Ghana: Score Justification Summary

1.1.1a National plan for AMR priority pathogens

Score: 100

There is a national AMR plan in Ghana that covers surveillance, detection and reporting of priority AMR pathogens. The primary policy documents for this are the Policy on Antimicrobial Use and Resistance, published in 2017 by the Ministry of Health, as well as the Ghana National Action Plan on Antimicrobial Resistance (2017-2021), published in 2017 by the Ministry of Health, both of which remain listed as policy documents on the Ministry of Health website. ¹²³

On page 17 of the Policy on Antimicrobial Use and Resistance, the national surveillance system for antimicrobial resistance is outlined and stated to be for the purpose of detection, and states that surveillance is done "to track changes in microbial populations, detect early resistant strains of public health importance, support the prompt notification and investigation of outbreaks and deploy more effective antibiotic treatment in clinical cases," but also states that no permanent surveillance system is in place for crop, fisheries and livestock sectors. ⁴ Workshops such as the the Ghana One Health Aquaculture workshop held in 2024 demonstrate that there has been activity in this area in recent years in Ghana, but it is unclear whether there is a specific plan for these sectors. ⁵ Page 17 of the Policy on Antimicrobial Use and Resistance also lists the need for scheduled reporting of data, and states that surveillance includes "scheduled and adequate periodic data submissions (reporting) received and processed at the national level", which is collected for HIV and TB, but there is no evidence of a specific scheduled report on AMR that can be found in the years following the publication of the national plan. ⁶

There is no evidence to show any updates to these documents, despite calls from health experts in 2024 in Ghana for strengthening of these plans, as the effects of AMR are understood to be growing in Ghana due to high consumption of antibiotics. ⁷ In 2022, academics were unable to determine whether some core parts of the national action plan on AMR had been implemented. ⁸ The Ghanaian Ministry of Health announced a national Infection Prevention and Control program in early 2024, which includes a system for AMR surveillance, but is yet to publish a report specifically outlining this. ⁹ In 2024, the Ghanaian Ministry of Health announced an initiative to combat AMR entitled "Identifying and Resolving Challenges with Antibiotic Use in Surgery", which focuses on three key areas: adherence to proper use of antibiotics, improving prescribing patterns before and after surgery, and reducing surgical site infections. ¹⁰

The Ghana 2017 Ghana National Action Plan on Antimicrobial Resistance (2017-2021) is still listed on the World Health Organisation as the sole AMR policy for Ghana. ¹¹ Academic research from 2024 demonstrates that the Ghana National Action Plan on Antimicrobial Resistance (2017-2021) is still the primary document referred to for AMR policy in Ghana. ¹²

1.1.1b Capacity of national lab/lab system to test for AMR priority pathogens

Score: 50

There is evidence that Ghana has laboratories that can test for AMR pathogens, but it is unclear which pathogens these are. The website of the antimicrobial resistance department at the Noguchi Laboratory at the University of Ghana states that they use "state of the art phenotypic and whole genome sequencing to investigate antimicrobial resistance in commonly isolated bacteria species recovered from humans, livestock/food and the environment", but only mentions Methicillin Resistant Staphylococcus aureus and Extended Spectrum Beta lactamase. ¹³

According to a 2024 article in the African Journal of Laboratory Medicine, some laboratories in Ghana are able to produce antibiograms within their facilities but are unable to perform comprehensive assessment and analysis of AMR data due to lack of biodata. ¹⁴ Likewise, studies have been conducted in Ghana during 2021 and 2022 using Ghanaian laboratories that do test for AMR bacteria in recent years. ¹⁵ Programs run by the Aurum Institute have established sentinel laboratories in Ghana and recently have focused on surveillance programs for AMR in 2024 and 2025.¹⁶ It is unclear, therefore, the extent to which the laboratories have capacity for AMR testing, and which priority pathogens are specifically tested for.

This is further emphasised by the lack of specific references to priority pathogen testing or laboratory capacity. The 2017 Policy on Antimicrobial Use and Resistance published by the Ministry of Health states that "a large majority of primary care laboratories do not have the capacity to do microbiology tests" suggesting that capacity is low. ¹⁷ The national guidelines for laboratory testing and reporting on respiratory infectious diseases in health facilities in Ghana published in 2020 by the Ministry of Health, makes no mention of testing of priority AMR pathogens. ¹⁸ There is no information on the Ministry of Health or Ghana Health Service websites that explicitly outlines priority AMR pathogens. ¹⁹²⁰

1.1.1c National environmental surveillance for AMR residues/organisms

Score: 0

There is no evidence that there is testing for AMR in the environment conducted by the Ghanaian government. The 2017 Policy on Antimicrobial Use and Resistance published by the Ministry of Health does make reference to the need for positive environmental cleaning and waste management, but does not make direct reference to testing of the environment. ²¹ Likewise, the Ghana National Action Plan on Antimicrobial Resistance (2017-2021) published by the Ministry of Health makes no direct reference to testing of the environment for AMR. Both of these policies were published jointly with the Ministry of Environment, Science, Technology and Innovation. ²² The Joint External Evaluation (JEE) for Ghana, conducted in February 2017, makes no reference to environmental testing of AMR. ²³ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ²⁴ There is no information available on the Ghana Health Service and Ministry of Health websites. ²⁵²⁶

1.1.2a National law(s) requiring prescription for antibiotic use (humans)

Score: 50

There is national legislation in place requiring prescriptions for antibiotic use for humans, but also evidence that there are gaps in enforcement. Two pieces of legislation cover prescriptions for medicines in general. Firstly, section 99 on page 45 of the 2013 Health Professions Regulatory Bodies Act (Act 857) published by the Republic of Ghana limits those who can give out prescriptions to medical professionals like medical doctors, physician assistants, midwives, and nurses. ²⁷
Likewise, section 118 of the 2012 Public Health Act (Act 851) published by the Republic of Ghana states that only drugs approved by authorities may be sold in Ghana. ²⁸ Neither the 2012 Public Health Act or 2013 Health Professions Regulatory Bodies Act specifically refer to antibiotics, however. Academic research published in 2017 in the BMC Public Health journal, however, suggested due to extensive prescription of antibiotics by unauthorised people, these laws are weak. According to the research, "weak adherence to regulations and guidelines, weak monitoring and contradictions in policy directives as major issues likely to contribute to antimicrobial resistance". ²⁹

1.1.2b National law(s) requiring prescription for antibiotic use (animals)

Score: 50

There is legislation that covers prescriptions for use by animals in Ghana, but the legislation does not specifically refer to antibiotics, and there is evidence that there are gaps in enforcement. Both section 103 of the 2013 Health Professions Regulatory Bodies Act (Act 857) and section 118 of the 2012 Public Health Act (Act 851) state that only drugs approved by authorities may be sold in Ghana, and section 103 makes explicit reference to "veterinary surgeon" as part of this. ³⁰³¹ Neither of the acts reference antibiotics explicitly.
Academic research from 2017 and 2021 has emphasised that the regulation and use of antibiotics in animals in Ghana is poor, owing to lack of regulation and policy of intake, distribution from unapproved sources, lack of surveillance, and lack of records. ³²³³

1.2.1a Laws/plans on zoonotic disease

Score: 100

There is evidence of legislation which covers spread of disease among animals. The Public Health Act, Act 851, 2012, produced by the Ghanaian government is designed to protect the health of both humans and animals. According to section 9 of the act, animals may be destroyed to stop the transmission of communicable diseases. ³⁴ The Diseases of Animals Act, Act 83, introduced in 1961, is also still in force, and gives power to the government to take action when facing epizootic diseases. ³⁵
According to a review of legislation on Ghanaian veterinary legislation produced by World Organisation for Animal Health in 2017, which included zoonotic disease prevention, the existing veterinary legislation in Ghana is generally of good internal quality but, aside from the Public Health Act of 2012, is old and largely outdated. ³⁶

1.2.1b Laws/plans on zoonotic disease spillover from animals to humans

Score: 100

There is evidence of national legislation and regulations which include specific measures for risk identification as well as reduction for zoonotic disease spillover events from animals to humans, but these are disaggregated across across several pieces of legislation and guides without a single document that coherently presents the requirements.
There is evidence of legislation covering transmission of diseases from animals under section 9, part 1, of the 2012 Public Health Act. This states that the destruction of an animal may be carried out when an authorised health officer believes an animal to be an agent in transmission of a communicable disease. The language used in this section is broad, however, and does not make specific reference to measures for risk detection. ³⁷
There is also evidence of surveillance guidelines. According to the website of the Ghanaian Veterinary Services Department, there is surveillance run by the Epidemiology Unit, and there is a 2025 Handbook on Animal Disease Surveillance available on the Ghanaian Veterinary Services Department website.³⁸³⁹ This guidance lists surveillance protocols for different zoonotic diseases and their relevance for human health, including whether these diseases can be transmitted to humans. ⁴⁰
The Ghanaian government has previously conducted zoonotic disease prioritization workshops in conjunction with the World Food and Agriculture Organization (FAO) and the U.S. Centers for Disease Control and Prevention in 2018, and with the FAO in 2024. ⁴¹⁴² As part of the 2024 workshop with the FAO, work was being done to finalize a One Health Policy Brief, which research has recommended be implemented in order to reduce the impact of zoonotic infection. ⁴³⁴⁴ There is no evidence that this has been implemented yet, however.
Neither the Ministry of Health website nor the Ministry of Food and Agriculture website list any specific policy document related to zoonotic diseases. ⁴⁵⁴⁶

1.2.1c Laws/plans for surveillance & control of multiple zoonotic pathogens

Score: 100

There is evidence of national legislation and guidelines that account for the surveillance and control of multiple zoonotic pathogens of public health concern. According to the Ghanaian Veterinary Services Department, there is surveillance run by the Epidemiology Unit, and there is a 2025 Handbook on Animal Disease Surveillance available on the Ghanaian Veterinary Services Department website. This guidance lists surveillance protocols for different zoonotic diseases. ⁴⁷
Neither the Public Health Act, act 851, 2012, nor the Diseases of Animals Act, act 83, 1961 make reference to domestic surveillance of zoonotic diseases. ⁴⁸⁴⁹ Part two, article 5, section 4 of the Public Health Act, 2012, states that the World Health Organization can collect information through its surveillance activities where it regards international disease spread. ⁵⁰ Section six of the Diseases of Animals Act, 1961 allows for veterinary authorities to inspect animals whenever is reasonable, but makes no reference of zoonotic pathogens. ⁵¹
The Food and Agriculture Organization has been making efforts to improve zoonotic surveillance in Ghana by running workshops in recent years, which has improved the ability of staff to identify diseases such as anthrax, zoonotic tuberculosis, and trypanosomiasis. ⁵² There is no evidence that these have been turned into national plans.

1.2.1d Cross-ministerial department/agency/unit for zoonotic disease

Score: 100

There is evidence of a department, agency, or similar unit dedicated to zoonotic disease that functions across ministries in Ghana. Zoonotic diseases falls under the remit of the Veterinary Services Directorate, which is within the Ministry of Food and Agriculture. According to the Ministry of Food and Agriculture website, the Veterinary Services directorate liaises between the Ministry of Food and Agriculture and the Ministry of Health. ⁵³ The Ministry of Health website makes no reference to a cross-government organisation that deals specifically with zoonotic diseases. ⁵⁴ There is no information available on the Ghana Health Service website. ⁵⁵

1.2.1e Presence of One Health strategic plan

Score: 0

Ghana does not currently have a comprehensive national One Health strategic plan in place, however, it has been taking active steps towards strengthening its One Health agenda over the past few years. There is evidence that in 2022, the One Health Policy for Ghana was at the final draft stage, however there is no evidence of this policy today. ⁵⁶ In August 2025, the country reaffirmed its commitment to the One Health approach at a national policy dialogue in Accra that provided a platform to review progress and chart next steps. ⁵⁷ The participants highlighted three priorities – preparing a policy brief for national leadership, framing the social and economic value of One Health, and advocating for dedicated funding. The event built on findings from a three-day stakeholder engagement in November 2024, which produced Evidence Briefs for Policy (EBPs) to strengthen Ghana’s evidence-based decision-making on One Health and antimicrobial resistance (AMR). According to media, the country has created a One Health Platform and developed a draft policy, though implementation has not yet begun.⁵⁸

1.2.2a Surveillance/reporting mechanism for zoonotic disease for livestock owners

Score: 100

There is evidence that Ghana has a national mechanism for owners of livestock to conduct and report on disease surveillance to the central government. According to section 3 of the 1961, Diseases of Animals Act, "[e]very owner or person having the charge of an animal which has died of, or is suffering from a disease, or which he has reason to suspect to have died of, or to be suffering from a disease, shall forthwith notify the nearest veterinary authority". ⁵⁹ The 2025 Handbook on Animal Disease Surveillance produced by the Veterinary Services Directorate, within the Ministry of Food and Agriculture, lists specific reporting times for different diseases, including those affecting livestock, but was inaccessible at the time of writing.

