Ghana NCD Alliance Civil Society Manifesto Putting: NCDs At The Centre Of Ghana’s 2020 Agenda

Introduction

Non-communicable Diseases (NCDs) have no respect for age, place or gender, or socioeconomic status. NCDs are the leading global health challenge in the 21st century, resulting in ill health, economic loss, life loss, diminished quality of life, and poor social development equally in both high-resource and low-resourced countries.

According to the World Health Organization (WHO), 41 million people die from NCDs each year, more than 85% are premature and occurring in low and middle-income countries¹. Unfortunately, over half of the world’s population cannot access essential healthcare and millions are driven into poverty each year because of out-of-pocket spending on health services.

NCDs cut across every facet of the Ghanaian economy and by extension global economies, thus the need to prioritize NCDs in all policy-making beyond health. NCDs include mental health, diabetes, cancers, hypertension, strokes, sickle cell, Asthma, etc. and even old age, therefore enacting policies across all sectors, will play a key role in the wellbeing of the over 28 million Ghanaians.

In 2016 alone, over 94,400 Ghanaians died from NCDs (WHO). An estimated 22, 000 lives in Ghana can be saved if all the WHO Best Buys for NCD prevention and control are implemented effectively. We must stand for action now so that many lives can be saved.

Ghana has made some progress in strengthening policy response to NCDs. These include the adoption of the Public Health Act (Tobacco Control Measures and Regulations) in 2012 and 2016, a 175% tax increase on tobacco products highest in the sub-region, the National Alcohol Policy of 2016, the National Policy and Strategy on NCDs and National Strategy for Cancer Control and in 2006, passed the Disability Act (Act 715). However, the implementation of these national laws and policies remains weak.

Reducing the burden of NCDs is essential to achieving Universal Health Coverage (UHC) and the Sustainable Development Goals (SDGs) in Ghana. Stronger national health systems that emphasis on integrated care, particularly at the primary healthcare (PHC) levels are imperative to reducing the burden of NCDs.

The elected government has a responsibility to ensure prevention, treatment, and care, and financial risk protection across the continuum of care is available especially for the poorest and most vulnerable populations.

Find the Ghana NCD Alliance Advocacy Agenda for more information in this link: https://ncdalliance.org/news-events/news/launch-of-the-ghana-advocacy-agenda-of-people-living-with-ncds

The Ghana NCD Alliance and People living with NCDs (PLWNCDs) strongly oppose the following trends:

• The inability of the government to meet all the health budget proposed by the Ministry of Health, this inhibits the development of health infrastructure and weakens health systems- NCDs are mostly affected with little or no budget allocation
• Inadequate regulations of the private health sector, allowing the sector to continue massive profiteering at the cost of patients, especially by cor­porate hospitals
• Hiking of prices of drugs due to lack of price control
• Advertising of all manner of goods and services injurious to the health of the people and especially to people living with NCDs and children
• Inadequate specialized healthcare professionals and public facilities for NCDs and other chronic diseases treatment and care

Rationale

The Ghana NCD Alliance and PLWNCDs all over the country request all political parties in the lead up to the 2020 December polls to invest in prevention, human right and social justice, treatment care and support and meaningful involvement of people living with NCDs and to note that upholding the funda­mental rights of humans as stated in Ghana’s Constitution also includes right to health without any discrimination or exception.

We expect that the par­ty elected will implement these recommendations and parties in opposition will join the rest of the CSOs and the media to continue to raise these proposals and demands for policy actions that address these health challenges.

In this context, we propose the following policy actions, in the lead up to the upcoming Presidential and Parliamentary elections to commit­ to by all political parties and candidates.

Recommendations

Ensure the attainment of Human Right and Social justice

Legislations on the right to healthcare should be enacted to ensure universal access to good quality and comprehensive health care services for the entire population and against stigma and discrimination at every level.

Access to treatment, care, and support services is a prerequisite for the fundamental human right to achieve the highest possible standard of physical and mental health and well-being.

