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Childhood vaccine shortage: A justification for Public Health Emergency Fund
• Availability of childhood vaccines would require more reliable source of funding
In February this year, there was uneasy calm among health workers and parents following reports of a widespread shortage of vaccines used for the routine immunisation of babies from birth to 18 months.
Vaccines said to be unavailable nationwide included Bacille Calmette-Guerin (BCG), which primarily prevents the occurrence of tuberculosis in babies, and OPV, which prevents polio infections. Others that prevent diseases such as whooping cough and measles were also in short supply.
Health workers said although there had been shortages in the past, it was not as pervasive as the scarcity recorded in 10 of 16 administrative regions of the country.
The President of the Paediatrics Society of Ghana, Dr. Hilda Mantebea Boye, had stated that the delay in the supply of the vaccine could lead to an outbreak of childhood diseases, including measles. And true to her words and other concerns expressed by many interest groups, about 100 cases of measles were detected in Northern Ghana by the time the first batch of vaccines had arrived.
Delay in the supply of vaccines was partly attributed to the depreciating Cedi but the Minister of Health Kwaku Agyeman Manu, at a press conference in Accra, explained that the situation was rather a “global challenge.” According to him, the shortage had nothing to do with the government owing suppliers but he gave the assurance that the situation would be resolved in due time.
To ease tension, the Health Minister indicated that no death was recorded as a result of the vaccine shortage.
Vaccination
Be that as it may, health experts say gaps in vaccination could “reduce immunity and require children to start the series all over again” hence the need to comply with recommended vaccine schedules. This, perhaps, explains the anxiety expressed by parents and health practitioners when the vaccines were taking too long to arrive.
Children are exposed to thousands of germs every day due to the food they eat, the air they breathe, and the things they put in their mouths. Because their immune system is not fully developed at birth, they are susceptible to infections and serious illnesses. Vaccines, therefore, help build their natural defenses and reduce the risk of contracting diseases.
It was, therefore, refreshing that good consignments were procured pending the delivery of additional supplies, as indicated by the government. Considering that it was the first time such a massive shortage was recorded, Dr. Kwaku Agyeman speaking on the floor of Parliament assured that the phenomenon would not occur again.
Shortage
During the period of the shortage, Private Health Practitioner, Dr. Amanda Nhyirah Biyeh, explained that facilities that did not have the vaccines relied on vitamins to “help sustain the children for some time.”
“Thirty percent of patients that come to our facility are pregnant women and children who come for vaccination. Sometimes there is an argument between nurses, doctors, and parents when we tell them there are no vaccines.”
“What we do is to give them vitamin B12, folic acid, and omega 3 fatty acids. These are the ones that help boost the immune system and help prevent some sickness until the children can go back and start their vaccination schedules again,” she noted.
Following the delivery of the first batch of vaccines on March 11, 2023, health workers are ensuring that parents who missed out on the routine vaccination would do the necessary “catch up”.
Donors
According to the Health Ministry, about $6.4 million had been paid to the United Nations Children’s Fund (UNICEF) which supplies the vaccines. Mr Agyeman, speaking on the floor of Parliament, did not indicate when the payments were made and what might have caused the delay.
As we await the delivery of the second batch of vaccines, the assurances and explanations given by the Health Ministry is an indication of the financial hurdle the country had to overcome to procure the vaccines.
To this extent, the government and health authorities cannot gloss over the fact that the availability of childhood vaccines in the future would require a more reliable source of funding.
Analysis presented by the Kaiser Family Foundation (KFF), a non profit organisation focusing on national health issues indicated that the Global Alliance for Vaccines and Immunization (GAVI), since its launch in 2000, had disbursed over $18 billion to support immunization efforts in low and middle-income countries, including Ghana.
GAVI is an independent public-private partnership and multilateral funding mechanism that aims at expanding global access to and use of vaccines, particularly among vulnerable children.
In 2017, development partners funded at least 19% of the country’s health expenditure but stakeholders say Ghana’s shift from low-income to middle-income status implies that the country would be “ineligible to receive concessional aid in the future.”
Civil Society Organisations and other health agencies agree that the loss of support from donor agencies could negatively impact the health system, such as procurement of medical products, availability of human resources, and lack of technical capacity to continue activities formally led by donors.
This and many factors give credence to why the country must stop paying lip service to the establishment of a Public Health Emergency Fund (PHEF) as captured in Ghana’s (2022- 2025) Medium Term Development Framework.
PHEF
The establishment of the fund would, undoubtedly, go a long way to help mobilise and disburse resources to respond effectively to potential health and humanitarian crisis in the future.
Although no casualty was recorded during the period of the shortage, one cannot imagine a future situation where children would not receive their recommended vaccines because there are no funds to procure same.
Again, a standby fund for health emergencies would have mitigated the recent inconveniences caused by the shortage of childhood vaccines. In the words of Dr. Biyeh, “we do not have to run out of vaccines.” According to her, the availability of funds would help in the procurement of enough cold chain facilities to store the vaccines.