1.2.2b Laws/regulations on data confidentiality to protect livestock owners

Score: 0

There is no evidence of specific legislation for safeguarding the confidentiality of information generated through surveillance activities for animals in Ghana. Although there is data protection legislation in Ghana, under section 63 of the Data Protection Act, 2012, the processing of personal data is exempt from the Data Protection Act when it is for the discharge of prevention, control, monitoring and eradication of disease. ⁶⁰ There is no explicit reference to data protection on the Veterinary Services Directorate website, or in the 2025 Handbook on Animal Disease Surveillance, which were not available at the time of writing. None of the 2017 Joint External Evaluation for Ghana produced by the WHO, the World Organisation for Animal Health (OIE) Performance of Veterinary Services (PVS) Gap Analysis report, or the PVS Veterinary Legislation Identification Mission Report for Ghana mention the presence of protections for confidentiality. ⁶¹⁶²⁶³ There is no information available on the Ghana Health Service and Ministry of Health websites. ⁶⁴⁶⁵ There is no information available in the 2008 Legal and Policy Framework for Health Information and Health Data Reporting produced by the Ministry of Health. ⁶⁶

1.2.2c Wildlife zoonotic disease surveillance

Score: 0

There is evidence that Ghana conducts surveillance of zoonotic disease in wildlife. According to the Ministry of Food and Agriculture website, the Veterinary Services Department conducts serological surveillance and testing and wildlife surveillance, as well as providing animal services for poultry and livestock. It does not specifically mention surveillance of poultry and livestock. According to the Ghana.gov website, the mission of the is to "enhance livestock, poultry and companion animals’ production and productivity", but does not explicitly mention surveillance. ⁶⁷ Both the website of the Veterinary Services Department, and the Handbook on Animal Disease Surveillance produced by the Veterinary Services Department in 2025, were inaccessible at the time of writing.

1.2.3a Annual reporting to OIE on zoonotic disease incidence

Score: 100

There is evidence of a mechanism for reporting notifiable diseases to WOAH. According to page ten of the Handbook on Animal Disease Surveillance produced by the Veterinary Services Department in 2025, the Veterinary Services Department is responsible for "[p]lanning for emergencies and reporting to international bodies" including WOAH. The handbook does not outline any specifics of how this takes place, however. ⁶⁸ According to the Veterinary Services Department's website, the epidemiology unit is responsible for collaborating with WOAH. ⁶⁹

1.2.4a Number of veterinarians per 100,000 people

Score: 0.74

1.2.4b Number of veterinary para-professionals per 100,000 people

Score: 2.87

1.2.5a Inclusion of private sector in national plan/law on zoonotic disease

Score: 0

There is no evidence of a specific plan, regulation, or legislation that mentions working with the private sector on controlling or responding to zoonoses. According to the 2025 Handbook on Animal Disease Surveillance produced by the Veterinary Services Directorate, one function of the Veterinary Services Directorate is to create an enabling environment for the private sector to participate in livestock industry, but there is no evidence of a specific plan to do so. ⁷⁰ According to the website of the Veterinary Services Directorate, their mandate includes partnering with other One Health stakeholders to control zoonotic diseases, but there is no evidence for whether these partners are private sector partners, nor a plan for partnering. ⁷¹ The Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, mentions the need for greater collaboration with the private sector, but does not specifically reference private collaboration on zoonotic diseases. ⁷² The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ⁷³ There is no information available on the Ghana Health Service and Ministry of Health websites. ⁷⁴⁷⁵

1.3.1a Updated national records of especially dangerous pathogen/toxin inventories

Score: 0

There is no evidence that Ghana has in place a record, updated within the past five years, of the facilities in which especially dangerous pathogens and toxins are stored or processed. There is no available evidence of a record on the Verification Research, Training and Information Centre (VERTIC) database. ⁷⁶ The Biosafety Act, act 831, 2011, makes no reference to storage of dangerous pathogens and toxins. ⁷⁷ There is no information publicly available from either the Ministry of Health or Ministry of Environment, Science and Technology websites. ⁷⁸⁷⁹ There is no information available on the Ghana Health Service. ⁸⁰

1.3.1b Biosecurity laws on facility security for especially dangerous pathogens

Score: 50

There is evidence of regulation that covers requirements for facilities dealing with storage and operations related to biosecurity, but this does not cover cybersecurity or failure reporting.
Page 32 of the National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana in 2023 outlines proper practices for storage of chemicals and risk assessment within the laboratory. The guide outlines proper operational procedures for dealing with pathogens and toxins. There is no mention of cybersecurity or failure reporting. ⁸¹
Likewise, the Biosecurity Regulations 2019, produced by the Republic of Ghana, does not mention storage or operations related to biosecurity. ⁸² There is no available evidence of any regulations related to storage regulations on the Verification Research, Training and Information Centre (VERTIC) database. ⁸³

1.3.1c Agency for enforcement of biosecurity laws/regulations

Score: 0

There is insufficient evidence for an organisation specifically tasked with enforcement of biosecurity legislation. The website of the Veterinary Services Department was inaccessible at the time of writing. According to the Ministry of Food and Agriculture website, the Veterinary Services Department is responsible for "[m]onitoring and enforcement of regulations on import and export of livestock and poultry and their products" but there is no mention of biosecurity. ⁸⁴ There is also the National Biosafety Authority, established by the 2011 Biosafety Act (Act 831), but this organisation is primarily concerned with genetically modified organisms and it does not address biosecurity specifically. ⁸⁵

1.3.1d Consolidation of especially dangerous pathogens into minimum # of facilities

Score: 0

There is no public evidence that Ghana has taken steps to consolidate inventories of pathogens or reduce the number of inventories permitted to hold pathogens. Section 5.4.1 of the National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana in 2023 outlines inventory control, but does not provide any information on consolidation of inventories. ⁸⁶ There is no information available on either the Ministry of Health or Ministry of Environment, Science and Technology websites. ⁸⁷⁸⁸ There is no publicly available information on the Noguchi Memorial Institute for Medical Research website. ⁸⁹ There is no website for the National Public Health and Reference Laboratories (NPHRL).

1.3.1e Capacity to conduct tests for anthrax/Ebola without culturing live pathogens

Score: 0

There is no publicly available evidence on whether Ghana has in-country capacity to conduct Polymerase Chain Reaction (PCR)–based diagnostic testing for Anthrax or Ebola. The website of the department of Virology at the Noguchi Memorial Institute for Medical Research at the University of Ghana states that they employ regular RT-PCR and quantitative PCR (Q-PCR) testing methods, and also states that their research activities include Ebola. It is unclear whether these testing methods are used for Ebola, however. There is no mention of Anthrax. ⁹⁰ Similarly, the Department of Parasitology at the Noguchi Memorial Institute for Medical Research does have capability for PCR testing, but does not directly state that it tests for either anthrax or ebola. ⁹¹ There is no website for the National Public Health and Reference Laboratories (NPHRL).
Ghana's 2017 Joint External Evaluation (JEE) Report makes no reference to PCR testing capabilities in Ghana, nor does the 2025 Handbook on Animal Disease Surveillance. ⁹²⁹³ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ⁹⁴ There is no information available on the Ghana Health Service and Ministry of Health websites. ⁹⁵⁹⁶

1.3.2a Biosecurity training using a standardised, required approach

Score: 33.33

There is evidence that staff are required to conduct biosecurity training in Ghana, but there is insufficient evidence of a national curriculum, a train-the-trainer program, or a required time period. According to section 2.4 on biosafety training in the National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana in 2023, "[a]ll employees should undergo annual or periodic biosafety /biosecurity pieces of training to equip them with the skills necessary to handle infectious organisms and biohazards". This is mandatory for all employees. ⁹⁷ According to the Noguchi Memorial Institute for Medical Research website, there is continuous training in biosafety for staff, as well as an overview of the institute's biosecurity program. There is no mention of a common national curriculum or a train-the-trainer program. ⁹⁸ There is no information on the National Biosecurity Authority website. ⁹⁹ There is no information available on the Ghana Health Service and Ministry of Health websites. ¹⁰⁰¹⁰¹

1.3.3a Personnel checks for permission to access to especially dangerous pathogens

Score: 0

There is little evidence of regulations or licensing conditions that specify that security and other personnel with access to especially dangerous pathogens, toxins, or biological materials with pandemic potential are specifically subject to drug testing, background checks, or psychological or mental fitness checks. Although wider law could be argued to cover safety within the workplace, there is very little specificity or information to suggest that drug testing, background checks, or psychological or mental fitness checks would be carried out. There is no specific mention of security and other personnel with access to especially dangerous pathogens, toxins, or biological materials with pandemic potential.
The 2010 Occupational Health and Safety Policy and Guidelines for the Health Sector produced by the Ministry of Health does include policies on checks and surveillance for all medical staff. Under section 4.2.1.3, this includes biological hazards. 4.2.1.4. outlines medical surveillance and monitoring of health of employees, which is expected to be undertaken by all staff, which includes provision of medical history and pre-placement physical examinations, but makes not specific mention of drug testing, background checks, or psychological and mental fitness checks, nor explicitly references staff involved with using dangerous pathogens, toxins, or biological materials with pandemic potential.¹⁰²
Neither the Biosafety (Management of Biotechnology) Regulations 2019 nor the Biosafety Act, 2011, produced by the Republic of Ghana make any reference to regulations or licensing conditions for those working with pathogens, toxins, or biological materials. ¹⁰³¹⁰⁴
Article 118 of Ghana's Labour Act, 2003, produced by the Republic of Ghana, states that the workplace should be safe and without risk to health, including the handling and use of substances, including prevention of contamination of workplaces by toxic gases, noxious substances, and other materials that could cause risk to safety or health. ¹⁰⁵
The 2023 National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana, does mention occupational safety, and outlines that new staff should receive training, but makes not mention of drug testing, background checks, or psychological or mental fitness checks. ¹⁰⁶

1.3.4a National transport regulations for Category A and B infectious substances

Score: 100

There is evidence that there is publically available regulation for the safe transport of infectious substances in Ghana. Although this evidence does not explicitly mention infectious substances, there is legislation that covers transport of biological substances. Article 46 of the Public Health Act, 2012, states that "parties shall, subject to national law and taking into account relevant international guidelines, facilitate the transport…of biological substances". ¹⁰⁷
Section 18.1.3 of the Ghana Civil Aviation Directives produced by the Ghana Civil Aviation Authority in 2018 states that "[t]ransport of infectious substances requires coordinated action by the shipper, the operator and the consignee to ensure safe transport…in accordance with the Technical Instructions". Section 18.3.2. states that infected live animals and infectious substances cannot be transported without exemption or approval from authorities. ¹⁰⁸
The Food and Agriculture Organization of the United Nations has conducted training (2024) in Ghana on the safe shipment of infectious substances in accordance with WHO regulations and International Air Transport Association Dangerous Goods Regulations. ¹⁰⁹
The 2023 National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana outlines explicitly guidelines concerning transport and shipment of infectious materials, including category A and B infectious substances in section 4.9. Section 4.9.2 outlines the difference between category A and B substances alongside packaging requirements, section 4.9.3.2 outlines the guidelines on packaging for transport domestically, section 4.9.3.3 for air transport, and section 4.9.3.4 for international shipping. ¹¹⁰

1.3.5a Laws/regulations on cross-border transfer and end-user screening

Score: 0

While there is regulation to oversee the cross-border transfer of chemical samples from laboratories in Ghana, there is no evidence that this requires end-user screening of dangerous pathogens, toxins, and pathogens with pandemic potential.
Section 4.9.3.4 of the 2023 National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana states that international regulations apply strictly for international shipments of samples. ¹¹¹
Section 18.1.3 of the Ghana Civil Aviation Directives produced in 2018 by the Ghana Civil Aviation Authority states that "[t]transport of infectious substances requires coordinated action by the shipper, the operator and the consignee to ensure safe transport…in accordance with the Technical Instructions" ¹¹² The Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, states that "biological specimens [are] packed in accordance to International Air Transport Association (IATA) standards by certified staff", but the evaluation does not specifically mention end-user screening of dangerous pathogens, toxins, and pathogens with pandemic potential. ¹¹³ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ¹¹⁴
There is no mention of cross-border transfer and end-user screening of dangerous pathogens, toxins, and pathogens with pandemic potential on the Ministry of Health, Ministry of Food and Agriculture, Ministry of Environment, Science and Technology websites, nor in the Public Health Act, 2012. ^115116117118 The Ghana Health Service Transport Policy, revised in 2016 was no accessible on the website of the Ghana Health Service. ¹¹⁹

1.4.1a Biosafety laws/regulations

Score: 0

There is no evidence of regulations for biosafety in Ghana. Ghana does have regulations covering biosafety nominally, covered by the Biosafety Act (2011) and Biosafety (management of biotechnology) Regulations (revised in 2019), but this legislation primarily covers genetically modified organisms rather than biosafety. ¹²⁰¹²¹ Page 18 of Ghana's 2017 Joint External Evaluation (JEE) report states that legislation needs amending to not just cover genetically modified organisms. ¹²² The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ¹²³ The 2023 National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana presents comprehensive guidelines on biosafety but are not legislation or regulations. ¹²⁴

