Health as a Right, Not a Privilege: Demanding equity and accountability in Ghana’s healthcare system

Health is not a luxury. It is not a privilege to be enjoyed only by the wealthy, the urban elite, or those with political influence. It is a fundamental right, inherent to every human being regardless of gender, geography, social class, or economic circumstance.

Indeed, the Universal Declaration of Human Rights and the International Covenant on Economic, Social and Cultural Rights affirm health as a fundamental human right, recognizing every person’s entitlement to the highest attainable standard of physical and mental well-being  a principle that Ghana, as a signatory, is bound to uphold.

Both the Universal Declaration of Human Rights and Ghana’s 1992 Constitution enshrine health as a fundamental right, with Articles 34(2), 36(10), and 37(3) essentially obligating the state to provide adequate facilities, safeguard worker welfare, and promote preventive care, yet the persistent inequities in Ghana’s health system reveal a painful gap between constitutional promise and lived reality.

To have life is to deserve quality life, and this should never be predicated on financial capacity, exclusionary policies, or unsustainable interventions.

At a recent engagement with the media,  President John Dramani Mahama outlined some of the progress made in Ghana’s health sector: the distribution of six million sanitary pads to young girls, funding to stabilize the National Health Insurance Scheme (NHIS), the “Mahama Cares” initiative, and supply of critical medical equipment, among others.

Yet,  he made a striking point that goes to the heart of our health discourse: “Access without quality is inadequate” and rightly so, mere access without sustainable, structured, and dependable systems undermine holistic well-being and, ultimately, national development.

A picture of inequities and crises

Our health security infrastructure also lags dangerously. Ghana ranked 105th out of 195 countries in the 2019 Global Health Security Index, reflecting fragile laboratory systems, weak surveillance, and poor emergency preparedness.

Meanwhile, non-communicable diseases (NCDs) such as hypertension, diabetes, kidney diseases and cancers are on the rise, now contributing to nearly 45% of deaths nationwide, according to WHO. However, health financing and policies remain disproportionately skewed toward infectious diseases, leaving NCD prevention and treatment underfunded.

And perhaps one of the most glaring blind spots is mental health. Despite the World Health Organization’s recognition of mental well-being as inseparable from overall health, Ghana consistently underfunds and sidelines mental health in national priorities.

The Mental Health Authority remains chronically under-resourced; only about 1.4% of Ghana’s health budget is allocated to mental health, most of which goes to psychiatric hospitals in Accra, Kumasi, and Pantang.

Rural areas are left virtually without structured services, meaning millions of Ghanaians facing depression, anxiety, schizophrenia, or substance abuse disorders have little to no access to care. This neglect reinforces stigma, drives social exclusion, and creates a silent public health emergency that continues to drain productivity and family well-being.

More concerning is what these inequities say about justice: What justice is accorded to citizens who die preventable deaths due to systemic negligence? What dignity is left when healthcare workers are overworked, underpaid, and under trained? What hope is sustained when disability inclusion and mental health are consistently not marked as national health priorities?

Contradictions we can’t ignore: Leadership, trust, and practice

Even more telling is this contradiction. While health governance is frontlined in political speeches and policy documents, leaders and their families often seek medical care in Western countries when illness strikes. What does that say about the quality of healthcare we provide at home?

It reveals a lack of confidence not in individual health workers or necessarily in individual hospitals alone, but in the systemic reliability: in diagnostics, in availability of specialists, in continuity of care, in trust that when it’s your turn, you’ll get competent care without lengthy delays or risk of complications.

When those who proclaim commitment to health reform do not themselves fully rely on the local health system, it erodes public trust and suggests that the system is not yet where it needs to be. It’s not simply symbolic; it’s a metric of the credibility of governance and the seriousness of our commitments.

The Accra initiative: A global vision from Ghana

In the midst of these realities, there is a new vision emerging. Deputy Chief of Staff, Finance and Administration, Nana Oye Bampoe Addo, has revealed that President Mahama is spearheading a bold global effort, the Accra Initiative, to redefine Africa’s place in the global healthcare landscape.

