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Opinions of Sunday, 15 October 2017

Columnist: Abdulai Mutaru

Is Africa condemned to curative measures?

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For the past years, health and Agriculture have proven to be significant sectors worth attention by various governments. Research shown that, it is factual that Industrial countries have not been able to solve the problem of the spiraling costs of health care resulting from technological development, public expectations of health care delivery, and in particular, the rapidly increasing size of their elderly populations. The people of many developing countries are still living in dire poverty with dysfunctional health care systems and extremely limited access to basic medical care.

As we move into the new millennium it is becoming increasingly clear that the biomedical sciences are entering the most exciting phase of their development, governments from the developed nations are investing much of their resources into proving primary health care.

But the Ghanaian system is rather unfortunate; it focuses more on cure rather than prevention. But the golden rule is and would always remain the same no matter the taste of time; “prevention is better than cure”. The focus on treatment, especially tertiary (hospital) care, rather than prevention and early detection at the primary health care level is reflected in the government’s health expenditure too, which focuses narrowly on hospitals at the expense of primary health care. Health systems in Ghana and for that matter Africa in general are geared to the management of episodes of infectious illness. We equip our hospitals and patiently wait for the ‘citizens and not spectators’ to fall sick and run to us, in which most times the patient either survives or dies. Needless to say, such health systems are very poorly prepared to cope with the demands and costs of chronic care.

World Health Organization’s report and Centers for Disease Control and Prevention has showed that the globe has rather moved from proving cure to health needs to preventing the disease from spreading in the first place. It is high time for us, as Ghanaians to reconsider our policies in terms of health, Agriculture and the energy sector.

There is a clear need for prevention of a disease developing in the first place and, once it has developed, early diagnosis and treatment. Dr Andreas Ullrich, cancer expert at WHO. Says “Earlier diagnoses have the potential to produce better treatment outcomes, especially with regard to cardiovascular diseases and some cancers,” and Gaita says: “Now it’s time to focus on prevention.”

It is fascinating sometimes when you hear incidence like outbreak of cholera; malaria and invasion of army-worms and many more, and then the government would say we are looking for support from world this and that to combat the challenge. I know and for the record, Ghana is still struggling with infectious diseases and weak health systems. The country faced grossly inadequate numbers of staff, mismanagement, inadequate motivation to hygiene officials and students, shortages of medicines and funds, and a sometimes total lack of insurance schemes to protect patients from catastrophic health care costs. Weaknesses in public health services drive patients to the more costly, often unregulated private sector, even for routine care.

But it would interest you to know that, in the developed world, you can’t see a crowded hospital like what we have here in Ghana and other African countries. This is not because they have money and can afford private or family health professional, but it is as a result of the nation’s proactive strategies in making sure disease of any kind does not gain a stable breeding ground to spread. This achievement is facilitated by their dedicated research personnel, institutions producing sanitary and hygiene officials.

The Dangers of life affecting Ghana and most African countries is that, life is repetitive; so most likely what you came to meet is what you would repeat. Majority of people living in Ghana would not be able to change their lives anyway; they would only repeat the life they came to meet because life is infectious and life is repetitive. Most Ghanaians become what they hate because they is nothing dramatic changes in their lives; we hate cholera, diarrhea, and malaria but we defecate openly, we see unclean environment and we reproduce unclean environment, simply because we are reproducing what we saw and we cannot change because we have not seen change.

This is to suggest that primary health care cannot be achieved unless there is significant change in the systems by government, strategic policies should be laid down to accelerate the speed of sanitation improvement in the nation. If the policies are enforced, primary health care delivery shall be achieved in the country.

In order to achieve primary health care delivery, I strongly suggest we consciously consider the following points:

1. Well thought out strategic policies should be considered with reference to the developed nations, that would help prevent rather than waiting for the incident to repeat itself.

2. Prevention is a million times the better option. What Ghana need is to focus on population-wide measures that make it easier for people to adopt healthy lifestyles. To do so, we need to revamp the hygiene schools and also provide better incentives (allowance) to students in the hygiene schools.

3. The president of the day is doing a good job for Ghana but I still hope to see the first president who would emulate Lee Kuan Yew; the first Prime Minister of Singapore after it became independence in 1965. He said, One of his first task is not to build roads and so on, but is to change the mentality of his people from third world thinking to first world thinking. Most people in Ghana still have third world mentality which makes it difficult for the nation to achieve risk free environment.

4. Every season the Ghanaian farmer loses to pathogens, which leads to decline in food production. However, research have shown that by 2030, the world's population is likely to increase by approximately 2.5 billion people, with much of this projected growth occurring in developing countries of which Ghana is part. As a consequence, food requirements are expected to double by 2025. So I think that government should not only motivate Nurses but he should extend the motivation to Agric students in the country who are our best hope to feeding the future.

Dr. Andreas U. Prevention is better than cure, Bulleting of the WHO, Vol 89: 2011

Dr. Otabil M. Going Global, Springboard 2015, Legacy and Legacy Foundation.

Giles J. Biosafety Trials Darken Outlook for Transgenic Crops in Europe. Nature 2003;425 (6960):751. [PubMed]

Lee K. Y. 2000. From Third World to First: The Singapore Story. New York: HarperCollins Publishers, 2000.

Professor Dan. G, Prevention is better than cure, Bulleting of the WHO, Vol 89:11

Weatherall, D. J. 1995. Science and the Quiet Art: The Role of Research in Medicine. New York: Rockefeller University, W. W. Norton, and Oxford University Press.

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