1.4.1b Agency for enforcement of biosafety laws/regulations

Score: 0

There is no publicly available evidence on who is specifically responsible for enforcement of biosafety and biosecurity in Ghana.
The National Biosafety Authority, established by the 2011 Biosafety Act, is mainly concerned with the use of genetically modified organisms, and it is not clear that it is responsible for biosafety and biosecurity outside of this. ¹²⁵
The 2023 National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana was drawn up by a Technical Working Group of multiple government agencies and non-government organisations. Under 2.3.1, the guidelines state that the "national agency shall be the competent national authority for biosafety and biosecurity." It is unclear who this refers to. ¹²⁶ There is no information available on the Ghana Health Service and Ministry of Health websites. ¹²⁷¹²⁸

1.4.2a Biosafety training using a standardised, required approach

Score: 33.33

There is evidence that staff are required to conduct biosafety training in Ghana, but there is insufficient evidence of a national curriculum, a train-the-trainer program, or a required time period. According to section 2.4 on biosafety training in the National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana in 2023, "[a]ll employees should undergo annual or periodic biosafety /biosecurity pieces of training to equip them with the skills necessary to handle infectious organisms and biohazards". This is mandatory for all employees. ¹²⁹ According to the Noguchi Memorial Institute for Medical Research website, there is continuous training in biosafety for staff, as well as an overview of the institute's biosecurity program. There is no mention of a common national curriculum or a train-the-trainer program. ¹³⁰ There is no information on the National Biosecurity Authority website. ¹³¹

1.5.1a Evidence of national assessment of dual-use research

Score: 0

There is evidence that an assessment has been conducted to determine whether ongoing research is occurring on especially dangerous materials with biological risks and/or other dual-use research, but this assessment has not yet finished and does not explicitly mention which materials they are concerned with. Ghana is currently engaged on a project lasting until 2026 assessing biological risks carried out as part of the European Union Chemical, Biological, Radiological and Nuclear Risk Mitigation Project 99 alongside 10 other African nations. According to the project website, Ghana is a project location.¹³² This includes dual use of materials, and is scheduled to last until June 2026, but no information is available on the specifics of the review. ¹³³ The 2023 National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana outlines guidance on how to conduct a biosecurity risk assessment, but makes no reference to one having been completed. ¹³⁴ The Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, does not mention especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. ¹³⁵ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ¹³⁶ There is no mention of such an assessment publicly available on the websites of the Ministry of Health or Ministry of Environment, Science and Technology. ¹³⁷¹³⁸ There is no information available on the Ghana Health Service. ¹³⁹

1.5.1b National law/regulation on oversight of dual-use research

Score: 0

There is no evidence that Ghana has national legislation and/or regulation requiring oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. The 2023 National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana does outline guidelines on how oversight should be structured in order to manage risks, but this does not explicit reference dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. ¹⁴⁰ The Biosafety Act, 2011, makes no reference to oversight of dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. ¹⁴¹ The Public Health Act, 2012 makes no reference to an agency for oversight of pathogens or toxins. ¹⁴² There is no information available on the Ghana Health Service and Ministry of Health websites. ¹⁴³¹⁴⁴

1.5.1c Existence of agency responsible for oversight of dual-use research

Score: 0

There is no evidence of an agency with the explicit responsibility for oversight of research with especially dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. The 2023 National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana does not list a specific agency that has the responsibility for oversight, and only provides information on how oversight should be structured. ¹⁴⁵ The Biosafety Act, 2011, makes no reference to an agency with responsibility for oversight of dangerous pathogens, toxins, pathogens with pandemic potential and/or other dual-use research. ¹⁴⁶ The Ghana National Biosafety Authority is primarily concerned with GMO usage in Ghana rather than dangerous pathogens or toxins. ¹⁴⁷ The Public Health Act, 2012 makes no reference to an agency for oversight of pathogens or toxins. ¹⁴⁸ There is no information available on the Ghana Health Service and Ministry of Health websites. ¹⁴⁹¹⁵⁰

1.5.2a Requirement to screen synthesised DNA against list prior to sale

Score: 0

There is no evidence that there is legislation and/or regulation requiring the screening of synthesized DNA (deoxyribonucleic acid) against lists of known pathogens and toxins before sale. The Public Health Act, 2012, does not specifically mention screening of synthesized DNA (deoxyribonucleic acid). ¹⁵¹ Neither the Biosafety (Management of Biotechnology) Regulations 2019 nor the Biosafety Act, 2011, make any reference to screening of synthesized DNA (deoxyribonucleic acid) against lists of known pathogens and toxins before sale. ¹⁵²¹⁵³ The Guidelines for Genome Editing Applications in Ghana 2023 produced by the National Biosafety Authority also makes no mention of screen of synthesized DNA. ¹⁵⁴ The 2023 National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana makes no mention of screen of synthesized DNA. ¹⁵⁵ There is no information available on the Ghana Health Service and Ministry of Health websites. ¹⁵⁶¹⁵⁷

1.6.1a Immunization rate for humans (measles/MCV2)

Score: 50

1.6.1b Availability of vaccination figures for livestock (FMD) through OIE database

Score: 0

There is no publicly available evidence on whether vaccination figures are provided by the WAHIS database. Data is provided in six-monthly reports as "Vaccinated in response to the outbreaks" for Foot and Mouth, but the data often reads zero even when there is high numbers of outbreaks. ¹⁵⁸ This is further emphasised by lack of any data for vaccination when seen in analytics mode. ¹⁵⁹

1.6.1c Equitablenature of national immunization strategy/plan

Score: 100

There is evidence that Ghana has an immunization strategy that is equitable and attempts to overcome socioeconomic inequalities. The Comprehensive Multi-Year Plan for immunizations (2015-2019) produced by several institutions within the Republic of Ghana in 2014, outlines Ghana's national immunization strategy. The plan does attempt to achieve equal distribution, with its tagline of "a plan to reach every district to reach every child”, and section 1.5.3 states that it aims to reach every child regardless of location. ¹⁶⁰ According to UNICEF, the Expanded Programme of Immunisation (EPI) aims to reach all women and children across Ghana. ¹⁶¹ According to a 2024 Ghana News Agency report, the Ghana Health Service has launched a Mass Vaccination Plan for Vaccine Preventable Diseases. ¹⁶² There is no specific information or strategy on the Ghana Health Service website. ¹⁶³

1.6.1d Vaccine hesitancy and build public trust coverage in vaccines in national immunization strategy/plans

Score: 0

There is insufficient evidence of an immunization strategy in Ghana, and it is unclear whether it includes measures to address vaccine hesitancy and build public trust in vaccines. Immunization strategy is the responsibility of the Ghana Health Service, but there is no policy document or information available on the website. ¹⁶⁴ According to the WHO, the Ghana Health Service has developed comprehensive communication guidelines as part of its roll out of Human Papillomavirus (HPV) and Hepatitis B birth dose (HepB-BD) vaccines to improve public trust and reduce vaccine hesitancy, but it is unclear if this is part of the national strategy of immunization. ¹⁶⁵ There is no information available on the Ministry of Health website. ¹⁶⁶

1.6.1e National advisory group for immunization strategy/plan

Score: 100

There is a national advisory group that provides guidance and advice on immunization strategy in Ghana. According to its internal procedures manual produced in 2021 by the Ministry of Health, the National Immunization Technical Advisory Group of Ghana (NITAG-Ghana) was established by the Ministry of Health in 2018 "to provide recommendations on
vaccine/vaccine delivery technologies policy in accordance with the National Health Strategy and the National EPI Policy and Guidelines" (page 6). ¹⁶⁷

1.6.1f Presence of an immunization programme for influenza

Score: 0

There is currently insufficient evidence that Ghana has an immunization programme for influenza. According to the WHO, Ghana is yet to introduce a Seasonal Influenza vaccine. ¹⁶⁸ There is no information available on the Ministry of Health website. ¹⁶⁹ The Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, does not mention influenza vaccination being conducted in Ghana. ¹⁷⁰ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ¹⁷¹ There is no information available on the Ghana Health Service website. ¹⁷²

1.7.1a Strategy/plan for resilience of health system

Score: 100

There is evidence of strategies and plans to develop a health system that is resilient to the challenges that climate change, including the threat of infectious diseases, in Ghana. Pages 144-145 of the Ghana National Climate Change Master Plan Action Programmes for Implementation: 2015–2020 produced by the National Climate Change Committee (NCCC) of Ghana in 2015, specifically address climate-sensitive diseases and public health measures, and provides objectives. These objectives include conducting "well-coordinated scientific research on the impacts on health of climate change" and improving "disease surveillance and response systems for the prevention and control of priority climate-sensitive diseases". ¹⁷³ Likewise, pages 4.12-14 of the Ghana National Climate Change Policy produced by the Ministry of Environment Science, Technology and Innovation in 2013 specifically addresses public health and climate change, providing policy challenges and proposals. A wide range of challenges are listed, including poor data, lack of climate change consideration within health issues, fragmentation of the health sector, and unequal access to care, among others. Objectives include improving data recording, enhancing knowledge of climate change in the health sector, and minimizing the effects of climate change on communities. Elsewhere in the document, infectious diseases are referenced, such as on page 6 which states that "[f]looding, for example, will increase the range of the mosquito and hence different strains of malaria, while the incidence of parasitic infections might increase." ¹⁷⁴ The Ministry of Health has a program called the Climate Change Health Project, but the website for the program is not functioning. ¹⁷⁵

2.1.1a Capacity of national lab system to conduct 5 or more WHO core tests

Score: 50

There is no evidence that there is legislation and/or regulation requiring the screening of synthesized DNA (deoxyribonucleic acid) against lists of known pathogens and toxins before sale. The Public Health Act, 2012, does not specifically mention screening of synthesized DNA (deoxyribonucleic acid). ¹⁷⁶ Neither the Biosafety (Management of Biotechnology) Regulations 2019 nor the Biosafety Act, 2011, make any reference to screening of synthesized DNA (deoxyribonucleic acid) against lists of known pathogens and toxins before sale. ¹⁷⁷¹⁷⁸ The Guidelines for Genome Editing Applications in Ghana 2023 produced by the National Biosafety Authority also makes no mention of screen of synthesized DNA. ¹⁷⁹ The 2023 National Biosafety and Biosecurity Guide for Laboratories produced by the Republic of Ghana makes no mention of screen of synthesized DNA. ¹⁸⁰ There is no information available on the Ghana Health Service and Ministry of Health websites. ¹⁸¹

2.1.1b Plan to conduct testing during a public health emergency

Score: 50

There is evidence of national guidelines for testing in the case of a public health emergency, and there is evidence of these plans specifically referring to scaling capacity and defining goals for testing, but not of testing of novel pathogens. Section 1.3 of the National Guidelines for Laboratory Testing and Reporting on Respiratory Infectious Diseases in Health Facilities in Ghana, produced by the Ministry of Health in 2020, states that in the case of an outbreak of infectious disease, laboratories are to test suspected cases, contacts, and confirmed cases, and states that capacity should be surged (but does not give a defined amount), and that testing should track the genetic evolution of the pathogen. Additionally, it provides clear goals for testing. It does not provide any defined numerical targets, however, and does not refer to testing of novel pathogens specifically. ¹⁸²
The Public Health Act, 2012, makes no explicit reference to testing in a public health emergency. ¹⁸³ The 2023 National Biosafety and Biosecurity Guide for Laboratories produced by the Laboratory Technical Working Group of the Republic of Ghana makes no reference of testing in a public health emergency. ¹⁸⁴

2.1.2a Existence of an accredited national lab serving as a reference facility

Score: 100

There is evidence of laboratories in Ghana gaining internationally recognised accreditation. According to the Integrated Quality Laboratory Services website, the National Public Health and Reference Laboratory (NPHRL) obtained the international standard, ISO 15189:2012 in 2021. This was carried out for the US Centers for Disease Control and Prevention (CDC) as part of the Global Health Security Agenda (GHSA). ¹⁸⁵

2.1.2b External quality assurance of a national lab serving as a reference facility

Score: 100

There is evidence of national laboratories in Ghana having external quality assessment. According to the Integrated Quality Laboratory Services website, the National Public Health and Reference Laboratory (NPHRL) obtained the international standard, ISO 15189:2012 in 2021. This was carried out for the US Centers for Disease Control and Prevention (CDC) as part of the Global Health Security Agenda (GHSA). ¹⁸⁶ According to the African Society for Laboratory Medicine (ASLM), a pan-African organisation based in South Africa, the African Society for Laboratory Medicines conducted a baseline assessment at Ghana’s National Reference Laboratory concerning its implementation of ISO/IEC 17043:2023 standards. ¹⁸⁷

