On March 12, 2020, the Ministry of Health announced the first two confirmed cases of COVID-19 in Ghana; these were imported cases as both persons had returned to Ghana from Norway and Turkey. Since then, the number of confirmed cases has shot up exponentially. Ghana’s approach of elaborate contact tracing and aggressive testing is commendable; however, there are still fears that some positive, undetected, and asymptomatic cases may be spreading the virus unknowingly.
It is apparent that any epidemiological modelling of the course of the pandemic in Ghana will be very different and perhaps more desirable than that for the hardest hit countries. Nevertheless, there are still legitimate fears of a fully-fledged COVID-19 epidemic in the country.
Besides morbidity, mortality, and economic issues, COVID-19 presents peculiar challenges to developing countries like Ghana. Of particular concern is how the already strained health system will be able to contain the full-blown epidemic in Ghana and not merely mitigate it. This is because a large-scale outbreak in Ghana is expected to overwhelm the health services, including the pharmaceutical sector, and put immense pressure on the economies of health.
Invariably, COVID-19 will impact the Ghanaian pharmaceutical sector as many countries restrict international travels and shipments. Moreover, prolonged factory closures in China and elsewhere means that certain products and equipment are not being produced. As a result, shortage of medical products and supplies is anticipated in the case of a full-blown pandemic. It is also prudent to expect that supply chain bottlenecks will hinder the supply of medical devices to sub- Saharan African nations including Ghana, at least, in the short term.
COVID-19 has already begun to impact the global pharmaceutical sector, with pharmaceutical ingredients that are manufactured in China being unavailable or increasing in price after extended factory closures and supply chain disruptions. India’s Directorate General of Foreign Trade announced in early March that the country would restrict export of 26 medical products and ingredients, including paracetamol and some antibiotics, which could lead to a shortage of supply in Africa. India produces a large percentage of the world’s generic medicines.
Already, the World Health Organization (WHO) has warned that severe and mounting disruption to the global supply of personal protective equipment (PPE)–caused by rising demand, panic buying, hoarding, and misuse–is putting lives at risk as regards COVID-19 and other infectious diseases. The WHO has therefore called on governments and industries to increase manufacturing of PPEs by at least 40% to meet the rising global demand.
The pharmaceutical industry in Ghana should be anticipatory of such crises. The continuous supply of medicines for disease prevention, diagnosis, and treatment should be guaranteed. A look at the Ghanaian pharmaceutical market shows that approximately 30% of products are locally manufactured, whereas 70% are imported; the latter originating mainly from India and China. Within the West African sub-region, Ghana has a comparatively strong pharmaceutical industry. Ghana has 32 registered pharmaceutical industries, compared to, for example, Nigeria, which has approximately 90 pharmaceutical manufacturers. This means that if local industries are adequately supported with funds, incentives, and favourable economic policies, and are provided with the needed technical support, Ghana should be able to produce most of the medicines and devices required for the fight against COVID-19 locally. Additionally, post-COVID-19, Ghana should work towards producing more than 60% of the medicines needed locally.
Currently, there is no specific approved treatment or vaccine for COVID-19. Treatment of the condition mainly involves supportive care and is therefore based on the clinical condition of patients. Such supportive treatment includes oxygen therapy, hydration, and management of fever and pain. Antibiotics are also administered if bacterial co-infection is present. Many of the medications used can be produced locally when industries are supported. This is especially important considering that COVID-19 management and SARS-CoV-2 containment are very resource-intensive.