On July 26, 2023, the U.S. entered into a historic partnership with Korea and Japan. At an event hosted by Honorable Kwaku Agyeman-Manu, Ghana’s Health Minister, in Accra, a Memorandum of Cooperation (MOC) was signed stating that the three countries’ foreign aid agencies, USAID, KOICA and JICA, will work together to help Ghana achieve its goal of Universal Health Coverage. This marks the first collaborative project between the three agencies and will increase the impact of USAID in Ghana. While JICA, USAID and KOICA have already been working collaboratively in Northern Ghana to provide health care support, the signing of this MOC will produce a more coordinated response, by ensuring, according to JICA, “effective utilization of each organization’s respective health care know-how and resources.”
A Forgotten Region
The partnership will focus on supporting Ghana’s North: the Upper West, Upper East, North East, Savannah and Northern Regions. Global Health initiatives supported by USAID in Ghana have not previously focused on these areas, despite the fact that they require the most aid as they have been excluded from positive trends regarding poverty and life expectancy in the country.
According to a report by the U.N., the percentage of Ghanaians living in poverty fell from 52% in 1992 to 29% in 2006. However, that same report states that, in the Northern Region, the poverty rate only fell from 63% to 52% over the same period, and actually increased in the Upper East Region, from 67% to 70%. From 2006 to 2012, some improvement was observed in these areas, particularly the Upper East and West, where rates declined from 73% to 44% and 89% to 71% respectively. However, progress in the Northern Region was still slow over this period and these three areas still have the highest rates of poverty in Ghana. These high poverty rates mean that Universal Health care will have the greatest impact on Ghana’s North since medical bills are a greater burden for those living in poverty. Additionally, the area currently lacks basic health care services because it is so far away from Accra.
Plan of Action
The agreement will focus on the following three key areas of health care in Ghana:
- Primary (essential) health care
- Health Governance at a regional and district level
- Global health security
Currently, Ghana’s primary health care system is the Community-Based Health Planning and Services (CHPS). For the last 20 years, it has aimed to reduce inequalities relating to health care by providing care in rural communities, particularly to women and children.
The partnership will build on this preexisting system, while also strengthening the quality of health services by working with health centers.
So far, USAID has promised to give $135 million to the project, between 2023 and 2027. KOICA, the Korean overseas aid department, has promised $22 million, while JICA has not yet laid out a figure since it is awaiting approval, but promises to invest its financial and technical resources once that approval is obtained.
This aid could not come at a better time, since the country is currently recovering from the COVID-19 pandemic, despite the help from USAID in Ghana in the form of case management and donation and deployment of vaccines. Additionally, Ghana is looking to strengthen its health care system to prevent any future pandemic threats.
Problems to Solve
Ghana is currently facing a vast range of threats to its citizens’ health, one of the greatest being malaria. Malaria is constantly present in all areas of Ghana, and it is among the 15 highest malaria-burdened countries in the world. Around 2% of global malaria deaths can be attributed to Ghana. However, in 2020-2021 cases remained stable and deaths fell by 1.7%, a small margin but a step in the correct direction. Additionally, access to insecticide-treated nets (ITNS) has seen a steady increase and stood at 67% in 2019. However, the use of these nets has not increased at the same rate and was only 43% in 2019.
Another major health problem faced by Ghanaians is HIV/AIDS. A 2019 study found HIV prevalence to be around 1.6%. The groups most affected were men who have sex with men and female sex workers. Currently, Ghana’s strategic plan for HIV, which began in 2021 and will continue through 2025 involves a 95% goal for testing, treatment and viral suppression targets. Aid from the partnership will contribute toward this goal.
This partnership marks a new frontier for USAID in Ghana. By collaborating, the three countries’ aid agencies have the potential to produce a coordinated, more efficient response to improve health care in Ghana, achieve the goal of universal health care and help people living in poverty.
– Lily Cooper