Why Should Ghana’s Yellow Fever Results Need a Senegalese Signature?

Between June and September 2026, Ghana recorded about 450 suspected cases of yellow fever, according to the Minister for Health (MyJoyOnline, 2026a). On 9th October the Minister announced that three cases in the Upper West had been confirmed and that all three patients had died (Ghana News Agency, 2026). On 1st November the Director-General of the Ghana Health Service (GHS) put the number of confirmed cases at four, in districts including Sissala West, Wa West and Nadowli-Kaleo (MyJoyOnline, 2026c).

According to official statements, those confirmations came from a laboratory in Dakar, Senegal. A patient falls sick in the Upper West, a Ghanaian laboratory tests the sample, and the sample is then shipped to Senegal for the result that counts internationally. That arrangement costs time.

The problem: a two-country journey for one answer

Ghana’s yellow fever samples make two trips. The first is inside the country, from a district clinic to the National Public Health and Reference Laboratory (NPHRL) at Korle-Bu or to Noguchi. The second is out of the country, to the Institut Pasteur de Dakar, which the World Health Organization (WHO) recognises as the Regional Reference Laboratory for yellow fever (Ghartey, 2026).

The first trip is already slow. A study of every suspected case Ghana tested between 2018 and 2022 found a median of 10 days from the day a patient fell ill to the day the sample reached the national laboratory. Only 41% of samples arrived within the three days WHO recommends after collection (Judson et al., 2025). A separate survey of 265 health facilities in nine regions put the average turnaround for referred specimens at 12 days (Nkrumah et al., 2025).

The ground-level reasons are not mysterious. In six Upper West and Ashanti facilities with high rates of rejected samples, 8 of the 15 health workers assessed had no training in specimen collection and handling, and temperature-tracking tools for samples in transit were largely missing (Attu et al., 2026).

Then comes the Dakar leg. The GHS Director-General has said samples are sent to Dakar irrespective of the local result, and that communication with Dakar takes a long time (Ghartey, 2026). International shipping has been a weak link across Africa: a 2018 assessment of laboratories in 25 high-risk countries, supported by Gavi, found that about half of presumptive yellow fever cases were never confirmed at the regional laboratory because of shipping problems (Johnson et al., 2021).

What the Director-General said

On TV3’s Hot Issues on Sunday, 1st November 2026, the Director-General of GHS, Dr Samuel Kaba Akoriyea, said WHO has already evaluated the Public Health Reference Laboratory. He said Ghana is now waiting for WHO to communicate the outcome in writing (Ghartey, 2026).

He explained why the samples still go abroad. Dakar is the laboratory the international system certifies, so Dakar’s results are the ones recognised. Once approval arrives, he said, results produced in Ghana would be accepted internationally (Ghartey, 2026).

On the same programme he said the current outbreak had been curtailed after four confirmed cases, and that GHS was still investigating community deaths that some have linked to yellow fever (MyJoyOnline, 2026c). The reports do not give a date for WHO’s decision.

What Ghana gains if WHO says yes

Nigeria offers a comparison. According to Resolve to Save Lives, which supported the work, Nigeria’s national reference laboratory in March 2021 became the first in the region to receive WHO accreditation to confirm yellow fever by PCR, without sending samples to Dakar. Confirmation time dropped from more than 30 days to within 24 hours (Resolve to Save Lives, 2021). If Ghana receives similar approval, it could expect similar gains.

Why not simply send Ghana’s samples to Nigeria? Nigeria’s accreditation, as described by Resolve to Save Lives (2021), allows its national laboratory to confirm Nigeria’s own cases. Under WHO’s testing system, national laboratories refer samples to a Regional Reference Laboratory for confirmation (World Health Organization, 2022), and that role sits with the Institut Pasteur de Dakar (Ghartey, 2026). Ghana’s samples therefore follow the WHO route to Dakar, not to a neighbouring national laboratory.

1. Faster outbreak declarations. In 2026 the government said it could not officially declare an outbreak until confirmation came back from Senegal (MyJoyOnline, 2026b). Local confirmation would let Ghana declare or rule out an outbreak on its own results.
2. Earlier vaccination. Ghana already begins parts of its response when several local antibody tests are positive (Judson et al., 2025). A declared outbreak, however, supports the full vaccination campaign, so faster confirmation could bring vaccines sooner to remote northern districts, where recent outbreaks began among unvaccinated nomadic populations (Judson et al., 2025).
3. Fewer lost samples. A sample that never leaves the country cannot be delayed at an airport, spoiled in transit or lost in a cargo hold. Across Africa, shipping problems have left about half of presumptive cases unconfirmed (Johnson et al., 2021).
4. Lower cost. International shipment of infectious specimens needs special packaging, couriers and paperwork. Resolve to Save Lives (2021) notes that strengthening testing is far cheaper than vaccinating.
5. Better patient care. Clinicians would know sooner whether they are dealing with yellow fever or another illness with similar signs.
6. A national asset beyond yellow fever. The same trained staff, equipment and quality systems can support testing for other outbreak-prone diseases.

What we lose if it does not happen

The 2021 outbreak shows the stakes. By late November 2021 it had produced 70 confirmed cases and 35 deaths across Savannah, Upper West, Bono and Oti, and the outbreak was confirmed after three samples tested positive by PCR at Institut Pasteur de Dakar (World Health Organization, 2021).

