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Opinions Sun, 5 Dec 2010

The world is listening to Ghana

The world is listening to Ghana!

Ghana is commanding world attention with the occasion of the recent 22nd triennial

conference of the Commonwealth Medical Association (CMA) and the first Global

Symposium of health systems research serving as interesting land mark reference

points.

Of all the rave previews flung the way of Ghana, it was the above statement by a

Nigerian colleague, captured in the title that I found most alluring.

For the Commonwealth meeting in Malta, Ghana was represented by a high powered

delegation from its medical Association, influenced no less by the nomination of

two of its members for executive positions. And then will come the high profile

dinner and opening ceremony. Among the dignitaries present would be the British

High Commissioner to Malta and the director of the Social Transformation Programme

of the Commonwealth.

Unknown to many, the latter would be Dr Sylvia Anie-Akwetey, recently of the Ghana

AIDS Commission and now with the Commonwealth Secretariat, headline sponsors of the

triennial event. When her ‘cover’ as a Ghanaian was blown, the alarm on the face of

the lone Nigerian delegate was better seen than described – “Ghana is here again?!”

And then Dr Sylvia Anie-Akwetey waltzes in gracefully and makes a passionate pitch

for non communicable diseases which “account for 60% of the global disease burden”

and which the “Commonwealth has been at the forefront in expressing concern and

raising awareness about.” In addition, she draws attention to the global scenario

where “the incidence of non-communicable diseases is on the rise in the

Commonwealth. This is more than a health challenge: it is increasingly, a

development challenge. This reflects a range of interlinked factors including

changing diet, tobacco and alcohol use and abuse and reduced physical activity. By

way of illustration, next week we will mark World Diabetes Day. Diabetes has been

seen as a side effect of affluence. However, the fact is that 80% of the diabetes

sufferers in the world are in low and middle income countries and a significant

proportion of these are the Commonwealth countries.”

Then she alarms us with an explosive revelation. The Commonwealth has set aside some

funds for supporting development work in all 54 member countries. This information

has been brought to the attention of Ministers of Health but “no one is asking. Why

is no one asking for this money to work with?”

The room is dead silent! The night has no answers for her.

When it matters most, she speaks up forcefully for Africa and for justice albeit in

charming diplomatically-flavored language. A Cypriot presentation unwittingly lets

drop that measures adopted to combat the twin problems of HIV infection and illegal

immigration to Cyprus include quarantine and mandatory HIV testing of the

‘captured.’ Dr Anie-Akwetey promptly draws attention to the global trend (including

the United States) moving away from making the HIV status of applicants a pre

condition of sorts for the determination of visa decisions etc While expressing

interest in the uniqueness of the Cypriot situation, she lets drop that this is

potentially a violation of peoples’ human rights. As diplomatic as she is, it is

clear a sore soft spot has been bruised judging from the wobbly unconvincing

response that follows from the Cypriot doctor.

In the substantive election, Drs Kwabena Opoku Adusei and Oheneba Owusu-Danso will

be elected and re elected Vice President for the West Africa region and General

Secretary of the CMA respectively.

Then will follow the first global symposium of health systems research in Montreux

that will witness the powerful gathering of 1200 participants from a 100 different

nations – the richness of the discussions underlined by the diverse and varying

experiences of an assortment of health system researchers, policy makers, donor

community, students etc.

Clearly, if there ever was an opportunity for any country to state its case on the

global platform, this was it.

In a regal opening ceremony replete with classical music, Dr Judith Rodin, President

of Rockefeller Foundation will tout Ghana’s investment of “approximately $115

million in institutional reform over six years. This is equivalent to 2.5 percent of

its total health expenditure. This investment, together with a major health reform

effort that was financed by a newly introduced value added tax, enabled a dramatic

boost in coverage …, even as the country’s health expenditure as a percentage of GDP

remained close to 6 percent.”

In further references, she would mention a recent workshop in India at which

“health officials from Ghana, Vietnam, Rwanda, India, Indonesia, and the

Philippines are brought together to trade best practices and share ideas for

implementing universal health coverage.”

In one grand plenary and numerous breakout sessions, the voice of Ghana will

resonate with insightful presentations on its national health insurance, quality

improvement work, on going work in the MDGs etc. Prof Irene Agyepong, Professor of

the Prince Claus Chair in Utrecht University and a director of the Ghana Health

Service made a powerful presentation on the political economy of health policy

formulation and implementation using Ghana as a case study. If the feedback received

on her presentations was anything to go by, then it would be fairly safe to conclude

that she leveraged well for Ghana. So insistent were some of her new found admirers

that special one-on-one meetings had to be arranged for her input in their on- going

research work.

It is announced in a session that a Foundation will soon be floating a call for

funding research work in African countries. Speaking to the official later, he lets

drop that offers to Ghana might be limited somewhat! Further probing reveals that

“Ghana under Prof Irene Agyepong’s leadership has managed to sequester more than

half of the first phase funding” which she has subsequently used to create space and

opportunities for many younger colleagues whom she is mentoring! Apparently, this

mentoring trait has been noticed and is the subject of an intense heart wrenching

conversation between two young Nigerian doctors.

Going forward;

How do we harness the diverse talents in-country and enormous international goodwill

that Ghana enjoys to accelerate the achievement of health outcomes? How do we align

research work to practical questions and provide feasible policy options to policy

makers? How do we build individual and institutional capacity to undertake research

at all levels and more importantly create the platform that enables the ready

translation of knowledge into policies adopted by politicians? How can the voice of

civil society be mobilized and strengthened in order to constrain researchers,

policy makers and politicians to focus on the outcomes that make a difference to us?

How do we get project Ghana airborne by moving away from individualized efforts and

achievements to the synergized joint success of the whole? How does Africa learn

from each other? How do we find the balance between collaborating with others while

defining our own research agenda as African nations with all the funding it will

entail?

Personally, it is worth acknowledging at this juncture, the gallant efforts of Prof

Fred Binka, himself a big international player and Dean of Legon’s School of Public

Health and Indepth Network that facilitated my engagement in what has turned out to

be an invaluable experience. I appreciate the opportunity.

It is time to show greater leadership within the health system and other sectors

that will marshal all this enormous goodwill and talent for revolutionary change. We

can and should be doing more because all the pedigree notwithstanding, we are still

very far from nirvana!

Sodzi Sodzi-Tettey

Columnist: Sodzi-Tettey, Sodzi