For winning a silver medal at the 2015 African Cup of Nations, the Black Stars are being handsomely rewarded in thousands of US dollars and Grand Jeep Cherokees. For finally winning a gold medal in Guinea worm eradication after 26 years in the wilderness, how will Ghana reward the tireless eradication team?
Ghana has been certified free of the Guinea worm scourge by the World Health Organisation(WHO)! And one would have thought the disease would be easy to eradicate. Potable water to affected communities was all that was needed after all. Today, Ghana has left the unenviable ranks of the last four countries still harbouring the worm, namely Ethiopia, Mali, Chad and South Sudan.
How did this momentous public health achievement come about? A chat with Dr Asiedu Bekoe, Manager of the Guinea Worm Eradication programme, put it all in perspective.
Some background
In 1989, Ghana had about 180,000 Guinea worm cases nationwide, but mainly in the Northern Region. Subsequently, the government and partners commenced a series of interventions. Key among the interventions was the provision of potable water. The effect within five years was dramatic. There was a sudden decline to around 8,000 cases. The combined effect of the Konkomba War and the withdrawal of support by some partners, however, led to a resurgence of cases until the government formed the Inter-Agency Co-ordinating Committee (IACC) around 1999-2000. It is this focused attention that saw a continuous decline until the last case was reported in 2010. This then ushered Ghana into a three-year pre-certification phase during which the country was supposed to demonstrate the continuous absence of the disease in spite of an active surveillance system. This, the country did.
In July 2014, the WHO sent a team of international experts also known as International Certification Team (ICT) to assess the state of readiness for eradication. The team looked out for two key things; the existence of a surveillance system actively searching for new cases and a high level of awareness in the general population of the disease and the existence of a cash reward for anyone reporting new cases.
After visiting all 10 regions, the ICT made a positive recommendation to the International Commission for Certification of Dracunculiasis Eradication (ICCDE) that Ghana had indeed met the criteria. This recommendation was tabled for consideration at the ICCDE’s meeting, held every other year, and scheduled for January 2015. After considering the Ghana country report, the ICCDE then made a recommendation to the Director General of the WHO, Dr Margaret Chan. On the basis of the country report and the recommendations from both the ICT and the ICCDE, the Director General pronounced Ghana free, having successfully eradicated the Guinea worm disease!
Dr Asiedu Bekoe sums up his feelings with these words, “Personally, I think that if you are able to get all the actors in a particular endeavour engaged and there is a clear focus, you can achieve success. The disease has been localised to Northern Ghana but the certification needed to show that awareness was truly national. We created the sense of a shared national goal by declaring that national certification equals regional certification which equals district certification. Some regional directors even invested their own regional resources in the programme. The certification team clearly saw the level of effort that had been out into the work by everyone!”
Contributions and support
The Guinea Worm Eradication Programme also paid glowing tribute to the following organisations and individuals for their contributions to this momentous achievement: the WHO/UNICEF/EU partnership that identified endemic communities and provided potable water (2007-2012) leading to the current 54 per cent potable water coverage in rural Ghana. This was in addition to other technical and financial support. To create awareness about the disease, Japan International Co-operation Agency (JICA) funded the printing of 200, 000 posters. Also acknowledged is the Carter Centre, especially in the early phase. Last but not least is the role of the central government in providing direction and resources in the fight.
Individuals that have distinguished themselves by their contributions are Dr Sam Bugri, the first programme manager and chairman of the
National Certification Committee, and Dr Seidu Korkor, immediate past programme manager, until 2010 when he handed the baton to Dr Asiedu Bekoe. In all this, the real foot soldiers have undoubtedly been the army of volunteers engaged in case searches etc. whose dedication and commitment have spurred this success.
Today, the Guinea worm team feels confident that the robust surveillance system deployed to eradicate the disease coupled with the rich experiences gathered and expertise of the health professionals remain available to the country to manage other communicable diseases such as Ebola and others.
Between 2015-2019, Ghana, with the global public health community, has entered into the post certification surveillance phase to detect any new cases, while the latter supports the four remaining countries to meet the 2019 target for global eradication of guinea worm.
I personally congratulate all whose diverse efforts have made this possible. God bless.
Sodzi Sodzi-Tettey
www.sodzisodzi.com
