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
