Former Deputy Health Minister Alexander Akwasi Acquah stated on Monday that Ghana is not yet prepared to cease relying on donor aid, warning that an abrupt cut-off would expose significant weaknesses in the nation’s health financing system. His remarks follow Ghana’s rejection of a US health deal, reigniting discussions about the country’s capacity to fund essential healthcare services independently.
Context of Donor Dependency
Ghana, like many developing nations, has historically depended on external funding to bolster its healthcare infrastructure and services. This reliance, while providing crucial support, has also created vulnerabilities.
The recent rejection of a US health deal has brought these vulnerabilities into sharp focus. This decision has prompted a national conversation about self-sufficiency in health financing.
Deepening Health Sector Strain
Mr. Acquah, a member of Parliament’s Health Committee, expressed strong reservations about Ghana’s readiness to forgo external support. He asserted that the country faces considerable challenges even when aid is received.
“Even though I was in my former position as the Deputy Minister, I could not come to terms with the fact that we had aid in terms of logistics from foreign partners, and we could not just clear them from the ports,” Acquah stated.
He highlighted logistical hurdles and potential revenue generation from aid, questioning the feasibility of complete independence. “You remember that big story, so even if the aid that is coming, we still want to take taxes on them to support our budgets, and now we say we want to win ourselves totally from them. How do we survive?”
Abuja Declaration and Inefficiencies
Acquah pointed out that even international commitments, such as the 15% health spending target under the Abuja Declaration, implicitly anticipate support from development partners.
“This 15% declaration by the Abuja declaration still demanded that there’s that level of support from developed countries, developed partners, and so kindly, we just have to buy the bullet,” he argued.
He stressed the immediate need to address internal inefficiencies in public spending. “And like Dr Nii Moi Thompson said, we may have to look into our systems and cut off all the waste, because there, there is a lot of waste within our public sector.”
Suffering Sector and Shrinking Flows
The former deputy minister warned that the health sector is already experiencing the negative effects of declining aid. “You cannot take away the health sector, you know, because most often than not, we have relied on aid. It’s become one of the major motivations.”
“I’m telling you, the health sector is suffering, because I know what is happening, especially when the USA and others got cut off,” he revealed.
He elaborated that specific areas within the health sector were heavily dependent on this external funding. “You know, there are certain areas that got a lot of motivation from some of this aid, and now that they are not coming, it’s become critical.”
GHS Engagements and Remaining Support
Recent engagements with the Ghana Health Service (GHS) and its agencies have underscored the potential risks ahead if financial strategies are not reassessed. Program managers presented a stark picture of the future.
“Very recently, I think about a month or so, we met the Ghana Health Service boss and their agencies and all the program managers in their presentation gave us an indication of what is ahead if we do not sit up to look at the finance and health financing,” Acquah shared.
While the US has withdrawn its support, other donor agencies remain engaged, providing Ghana with a crucial window of opportunity to re-evaluate its strategy. “I thank God, it’s only the US that is playing this kind of game with us. There are some other donor agencies that are still with us, you know, and so it gives us an opportunity to start looking beyond it. And let’s look at our source,” he concluded.
Looking Ahead
The situation calls for urgent reforms in public financial management and a strategic diversification of health sector funding sources. Stakeholders will be closely watching how Ghana navigates these challenges and whether it can successfully transition towards greater financial autonomy in its healthcare system without compromising service delivery.
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