2.2.1a Nationwide specimen transport system

Score: 0

There is insufficient evidence of a national specimen transport system in Ghana. According to page 24 of the Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, Ghana does have a specimen referral and transport system in place, but there is no mention that this is nationwide. Page 23 states that development of a national specimen referral and transportation system is a priority. ¹⁸⁸ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ¹⁸⁹ In 2025, private drone company Zipline has partnered with the Ministry of Health and Ghana Health Service to provide transport services nationwide for medical supplies and specimens, but there is insufficient evidence that this is a nationwide system. ^190191192 There have also been pilots of national specimen referral system, conducted in 2022, and recommendations were made in order to provide a more effective system for a broader scale up, but it is unclear whether this scale up has taken place. ¹⁹³

2.2.2a Plan to rapidly authorize/license laboratories to scale-up testing during an outbreak

Score: 0

There is insufficient evidence of a plan in place to rapidly authorize or license laboratories to supplement the capacity of the national public health laboratory system to scale-up testing during an outbreak in Ghana. There is mention of the publication of a National Public Health Laboratory Network Strategic Plan (2023–2027) within media outlets, but this document is not available on the Ministry of Health website, or elsewhere. ¹⁹⁴ There is no information available on the Ghana Health Service and Ministry of Health websites. ¹⁹⁵¹⁹⁶ The Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, does not mention any plan for licensing. ¹⁹⁷ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ¹⁹⁸

2.3.1a Evidence of ongoing event-based and indicator-based surveillance and analysis

Score: 50

There is evidence that Ghana conducts event-based and indicator-based surveillance and analysis for notifiable and novel infectious diseases, but there is insufficient evidence available that this is conducted daily in recent years. Page two of the Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, states that the surveillance system in human health incorporates indicator, syndromic and event-based surveillance. ¹⁹⁹ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ²⁰⁰ There is evidence that Ghana provides data for weekly bulletins on outbreaks provided by the WHO. ²⁰¹ According to section 2.2 of the 2002 Technical guidelines for Integrated Disease Surveillance and Response in Ghana "[b]oth outpatient and inpatient health care facilities must keep daily summaries of priority diseases that they see". ²⁰² According to academic research published in 2016, disease surveillance reporting is conducted daily. ²⁰³

2.3.1b Evidence of a mechanism (such as IHR focal point) for reporting notifiable diseases to the WHO within the set timeline

Score: 100

There is evidence of a mechanism for reporting notifiable diseases to the WHO. As part of the Public Health Act, 2012, Annex I section 6(b) states that for a public health response at a national level, the WHO will be notified through the National IHR Focal Point. In the same act, article 7 states that if Ghana has evidence of an "unexpected or unusual public health event" it shall provide all the public health information to the WHO. ²⁰⁴ According to the WHO, the Ministry of Health and Ghana Health Service are the partnering organisations for health emergencies. It is unclear when this website was last updated. ²⁰⁵ The Ghana Health Service is stated on the website of the Ministry of Health as establishing an "effective mechanism for disease surveillance, prevention and control" in Ghana, but does not have a working website. ²⁰⁶

2.3.2a Electronic national and sub-national reporting surveillance system

Score: 100

There is evidence that the Ghanaian health service uses an electronic system for reporting of disease outbreaks at a national and subnational level. According to academic research from 2016, the District-wide Health Information Management System has been implemented in Ghana since 2007, and involves daily summary sheets and integrated disease surveillance and response reporting forms being sent to the district health directorate which are changed into electronic formats which then produce regional and national data. ²⁰⁷ Academic research published in 2022 demonstrates that the District-wide Health Information Management System was still in use in 2021. ²⁰⁸ According to page 28 of the Joint External Evaluation (JEE) for Ghana conducted by the World Health Organization in 2017, there is "web-based electronic reporting from the district up to the national level". The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ²⁰⁹²¹⁰

2.3.2b Collection of ongoing/real-time lab data by electronic surveillance system

Score: 0

There is evidence of a database for disease surveillance in Ghana that is real-time, but there is no access available to its data or breakdowns of its data, nor evidence that this is for laboratory data. According to page 28 of the Joint External Evaluation (JEE) for Ghana conducted by the World Health Organization in 2017, there is "web-based electronic reporting from the district up to the national level" and this is real-time, but there is no mention of this system including laboratory data. The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ²¹¹²¹² According to pages 10-11 of the Ministry of Health's Health Information System Strategic Plan (2022-2025), the "District Health Information Management System (DHIMS2) platform is a web-based system that is used to facilitate the management of health care data from the districts" in Ghana, but there is no mention of whether laboratory data is specifically collected. ²¹³

2.3.3a National wastewater surveillance programme or initiative

Score: 100

There is evidence of ongoing national wastewater surveillance programme in Ghana.

In November 2024, the Gates Foundation committed $3.8 million over 36 months to support Ghana Health Service in implementing wastewater surveillance of priority pathogens as part of integrated disease surveillance nationwide. ²¹⁴ In the past, Ghana has integrated polio environmental surveillance (ES) as part of its eradication efforts—collecting sewage samples from specific sites to detect poliovirus circulation. ²¹⁵ Additionally, early COVID‑19 wastewater surveillance pilots were conducted between 2021 in the Greater Accra Region. These involved weekly grab sampling from sewer catchments and public toilets, analyzed using RT-qPCR to track community-level SARS-CoV‑2 trends. ²¹⁶

Moreover, in May 2025, the Ghana Health Service (GHS) launched a two-day training programme for frontline surveillance officers focused on wastewater-based environmental surveillance. The training targets detection of pathogens like Salmonella typhi, Hepatitis E, Vibrio cholerae, and the measles virus through wastewater analysis. ²¹⁷ The training is a collaboration between GHS’s Disease Surveillance Department and Kwame Nkrumah University of Science and Technology (KNUST), supported by the Gates Foundation and the U.S. CDC.

In Ghana, ES for polio detection was piloted in 2016, formally instituted in 2018, and yielded its first detection of cVDPV2 in July 2019 from the Northern Region, prior to any clinical cases. However, since its full implementation in 2018, Ghana’s ES system has not undergone formal evaluation to assess its performance and effectiveness.²¹⁸ According to the WHO, Ghana now has 14 ES sites strategically placed across the country in high-risk and mobile populations. Environmental surveillance officers collect wastewater samples from drainage points and sewage systems, often navigating challenging terrain and carrying equipment. Each sample is handled with strict biosafety protocols and transported under reverse cold chain conditions to laboratories such as the Noguchi Memorial Institute for Medical Research (NMIMR) in Accra.²¹⁹²²⁰

2.4.1a Common usage of electronic health records

Score: 100

There is evidence that electronic health records are used in Ghana, and that they are commonly used. According to the Minister of Health reported by the Ghana News Agency, 21 million Ghanaians (over half the population) have their data within the Lightwave Health Information Management System (LHIMS). ²²¹ According to a Citi Newsroom report, the Dormaa Ahenkro Presbyterian Hospital enrolled 128,690 patients into the electronic health record system provided by Lightwave Health Information Management System (LHIMS), while the Amasu Health Centre recorded 9,934 enrollments. ²²² According to the Lightwave website, 25 million Ghanaians use the platform. ²²³

2.4.1b Public health system access to individual electronic health records

Score: 100

The Ministry of Health does have access to health information held by health facilities, but it is unclear whether this includes electronic information. According to the policy on medical records, "[e]very health facility regardless of ownership shall participate in health information reporting by providing information requested by the Ministry of Health on regular basis." ²²⁴ The Lightwave Health Information Management System (LHIMS) has been implemented by the Ghana Health Service and allows access to electronic medical records at all levels of treatment and departments by hospitals across Ghana. ²²⁵

2.4.1c Existence of data standards for health record data comparability

Score: 0

There is no available evidence to show that there data standards to ensure data is comparable. No information is available from the Lightwave Healthcare Solutions or from the Ministry of Health announcement on the Lightwave Health Information Management System (LHIMS). ²²⁶²²⁷ There is no mention of comparable data in the National E-Health Strategy produced by the Ministry of Health, but it is unclear when this document was published. ²²⁸ The Ghana Health Service Policy and Strategy on Digital Health 2023-2027 policy document makes no reference to comparable data or what data will be provided. ²²⁹

2.4.2a Data sharing mechanisms

Score: 0

There is insufficient evidence that data is shared across ministries. According to a report produced by the U.S. Centers for Disease Control and Prevention, the Ministry of Health provides weekly and monthly electronic bulletins on trypanosomiasis that are shared with the Ministry of Food and Agriculture (page 8), but it is unclear when this report was produced. ²³⁰ Page 21 of the Health Information Strategic Plan 2022-2025 produced in 2022 by the Ministry of Health, discusses sharing of health data and information, but makes no mention of established mechanisms for sharing data between ministries. It states the need to develop "system-wide methodologies for the sharing of health information" and to integrate "the existing fragmented data information systems", but makes no mention of an existing mechanism. ²³¹ The 2005 Technical guidelines for Integrated Disease Surveillance and Response in Ghana produced by the Ministry of Health, makes no mention of sharing data. ²³² The National E-Health Strategy produced by the Ministry of Health makes no mention of sharing data across ministries. ²³³ No information was available on the websites of the Ghana Health Service or the Ministry of Health. ²³⁴²³⁵ According to page 8 of Ghana's Joint External Evaluation (JEE) report, conducted in December 2017 by the World Health Organization, "there is a mechanism for timely and systematic information exchange between animal surveillance units, laboratories, human health surveillance units and other relevant sectors regarding potential zoonotic risks events through routine reporting and quarterly stakeholder meetings"; however, the JEE goes on to note on page 13 that "there is no formal channel between the public health and animal sectors to share information or collaborate." The JEE also notes on page 13 that "neither event-based nor syndromic surveillance is well established in the animal health sector", making it somewhat unclear how effective the existing cross-sectoral mechanism is. ²³⁶The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ²³⁷

2.4.3a Availability of de-identified health surveillance data on disease outbreaks

Score: 100

There is evidence that de-identified data is published by government sources on infectious diseases in Ghana, but the data is sparse, with low coverage. Data on the prevalence of some diseases has been published in annual reports produced by the Ministry of Health, but there has been no data since 2015. ²³⁸ Data for Malaria and HIV are published in the Demographic and Health Survey produced in conjunction with the Ghana Health Survey and the Ghana Statistical Service. This data is not annual, however, and it is intermittently published. The latest data was for 2022, published in 2023. Before that, the data was for 2014. ²³⁹

2.4.4a Confidentiality legislation/regulations for identifiable health information

Score: 100

There is legislation to protect the confidentiality and security of health data in Ghana. According to section 1.4 of the Ghana Health Service Policy and Strategy on Digital Health 2023-2027 policy document published in 2023, the Cyber Security Authority has designated the Ghana Health Service as a sector having critical information infrastructure that requires processing of data with confidentiality. In the same document, Section 2 entitled Legislation, Policy and Compliance states the need for data security, privacy and confidentiality as key to creating a positive digital environment. ²⁴⁰
Article 83 of the Data Protection Act, 2012, states that individuals are not required to provide medical records both physical or mental, if requested to. ²⁴¹
According to the Public Health Act, 2012, article 21 of the third schedule states that information collected under the Public Health Act will be party to data protection laws, and confidentiality will be protected. ²⁴²

2.4.4b Inclusion of cyber protections in health data confidentiality law/regulation

Score: 100

There is evidence that regulations safeguarding the confidentiality of identifiable health information mention cyber attacks. According to section 2.3.1 of the Ghana Health Service Policy and Strategy on Digital Health 2023-2027 policy document published in 2023, the regulations are mindful of the weaknesses of the current system to cyber-attacks. Section 2.5 lists cyber-attacks and ransomware as key threats to the Ghana Health Service. ²⁴³

2.4.5a Cooperative commitments or agreements within regions

Score: 0

There is no evidence of Ghana sharing public health data directly with other countries, but Ghana is required to share data with the WHO in the case of a public health emergency, and the WHO can make this data available to other countries. There is no limitation to diseases mentioned. As part of the Public Health Act, 2012, Ghana is required to share data with the WHO, who can then disseminate this data to other states (article 9 – Information and Public Health Response, page 149), where there is a public health emergency of international concern. Article six of part two on Information and Public Health Response states that Ghana must notify the WHO of all public health emergencies of international concern within 24 hours, and continue to provide data, including "case definitions, laboratory results, source and type of the risk, number of cases and deaths, conditions affecting the spread of the disease and the health measures employed". ²⁴⁴

There is no available evidence of bilateral or multilateral agreements to share public health data. There is no specific legislation concerning data protection internationally, but article 89 of the Data Protection Act, 2012, does legislate a fine for selling of the data of another person. ²⁴⁵

2.5.1a National support to conduct contact tracing in the event of a public health emergency

Score: 50

There is evidence of Ghana employing a system that operates subnationally to assist with contact tracing in a pandemic, but no evidence of systems to prepare for contact tracing for future pandemics. Ghana utilised SORMAS (Surveillance Outbreak Response Management Analysis System) during the COVID-19 pandemic, which is a collaborative platform that allows for sharing of data during a pandemic.²⁴⁶ It is a private company in partnership with the Ghana Health Service. According to the SORMAS booklet, it operates a contact tracing platform as part of this. ²⁴⁷ There is no reference to SORMAS on the Ghana Health Service website. ²⁴⁸ Contact tracing training did take place during the COVID-19 pandemic, but there is no evidence of it being part of a national plan. ²⁴⁹

