The Global Health Preparedness Programme in Ghana
About the Programme and the International Health Regulations
In 2015, the Norwegian Institute of Public Health (NIPH) launched the Global Health Preparedness Programme (GHPP). Collaborating with Malawi, Ghana, Moldova and Palestine, the intention of this initiative is to provide public health knowledge to support the building and enhancing of global health preparedness and security in these countries through implementation of the International Health Regulations (IHR, 2005), contributing to the global efforts and initiatives to improve IHR (2005) capacity assessments, implementation and prioritisation.
The planned activities in each country are based on individual country needs, although they are linked to objectives that support the overall goal of the GHPP, to contribute to improved capacity to prevent, detect and respond to public health events of national and international concern. The country-specific GHPP activity plans for implementing and strengthening the IHR core capacities has been developed in collaboration with each partner country based on the results of the initial assessments and country-specific priorities as indicated in the countries’ respective IHR action plans.
The international health regulations are legally binding regulations for all WHO member states that aim to support the international community to prevent and respond to public health crisis. Paragraph 44 of the IHR (2005) states that “State Parties shall undertake to collaborate with each other to detect and assess events, to provide or facilitate technical support, to mobilize resources, and to formulate legislation to support the implementation of the Regulations.”
This paragraph incentivised the NIPH to establish the GHPP in order to support the strengthening of the IHR (2005) core capacities in Ghana. The activities included in the GHPP are also a part of Norway’s contribution to the Global Health Security Agenda (GHSA), a global initiative that support countries’ capacity to help create a world safe and secure from infectious disease threats.
History of Collaboration
Since 2011, NIPH and health authorities in Ghana have been discussing possibilities for the establishment of a national public health institute in Ghana including structures for detection, assessment and response to public health events. The Ebola outbreak in West-Africa in 2014 highlighted the need for stronger collaboration on public health preparedness and response, and as Norway joined the global initiative, the Global Health Security Agenda, to partner with countries in West Africa to build more resilient health systems.
Norway’s long history of collaboration with Ghana, and the existing relationships with other partners supported the decision to partner with Ghana for the Global Health Preparedness Programme.
The preliminary missions in 2015 and early 2016 were aimed to mobilise and formalise the Global Health Preparedness Programme collaboration in Ghana, while the latter part of 2016 and early part of 2017 were mainly focused on technical work and concrete activity planning.
In collaboration with Ghana Health Services and WHO, NIPH supported a workshop to test Ghana’s alert and response capacities for å public health event of chemical origin in September 2016.
The tabletop exercise provided stakeholders in Ghana the opportunity to identify strengths, gaps and areas for improvement in handling the detection, alert and response to a chemical public health crisis. The exercise demonstrated that further developments are required to ensure operationalisation of existing structures, and to ensure that the systems are robust and will allow for timely detection, assessments, reporting and response to all public health events, regardless of origin.
Health Profile – Ghana
The Republic of Ghana is located along the Gulf of Guinea and the Atlantic Ocean in West Africa and is defined as a middle-income country according to the World Bank definition. According to the WHO, Ghana has made steady progress in improving the health status of its population over the last decades, with life expectancy increasing from an average of 50 years in 1960 to 65 years in 2015.
However, the health situation in Ghana is characterised by significant geographical and financial inequalities. Communicable diseases, such as HIV/AIDS, malaria and tuberculosis, are still major causes of morbidity and mortality in Ghana. In addition, Ghana is experiencing an increase of non-communicable diseases such as stroke and ischemic heart disease, leading to a so-called double burden of disease for the health system.
Implementation of the project in Ghana
For the project in Ghana, the Norwegian Institute of Public Health (NIPH) collaborates closely with Ghana Health Services and the World Health Organization’s (WHO) Country office.
In partnership with other organisations, NIPH has participated in an external evaluation in Ghana that assessed the country’s ability to prevent, detect and respond to public health threats and the ability to achieve the implementation of the IHR2005. The method for the assessment was the Joint External Evaluation (JEE) tool, the Global Health Security Agenda’s (GHSA), evaluation tool endorsed by WHO for use in IHR assessments. The JEE found that several areas to be strengthened within Ghana to ensure the detection, prevention and response to public health events, despite several well-established preparedness mechanisms in place.
The key elements for collaboration between NIPH, the Ghana Health Services and the World Health Organization’s (WHO) Country office were identified:
- Process support to strengthen the specimen referral and transport system
- Collaboration on developing or adapting a rapid risk assessment tool for chemical events and contribute to simulation exercises to test the tool. Support development of an Environmental Health module to the Field Epidemiology Training Programme (FETP) in Ghana, focusing on chemical hazards.
- Collaborating on improving event-based surveillance in Ghana, with an emphasis on how to coordinate the vertical reporting lines of events in chemical preparedness, food safety and health, and to promote systematic sharing of data between the relevant sectors.
The project activities are funded by Norad through the Programme for Global Health Preparedness.
Ghana Health Service (GHS)
The Public Health Division of Ghana Health Service (GHS), which administratively lies under the Ghanaian Ministry of Health (MoH), is responsible for coordination, guidance and development of a number of public health functions, including surveillance and disease control systems. The National Focal Point for IHR (2005) is based at the Public Health Division of GHS. The Public Health Division includes two departments, the Disease Surveillance Department and the Disease Control Department.
The MoH in Ghana has given GHS the mandate to develop a concept note for the establishment of a Ghana National Public Health Institute. NIPH and US CDC are collaborating with GHS to support this establishment with backing from the International Association of National Public Health Institutes − IANPHI.
World Health Organization (WHO)
The World Health Organization is the lead health authority within the United Nations. The organization works in close collaboration with other UN agencies, donors, non-governmental organizations (NGOs), WHO collaborating centres and the private sector in order to achieve its goal of building a better, healthier future for all people.
The WHO Country Office in Ghana is running nine health programmes in the country and is collaborating closely with WHO Regional Office for Africa (AFRO) in supporting Ghana in strengthening the health system.