The Head of the Department of Epidemiology and Disease Control at the University of Ghana, Professor Ernest Kenu, has warned that infectious diseases continue to spread in Ghana not because of weak border controls but due to failures within the country’s health and sanitation systems.

Delivering his inaugural lecture at the University of Ghana’s Great Hall on Thursday, June 25, under the theme, “Disease Smuggling: The Unseen Cargo in Global Health Security – Lessons from Cholera and COVID-19 in Ghana,” Prof. Kenu said disease-causing germs move silently through contaminated water, poor sanitation, overcrowded spaces and weak surveillance systems.

According to him, Ghana’s first documented cholera case was recorded in September 1970 after a traveller from Togo collapsed at the then Accra International Airport.
However, he said the outbreak’s actual source was a Ghanaian fisherman who had died in Togo and whose body was brought back home by relatives, unknowingly carrying the cholera bacteria.

Since then, he said, Ghana has recorded more than 15 cholera outbreaks, with poor sanitation continuing to fuel the disease.

Prof. Kenu disclosed that in 2014, Greater Accra alone recorded 20,199 cholera cases and that nearly 80 per cent of the country’s index cases were linked to prior travel to the capital.

He further revealed that during the 2016 cholera outbreak in Cape Coast, visiting a treatment centre increased a person’s chances of becoming infected by twelve times, turning healthcare facilities into centres of transmission.

The epidemiologist stressed that simple handwashing with soap and running water could reduce diarrhoeal diseases by between 32 and 48 per cent and provide a return of two dollars for every one dollar invested in handwashing programmes.

Touching on the COVID-19 pandemic, Prof. Kenu said the virus entered Ghana in March 2020 through travellers from Turkey and Norway.

He said the government responded quickly by closing the country’s borders, imposing restrictions and introducing enhanced surveillance measures, including testing everyone living within a one-to-two-kilometre radius of a confirmed case.

According to him, studies on the first 17,763 confirmed COVID-19 cases in Ghana showed that nearly 80 per cent of infected persons had no symptoms, allowing the virus to spread unnoticed.

He revealed that only 12.3 per cent of people observed proper hand hygiene in public spaces, while nearly 60 per cent of people wore face masks incorrectly during the pandemic.

Prof. Kenu said delays in laboratory test results, which in some cases lasted up to 10 days, also contributed to the spread of the virus.

He noted that when Ghana reopened its borders, health authorities successfully integrated COVID-19 surveillance into the country’s existing influenza-like illness surveillance system, improving efficiency and strengthening disease monitoring.

In an unexpected development, Prof. Kenu said a Phase II clinical trial for a new cholera treatment conducted between 2021 and 2023 failed because there were no patients to enrol.

He explained that the improved handwashing and hygiene practices introduced during the COVID-19 pandemic had reduced cholera transmission so significantly that the trial ended without recording a single cholera case.

The professor noted that poor sanitation and inadequate hygiene practices currently cost Ghana between US$290 million and US$500 million annually, representing about 1.6 per cent of the country’s Gross Domestic Product.

Warning of future threats, Prof. Kenu said Ghana could face outbreaks from antimicrobial-resistant cholera strains, new coronavirus variants, Ebola or other unknown diseases emerging from environmental and ecological changes.

He called on the country to invest in field epidemiology training, decentralised laboratory systems, community-based surveillance and integrated digital disease monitoring systems.

“Disease smuggling will never stop at passport control points. It ends when our systems function effectively and when every citizen becomes part of disease surveillance,” he stated.

Prof. Kenu urged authorities to improve access to safe water, strengthen sanitation systems, enforce infection prevention measures in health facilities and promote proper handwashing practices to protect the country from future outbreaks.

Chairperson of the event and Vice-Chancellor of the University of Ghana, Professor Nana Aba Appiah Amfo, said Professor Kenu’s lecture had highlighted the fact that some of the world’s greatest public health threats are often invisible and can spread silently if systems are not prepared to respond.

She noted that the lessons from Ghana’s experiences with cholera and COVID-19 showed the importance of investing in strong health systems, disease surveillance and preventive measures to protect lives and livelihoods.

Prof. Amfo further urged policymakers, researchers and the public to apply the lessons from the lecture by prioritising public health and strengthening the country’s preparedness for future disease outbreaks, stressing that health security is a shared responsibility.

By: Jacob Aggrey