in 2017, the plan (2018-2057) is expected to address structural development challenges plaguing the country and present an opportunity for Ghana to have a carefully calibrated comprehensive development plan that provides sufficient space for global development commitments such as the SDGs and the African UnionÕs Agenda 2063.
The National Development Planning Commission (NDPC), established under Articles 86 and 87 of the 1992 Constitution, is spearheading implementation the plan to ensure that national policies are in sync with it while promoting effective coordination, preparation, implementation, monitoring and evaluation of national policies and strategies.
Once every four years, the NDPC leads the preparation of the Medium-Term National Development Policy Framework (MTNDPF) to guide development initiatives in the country.
Out of this, Ministries, Departments and Agencies (MDAs) and Metropolitan, Municipal, and District Assemblies (MMDAs) are expected to develop their Medium-Term Development Plans (MTDPs) and subsequently annual plans and budgets for implementation every year.
Following the end of the MTNDPF (2018-2021); Agenda for Jobs-Creating Prosperity and Equal Opportunity for all, the NDPC is now leading the implementation of a new MTNDPF (2022-2025) expected to guide medium-term economic recovery and transformation of the country.
The plan is projected to rebound the economy from the ramifications of the COVID-19 and restore macroeconomic stability while building a resilient healthcare delivery system to withstand future shocks.
It targets sustained growth of MMDAs for improved livelihoods and social development within the context of reducing poverty and promoting public-private partnerships for socio-economic development.
The MTNDPF revolves around six broad sectorial groupings namely: Economic Development; Social Development; Environment, Infrastructure, and Human Settlement; Governance, Corruption, and Public Accountability; and Emergency Planning and Response (EPR) – including COVID-19 recovery plan, implementation, coordination, monitoring, and evaluation.
The EPR measures considered in the medium-term plan are expected to respond to six (6) threats of epidemics such as cholera, Ebola, COVID-19, Cerebrospinal Meningitis (CSM), insect infestation (armyworm), polio and HIV/AIDs, which have been captured under biological threats.
Prior to COVID-19, Ghana had recorded a number of epidemic outbreaks which have claimed many lives and maimed others.
The inclusion of EPR in the medium-term plan is therefore “to build resilience to withstand threats of different dimensions, including COVID-19” and better position the country to effectively manage public health emergencies.
Lessons from the COVID-19 point to the fact that real threats facing GhanaÕs health system are weak surveillance systems; weak institutional capacities; non-compliance with health regulations; unapproved health emergency preparedness and response plans; lack of emergency funds; weak inter-sectoral collaboration; inadequate health infrastructure and personnel.
Thus, the MTNDPF (2022-2025) aims to address these risks through the development of a health emergency preparedness and response plan, improve surveillance, monitoring, and evaluation of health threats, epidemics, pandemics and enforcement of the Public Health Act.
It is intended also that in the medium term, the country establishes a public health emergency fund and strengthens the Ghana Centre for Diseases Control and other disease control centres across the country.
Consequently, seven Districts across the country have been selected to implement various EPR activities this year as part of their 2022 Annual Action Plans (AAP) to the tune of GHc3.1million
These Districts – Tema Metropolitan Area, Accra Metropolitan Area, Shai Osudoku, Ga South, Akuapem North, Birim South, and Lower Manya Krobo – are expected to carry out activities, including public sensitisation to diseases of public health importance, support preventive health education, build the capacity of the Assembly staff and relevant departments to respond to emergencies, intensify disease surveillance and response on diseases like Yellow Fever, Measles, AFP, Cholera, Schistosomiasis, Scabies and COVID-19.
In the Lower Manya Krobo District, for instance, an estimated amount of GHc2.1 million has been earmarked for the construction of an isolation center and a laboratory equipped with requisite equipment and logistics.
These projects are to be funded by the Government of Ghana (GOG) and donor partners and with allocations from Annual Budget Funding Amount (ABFA) and internally-generated funds (IGF) of the various MMDAs.
The integration of EPR into the country ’s medium-term development plan is indicative of deliberate efforts by the government to address critical gaps in epidemic preparedness and position Ghana to better handle public health emergencies in the future.
Legal Consultant and Director of Health Services of Berekum Municipal in the Bono Region, Dr. Bedima Duut, welcoming the consideration of EPR in the MTDPs, said the availability of funds at the local level to execute public health activities has been a perennial challenge.
Section 78 of the Local Governance Act (2016) Act 936 establishes Departments at the local level and spells out functions, which include a Health Department responsible for executing health activities and programmes like EPR activities, he said.
According to Dr Duut, although the 1992 Constitution guarantees sources of revenue to District Assemblies, including the District Assembly Common Fund (DACF); foreign grants and donations under the District Assembly Performance Assessment Tool (DPAT); and internally-generated funds mainly from licences, fees, taxes, and rates, there was no clear-cut provision to fund health or EPR activities at the local level.
“No fund has been established directly by the Constitution or any law for health or EPR and the health of citizens cannot be guaranteed without adequate funding. There are no dedicated funds for EPR activities at the District Level and the formula for disbursement of DACF or grants does not include EPR, he noted.
The Lawyer urged that moving forward, the Ministry of Finance includes EPR activities in its budget guidelines issued for each financial year and insist that local authorities capture EPR in their formula for disbursing DACF.
“A percentage of total government revenue should be disbursed directly to the Health Departments, through the Assemblies specifically for epidemic preparedness and response, the assessment of Assemblies for grants should include assessment of expenditure on EPR and in the shortest term possible, the country should establish a public health fund, he advised.
In a communique issued in reaction to the MTNDPF, non-governmental organisation, SEND-GHANA which is implementing a project aimed at improving EPR financing said, an assessment of the MMDAs 2022 AAPs to determine measures undertaken to finance EPR shows that budgetary allocations are available to support emergency interventions.
Beneficiary MMDAs have indicated that MTDPs have been submitted to the NDPC awaiting final approval, it said.
It thus charged health directorates to request these funds for the implementation of listed EPR activities urging MMDAs also, to endeavour to release funds to carry out the activities.
Goal three of the SDGs seeks to ensure health and well-being for all, including a bold commitment by governments to end present and emerging epidemics by 2030.
“The bottom line is many countries have demonstrated what works; strong preparedness systems coupled with decisive responses.
When countries can prepare and respond appropriately, even if not perfectly, their communities, neighbours and the world are safer.

(preventepidemics.org)

BY ABIGAIL ANNOH

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