1. The virus keeps its head start. While a sample is in transit, Aedes mosquitoes keep biting. A preprint review of African outbreaks from 2010 to 2025 found a median of about 90 days from the index case to reactive vaccination (Haring et al., 2026). Waiting for confirmation is one step in that chain.
2. Lives at stake. All three of the first confirmed patients in 2026 died (Ghana News Agency, 2026), and the Minister said 15 other suspected deaths were under investigation (Adom Online, 2026). Severe yellow fever progresses quickly, so delays in confirming it matter.
3. Risk to our neighbours. During the 2021 outbreak, WHO noted that the affected area shares porous borders with Côte d’Ivoire and Burkina Faso, with potential for spread beyond Ghana (World Health Organization, 2021). Slow confirmation in Ghana can become a regional problem.
4. Dependence on support that may not last. Much of Africa’s yellow fever laboratory and shipping system runs under the WHO-led Eliminate Yellow Fever Epidemics (EYE) strategy, which transitions at the end of 2026 (Haring et al., 2026). If that support changes, a country without its own confirmation capacity could be more exposed.
5. Wasted local capacity. Ghanaian laboratories already test every sample first. Under the current arrangement, their results are not accepted internationally as confirmation (Ghartey, 2026).

Certification is the start, not the end

WHO approval would remove the Dakar leg. It would not fix the delay inside Ghana, where the median time from a patient falling ill to the sample reaching the national laboratory was 10 days, and most samples took more than three days to arrive after collection (Judson et al., 2025). The steps below could help. The published reports reviewed for this article do not show any of them in place nationwide.

1. A 72-hour yellow fever courier rule. Attu et al. (2026) recommend a dedicated cold-chain network that delivers specimens within 72 hours. Ghana’s integrated sample referral pilot in the Northern and Greater Accra regions brought yellow fever turnaround to 5 to 7 days (Owusu et al., 2025). It should go national, with motorbike riders paid per sample delivered on time.
2. A northern confirmatory hub. Nigeria put a laboratory in each of its six geopolitical zones (Resolve to Save Lives, 2021). Upgrading the existing Tamale Public Health Laboratory into a confirmatory hub, linked to the NPHRL, would serve the Savannah, Northern and Upper regions where outbreaks begin.
3. Rapid tests at district level. A yellow fever IgM rapid test evaluated in Ghana showed 96.3% sensitivity and 97.9% specificity against ELISA (Ofosu-Appiah et al., 2022). Wider use in district hospitals for screening, not confirmation, could flag suspected clusters earlier.
4. A public turnaround dashboard. GHS could publish, every week, how long each region’s samples took from collection to result. What gets measured in public gets fixed.
5. A protected budget line for reagents. In the 2018 assessment of 25 African countries, 21% of specimens went untested because of a lack of kits or reagents (Johnson et al., 2021). Certification means little if the shelves are empty.
6. Aim higher than approval. Once certified, Ghana should seek to become a reference laboratory for its neighbours. Then the question in the title could be turned around.

Ghanaian scientists already test these samples first. The task now is to make sure their answer is the one the world accepts, and that it arrives while there is still time to act on it.

References

Adom Online. (2026). Yellow fever: Three deaths confirmed, 15 under investigation in Upper West. https://www.adomonline.com/?p=2716185

Attu, J. A., Nkrumah, B., Kutame, R., et al. (2026). Contributory factors to specimen rejection for measles and yellow fever testing at the National Public Health and Reference Laboratory, Accra, Ghana. Journal of Interventional Epidemiology and Public Health. https://doi.org/10.37432/jieph-confpro7-0073

Ghana News Agency. (2026, October 9). Health Minister confirms three yellow fever cases in Upper West. https://gna.org.gh/2026/10/health-minister-confirms-three-yellow-fever-cases-in-upper-west/

Ghartey, R. (2026, November 1). Yellow fever tests in Ghana to be soon recognised internationally as WHO evaluates Public Health Reference Laboratory. 3News. https://3news.com/news/yellow-fever-tests-in-ghana-to-be-soon-recognised-internationally-as-who-evaluates-public-health-reference-laboratory

Haring, C., Lee, S., Dowdy, D., & Judson, S. (2026). Yellow fever outbreaks and reactive vaccination in Africa, 2010–2025: A scoping review and analysis [Preprint]. Research Square. https://doi.org/10.21203/rs.3.rs-10538163/v1

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MyJoyOnline. (2026b). Fumigation must begin immediately to contain suspected yellow fever – SEND Ghana. https://www.myjoyonline.com/fumigation-must-begin-immediately-to-contain-suspected-yellow-fever-send-ghana/

MyJoyOnline. (2026c, November 2). GHS contains yellow fever outbreak after confirming four cases. https://www.myjoyonline.com/ghs-contains-yellow-fever-outbreak-after-confirming-four-cases/

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Resolve to Save Lives. (2021, November 23). Improving the ability to test for yellow fever: A low-cost, country-led intervention in Nigeria. https://resolvetosavelives.org/strategies-in-action/testing-for-yellow-fever-in-nigeria/

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