Today, Ghana marks exactly five years since the first COVID-19 case was recorded on 12th March 2020. The pandemic was a critical test of the resilience of public health systems worldwide, including Ghana.

Current data available shows that about 172,000 people were affected with 1,462 deaths recorded across the country. However, the country’s surveillance system remained robust throughout the pandemic until the World Health Organization declared it over as a global health emergency in 2023.

The country’s response to COVID-19 was recognized as one of the most effective in terms of case detection, management, and control of virus transmission. As we mark the fifth anniversary of the first confirmed case, it is a time to look back at the major public health successes that have reshaped Ghana’s public health system to prepare for future outbreaks.

The first case was reported while Ghana was already battling outbreaks of circulating vaccine-derived poliovirus type 2 (cVDPV2) in some regions. This triggered a national response of an all-government approach to pandemic management.

The successful coordination of response activities by the central government, with inter-ministerial collaboration, highlighted the potential need for public health in Ghana to receive the attention that it requires.

This whole-of-government approach was potentially transformative for public health practice, as it placed public health at the forefront of national priorities for the first time in many years.

The pandemic created a unique opportunity to transform disease surveillance, case management, public health policies, infrastructure, and workforce capacity.

The establishment of the national and regional Public Health Emergency Operation Centers (PHEOCs) to help in the coordination and management of the pandemic and other outbreaks during the period was one of the key successes.

This was a very bold step in strengthening the national response, since it provided a centralized point for coordination, data management and other critical response activities.

The public health system also experienced a great transformation in disease surveillance. There was a digital transformation from the traditional paper-based system for reporting and managing data through the nationwide rollout of Surveillance Outbreak Response Management and Analysis System (SORMAS) and other systems.

These systems have been instrumental in responding to multiple outbreaks during and after the pandemic, significantly strengthening public health practice across all functional levels of Ghana’s health system.

Moreover, the pandemic resulted in an enhanced laboratory testing capacity in the country and the adoption of creative methods like pooled testing, which ranked Ghana as one of the top-performing countries in the WHO African Region (AFRO) in terms of COVID-19 tests performed per 100,000 population.

This was later followed by a number of other nations to make testing more efficient.

The crisis also accelerated the full utilization of national and regional reference laboratories, Noguchi Memorial Institute for Medical Research (NMIMR), Kumasi Centre for Collaborative Research in Tropical Medicine (KCCR), Veterinary Services Directorate (VSD), Council for Scientific and Industrial Research (CSIR), and other private laboratories.

This demonstrated how Ghana’s public health system can leverage existing institutions and infrastructure to enhance diagnostic capacity during future outbreaks when traditional health systems become overwhelmed.

An achievement worth noting was a coordinated case management system that ensured that every region had a dedicated team to handle serious COVID-19 cases.

It also improved Ghana’s referral system. Recognizing the need for a specialized infectious disease center, the government, in collaboration with the private sector, established the 100-bed Ghana Infectious Disease Centre (GIDC). During the pandemic, this facility was instrumental in providing specialized care, and it will continue to be a useful centre in treating infectious diseases.

The need for such centers was much prevalent during the continuing pandemic, and there have been plans to construct similar facilities across the nation to strengthen management and treatment capabilities.

Public-private partnerships in response to the pandemic also encourgaed innovation and self-sufficiency in Ghana’s public health response. The private sector also helped to ensure the production of personal protective equipment (PPE), medications, sanitizers, and other essential supplies to minimize the effects of the global supply chain disruptions.

This partnership guaranteed that health workers around the country had a regular supply of protective equipment and that the general population could obtain basic goods for a key moment in the pandemic. This strong support for the public health sector during the crisis contributed to overall compliance of public health measures.

Another major success was the deepened collaboration among academia, public health experts, and policymakers. The pandemic encouraged close collaboration with research institutions that allowed for the fast development of guidelines, training materials, and policy recommendations.

Evidence-based insights derived from real-time data collection, modeling, and analysis ultimately informed Ghana’s decision-making as it executed this public health response.

The integration of science and policy was crucial to shaping the country’s COVID-19 response and should set the standard for the future management of health crises.

As one of the most crucial long-term results of the pandemic, the pandemic had shown there was a great need for self-sufficiency to produce vaccines. This has resulted in the creation of the National Vaccine Institute (NVI) in Ghana, which is responsible for the facilitation of local vaccine production.

This will strengthen Ghana’s capacity for responding to future outbreaks and play a role in the control of vaccine-preventable diseases.

Although COVID-19 disrupted service delivery in many ways, it has also demonstrated the best in Ghana’s public health system. Improvements in disease surveillance, laboratory capacity, case management, public-private partnerships, and self-sufficiency in vaccines have made a lasting imprint.

These successes should be built upon so Ghana can sustain a stronger and proactive public health system for combating current and new infectious disease threats.