Hope for Future Generations (HFFG Ghana) welcomes the Inaugural African Union (AU) Biennial Joint Meeting of Ministers of Health and Finance for Eastern and Southern Africa Regions which took place on 8 – 9 October 2020.
We applaud the African Union for the leadership on the Africa Leaders Meeting framework and commitments, which has laid a foundation for the Health Financing agenda in Africa. This framework recognises that external partners cannot solely support Africa’s human capital development. It also demonstrates Africa’s leadership towards increased and efficient investments in health.
In Ghana, COVID-19, has led to economic contraction. Given significant revenue shortfalls, most countries, including Ghana are responding to the crisis by increasing spending mostly financed by increasing debt. Ghana has also introduced tax policy measures (including tax cuts and deferrals) to counter the economic effects of Covid-19.
We welcome the temporary debt relief by lending partners through a reduction in debt financing obligations in 2020. The suspension of debt service payments from official bilateral creditors through the Debt Service Suspension Initiative (DSSI) between May and December 2020 will allow for the reallocation of spending to health and other Covid-19-related areas.
We are concerned that prior to the pandemic, Ghana had not met the recommended health investments threshold of 5% of DGP; 15% of total Government Total Expenditure; $86 per capita.
Our concern is not only on health spending in 2020 but also on what may occur in 2021 and in the years to come as government spending falls and normal debt servicing resumes. We therefore submit the following perspectives:
- The Government of Ghana will need to raise additional revenues. This will require building more effective tax systems. Those with the broadest shoulders will need to bear more of the burden, whether through administrative reforms to improve collection, or through changes in tax policy. The efficiency of the tax system can also be improved through the expansion of environmental taxation and cutting wasteful subsidies and tax expenditures (Granger, et al., 2020).
- The Ministry of Finance will need to take measures to reallocate increased funds towards the health sector. Whilst all sectors tend to consider themselves under-funded, Hon Kwaku Agyeman Manu will have to assess the needs of the health sector, in comparison to other sectors and fund health adequately.
- The Minister for Health will need to better allocate and make better use of funding within the health sector. Better priority setting can help focus spending on the most efficient and effective programmes (Glassman et al., 2017). Reforms to expenditure management can ensure that frontline service providers have sufficient flexibility to respond to the new conditions and improve performance (Barroy et al., 2019).
- The Government of Ghana will need to address social barriers to equitable access to health services. With COVID-19 pushing Ghana into extreme poverty, the economic shocks – and disruption to health, nutrition, and education – have multiplied the devastation of the pandemic well beyond the direct impact of illness from the virus. There is a need for a powerful, equitable response to the pandemic that protects the poorest and most marginalized communities. This includes ensuring that gender and human rights barriers to equitable access to services are addressed.
Ensure that savings from the Debt Service Suspension Initiative (DSSI) are reallocated to health and other Covid-19-related expenses and that spending goes where it’s needed the most to ensure investment in basic needs for the most vulnerable.
Once the urgency of addressing the health crisis subsides, the Government should focus interventions on mitigating the lasting economic damages caused by Covid-19. To preserve labour productivity, there is a need to continue to progressively build human capital for health, nutrition and education.
- The Government should invest more in health research & development. The impact of the COVID-19 crisis is a powerful reminder of the need for greater investments in health research and development in Ghana.
As communities and civil society, we are committed to our role on accountability in ensuring that Ghana builds back better.