2.5.1b Provision of wraparound services to enable self-isolation/quarantine as recommended

Score: 100

There is no evidence of a specific economic or medical plan for dealing with the outbreak of a pandemic or public health emergency in Ghana, but there is historical evidence from Ghana's response to COVID-19. There is evidence that Ghana provided additional funds for dealing with the COVID-19 pandemic. The Ghanaian government used funds provided by the World Bank mitigate the effects of COVID-19 and ameliorate its economic opening. ²⁵⁰ According to an Ernst and Young report, frontline healthcare workers were given a "daily allowance of GHS150 (approx. US$26) payable to those undertaking contact tracing". ²⁵¹ According to page 14 of the Ghana COVID-19 Emergency Response on Vaccines Second Additional Financing document produced by the Ministry of Health in 2021, cash transfers were provided to support to access to and use of health services for families. Isolated and quarantining individuals also received "psychosocial counselling support, food-baskets and feeding during the isolation, quarantine and treatment period". ²⁵²

2.5.2a Strategy for tracing and quarantining international travelers

Score: 0

There is no specific plan or cooperative agreement between the public health system and border control authorities to identify suspected and potential cases in international travelers and trace and quarantine their contacts in the event of a public health emergency in Ghana. There is evidence for training having been completed. In 2021, the International Organization for Migration, the Ghana Health Service, the Ghana Immigration Service and the World Health Organization, all participated in a workshop on infection prevention and control. This was part of a larger project entitled “Reinforcing Infection Prevention and Control (IPC) capacities along Ghana’s borders for a coordinated response to public health emergencies”. ²⁵³ There is no evidence for a plan on the Ghana Health Service, Ghana Immigration Service, or Ministry of Health websites. ²⁵⁴²⁵⁵

2.6.1a Access to field epidemiology training program in country and/or abroad

Score: 100

Ghana does have an applied epidemiology training program based in the country. There is no evidence that the government provides resources to send citizens to another country to participate in applied epidemiology training programs. The Ghana Field Epidemiology and Laboratory Training Program (GFELTP) is a competency-based program that was established in October 2007, and currently runs an Advanced Program, a FETP-Intermediate and FETP-Frontline trainings in Ghana. ²⁵⁶ There is evidence that this program is connected with other countries, but appears to act as a regional hub for other nations in West Africa. ²⁵⁷

2.6.1b Existence of field epidemiology training for animal health professionals

Score: 100

There is evidence of field epidemiology training programs that are explicitly inclusive of animal health professionals in Ghana. There is no evidence of a specific FELTV course. The Ghana Field Epidemiology and Laboratory Training Program (GFELTP) includes applied epidemiology and public health laboratory practice for veterinarians as part of its two year Advanced Program. ²⁵⁸ According to the website of the Ghana Field Epidemiology and Laboratory Training Programme, the programme was established in 2007 and runs, in collaboration with the US Centers for Disease Control and Prevention (CDC), Advanced, Intermediate and Frontline levels of training in Ghana. The programme seeks to "improve national capacity to respond to public health emergencies such as disease outbreaks, natural disasters and other unusual public health events including those that could be a result of chemical or biological terrorism". ²⁵⁹

2.6.2a Evidence of at least 1 trained field epidemiologist per 200,000 people

Score: 100

According to a 2024 3News news report, there are 272 epidemiologists in Ghana. This figure is provided by Dr. Anthony Dongdem, a senior lecturer at the University of Health and Allied Sciences in Ghana. For a population of 33,790,000 in Ghana, this would mean there is at least one epidemiologist per 200,000 people in Ghana. The report makes no distinction between field epidemiologist and epidemiologist. ²⁶⁰

3.1.1a National emergency response plan for diseases with pandemic potential

Score: 33.33

There is no publicly available overarching national public health emergency response plan in Ghana, but there is evidence that one is in place. There is no specific policy document that can be located on either the Ministry of Health or the Ghana Health Service websites. ²⁶¹²⁶² The Public Health Division of the Ghana Health Service is responsible for public health strategic plans, but does not have its own website and is only mentioned on the Ghana Health Service website. ²⁶³ According to the WHO, following its Joint External Evaluation (JEE) in 2017, Ghana developed a National Action Plan for Health Security in 2018, but this is only referenced by the WHO and is unlocatable on official government websites, nor is a copy locatable from other sources. Page 37 of the JEE states that "Ghana has a national public health emergency preparedness and response plan", but there is no evidence of this plan. ²⁶⁴²⁶⁵ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ²⁶⁶

3.1.1b National public health emergency response plan published in past 3 years

Score: 0

There is no evidence of an overarching national public health emergency response plan in Ghana. There is no specific policy document that can be located on either the Ministry of Health or the Ghana Health Service websites. ²⁶⁷²⁶⁸ The Public Health Division of the Ghana Health Service is responsible for public health strategic plans, but does not have its own website and is only mentioned on the Ghana Health Service website. ²⁶⁹ According to the WHO, following its Joint External Evaluation in 2017, Ghana developed a National Action Plan for Health Security in 2018, but this is only referenced by the WHO and is unlocatable on official government websites, nor is a copy locatable from other sources. ²⁷⁰²⁷¹

3.1.1c One health principles by covering multiple threat types

Score: 0

There is no evidence of an overarching national public health emergency response plan in Ghana. There is no specific policy document that can be located on either the Ministry of Health or the Ghana Health Service websites. ²⁷²²⁷³ The Public Health Division of the Ghana Health Service is responsible for public health strategic plans, but does not have its own website and is only mentioned on the Ghana Health Service website. ²⁷⁴
According to the WHO, following its Joint External Evaluation in 2017, Ghana developed a National Action Plan for Health Security in 2018, but this is only referenced by the WHO and is unlocatable on official government websites, nor is a copy locatable from other sources. ²⁷⁵²⁷⁶ There is no evidence of a plan on the National Disaster Management Organisation website. ²⁷⁷

3.1.1d Vulnerable populations in national public health emergency response plan

Score: 0

There is no evidence of an overarching national public health emergency response plan in Ghana. There is no specific policy document that can be located on either the Ministry of Health or the Ghana Health Service websites. ²⁷⁸²⁷⁹ The Public Health Division of the Ghana Health Service is responsible for public health strategic plans, but does not have its own website and is only mentioned on the Ghana Health Service website. ²⁸⁰
According to the WHO, following its Joint External Evaluation in 2017, Ghana developed a National Action Plan for Health Security in 2018, but this is only referenced by the WHO and is unlocatable on official government websites, nor is a copy locatable from other sources. ²⁸¹

3.1.2a Mechanism to engage private sector in outbreak preparedness/response

Score: 0

There is no evidence of a specific mechanism for engaging with the private sector to assist with outbreak emergency preparedness and response in Ghana. There is no specific policy document for emergency response to a public health emergency and private sector assistance that can be located on either the Ministry of Health or the Ghana Health Service websites. ²⁸²²⁸³ The Public Health Division of the Ghana Health Service is responsible for public health strategic plans, but does not have its own website and is only mentioned on the Ghana Health Service website. Although it mentions "[d]eveloping partnerships with relevant stakeholders", there is no mention of private companies or who these stakeholders are. ²⁸⁴ According to the WHO, following its Joint External Evaluation in 2017, Ghana developed a National Action Plan for Health Security in 2018, but this is only referenced by the WHO and is unlocatable on official websites. No mention of the private sector is made in any reference to this plan. ²⁸⁵
Although there was engagement between the Ghanaian government and the private sector during COVID-19, research shows that this was difficult, and there was no distinct mechanism of the Ministry of Health for engagement. ²⁸⁶

3.1.3a Policy/plan/guidelines in place to implement non-pharmaceutical interventions (NPIs)

Score: 0

There is insufficient evidence that Ghana has a policy, plan or guidelines in place to implement non-pharmaceutical interventions (NPIs) during an epidemic or pandemic. The 2002 Technical guidelines for Integrated Disease Surveillance and Response in Ghana produced by the Republic of Ghana makes no mention of non-pharmaceutical interventions. ²⁸⁷ Ghana did implement non-pharmaceutical interventions as part of its COVID-19 response under the Imposition of Restrictions Act, 2020 (Act 1012), but it is unclear whether this is part of any wider guidelines or policy on epidemic response. This legislation allows the restrictions of some freedoms in order to protect public health. ²⁸⁸ There is no information available on the Ghana Health Service and Ministry of Health websites. ²⁸⁹²⁹⁰

3.2.1a Completion of biological-focused IHR exercise with the WHO in past year

Score: 100

There is no evidence of an overarching national public health emergency response plan in Ghana, and therefore no evidence of such a plan being activated. There is, however, evidence that Ghana has completed a national-level biological threat-focused exercise with the World Health Organization (WHO) in the past year. From November 11 to 15, 2024, the WHO, in collaboration with United Nations Children's Fund (UNICEF), World Food Programme (WFP), Médecins sans frontières (MSF), and the Ghana Armed Forces (GAF) conducted a comprehensive simulation exercise in Ghana to strengthen regional readiness for infectious disease outbreaks. ²⁹¹²⁹² There is no evidence of a plan being activated available on the Ghana Health Service and Ministry of Health websites. ²⁹³²⁹⁴ There is no evidence on the Verification Research, Training and Information Centre (VERTIC) database of any plan being activated. ²⁹⁵ There is no evidence of a plan being activated on the National Disaster Management Organisation website. ²⁹⁶ There is no evidence on the Ministry of Food and Agriculture. ²⁹⁷

3.2.1b Evidence of bio-focused exercise to identify gaps/best practices

Score: 0

There is no evidence that Ghana has identified a list of gaps and best practices in response and developed a plan to improve response capabilities in the past year. There is no such report published on the Ministry of Health, Ghana Health Service or National Disaster Management Organisation websites. ^298299300

3.2.2a Evidence of national-level biological threat-focused exercise that includes private sector

Score: 0

There is no evidence that Ghana has undergone a national-level biological threat-focused exercise that has included private sector representatives in the past year. No private companies are referenced in regards to the simulation exercise to strengthen regional readiness for infectious disease outbreaks that took place in Ghana in November 2024. ³⁰¹³⁰² There is no information available on the Ghana Health Service and Ministry of Health websites. ³⁰³³⁰⁴

3.3.1a Existence of Emergency Operations Center (EOC)

Score: 100

Ghana does have an Emergency Operations Centre (EOC). According to the National Disaster Management Organisation (NADMO), the EOC is managed by the National Disaster Management Organisation. All emergencies are first reported to this department. ³⁰⁵ According to the Stimson website, the EOC in Ghana have so far dealt with ongoing COVID-19, Meningitis, monkeypox, vaccination of COVID-19, and media scans to track rumours. ³⁰⁶ There is no specific website for the EOC, nor mention of the EOC on the Ghana Health Service or Ministry of Health websites. ³⁰⁷³⁰⁸

3.3.1b Requirement for EOC to conduct/evidence EOC conducts at least annual drills

Score: 0

There is insufficient evidence that the Emergency Operations Center (EOC) is required to conduct a drill for a public health emergency scenario at least once per year or conduct a drill at least once per year. There is no information on the EOC section of the National Disaster Management Organisation website stating the existence of annual drills. ³⁰⁹ There is no information available on the Ghana Health Service and Ministry of Health websites. ³¹⁰³¹¹ There is no specific website for the EOC. There is no mention of the EOC in the 2005 Technical guidelines for Integrated Disease Surveillance and Response in Ghana produced by the Ministry of Health. ³¹² There is no evidence on the Verification Research, Training and Information Centre (VERTIC) database. ³¹³ The Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation makes no mention of drills needing to be conducted one a year. ³¹⁴ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ³¹⁵ Ghana did conduct a multi-agency simulation exercise in 2024, but there is no evidence that this was conducted as part of a required annual drill. ³¹⁶

3.3.1c EOC activation within 120 minutes of identification of emergency/scenario

Score: 0

There is no public evidence to show that the Emergency Operations Center (EOC) has conducted any coordinated emergency response or emergency response exercise in the last year. There is no information given of such an exercise on the National Disaster Management Organisation (NADMO) website. ³¹⁷ There is no information available on the Ghana Health Service and Ministry of Health websites. ³¹⁸³¹⁹ Ghana did conduct a multi-agency simulation exercise in 2024, but there is no evidence that this involved the Emergency Operations Center. ³²⁰

3.4.1a Joint exercise/procedures for potential deliberate biological events

Score: 0

There is no evidence that public health and national security authorities have carried out an exercise to respond to a potential deliberate biological event, or that there are regulations and MOUs in place to respond to a deliberate attack. There is no information available of such an exercise on the National Disaster Management Organisation (NADMO) website. ³²¹ No evidence if available on the Verification Research, Training and Information Centre (VERTIC) database website. ³²² There is no relevant information with the Public Health Act, 2012. ³²³ There is no available information on the Ministry of Health website. ³²⁴ There is no information available on the Ghana Health Service website. ³²⁵