Availability and access to essential lifesaving medicines and products for people living with NCDs is, unacceptably, still out of reach for millions of people around the country, particularly in low income, poorest, and most vulnerable populations. A particular issue is the inadequate supply of glucometers at the community health centers for diagnoses.

Prevention, research, and implementation of NCDs policies

Increase in public investment in health and NCDs prevention, research, and implementation, focusing on prevention across the lifespan. According to WHO for every US$1 invested in scaling up actions to address NCDs in low- and lower-middle-income countries, there will be a return to society of at least US$7 in increased employment, productivity, and long life.

Governments need to increase domestic investment through domestic revenue mobilization, and other sources such as taxes on alcohol, tobacco, sugar-sweetened beverages (SSBs), fossil fuel, etc. and allocate more public financing for health. Increasing substantially the public expenditure on health and NCDs to be financed primarily through domestic taxation will help achieve the “Ghana Beyond Aid Agenda”.

Placing multi-sectoral collaboration at the heart of the NCD response means working together and winning together. Young people need to be on board as stakeholders in the NCD/health response: they are the main targets of unhealthy commodity industries.

Invest in research and development to quantify Ghana’s NCD burden and build strong evidence for NCD prevention and control as currently highly, it is inadequate.

Provision of Treatment Care and Support Services

The huge costs associated with the treatment and care for NCDs have caused many PLWNCDs to lose their businesses and income, leading to total neglect by their families and friends.

The capacity of the Public Sector Health System should be enhanced to monitor and analyze new elements of social determinants of health to recommend preventing and mitigating measures.

Design and implement UHC that addresses the growing burden of multi-morbidities and considers the practical needs of people living with more than one chronic condition.

The government must ensure the availability of comprehensive services for early detection, diagnosis, treatment, psychological, rehabilitative, palliative care for those with NCDs and other chronic conditions.

Introduce a policy that mandates everyone to know their health status via a health card connected to the National identification card and National Health Insurance Card.

Expansion of the National Health Insurance Scheme to cover comprehensive services, treatment, and care of NCDs

Decentralized healthcare services that enable access at the local level including equipping Community Based Health Planning and Services (CHPS) compounds and health centers with physiotherapy facilities and basic diagnostics equipment especially in hard to reach places.

Meaningful involvement of CSOs and People living with NCDs

People living with NCDs can be critically resourceful in the National NCD and Health response. They can contribute meaningfully across the spectrum of the health and NCD related activities from research, policymaking, programme planning to implementation as well as monitoring, evaluation, and accountability efforts.

Consult with and actively involve people living with NCDs, young people, and civil society actors directly or through their representative organizations when designing, planning, implementing, and evaluating policies, laws, and services that affect them directly or indirectly.

Other recommendations

Active participation by the government in all high-level decision making bodies and meetings especially UN high-level meetings on health/NCDs.

Ensure increased transparency in NCD care and access to unbiased information about the benefits and harm of our drugs.

Conclusion

The next government should increase ambition by developing a cross-government plan for preventing NCDs and promoting good health. This should lead to a workplan of policies and outcomes for each government department, running alongside the National Policy on NCDs. The plan must meaningfully address the root causes of NCDs problems.

Further, the next government should show ambition and boldness in utilizing taxation, regulation, and legislation –these have been proven to be the most effective tools for driving sustained improvements in population health.

Finally, we urge all political parties to effectively adopt and implement the recommendations to show the ambition and boldness necessary to prioritize, protect, and promote the public’s health.

We call for increased political buy-in for free, quality, and accessible universal healthcare for all without exception.

Contacts

Labram Musah: National Coordinator, Ghana NCD Alliance

For Ghana NCD Alliance, NCDs CSOs and People living with NCDs

Email: [email protected] Mobile: 024 3211854

Find out more about the GhNCDA: https://ghanancdalliance.org/index.html