An Open letter to Honorable Members of Ghana’s Parliament Parliament House Accra, Ghana

Dear Esteemed Members of Parliament,

I hope this letter reaches you well amidst the fog of economic malaise. I write to you today as a young Pharmacist heeding to the inaugural call of the President and one who is deeply passionate and concerned about the public health of my fellow Ghanaians. The issue at hand is a pressing one and of paramount concern and it pertains to the escalating costs of dialysis in our country.

To provide context, allow me to begin by recounting the history of dialysis in Ghana, a journey that reflects our unwavering commitment to provide life-saving care to our citizens. Ghana inherited a purely curative unlike the ideal preventative health system from the colonial regime compounded by the double burden of chronic non-communicable and infectious diseases.

 In 1972, Valco imported the first hemodialysis machine into our nation, a move that was driven by the desire to save lives. The first beneficiary of this technology was Madam Lily Duker. Subsequently, Valco facilitated the training of Dr. Yaw Anim-Addo and the esteemed Matron Madam Ohene Ampofo of Korle Bu in the USA.

Moreover, it is a point of pride that the fluids necessary for dialysis were initially produced right here in Ghana by Intravenous Infusions PLC. This pioneering company, incorporated in 1969 and operational since 1974, has been a beacon of hope, saving countless lives and contributing significantly to our nation’s health sector.

Over the long duree, Ghana has dedicated nephrologists albeit in small number manage our mammoth population against all odds.

The crux of the problem lies in the fact that out of our population of 30.8 million, an estimated 5 million Ghanaians suffer from kidney-related issues. While the National Health Insurance Scheme covers the cost of acute dialysis up to GHC 850 (approximately USD 80), there is no insurance coverage for chronic Renal Replacement Therapy (RRT). This places an immense financial burden on affected families, often pushing them into severe financial crises. It is disheartening to witness our fellow Ghanaians resorting to crowdfunding for medical support when facing kidney diseases. We must prioritize and implement a sustainable model to alleviate this suffering.

In 2018, Professor Michael Mante-Kole, President of the Ghana Kidney Association (GKA), emphasized the need for a comprehensive National Renal Care Policy. This policy seeks to address the deficiencies in renal care in Ghana, offering guidelines for the treatment of Chronic Kidney Disease and advocating for the inclusion of renal care under the National Health Insurance Scheme, as well as subsidies for dialysis care.

With the current funding model relying predominantly on out-of-pocket expenses, it is essential that we explore alternative funding modalities. These include government funding, private insurance, employment-based insurance, and support from charitable organizations.

As per the 1992 Ghana Constitution, Article 174 empowers Parliament to impose all taxation in our nation, grant tax incentives, and waivers. Given this authority, I appeal to you, our elected representatives, to consider granting tax reprieves on the imported consumables necessary for the operation of dialysis centers. This strategic move would significantly reduce the financial burden on these essential facilities and promote the well-being of our citizens.

Additionally, I recommend the following five solid actions to address this pressing issue:

1. Tax Reprieve on Imported Consumables: Grant tax exemptions or reductions on imported consumables required for dialysis treatment. This measure will directly lower the operational costs of dialysis centers and enable them to offer more affordable services.

2. Incorporate Renal Care into NHIS: As proposed in the National Renal Care Policy (Ghana Kidney Association), work towards including renal care, including dialysis, under the coverage of the National Health Insurance Scheme. This will ensure that all Ghanaians have access to essential renal care services.

3. Subsidies for Dialysis: Implement subsidies for patients with End-stage Kidney Disease to help alleviate their financial burden. This will be in line with the draft National Renal Care Policy’s recommendations.

4. Promote Preventive Healthcare: Launch a mass literacy program on chronic disease prevention. Addressing the root causes of kidney diseases through education on hypertension, diabetes, and other chronic conditions is essential to reducing the prevalence of kidney diseases in our country.

5. Explore Local Production: Encourage the production of necessary dialysis consumables within Ghana to reduce reliance on imports and create job opportunities.

Ghana is currently facing economic challenges, and Ghanaians understand the need for fiscal responsibility. However, it is equally crucial that we safeguard the health and well-being of our citizens. The consequences of inaction in this regard could be dire, pushing more Ghanaians into poverty due to the financial burden of chronic diseases.

We humbly beseech you, esteemed Members of Parliament, to consider these recommendations seriously and take decisive action to alleviate the suffering of our fellow Ghanaians. In doing so, you will not only save lives but also contribute to the overall health and prosperity of our nation.

Thank you for your time, attention, and dedication to the betterment of Ghana. We remain hopeful that you will prioritize this critical matter for the benefit of our beloved nation.

Yours sincerely,