3.5.1a Risk communication plan for specific use during a public health emergency

Score: 100

There is no evidence of an overarching national public health emergency response plan in Ghana, but the Ghana COVID-19 Emergency Response on Vaccines Second Additional Financing Stakeholder Engagement Plan (P176485) produced by the Ministry of Health in 2021 does outline a strategy for risk communication specific to the COVID-19 response. ³²⁶ There is no mention of a risk communication strategy on the Ministry of Health website or Ghana Health Service websites. ³²⁷³²⁸ The Public Health Act, 2012, makes no mention of a communication strategy in the case of a public health emergency and only details legislation on reporting public health emergencies to the WHO. ³²⁹ There is the National Communication Strategy for COVID-19 Vaccine Introduction produced by the Ghana Health Service in 2021, but this does not cover communications for an overarching response. ³³⁰

3.5.1b Inclusion of different population & sector needs in risk communication plan

Score: 0

There is insufficient evidence of a risk communication plan in Ghana. There is no mention of a risk communication strategy on the Ministry of Health website or Ghana Health Service websites. ³³¹³³² According to news reports, a National Standard Operating Procedures for Risk Communication and Social Mobilization During Public Health Emergencies report was published in 2020 by the Ghana Health Service, but no such document is publicly available. ³³³ The Public Health Act, 2012, makes no mention of a communication strategy targeted at the domestic population in the case of a public health emergency and only details legislation on reporting public health emergencies to the WHO. ³³⁴ There is the National Communication Strategy for COVID-19 Vaccine Introduction produced by the Ghana Health Service in 2021, but this does not cover communications for an overarching response. ³³⁵

3.5.1c Designation of a specific government spokesperson during a public health emergency

Score: 0

There is no evidence of a risk communication plan in Ghana. There is no mention of a risk communication strategy on the Ministry of Health website or Ghana Health Service websites. ³³⁶³³⁷ The Public Health Act, 2012, makes no mention of a specific person within the government to act as a spokesperson in the case of a public health emergency. ³³⁸ There is the National Communication Strategy for COVID-19 Vaccine Introduction produced by the Ghana Health Service in 2021, but this does not cover communications for an overarching response.

3.5.2a Government use of media platforms to share info on public health emergencies

Score: 100

There is evidence that the public health system regularly shares information and that this includes posts dispelling misinformation. The Ministry of Health regularly posts updates on Facebook and Twitter. ³³⁹³⁴⁰ One post from the 13th June 2025 shows dispelling of misinformation. ³⁴¹

3.5.2b Evidence that senior leaders have shared mis/disinformation on infectious diseases

Score: 100

There is insufficient evidence that senior leaders (president or ministers) have shared misinformation or disinformation on infectious diseases in the past two years in Ghana. No information was found on the Ministry of Health or Ghana Health Service websites. ³⁴²³⁴³

3.6.1a Percentage of households with Internet

Score: 61.75

3.6.2a Mobile-cellular telephone subscriptions per 100 inhabitants

Score: 53.44

3.6.3a Gender gap in access to a mobile phone (percentage points)

Score: 83.33

3.6.4a Gender gap in access to the Internet (percentage points)

Score: 54.17

3.7.1a Restrictions on export/import of medical goods due to an infectious disease outbreak

Score: 0

There is no evidence that Ghana has implemented restrictions on export/import of medical goods within the past year in response to an infectious disease outbreak. No information was found on the Ministry of Health, Ministry of Foreign Affairs, Ministry of Food and Agriculture, Ghana Immigration Service, or Ghana Health Service websites. ^344345346347

3.7.1b Restrictions on movement and/or exports/imports due to disease outbreak

Score: 0

There is no evidence that Ghana has implemented restrictions on export/import of non-medical goods within the past year in response to an infectious disease outbreak. No information was found on the Ministry of Health, Ministry of Foreign Affairs, Ministry of Food and Agriculture, Ghana Immigration Service, or Ghana Health Service websites. ^{348349350351352}

3.7.2a Evidence of travel ban due to an infectious disease outbreak

Score: 0

There is no evidence that Ghana has implemented inbound or outbound travel restrictions due to an infectious disease outbreak in the past year. No information was found on the Ministry of Health, Ministry of Foreign Affairs, Ghana Immigration Service, or Ghana Health Service websites. ^353354355356

3.7.2b Risk-based approach to international travel-related measures

Score: 0

There is no evidence that Ghana utilises a risk-based approach to international travel-related measures. No information was found on the Ministry of Health, Ministry of Foreign Affairs, Ghana Immigration Service, or Ghana Health Service websites. ^357358359360

4.1.1a Doctors per 100,000 people

Score: 3.48

4.1.1b Nurses and midwives per 100,000 people

Score: 51.4

4.1.1c Updated health workforce strategy to address human resource shortfalls

Score: 0

There is insufficient evidence that Ghana has a workforce strategy to identify fields where there is an insufficient workforce and strategies to address these shortcomings. There is evidence that there has been a workforce strategy published in the past five years. According to a Ministry of Health press release from 2023, a strategy entitled 'Building a Resilient One Health Public Health Workforce in Ghana' was released that was aimed at restructuring health workforce in Ghana. ³⁶¹ This strategy is not publicly available on the Ministry of Health website. ³⁶² The Staffing Norms for the Health Sector document produced by the Ghana Health Service was revised in 2015, and outlines staffing numbers needed per health facility to deal with different workloads. ³⁶³

4.1.1d Health system capacity for essential health services

Score: 0

There is evidence that Ghana does not have sufficient capacity to deliver essential services across the whole of Ghana.

The Joint external evaluation of the International Health Regulations (10–14 February 2025) states that "Ghana has developed a Comprehensive EHS Package along with plans and guidelines to ensure the continuity of EHS during emergencies, primarily at the national level. Mechanisms for monitoring service continuity, such as the IDSR and the District Health Information System 2, are also established at this level. However, these systems and guidelines are not fully operational or consistently implemented at the intermediate and primary public health levels. This gap limits the country’s ability to ensure uniform emergency preparedness and response across all tiers of the healthcare system. As a result, while national-level frameworks are robust, the lack of effective implementation at lower levels remains a significant challenge." Moreover, the JEE explains that there is no adequate funding and resources to ensure the adequate functioning of the emergency operations centre.³⁶⁴

According to the National Essential Health Services Package 2022-2030 published by the Ministry of Health in 2022, Ghana is still in the process of working towards Universal Health Coverage by 2030. According to the report, 50% of health facilities lack appropriate basic infrastructure for primary care provision. ³⁶⁵ According to page 12 of the National Healthcare Quality Strategy published by the Ministry of Health in 2024, "Ghana continues to experience fragmentation and inequities in its health service delivery due partly to the disproportionate support of vertical health policies and programmes which have led to sub-optimal healthcare". ³⁶⁶ According to page 11 of the 2022-2030 National Essential Health Services Package Ghana produced by the Ministry of Health, "approximately 50% of health facilities suffer from a lack of appropriate basic infrastructure (including equipment) and over 64% of the population make out-of-pocket payments for health services". ³⁶⁷

4.1.1e Essential health services continuity plan for public health emergencies

Score: 0

There is no evidence of a specific plan for continuation of essential healthcare services during a public healthcare emergency in Ghana. The National Essential Health Services Package 2022-2030 published by the Ministry of Health in 2022 does reference management of public health emergencies, but does not refer to continuation of services. ³⁶⁸ Ghana is stated as having a National Action Plan for Health Security, but this plan is not publicly available on either government or WHO websites. ^369370371 There is no specific plan referenced on either the Ministry of Health or Ghana Health Service websites. ³⁷²³⁷³

4.1.2a Hospital beds per 100,000 people

Score: 14.02

4.1.2b In-country capacity to isolate patients with highly communicable diseases

Score: 100

There is evidence that Ghana has the capacity to isolate patients with highly communicable diseases in a biocontainment patient care unit. According to news reports, the Ghana Infectious Disease Center is a 100-bed capacity, infectious disease center built in 2020. ³⁷⁴ Recent Facebook updates demonstrate that the Ghana Infectious Disease Center is still in operation. The Ghana Infectious Disease Center does not have an official website, and there is insufficient evidence that it specifically has isolation rooms. According to a Ministry of Health press release, the Paediatric Intensive Care Unit at the Korle-Bu Teaching Hospital has isolation rooms. ³⁷⁵ According to academic research from 2021 looking at the capacity of intensive care units in Ghana, intensive care units in Ghana did contain isolation rooms. ³⁷⁶

4.1.2c Demonstrated capacity / evidence of plan to expand isolation capacity

Score: 0

There is evidence of testing of a plan to increase capacity to deal with an infectious disease outbreak has been conducted in Ghana in the last two years, but no mention that this includes isolation. According to a WHO 2024 press release, a simulation exercise was held that mocked an Ebola outbreak and included the building of a healthcare facility in 24 hours, which included beds. There is no mention that these are specifically for isolation, however. ³⁷⁷ There is no information available on the Ghana Health Service and Ministry of Health websites. ³⁷⁸³⁷⁹ There is no evidence from news reports. No evidence was found on the Ghana WHO website. ³⁸⁰

4.2.1a National procurement protocol for the acquisition of routine laboratory/medical supplies

Score: 0

There is evidence of a protocol for procurement by the Ministry of Health of routine supplies for medical and laboratory usage in Ghana, but there is no evidence of what products were procured since drafting the act in 2003. Page 11 of the Procurement Procedure Manual published in 2006 by the Ministry of Health outlines procedures for procurement in the health sector. It states that routine procurement is undertaken by the Procurement Unit. Laboratory supplies are included within this document, seperate from medical supplies, but there is no mention of what these laboratory supplies include. ³⁸¹ The Public Procurement Act, 2003, outlines the legal framework for public procurement, including goods for hospitals. It makes no reference to the Ministry of Health or the Ministry of Agriculture having a specific protocol for acquisition of items for routine needs. ³⁸² No such protocol is mentioned on the Supplies, Stores And Drugs Management Division of the Ghana Health Service website, nor on the Procurement and Supply Chain Directorate section of the Ministry of Health website. ³⁸³³⁸⁴ Page 24 of the Joint External Evaluation for Ghana conducted by the World Health Organization in 2017 states that the Ministry of Health "has a country procurement process for general laboratory supplies for core laboratories under the National Procurement Act, 2003 (Act 633)." ³⁸⁵ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ³⁸⁶

4.2.2a Stockpile of medical supplies for national use during a public health emergency

Score: 33.33

There is evidence that Ghana has a stockpile of medical supplies for national use during a public health emergency, but it is unclear what it contains. According to academic research published in 2022, neither the Ministry of Health nor the Ghana Health Service has a dedicated space for stockpiles, and there is no funds for stockpiling commodities. ³⁸⁷ The Ghana Health Supply Chain Master Plan (2025-2029) published by the Ministry of Health does not make any mention to stockpiles for pandemic or epidemic purposes. ³⁸⁸ Page 42 of the Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, states that Ghana does have a "stockpile of medical countermeasures available for national use during a public health emergency only for cholera". ³⁸⁹ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ³⁹⁰

4.2.2b Stockpile of laboratory supplies for national use during a public health emergency

Score: 0

There is no publicly available evidence that Ghana has a stockpile of laboratory supplies for national use during a public health emergency specifically. The Ghana Health Supply Chain Master Plan (2025-2029) published by the Ministry of Health does not make any mention to stockpiles for pandemic or epidemic purposes. ³⁹¹ There is no information available on the Ghana Health Service and Ministry of Health websites. ³⁹²³⁹³ Page 42 of the Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, states that Ghana does have a "stockpile of medical countermeasures available for national use during a public health emergency only for cholera", but makes no mention of laboratory supplies. ³⁹⁴ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ³⁹⁵

4.2.2c Annual review of national stockpile to ensure sufficient supply

Score: 0

There is no publicly available evidence that Ghana conducts or requires an annual review of the national stockpile to ensure the supply is sufficient for a public health emergency. The Ghana Health Supply Chain Master Plan (2025-2029) published by the Ministry of Health does not make any mention to stockpiles for pandemic or epidemic purposes. ³⁹⁶ There is no other information available on the Ghana Health Service and Ministry of Health websites. ³⁹⁷³⁹⁸ Page 42 of the Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, states that Ghana does have a "stockpile of medical countermeasures available for national use during a public health emergency only for cholera", but makes no mention of an annual review. ³⁹⁹ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ⁴⁰⁰

4.2.3a Plan/agreement to produce/procure medical supplies during a public health emergency

Score: 100

There is no evidence of a specific plan for procurement, manufacture or expedition of medical supplies during a public health emergency, but there is specific legislation for urgent procurement in the case of an emergency. The Procurement Procedure Manual published in 2006 by the Ministry of Health does reference emergency procurement, and states that procurement can be undertaken in line with Section 40 of the 2003 Public procurement Act, which states that a procurement entity can engage in single-source procurement where there is an urgent need for the goods. ⁴⁰¹⁴⁰² Additionally, section 3.3.3 of the 2025 Guidline on Lot Release of Vaccines and/or Other Biological Products in Ghana produced by the Food and Drug Authority states that medical products can be expedited and not subject to Lot Release protocols in the case of a public emergency. ⁴⁰³ Page 42 of the Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, states that there "are no agreements in place with manufacturers or distributors to procure medical countermeasures during a public health emergency" and also states that with "the exception of antibiotics, Ghana has limited capacity to produce vaccines, laboratory diagnostics or equipment in country". There is no mention of expedition of medical supplies through points of entry. ⁴⁰⁴ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ⁴⁰⁵

