By Amos Safo
Ghana may be positioning herself as a health and medical tourism destination if the planned construction of one hundred and eleven health and medical infrastructure across the country is delivered. Tagged as Agenda 111 the ultra-modern health and medical infrastructure is potentially the largest healthcare project in West Africa.
Last week President Nana Addo Dankwa Akufo-Addo cut a symbolic sod at Trebe, a town in Ashanti Region to signal the commencement of the Agenda 111 hospital projects across the country. Agenda 111 project includes 101 district hospitals, six regional hospitals in the newly created regions, two specialised hospitals in the middle and northern belts, as well as a regional hospital in the Western Region and the renovation of the Effia-Nkwanta Regional Hospital.
According to President Akufo-Addo, the coronavirus pandemic exposed the deficiencies and the structural gaps of the healthcare system due to years of under investments and neglect of the health sector. Therefore, the current investment is an attempt to address the uneven distribution of healthcare infrastructure and also to make Ghana the centre of excellence in healthcare delivery in the sub region.
Contrary to the notion that Agenda 111 was an afterthought, President Akufo-Addo said the investment was an original plan to inspire growth in the various sectors of the economy and also to help create jobs for the youth, adding, “It is a Ghana first agenda.” “It’s the largest healthcare infrastructure project ever taken in the history of Ghana since independence”, he said.
The project is to ensure that all Ghanaians have access to quality healthcare services and with the National Health Insurance Scheme, boost the provision of healthcare infrastructure and financial accessibility to healthcare. The facilities to be accessed by Ghanaians include, four state-of-the-art surgical theatres for maternity, obstetrics and gynaecology, a full complement of male, female, paediatric and isolation wards, among others.
Attaining SDG Three
Health is one of the three essential social services which is designated by the United Nations as a universal right. The others are education and water and sanitation. Therefore, the objectives of the investment are two-fold. First it is to improve quality healthcare delivery at the district level; and secondly to boost access to healthcare services for all citizens in tandem with United Nations’ Sustainable Development Goal Three. SDG Three enjoins member states to provide health and well-being for all, including a bold commitment to end the epidemics of AIDS, tuberculosis, malaria and other communicable diseases by 2030. It also aims to achieve universal health coverage and provide access to safe and effective medicines and vaccines for all citizens, irrespective of social and economic status.
Health tourism
Touted as the largest health infrastructure ever in our country’s history, Agenda 111 casts a vision for Ghana’s health care sector to become a centre of medical excellence and a destination for medical tourism”, says the President. During the Commonwealth Speaker Series on African Healthcare in 2019, speakers were unanimous in their views that Ghana can become a medical tourist destination for the entire West Africa region. Dr Rodney Armstead, President of LuccaHealth Medical Centre, was optimistic that Ghana offers better opportunities to foreign investors such as, LuccaHealth, a United States (US) medical facility to improve healthcare, and to work with Ghanaian institutions and doctors to provide excellent health services for health tourists.
The top ten medical tourism destinations are Japan, Korea, the US, Taiwan, Germany, Singapore, Malaysia, Sweden, Thailand and India. These countries are earning billions of dollars in health revenue, with much of it coming from Africa. In Africa only South Africa is a top destination for medical tourism, with many Africans, including Ghanaians increasingly going to that country for medical attention. This is the vision Ghana hopes to replicate, perhaps, to diversify its revenue.
President, Akufo-Addo disclosed that Africans spend about $6 billion annually to seek medical care abroad and was hopeful that when completed, the sector could generate about $2 million to the country’s GDP annually. The population of West Africa is expected to reach 1.5 billion people by 2030, which explains why Ghana is positioning herself to serve this population. Together with a strong and emerging pharmaceutical sector, health tourism might just be the strategy Ghana needs to diversify revenue, in an era of dwindling revenue from the real sector due to the impact of COVID 19. My only worry is the ease with which other West African nationals acquire Ghana ID cards and access health and other services without any form of taxation or payment for the service.
Source of funding
According to the President the government has already devoted US$100 million from the Eurobond as initial funding for Agenda 111 project, but the long-term investment could hit $1.5 billion. “So far sites have been identified for 88 of the 111 hospitals, and after cutting the sod, work on the other 87 sites will also commence”, says the President. He announced that the acquisition of the remaining 13 sites will be completed shortly for work to begin. All things being equal the hospitals are to be completed in 18 months and works will begin on the regional and other hospitals in the latter part of the year.” Each of the hospitals will be built at the cost of $12.8 million and another $4.8 million would be spent equipping them, bringing the total cost of each of the hospitals to $17.60 million and it is expected to be completed within 18 months.
However, there are growing concerns over where the government will raise the rest of the money to pay for the completion of the 111 hospitals. The concerns come at the time the debt level of economy is rising and not correlating with the ongoing infrastructure development. However, the Vice President Dr. Mahamudu Bawumia has fought back, explaining that although the country’s total public debt has increased from GH¢122 billion in 2016 to GH¢214 billion( 62.2% of GDP ) in 2019, a strong fiscal and better debt management has slowed the rate of debt accumulation and reduced it to the lowest in the last decade.
On how the project will be financed, Deputy Minister of Finance, and Member of Parliament for Ejisu, Mr. John Kumah has also explained on radio that government will use budgetary and financial arrangements to provide the financing. He said the government will also empower the Ghana Infrastructure Fund to raise part of the funding from the private sector. Mr. Kumah further explained that government does not expect that all contractors will raise certificates for payment at the same time. Since all contractors are not to raise the certificates at the same time payment will be guaranteed.
Job creation
The construction of the 88 district hospitals would also provide opportunities to about 250 domestic contractors to supervise the work. It is estimated that 25,000 people would be employed during the design and construction phase of the 111 hospital that providing direct jobs to architects, masons, carpenters and other construction workers in the country. On completion about 20,000 health professionals, including doctors, specialists, nurses and other allied health workers would be employed. Further domestic facility management professionals as part of the government policy of developing domestic capability in the building and construction sectors of the economy. “This, would undoubtedly help retain most of the money in the country to engender further investment,” says the President. The use of local capacity will reduce the unemployment rate among the youth. Unemployment is one of the demands of the adherents of ‘Fix the economy.” In a way, agenda 111 is a clear response to fix the country in the health sector.
Local participation
In fact, the use local consultants and constructors is an indication that the government has confidence in our local content, in as much as the project will improve local participation in the manufacturing and construction sector, empower the local economies and incentivize the private sector to become the engine of growth. It is refreshing to note that all the district hospitals will be designed and built by Ghanaian companies. This will undoubtedly lay the foundation for the launching of a nation-wide housing programme for a construction revolution. Certainly, the development of local capacity will ensure that the bulk of the money remains in Ghana for further development.
Diabolic agenda
Agenda 111 has clearly overshadowed the diabolic agenda of some individuals and groups to oust the indefatigable Minister of Health, Mr. Kwaku Agyeman-Manu. An assessment of plans to procure the Sputnik COVID 19 vaccines indicates he did nothing wrong to the point of causing financial loss to the state, though there was some indiscretion in the process. In his untiring efforts to help Ghana overcome the devastating impact of COVID 19, the Minister got the virus and survived by the special grace of God. The manner the opposition sought to give him a bad name and to hang him, perhaps, relives the notion that Ghana is not worth dying for. Vilifying him for working in the public interest is unpatriotic. In fact, Agyeman-Manu is one of the star performers of the Akufo-Addo Administration. It is only hoped that the government will keep its commitment and find the money to complete Agenda 111 as planned.
