How well is Ghana—with one of the best testing capacities in Africa—responding to COVID-19?

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors are Jiaqi Zhang, Justice Nonvignon, and Wenhui Mao. The first two COVID-19 cases in Ghana were confirmed on March 12, 2020. As of July 23, 2020, there have been 32,969 confirmed COVID-19 cases with 168 deaths. The virus has disproportionately affected southern Ghana—52 percent of cases are in Greater Accra (Table 1). With a population of about 30 million—the 10th largest in sub-Saharan Africa—Ghana now has the fourth highest number of cases in sub-Saharan Africa (after South Africa, Egypt, and Nigeria). The reason is that Ghana has one of the highest testing rates when compared to other African countries. Table 1. Half of Ghana’s COVID-19 cases are in and around the capital city Region Cases Greater Accra 17,152 Ashanti…
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How well is India responding to COVID-19?

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors are Ipchita Bharali, Preeti Kumar, and Sakthivel Selvaraj. The first COVID-19 case in India was detected on January 30, the same day that WHO declared it a public health emergency of international concern. India went into lockdown almost two months later. On June 8, after 10 weeks of lockdown, India started a phased reopening of its economy. With Unlock 1.0, the country is trying to balance attempts to revive the economy while dealing with increasing caseloads and new hotspots. On June 30, official COVID-19 cases stood at over 585,000, and more than 17,500 deaths (Figure 1). While recovery rates have improved to 60 percent and the death rate is relatively low considering that India is the fourth most-impacted country…
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How well has Nigeria responded to COVID-19?

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors are Siddharth Dixit, Yewande Kofoworola Ogundeji, and Obinna Onwujekwe. On January 23, 2020, the World Health Organization’s International Health Regulations (IHR) Emergency Committee advised that “all countries should be prepared for containment, including active surveillance, early detection, isolation and case management, contact tracing and prevention of onward spread of 2019-nCoV infection, and to share full data with WHO.” On January 30, 2020, the WHO declared COVID-19 to be a public health emergency of international concern. Is Nigeria prepared to respond effectively to pandemics? In 2017, during the WHO’s Joint External Evaluation (JEE) of IHR core capacities (an independent, collaborative multi-sectoral effort to assess a country’s capacity to prevent, detect, and respond to public health risks), Nigeria scored poorly both…
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Coronavirus: The new normal

Policy Blog
This blog is the text of a YouTube live talk given by our Center’s Director, Gavin Yamey, on June 12, 2020. Hello and thank you so much for joining this YouTube live conversation today on Coronavirus: The new normal. My name is Gavin Yamey, I’m a Professor of Global Health and Public Policy at Duke. I direct the Center for Policy Impact in Global Health in the Duke Global Health Institute. To give you a little bit of my background: I’ve had a rather eclectic career—I’m a physician who then became a health journalist who then became a public health researcher—and today I try and wear all three hats at the same time in my work on global health policy. Global health policy essentially means trying to achieve large scale…
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Crossing the quality chasm: Nigeria’s long walk to universal health coverage

Policy Blog
In a recently published blog, my friend Dr Abiodun Awosusi narrated this very touching story: “I walked into the paediatric unit of a teaching hospital in Nigeria a few years ago to review a patient. On the first bed was a lifeless child. He was brought in dead a few minutes earlier by his parents. His mother, “Bisi”, wept uncontrollably. While in tears, she recounted how difficult it was for them to borrow money to get to the hospital. Although they got some money from a chief in the community, the two-year-old baby died before they got to the hospital”. Many households such as this one have been pushed into poverty, debt, and financial hardship as a result of seeking health care. In Nigeria, data from the 2017 National Health…
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Ghana: Healthcare for a Country in Transition

Policy Blog
This blog was first published in Duke Global Health Institute News. The author Mary-Russell Roberson. Among sub-Saharan African countries, Ghana stands out for its high rate of health insurance coverage: About 40 percent of the population has policies available through the National Health Insurance Scheme (NHIS). But the NHIS is costing the government more than expected. A proposed cost-saving policy, called capitation, would pay providers per patient rather than for each service provided. The policy looked good on paper, but failed in a pilot program. Gilbert Abiiro wanted to know why. He’s a lecturer/researcher at the University for Development Studies in Ghana, who recently spent eight weeks at Duke as a fellow of the Center for Policy Impact in Global Health. In Ghana, Abiiro interviewed providers, policymakers, politicians, and people who…
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Preparing for pandemics such as coronavirus—will we ever break the vicious cycle of panic and neglect?

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors are Gavin Yamey, Marco Schäferhoff, Kaci Kennedy McDade, and Wenhui Mao. On January 30, 2020, the World Health Organization (WHO) determined that the outbreak of the 2019 novel coronavirus (2019-nCoV) that originated in China was a Public Health Emergency of International Concern. Although researchers quickly identified and sequenced the virus, our weak global pandemic preparedness system has led to rising numbers of people infected with 2019-nCoV worldwide. The virus is highly transmissible, and is likely to become a pandemic. WHO has requested $675 million for a coronavirus preparedness and response plan. When a pandemic occurs, global health donors rush to provide a burst of pandemic funding. Then, just as we saw in the wake of past outbreaks like the…
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What happens to health financing during the middle-income transition?

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors are Ipchita Bharali and Indermit Gill. As countries move from low to middle income, they experience big shifts in the composition of public and private spending on health. One reason for the change in financing is the eligibility criteria for concessional development assistance: Foreign aid starts to decrease after countries move into middle income. This is evident from a snapshot of health expenditures across the income spectrum, used to proxy what happens to a country as its per capita income increases. Figure 1 charts health expenditures by source for countries organized from lowest to highest GDP per capita in year 2015; charts for 2000, 2005, and 2010 look similar. The black vertical lines mark the gross national income (GNI)…
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My Experience as a Global Health Policy Fellow

Policy Blog
My Experience as a Global Health Policy Fellow I have recently finished a two-month global health policy fellowship at the Center for Policy Impact in Global Health (CPIGH). This fellowship program is aimed at mid-career health professionals from CPIGH’s partner countries. As a researcher with the Health Policy Research Group, University of Nigeria, my main research interests are health services; health systems governance and accountability; analysis of health policies, plans and strategies; and getting research evidence into policy and practice. And so, when I discovered that my application for the fellowship at CPIGH was successful, I looked forward to opportunities to deepen my capacity in the field of global health policy and systems, which I hoped would help me to make a more impactful contribution to global heath. Working as…
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The 5 problems China must tackle now to achieve the 2030 health SDGs

Policy Blog
This blog was first published in Brookings Future Development Blog. The authors are Shu Chen, Wenhui Mao, and Shenglan Tang. China made impressive gains during the Millennium Development Goal (MDG) era. According to the Report on China’s Implementation of the Millennium Development Goals (2000-2015), China’s achievements included the following: “The number of medical technicians and staff per thousand people rose from 3.63 people in 2000 to 5.40 people in 2014, and the number of beds per thousand in medical and health institutions increased from 2.38 in 2000 to 4.77 in 2014. … The under-five child mortality rate dropped from 61.0% in 1991 to 12.0% in 2013; the gap between urban and rural areas in child mortality rate was narrowed from 1:3.4 to 1:2.4; the maternal mortality rate dropped from 88.8 per…
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