4.2.3b Plan/agreement to produce/procure lab supplies during a public health emergency

Score: 0

There is insufficient evidence that Ghana has regulations to expedite the entry of laboratory supplies in the case of a public emergency. Section 3.3.3 of the 2025 Guideline on Lot Release of Vaccines and/or Other Biological Products in Ghana produced by the Food and Drug Authority states that some medical products can be expedited and not subject to Lot Release protocols in the case of a public emergency, such as vaccines and biological products. ⁴⁰⁶ Page 42 of the Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, states that there "Ghana has limited capacity to produce vaccines, laboratory diagnostics or equipment in country". ⁴⁰⁷ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ⁴⁰⁸ The Ghana Health Supply Chain Master Plan (2025-2029) published by the Ministry of Health does not reference manufacture or procurement of laboratory supplies or public health emergencies. ⁴⁰⁹

4.2.3c Mechanism emergency logistics and supply chain management

Score: 0

There is no evidence of a specific mechanism or system for national and subnational levels for emergency logistics and supply chain management in Ghana. The Ghana Health Supply Chain Master Plan (2025-2029) published by the Ministry of Health outlines the objectives and strategies of health supply chains in Ghana, but makes no mention of supply chains in the case of emergencies. ⁴¹⁰ According to section 3.9 of the Ghana Health Supply Chain Master Plan, there is a logistics management system in Ghana called the Ghana Integrated Logistics Management Information System, but there is no available evidence outlining the features of this system in an emergency. There is no mention of emergency use of the system on the Ministry of Health website, nor is it clear when this system was introduced. ⁴¹¹

4.3.1a Plan/program/guidelines for dispensing MCMs during a public health emergency

Score: 0

There is no evidence of a plan, program, or guidelines in place for dispensing medical countermeasures (MCM) for national use during a public health emergency in Ghana. The Ghana Health Supply Chain Master Plan (2025-2029) published by the Ministry of Health does not reference dispensing during a public health emergency. ⁴¹² The Public Health Act 2012 does not specifically mention any regulations for dispensing of MCM during a public health emergency. ⁴¹³ There is no information available on the National Disaster Organisation Website. ⁴¹⁴ The Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, does not discuss dispensing. ⁴¹⁵ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ⁴¹⁶ There is no information available on the Ghana Health Service and Ministry of Health websites. ⁴¹⁷⁴¹⁸

4.3.2a Plan to receive foreign health personnel during a public health emergency

Score: 0

There is no evidence of a public plan to facilitate workforce surge in an emergency in Ghana. The Staffing Norms for the Health Sector published by the Ministry of Health in 2014 outlines human resource planning for the number of health workers needed at any given health facility. This document makes no mention of surging workforce during an emergency. ⁴¹⁹ There is no evidence of a public plan on either the Ministry of Health or Ghana Health Service websites. ⁴²⁰⁴²¹ There is no information available on the National Disaster Organisation Website. ⁴²² According to page 43 of the Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, there is "no formal plan in place to identify procedures and decision-making, training criteria and standards or address regulatory and licensure concerns related to sending and receiving health personnel during a public health emergency" ⁴²³ The World Health Organisation JEE activities page lists the JEE as "conducted" in February 2025, but does not provide a downloadable report or summary as provided for other countries. ⁴²⁴

4.3.2b Plan to facilitate workforce surge in an emergency

Score: 0

There is no evidence of a public plan in place in Ghana to receive health personnel from other countries to respond to a public health emergency. According to page 43 of the Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, there is "no formal plan in place to identify procedures and decision-making, training criteria and standards or address regulatory and licensure concerns related to sending and receiving health personnel during a public health emergency". The evaluation also states that Ghana "is not part of any regional/international personnel deployment agreements such as the Global Outbreak and Alert Response Network (GOARN)" ⁴²⁵ A JEE was conducted for Ghana in 2025, but makes no mention of receiving health personnel from other countries. ⁴²⁶ The Ministry of Health in Ghana has published the Building a Resilient One Health Public Health Workforce in Ghana workforce policy document in 2023, but this document is not publicly available. ⁴²⁷ No information was found on the Ministry of Health or National Disaster Organisation website. ⁴²⁸⁴²⁹ There is no information available on the Ghana Health Service website. ⁴³⁰

4.3.2c Plan to redeploy existing health personnel within the country

Score: 0

There is no evidence of a public plan to redeploy health personnel in an emergency in Ghana. The Staffing Norms for the Health Sector published by the Ministry of Health in 2014 makes no mention of redeploying health personnel during an emergency. ⁴³¹ There is no evidence of a public plan on either the Ministry of Health, Ghana Health Service or National Disaster Organisation websites. ^432433434

4.4.1a Constitutional guarantee of citizens’ right to medical care

Score: 50

The constitution of Ghana aspires for the right to good healthcare but does not explicitly guarantee it. Chapter Six, article 34, part 2, states that the "President shall report to Parliament at least once a year all the steps taken to ensure the realization of the policy objectives contained in this Chapter and, in particular, the realization of…the right to good health care". ⁴³⁵

4.4.1b Access to skilled birth attendants (% of population)

Score: 82.35

4.4.1c Out-of-pocket health expenditures per capita, PPP (current international $)

Score: 92.21

4.4.1d Coverage of essential health services through universal health coverage

Score: 43.75

4.4.1e Total population pushed below a relative poverty line by household health expenditure (60% of media daily per capita consumption or income)

Score: 96.09

4.4.1f Rate of mortality amenable to health care

Score: 60.57

4.4.2a Guaranteed paid sick leave

Score: 0

There is insufficient evidence as to whether paid sick leave is available in Ghana. Section 24(1) of Ghana’s Labour Act, 2003 (Act 651) states that "A period of absence from work allowed owing to sickness, which is certified by a medical practitioner, and which occurs after the commencement of and during annual leave shall not be computed as part of the leave". There is no differentiation between physical and mental illness made, and no indication that leave is paid. ⁴³⁶ Other non-governmental sources differ in whether sick leave is paid or not. ⁴³⁷⁴³⁸

4.4.3a Government prioritisation of care for healthcare workers during response

Score: 0

There is no evidence that the Ghana government issued legislation, a policy, or a public statement committing to provide prioritized healthcare services to healthcare workers who become sick as a result of responding to a public health emergency. No information is available on the National Disaster Management Organisation or Ministry of Health websites. ⁴³⁹ According to academic research published in 2024, there were incentives of tax relief, transport support and salary increases for Ghanaian healthcare workers during the COVID-19 pandemic, but no evidence of prioritised access to healthcare. ⁴⁴⁰

4.5.1a Existence of system for communication during a public health emergency

Score: 0

There is insufficient evidence of a specific system for communication public health officials and healthcare workers to communicate during a public health emergency. According to academic research, published in 2022, "[w]hile NADMO [National Disaster Management Organisation] has guidelines for coordination of the relevant ministries and agencies, there is no operational communication and data sharing among the lead persons in these institutions. These institutions tend to communicate during emergencies and this situation does not allow for good planning and the effective response to health emergencies." ⁴⁴¹ No information is available on the National Disaster Organisation concerning communications. ⁴⁴² Ghana does have systems for sharing of data between institutions, and between frontline healthcare workers and policymakers, such as the Surveillance, Outbreak Response Management and Analysis System (SORMAS) and Lightwave Health Information Management System (LHIMS), but it is unclear that these systems have direct communication facilities for use in an emergency. ⁴⁴³⁴⁴⁴ There is no information available on the Ghana Health Service and Ministry of Health websites. ⁴⁴⁵⁴⁴⁶

4.5.1b Inclusion of public and private sector in healthcare communication system

Score: 0

There is insufficient evidence of a specific system for communication public health officials and healthcare workers to communicate during a public health emergency, and therefore insufficient evidence of a system for communication between public and private healthcare workers during an emergency. According to academic research, published in 2022, "[w]hile NADMO [National Disaster Management Organisation] has guidelines for coordination of the relevant ministries and agencies, there is no operational communication and data sharing among the lead persons in these institutions. These institutions tend to communicate during emergencies and this situation does not allow for good planning and the effective response to health emergencies." There is no mention of communication with private sector workers. ⁴⁴⁷ No information is available on the National Disaster Organisation concerning communications. ⁴⁴⁸ Ghana does have systems for sharing of data between institutions, and between frontline healthcare workers and policymakers, such as the Surveillance, Outbreak Response Management and Analysis System (SORMAS) and Lightwave Health Information Management System (LHIMS), but it is unclear that these systems have direct communication facilities for use in an emergency, and there is no mention of communication with private sector workers. ⁴⁴⁹⁴⁵⁰ There is no information available on the Ghana Health Service and Ministry of Health websites. ⁴⁵¹⁴⁵²

4.6.1a Evidence of national public health system monitoring and tracking of HCAIs

Score: 0

There is insufficient evidence of monitoring and tracking of the number of healthcare associated infections (HCAI) that take place in healthcare facilities in Ghana. According to a Ministry of Health press release, the Ministry of Health will implement the National Infection Prevention and Control Strategy between 2024-2028, which was stated to include establishment of a system for Healthcare-Associated Infections (HAIs), but there is no evidence of this strategy being published on either the Ministry of Health or Ghana Health Service websites. ^453454455 The Health Information System Strategic Plan (2022-2025) published by the Ministry of Health in 2022 makes no mention of healthcare associated infections. ⁴⁵⁶ There is no data available on the Ghana Health Service website. ⁴⁵⁷

4.6.1b Infection prevention and control programme

Score: 0

There is evidence of a national infection prevention and control strategy in Ghana, but it is unclear whether this has been implemented. According to a Ministry of Health press release, the Ministry of Health will implement the National Infection Prevention and Control Strategy between 2024-2028. It is unclear when this press release came out. ⁴⁵⁸ There is no evidence of the strategy being published on either the Ministry of Health or Ghana Health Service websites. ⁴⁵⁹⁴⁶⁰

4.6.1c National plan to ensure a safe environment in health facilities

Score: 100

There is evidence of a plan to ensure a safe environment in health facilities nationally in Ghana. The National Strategy for Water, Sanitation and Hygiene-Infection Prevention and Control in Healthcare Facilities produced by the Ministry of Health in 2020, outlines a strategy to combat hospital-associated infections due to poor hygiene and water sanitation. ⁴⁶¹. The National Healthcare Quality Strategy (2024-2030) published by the Ministry of Health in 2024 includes section 1.5.1 on safety which outlines the lack of data on safety despite good knowledge of patient safety within health facilities, and does not give details of any specific plan to increase safety in health facilities. ⁴⁶² No additional information was found on the Ministry of Health website. ⁴⁶³

4.7.1a Requirement for ethical review before beginning a clinical trial

Score: 100

There is evidence of a national requirement for ethical review before beginning a clinical trial in Ghana. According to section 155(3)(b) of the Public Health Act 2012, in order to conduct a clinical trial, "an ethical clearance issued by an approved institute for medical research" must be attained. ⁴⁶⁴

4.7.1b Expedited approval for clinical trials of unregistered MCMs during epidemics

Score: 100

There is an emergency use authorization and fast track process available for clinical trials in Ghana. The Guideline for Conduct of Clinical Trials During Emergencies published by the Food and Drugs Authority in 2024, states that applications for clinical trials can be fast tracked where there is the need to expedite the process during an emergency.⁴⁶⁵ The Guideline on Emergency Use Authorization of Medical Products published by the Food and Drugs Authority in 2024 outlines the guidelines for approval of "unregistered medical product or an unapproved use of a registered medical product during a Public Health Emergency". This allows the use of unregistered or unapproved medical products during a public health emergency. This does not explicitly state clinical trials, however. ⁴⁶⁶

4.7.2a Existence of agency responsible for approving new human MCMs

Score: 100

The Food and Drugs Authority is responsible for approving new medical countermeasures (MCM) for humans in Ghana. The Food and Drugs Authority is responsible for clinical trials in Ghana, including vaccines and medicines. ⁴⁶⁷

4.7.2b Expedited approval for human MCMs during public health emergencies

Score: 100

There is evidence that there is an expedited process for approving medical countermeasures (MCM) for human use, but not of recognition of approval decisions taking place elsewhere during public health emergencies. Section 7.1 of the Guideline for Conduct of Clinical Trials During Emergencies published in 2024 by the Food and Drugs Authority states that applications for clinical trials, for human use, can be fast tracked where there is the need to expedite the process during an emergency. There is no specific restriction to the scope of the clinical trial given. Section 5 also states that there is joint review with other receiving national drug regulatory agencies and institutional review boards, but it is not clear whether this means other international bodies. ⁴⁶⁸