The initiative seeks to:

Increase domestic investment in health,

– Ensure that Africans are central to shaping health systems across the continent, not passive recipients of aid or external best-practices,

– Form a presidential task force to ensure re-imagining and restructuring of global health systems remains a top priority, and

– Expand its scope in UN General Assembly meetings  to include countries beyond Africa, in South America, Asia, and other regions.

This recalls the leadership of former Nigerian President Olusegun Obasanjo, whose efforts around the HIV/AIDS crisis led to the establishment of the Global Fund — a landmark, home-grown, global response. The Accra Initiative has the potential to be similarly transformative, provided it matches vision with honesty about our domestic shortfalls.

Health and justice

Health, as a matter of right, demands accountability. Citizens disadvantaged by systemic negligence suffer an injustice no less severe than those deprived of liberty or dignity.

Corruption, the politicization of governance, weak regulatory enforcement, and lack of civic courage deepen these disparities. Policies without inclusivity, interventions without sustainability, and systems without ethical grounding fail the very people they purport to serve.

The way forward

With data and experiences clarifying where we stand, here are practical steps to close the gaps and make rights real:

Elevate quality as a priority

• Not only more staff, but better training, ongoing professional development, ethical standards, regular audits, and accountability for quality outcomes.
• Invest in health facility readiness: equipment, laboratory capacity, supply chains, diagnostics.

Target inequalities explicitly

• Because the poorest and those in remote, rural, or northern regions are falling behind. Policies should be pro-poor, with resources tied to disadvantaged (geographic, socioeconomic, gender, disability).
• Free or highly subsidized maternal, neonatal, and child health services in underserved areas.

Ensure trust and transparency

• Leaders must lead by example: using local health services builds trust.
• Public reporting of outcomes: mortality ratios, service quality, patient experiences by incorporating customer/feedback services.

Support the Accra initiative, but ground it locally

• The Accra Initiative must not only shape global frameworks but also catalyze domestic reform. It must link international advocacy with local implementation.
• Ensure that international attention does not become a smokescreen for unfulfilled promises on the ground.

Strengthen emergency preparedness & Non-Communicable Diseases (NCDs)

• As data shows, mortality from NCDs is growing. Resources are still far more weighted toward infectious disease.
• Build surveillance systems, prepare for outbreaks, enhance lab capacity, and ensure service readiness even under stress.

Embed inclusivity: Gender, disability, vulnerable groups

• Ensure health policies explicitly incorporate persons with disabilities, special populations, slum dwellers, migrants, and rural remote communities.

Improve spatial access: many cannot physically reach good healthcare in reasonable time.

Sustainability & Depoliticization

• Health reforms must survive beyond electoral cycles. Longer-term funding, bipartisan support, independent oversight.
• Donor assistance should support capacity building rather than fostering dependency.

Conclusion: A demand for accountability & a promise of redemption

Ghana’s progress in healthcare is real. But progress without justice is hollow. As long as a child’s survival depends on where he/she is born; as long as illness condemns the poor to debt or death; as long as access without quality prevails; we have not fulfilled the right to health.

When leaders proclaim that every Ghanaian deserves healthcare, that every African must shape and benefit from the systems that serve them, those must be more than words. The Accra Initiative offers a new possibility — a chance for Ghana and Africa to lead on the world stage, to reimagine health governance to be fair, inclusive, and locally empowered.

But the credibility of that possibility depends on domestic consistency: ensuring that even in our most remote region, even for the poorest woman, quality care is available and trusted not only when they are well, but when they are sick.

Health must never be at the mercy of political will, donor interests, or the “accident” of birth. It must be guaranteed, protected, and sustained as a matter of justice. Only then can we speak of a truly equitable, resilient, and humane healthcare system — one that upholds the dignity of every Ghanaian, strengthens our economy, and secures our collective future.

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DISCLAIMER: The Views, Comments, Opinions, Contributions and Statements made by Readers and Contributors on this platform do not necessarily represent the views or policy of Multimedia Group Limited.