“If the fund is established it would help the health centres a lot. The funds would ensure that we do not have to wait for a long time to raise funds or receive vaccines from elsewhere,” she said.
The government continues to play its part by raising domestic revenue to support the health budget. But to build a more resilient and responsive health system, we would have to look beyond external partners and fast-track the establishment of a Public Health Emergency Fund.
It would not only help us respond quickly to avoidable situations, such as the shortage of vaccines for childhood immunisation but would help provide adequate and sustained funding or backing for the country’s fragile public health system.
Availability of childhood vaccines would require more reliable source of funding
By Ernest Nutsugah
When Abigail Fremah steps up to the Armwrestling table, the noise fades, the tension settles, and order takes over.
Despite a calm, but firm and meticulous disposition, she has become one of the quiet forces shaping Ghana’s growing reputation in the sport, not as an athlete, but a referee trusted on the continental stage.
Abigail’s journey into Armwrestling did not begin at the table. Like many Ghanaian sports enthusiasts, she grew up playing several disciplines. Football was her first love, but she also featured in volleyball and basketball during her school years. Sports, she says, was simply a way of life not just for her.
“It runs through the family. All my siblings are into sports,” she stated.
“I was involved in almost every sport in school, football, volleyball, netball, hockey; I did everything,” she recalls.
Her academic background in Health, Physical Education and Recreation laid a solid foundation for her sporting career. While on scholarship at the university (University of Cape Coast), she often used her modest budget to support young athletes, sometimes sharing skills and even T-shirts at programmes she attended. Giving back, she explains, has always been part of her motivation.
However, as she matured as an athlete, Abigail made a critical self-assessment.
“Armwrestling involves a lot of strength,” she admits. “Looking at my body type, I realised I couldn’t fit properly as a competitive athlete.”
That moment of honesty pushed her to a different trajectory but equally important path in sports; which is officiating.
During her National Service, she was encouraged by Mr Charles Osei Asibey, the President of the Ghana Armwrestling Federation (GAF), to consider officiating. He introduced her to a technical official, Mr Hussein Akuerteh Addy, who formally took her through the basics of Armwrestling officiating in 2021.
“I started as a case official,” she says. “We moved from region to region every week, officiating competitions. That’s where it all began.”
By 2022, Abigail was actively involved in national assignments, though she missed the African Championship that year. Her breakthrough came in 2023, when Ghana hosted the African Armwrestling Championship.
It was her first experience officiating at a major international competition and it changed everything.
“That was my first national and international exposure at the same time,” she says. “It really opened my eyes.”
Today, Abigail is a World Junior Armwrestling Referee, a status earned through performance, consistency and discipline. She explains that progression in officiating was not automatic.
“It’s all about performance, your appearance at African Championships, your conduct, how you handle pressure; that’s what takes you to the world level,” she stressed.
As a referee, Abigail’s priority is safety and fairness. Armwrestling, she notes, comes with risks, particularly injuries to the wrists, elbows, shoulders and arms.
“If athletes don’t follow the rules or refuse to listen to officials, injuries can happen,” she explains, adding that focus was everything.
Before every match, she ensures that all equipment which includes elbow pads, hand pegs and table alignment were properly set. Athletes are not allowed to cover their elbows, must grip correctly, and must follow the referee’s commands precisely.
“We make sure everything is fixed before the grip,” she says. “Once we say ‘Ready… Go’, there should be no confusion.”
She is also firm on discipline. Warnings are issued for infractions, and repeated misconduct attracts penalties.
“The referee must be respected, if you don’t listen, the rules will deal with you,” she says.
Abigail credits her confidence partly to her sporting family background. Her mother was a volleyball player, while other family members also participated in sports. Though they were initially concerned about her safety, her rise to the top reassured them.
“They were afraid at first,” she admits. “But they were also very proud, especially because some of them never got the opportunity to reach this level.”
Looking ahead, Abigail is optimistic about the future of Armwrestling in Ghana. In less than a decade, the country has produced African and world-level medalists, a sign, she believes, of great things to come for Ghana.
“Whenever we go out, we come back with medals such as gold and silver,” she says, and to her that was a sign of growth.
In the next five to ten years, Abigail sees herself rising to become a World Master Referee, the highest officiating level in the sport. Until then, her routine remains intense, training four times a week, working closely with athletes, standing on her feet for hours, and constantly refining her understanding of the rules.
“I love this sport,” she says simply. “That love is what keeps me going.”
Abigail encouraged women to be bold and intentional about their place in sports saying “don’t limit yourself because of fear or stereotypes.”
She also urged women to invest in learning, discipline and consistency, stressing that respect was earned through performance.
For Abigail, as Ghana’s armwrestlers continue to make their mark, she will remain where she is most effective at the table, ensuring the game is played right.
By Esinam Jemima Kuatsinu
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As he had promised Aperkeh, the elderly man and his wife and three daughters stopped by Aperkeh’s parents’ house. Mr Amando and his family were preparing to settle in for the night.
“Brother Ben and family”, Mr Joshua Amando said warmly, “although I know you are here on a matter that can hardly be described as joyous, it is still good to see you. You are welcome. Please sit down while I bring you water”.