5.1.1a Submission of IHR reports to the WHO in past year

Score: 100

Ghana has submitted an IHR Self-Assessment Annual Report (SPAR) to the WHO for the last calendar year, with the latest submission in 2024.⁴⁶⁹

5.1.2a Existence of specific risk reduction strategies for epidemics and pandemics

Score: 0

There is no publicly available evidence of a national risk reduction strategy, nor one that includes pandemic or epidemic risk assessment in Ghana. There is no mention of pandemics or epidemics on the National Disaster Management Organisation website. ⁴⁷⁰ The Ghana plan of action on disaster risk reduction and climate change adaptation, published by the National Disaster Management Organisation, makes no mention of epidemic or pandemic risk assessment. It is unclear when this report was published. ⁴⁷¹ There is no evidence of a risk reduction plan for epidemics or pandemics on either the Ministry of Health or Ghana Health Service websites. ⁴⁷²⁴⁷³

5.2.1a Existence of public health emergency agreements with regional neighbors

Score: 100

Ghana has signed agreements that include cross-border operations concerning public health emergencies. Ghana is a member of the West African Health Organization, a part of Economic Community of West African States (ECOWAS), which includes cooperation on epidemics and other health emergencies. ⁴⁷⁴ There is evidence of Ghana contributing surveillance data to reporting produced by the West African Health Organization, such as Mpox data from 2024. ⁴⁷⁵ According to news reports, Ghana signed an Memorandum of Understanding with Africa Centres for Disease Prevention and Control in 2025 that focuses on strengthening regional capacity to tackle health emergencies, which includes cross-border surveillance. ⁴⁷⁶ Ghana is part of the Africa Centres for Disease Prevention and Control, which according to the 2024 "Strengthening Cross-Border Surveillance and Information Sharing in Africa" report, has implemented strategies for coordination and and sharing of data. ⁴⁷⁷

5.2.1b Existence of animal health emergency agreements with regional neighbors

Score: 0

There is insufficient evidence that Ghana has cross-border agreements, protocols or MOUs with neighbouring countries, or as part of a regional group, with regards to animal health emergencies. Page 47 of the Joint External Evaluation (JEE) for Ghana, conducted in 2017 by the World Health Organisation, states that "Ghana has a well-established cross-border exchange of health information, with regular quarterly epidemiological meetings being conducted between district health staff and border agents in neighbouring countries", but does not explicitly state that this concerns animal health emergencies. ⁴⁷⁸ The World Health Organisation conducted a JEE in February 2025, but there is no evidence of cross-border agreements. Instead, page 59 states that there "are no memoranda of understanding with neighboring countries to ensure coordinated responses, limiting cross-border collaboration". ⁴⁷⁹ No information is available on the Veterinary Services Department, Ministry of Health, National Disaster Management Organisation, or Ghana Health Service websites. ^480481482483

5.3.1a Biological and Toxin Weapons Convention status

Score: 100

Ghana has signed and ratified the Biological Weapons Convention. It was signed on 4th October 1972 and ratified on 6th June 1975. ⁴⁸⁴

5.3.1b Submission of CBMs to the Biological and Toxin Weapons Convention

Score: 100

Ghana has submitted confidence building measures for the Biological Weapons Convention in the past three years. According to the United Nations BWC Confidence Building Measures platform, Ghana submitted a report in April 2025. ⁴⁸⁵

5.3.1c Submission of UNSCR 1540 reports

Score: 100

Ghana has provided the required United Nations Security Council Resolution (UNSCR) 1540 report to the Security Council Committee. Ghana's most recent report is from 2015. ⁴⁸⁶

5.3.1d Extent of UNSCR 1540 implementation on public health emergencies

Score: 25

5.3.2a Membership in global health security and/or biological weapons agreements

Score: 0

Ghana is not a member of any of the three organisations listed. Ghana is not a member of the Global Partnership Against the Spread of Weapons and Materials of Mass Destruction. ⁴⁸⁷ Ghana is also not a participant of the Australia group nor a member of the Operational Experts Group of the Proliferation Security Initiative, but is an endorsing country and a participant. ^488489490

5.4.1a Completion and publication of JEE (or GHSA pilot external assessment) report

Score: 100

Ghana has completed a JEE in the past five years. Ghana completed its second Joint External Evaluation (JEE) in February 2025. ⁴⁹¹

5.4.2a Completion and publication of PVS report (past five years)

Score: 0

Ghana has not completed a Performance of Veterinary Services (PVS) assessment in the last five years. According to the World Organisation for Animal Health website, the last assessment was conducted in 2018. ⁴⁹² Ghana did conduct a National Bridging Workshop on the International Health Regulations and the Performance of Veterinary Services in 2022, but this does not amount to a Performance of Veterinary Services assessment. ⁴⁹³

5.4.2b Completion and publication of PVS gap analysis (past five years)

Score: 0

Ghana has not completed a Performance of Veterinary Services (PVS) gap analysis in the last five years. According to the World Organisation for Animal Health website, the last Performance of Veterinary Services (PVS) gap analysis was conducted in 2011.⁴⁹⁴

5.5.1a Evidence of allocated national funds to improve capacity to address epidemic threats

Score: 0

There is insufficient evidence that Ghana has allocated national funds to improve capacity to address pandemic or epidemic threats within the past three years. According to news reports, Ghana has received money from the Food and Agriculture Organisation and the Pandemic Fund, but it is unclear that money has come from internal revenue distribution. ⁴⁹⁵⁴⁹⁶ Page 12 of the Medium Term Expenditure Framework for the Ministry of Health published in 2025, states that "[m]oving forward, the Ministry will enhance epidemic preparedness and response capacity through expanded immunization programs, integrated disease surveillance, and improved water, sanitation, and hygiene (WASH) interventions", but it is unclear whether this has already meant direct allocation of money. ⁴⁹⁷ Page 60 of the Medium Term Expenditure Framework for the Ministry of Health published in 2023 does mention "Strengthen epidemiological surveillance on priority disease", but it does not clearly demarcate any funds for this. ⁴⁹⁸ There is no evidence available on the Ministry of Health of Ghana Health Service websites. ⁴⁹⁹

5.5.2a National budget to address gaps identified in JEE, NAPHS or GHSA roadmap

Score: 0

There is no evidence of a Joint External Evaluation (JEE) report, National Action Plan for Health Security (NAPHS), or national GHSA report specifically mentioning funding commitments that cover the past five years or the future. According to page 14 of the 2025 JEE for Ghana, "[t]here is no earmarked budget specifically for IHR implementation, leading to dependency on external funding". ⁵⁰⁰ The 2017 Ghana JEE report does mention funding but does not set out any specific funding commitments that cover the past five years. ⁵⁰¹ There is no publicly available National Action Plan for Health Security (NAPHS) for Ghana available from the WHO. ⁵⁰² Ghana is a member of the GHSA, but there is no publicly available plan or report that outlines any spending commitments on the Ministry of Health or Ghana Health Service websites. ⁵⁰³⁵⁰⁴

5.5.2b National budget to address gaps identified in PVS assessment or gap analysis

Score: 0

Ghana has not completed a Performance of Veterinary Services (PVS) gap analysis or PVS assessment in the last 5 years. ⁵⁰⁵ According to the World Organisation for Animal Health website, the last PVS assessment was conducted in 2018, but this report is not publicly available on the World Organisation for Animal Health website or Ministry of Food and Agriculture website. ⁵⁰⁶⁵⁰⁷

5.5.3a Emergency public financing during a public health emergency

Score: 100

There is is evidence of a specific emergency public financing mechanism or fund which Ghana can utilise in the face of a public health emergency. During the COVID-19 pandemic, Ghana had special funds set up as part of its National Emergency Preparedness and Response Plan (EPRP) for COVID-19 to deal with the response but these were temporary. ⁵⁰⁸ There have been recent calls for a Public Health Emergency Fund to be set up in Ghana. ⁵⁰⁹ Ghana is party to the African Public Health Emergency Fund, but is currently in arrears. ⁵¹⁰ Additionally, Ghana is eligible for loans from the International Development Association, according to its website. ⁵¹¹

5.5.4a Commitments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is evidence that a minister in Ghana has made a public commitment to improve domestic preparedness for pandemics in Ghana in the last three years. On 13 June 2025, Health Minister Kwabena Mintah Akandoh inaugurated the National Pandemic Steering Committee, and emphasised the need to prioritise investments in Ghana’s laboratory systems, disease surveillance, and health infrastructure. ⁵¹²

5.5.4b Investments to improve domestic or foreign capacity for epidemic threats

Score: 100

There is evidence that Ghana has received financing from donors to improve its domestic capacity to address epidemic threats. In 2024, Ghana was awarded money from the WHO and FAO for strengthening its pandemic preparedness. ⁵¹³

5.5.4c Evidence that the country has fulfilled its full WHO contribution within the past two years

Score: 0

There is no evidence of Ghana paying its contribution to the WHO in the last two years. The programme based budget for the Ministry of Health does not mention WHO contributions. ⁵¹⁴ According to the WHO, Ghana was in arrears in 2023 and 2022. ⁵¹⁵ There is evidence from 2025 that shows Ghana is still in arrears. ⁵¹⁶

5.6.1a Sharing of genetic/biological data and materials beyond influenza

Score: 0

There is no evidence of a specific plan or policy for sharing genetic data, clinical specimens, or isolated specimens internationally in Ghana. The Ministry of Health's Health Information System Strategic Plan 2022-2025 does include a strategy for sharing of data, but this makes no mention of sharing genetic data, clinical specimens, or isolated specimens internationally. ⁵¹⁷ No evidence of a plan or policy for sharing data internationally could be found on the Ghana Health Service website. ⁵¹⁸

5.6.1b Evidence of non-compliance with sample sharing element of PIP framework

Score: 100

There is no evidence that Ghana has not shared samples in accordance with the Pandemic Influenza Preparedness (PIP) framework in the past two years. No news articles or press releases were found stating problems with influenza preparedness on the Ministry of Health or Ghana Health Service websites. ⁵¹⁹⁵²⁰ In 2024, the International Health Regulations (IHR) National Focal Point for Ghana notified the World Health Organization of an influenza outbreak and shared samples. ⁵²¹

5.6.1c Evidence of non-sharing of pandemic pathogen samples during an outbreak

Score: 100

There is no evidence that Ghana has not shared pandemic pathogen samples during an outbreak in the past two years. No news articles or press releases were found stating problems with not sharing of pandemic pathogen samples on the Ministry of Health or Ghana Health Service websites. ⁵²²⁵²³ In 2024, the International Health Regulations (IHR) National Focal Point for Ghana notified the World Health Organization of an influenza outbreak and shared samples. ⁵²⁴

6.1.1a Policy formation

Score: 75

6.1.1b Quality of bureaucracy

Score: 25

6.1.1c Excessive bureaucracy/red tape

Score: 25

6.1.1d Vested interests/cronyism

Score: 50

6.1.1e Corruption

Score: 42

6.1.1f Accountability of public officials

Score: 25

6.1.1g Human rights risk

Score: 50

6.1.2a Orderly transfers of power

Score: 75

6.1.3a Risk of social unrest

Score: 25

6.1.4a Risk of terrorism

Score: 50

6.1.4b Level of illicit arms flows within the country

Score: 50

6.1.4c Risk of organized criminal activity

Score: 50

6.1.5a Presence or risk of armed conflict

Score: 75

6.1.6a Government territorial control

Score: 100

6.1.7a International tensions

Score: 75

6.2.1a Adult literacy rate (15+ years old, both sexes)

Score: 81.02

6.2.2a UNDP Gender Inequality Index score

Score: 37.13

6.2.3a Poverty gap at $1.90 a day (2011 PPP) (%)

Score: 84.62

6.2.3b Share of employment in the informal sector

Score: 0

6.2.3c Coverage of social insurance programs (% of population)

Score: 0

6.2.4a Public confidence in government

Score: 100

6.2.5a Robust, open, diverse local media and reporting

Score: 100

6.2.6a Gini coefficient

Score: 56.5

6.3.1a Adequacy of road network

Score: 25

6.3.2a Adequacy of airports

Score: 50

6.3.3a Adequacy of power network

Score: 25

6.4.1a Urban population (% of total population)

Score: 41.31

6.4.2a Change in forest area (percentage points)

Score: 80.62

6.4.3a Natural disaster risk

Score: 50

6.5.1a Total life expectancy (years)

Score: 52.34

6.5.1b NCD mortality rate

Score: 65.36

6.5.1c Population aged 65+

Score: 84.79

6.5.1d Tobacco use (% of adults)

Score: 87.57

6.5.1e Level of adult obesity (%)

Score: 60.21

6.5.1f Age-standardised prevalence of mental health disorders (per 100 000 people)

Score: 86.27

6.5.2a Access to potable water

Score: 89.99

6.5.2b Access to at least basic sanitation facilities

Score: 31.9

6.5.2c Percentage of health-care facilities with no access to any electricity supply

Score: 72.92

6.5.3a Domestic general government health expenditure per capita (PPP)

Score: 11.4

6.5.4a Trust medical and health advice from the government

Score: 100

6.5.4b Trust medical and health advice from medical workers

Score: 100