Non-State Actors in Health calls for committed approach in disease management

Members of Non-State Actors (NSA) for Health Ghana, a national advocacy network, have called for a complete change in the approach and mindset of Ghanaians towards the management of HIV, Malaria and TB in the country.

The NSA, consisting of health activists of corporations, civil society, media organizations and private businesses, is, therefore, urging the government, donors, civil society and the private sector, to show evidence and take stronger country ownership of HIV, TB, and malaria management.

In a communique issued at the end of a day’s dialogue on finding ways to enhance the implementation of the country’s HIV, TB and malaria for sustainable impact, the NSA said a stronger political commitment in terms of contributions to matching funds, and co-financing obligations was urgently needed.

Also, improved professionalism in the submission of co-financing proposals for better clarity and the offering of a stronger argument for a “business case” to the donor partners was critical, the Communique copied to the Ghana News Agency said.

Below is the full text of the communiqué:

Consultation, Dialogue and Strategic Direction During the meeting, all participants present, acknowledged that Ghana had witnessed an increase in new infections over the last seven years (in the general population by 21% and among the youth (15-24 years) by 45%; recording over 19, 000 new infections in 2017. Participants also acknowledged that HIV infection is more prevalent amongst couples in stable heterosexual relationships or couples involved in casual heterosexual sex who are not aware of; or are apathetic of their positive status.

Challenges to meeting National Targets-HIV

The meeting expressed concern that discrimination and stigmatization is rife countrywide. This is coupled with poor quality of care reflected by the disinterest of some medical staff in HIV counselling, treatment and care as well as treatment illiteracy among people living with HIV (PLHIV).

Food insecurity among a cross-section of PLHIV and poor logistic management of Antiretroviral drug distribution are also obstacles impeding Ghana’s attainment of the global 90-90-90 target (as only 113, 000 of the estimated 316, 000 people living with HIV are on treatment).

The meeting further noted that poor data management and poor data analysis coupled with limited utilization of data for programmes remain issues that continue to bedevil efficient HIV management in the country.

Challenges to meeting National Targets-TB

The same reasons account for Ghana being ranked second from the bottom in terms of countries that are achieving their targets in finding TB cases.

Partnership between Government of Ghana and the Global Fund to Fight AIDS, Tuberculosis and Malaria (GF) and the U.S government’s President Emergency Fund for AIDS Relief (PEPFAR)

The meeting also noted with concern that in the wake of dwindling of global donor support, Ghana has had an abrogation of an MOU of $19.5 million grant from the US President’s Emergency Fund for AIDS Relief (PEPFAR) and the withdrawal/recovery of $1.6 million from Ghana’s Global Fund 2018-2020 country allocation, due to her inability to match some of her co-financing obligations.

The Government of Ghana’s Financial Support the past couple of years
The meeting observed and appreciated the efforts of the government of Ghana to support HIV and TB interventions and the increase in funds commitment in response to the HIV epidemic but also acknowledged that the consequence of the challenges stated above is that Ghana’s efforts towards reaching HIV Epidemic Control by 2030 might not be achieved.

Our Collective Decision

With the unfortunate increase of the national HIV prevalence rate from 1.7% in 2017 to 2.4 % in 2018, we, the members of Non State Actors for Health Ghana, are calling for a complete change in approach and mindset with regard to HIV & TB management in the country by demanding the following from the government, donors, civil society and the private sector:

1. Evidence of Country Ownership

• Stronger country ownership of HIV/TB management.

• Stronger political commitment in terms of contributions to matching funds, co-financing obligations.

• Improved professionalism in the submission of co-financing proposals for better clarity and offering a stronger argument for a “business case” to the donor.


2. Grant Release Procedure

• Modification of current grant architecture (from the process of fund release through to implementation) and streamlining of fund grant facilitation processes.

• Rebalancing the Global Fund allocation to the National AIDS and STI Control Programme to drive both absorption and maximize impact by including the private sector in HIV management at the national programme level.

3. Implementation of Programme

• Diversification of treatment services to include the Private Sector and ensuring that they adhere to the Ministry of Health/Ghana Health Service guidelines.

• Stronger engagement of youth (10 -24 years) in the prevention of new infections.

• Efficient and effective utilisation of resources by Programme Managers to achieve programme results and outcomes.

• Ensure the availability of paediatric ARV and prevention of HIV/TB commodities shortages across the country.

• Increased education of the general public (including religious/traditional leaders and herbalists) about the need for them to play a more active role in HIV/TB prevention.

4. Monitoring

• Improved monitoring systems, data analysis and data utilization for programmes at all levels of HIV management whether implementation is by Government or Private Sector.