“Yes, we will take water, even though we are hardly thirsty, because this is our home”.
“Okay, Ben”, he started after they had drank, “Let me go straight to the point. My daughter Priscilla has told me about the goings on between her brother Aperkeh and our daughter Stella.
Before informing me, Priscilla had expressed concern to Aperkeh about some habits he is adopting, especially the late nights and the drinking. She tells me that one Saturday morning, she was there when Stella complained about his drinking and some girls who had come to the house to look for him, and he assaulted her.
I called him and complained, but all he could say was that I don’t know what caused him to react that way, so I could not judge him. Now he does not answer my calls.
I have sent Priscilla to his house to call him, but he has refused to come. Unfortunately, Ben, my son is a much different person than the young boy who completed university and started work at the bank. I am really embarrassed about his treatment of Stella”.
“Joshua, let me assure you that even though what is happening is very unfortunate, it will not affect our relationship.
We have been friends since childhood, and I thought that with their parents’ blessing, the relationship between Aperkeh and Stella would grow to become a blessing to all of us. But there appears to be a real challenge now.
Stella thinks that Aperkeh wants her out of his house, and indeed Aperkeh himself told me that, about an hour ago.
So I’m taking my daughter home. I suggest that you do what you can to straighten him out, but if it does not work out, let’s accept the situation and continue to be one family.
I am sure that being the well behaved girl that she is, Stella will meet a young man who will cherish her. Fortunately, this problem is happening early in the day, so they can sort things out if possible, or move on with their lives if they are unable to stay together”.
“I’m really grateful for that, Ben. I will do my best in the next few days to reason with him, because apart from the relationship with Stella, Aperkeh is risking his job and career with this lifestyle.
A good job and salary offers an opportunity to gather momentum in life, not to destroy yourself”.
“Okay Brother Joshua. We will say goodnight. I hope to hear positive news from you”.
As he descended in the lift from the fourth to the ground floor, Aperkeh wondered who would be waiting at the reception to see him at nine on Monday morning. He had spent good time with both of his new girls during the weekend, so it had to be someone else. He got out of the lift and pulled a face when he saw Priscilla.
“Priscilla”, he said as he sat down by her, “what do you want here? You know Monday morning is a busy time at the bank. I am a very busy person, so say what you want, I have work to do”.
“You are very funny, Aperkeh. You are telling me, your sister, that you have work to do, so I should hurry up? Okay, Dad says I should advise you to come home tonight, because he wants to discuss the issue of Stella with you. He sent me to you twice, and you did not come.
He has tried to call you quite a number of times, but you have refused to answer his calls. He says that if you do not come tonight, you will be very surprised at what he will do. He says you will not like it at all, so better come.
“What is all this? Why won’t you people leave me alone? Stella is very disrespectful. I told her that if she wanted to continue to live in my house, she must obey me. It is that simple.
She chose to continue ordering me about, controlling me in my own house, so I told her that if she could not live under my conditions she should leave. And she left. In fact, her own father came and took her away. So what again?’’
“How did she disobey or control you? Was she complaining about your continuous drinking and late nights? And did you slap her on several occasions because of that? Did you tell her that if she could not live under your conditions she should leave? You actually said that to her father? You have forgotten that before she came to live with you, our two parents met and agreed, and gave it their blessing?’
“Why don’t you leave, Priscilla? I don’t have to listen to all that”. “Okay, I will go. Your father who gave birth to you and educated you to university level sends me to you, and you ask me to leave? I wish you would defy him, and refuse to come home as he’s telling you, because he is planning to give you the discipline you badly need. Let me tell you. Stella is such a beautiful and decent girl, and I assure you that someone will grab her before you say Jack. You are only 30 years old, and you have already become a drunkard”.
As he walked towards the lift, Aperkeh decided on what to do. He would go home, and calmly listen to what his father had to say. The old man was very unpredictable, and he wouldn’t dare ignore him. So he would take all the insults and threats, but as for Stella she was history. According to Priscilla, Stella was beautiful and all that, but she had not seen the two curvaceous princesses who were all over him, ready to do anything he asked. And these were not barely literate waakye girls, but university graduates from wealthy homes, really classy girls. With stuff like that, who needs a waakye girl? He smiled as he took his seat.
A few minutes to five, Aperkeh was packing up to leave for home to meet his dad when his phone rang. It was Priscilla.
“Aperkeh, Dad says you don’t need to bother to come. Stella’s dad says she came to him early this morning to plead that she would rather stay at home than return to your house. She thinks you are already decided to be rid of her, and she does not want to risk being assaulted again. So it’s done. You can go ahead and enjoy the nice life you have started”.
Before he could tell her to go to hell, Priscilla hanged up the line. He was partially stung that his dad had virtually cut him off. The last thing anyone would want was to fall out of relationship with his own family, which had always supported him.
But the truth was he was no longer interested in Stella. What was wrong with going by one’s feelings? He could only hope that one day, his parents and sister would try to reason with him.
By Ekow de Heer
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