The measures that many governments globally have introduced to prevent the spread of COVID-19, including on movement and the conduct of socio-economic and political activities, have disrupted people’s lives and income. The frustrations and dissatisfaction that developed has had the potential to spiral out of control and to develop into political and social unrest and, in some cases, even violent conflict.
A largely bipartisan and rule of law-based approach to managing COVID-19, including broad consultations with civil society and the private sector, have strengthened Ghana’s resilience and prevented political and social unrest @LindaDarkwa #C19ConflictMonitorTweet
The use of strategic communication has been fundamental to enhancing transparency in the management of Ghana’s response efforts. On recording the first cases of COVID-19 in the country, the government addressed the nation and outlined measures designed to achieve five key objectives: to stop the importation of the virus; to detect and contain cases; to provide adequate healthcare for those infected; to minimise the impact of the virus on socio-economic life and to put in place measures to transform the challenges that had been caused by the pandemic, including shortages of critical supplies; and to deepen the country’s domestic capacity and enhance self-reliance. Intensive public education through multiple channels and various languages and formats was instrumental in educating the general public on prevention and management measures. Key communication by known and respected public officials – including the president and traditional and religious leaders – helped to drive home these messages.
Rule of law
Situating the COVID-19 prevention, management and response efforts in the rule of law enhanced the legitimacy of efforts. Pending the enactment of specific legislation for the imposition of restrictions to address the public health emergency confronting the nation, the minister of health evoked relevant sections of the Public Health Act 2012 to deal with the crisis. Subsequently, legislation to deal with emergencies and disasters requiring restrictions for the preservation of public safety, health and general protections was passed by Parliament to authorise the imposition of restrictions to certain freedoms by the government. The promulgation of a law by Parliament reinforced the country’s bipartisan approach to addressing the pandemic.
As the pandemic raged, a partial lockdown was imposed in the most affected regions of the country – the Greater Accra region, including Kasoa and Tema, and the Greater Kumasi region – to break the chain of transmission, contain the virus and aid enhanced surveillance. The country’s air, sea and land borders were also closed to human traffic to stop further importation of the virus. A two-week mandatory quarantine – at the government’s cost – imposed on the last set of passengers who arrived on the eve of the lockdown proved to be critical, as a significant number tested positive for COVID-19.
To help mitigate the socio-economic impact of the movement restrictions on the most vulnerable members of the affected population, several measures were put in place. These included a three-month full absorption of water bills for all consumers, as well as the electricity bills of low-income consumers (the poorest of the poor) and a 50% subsidy for all others within the same period. It is of particular significance that arrangements were made for the supply of free water to households without water supply. Also, free meals and accommodation were provided to the most vulnerable members of the affected population and homeless people during the lockdown period. The government’s efforts in that regard were complemented by faith-based bodies, corporate bodies, the private sector and individuals.
Extensive public education on the roles of the different security institutions (e.g. police, military) in the enforcement of the lockdown was critical in promoting confidence-building among the general population and, to a large extent, helped to enforce the lockdown. Aggressive contact tracing and enhanced testing during the period enabled the early detection, isolation and treatment of infected people.
Adaptive and context-specific mechanisms
Utilising a whole-of-government effort, the principle of subsidiarity was operationalised to deal with the COVID-19 crisis. Through the establishment of an interministerial committee on COVID-19 response, national-level strategic guidance was provided to the decentralised local structures of the governance architecture to develop cross-sectoral emergency response plans. This made it possible for the government machinery at the various levels to adapt and develop context-specific mechanisms, aligned to the national strategy, to address the pandemic. The intersectoral committees at the subnational level identified appropriate facilities to serve as isolation centres and hospitals for the management of COVID-19 cases. For instance, in the capital Accra, which had the highest number of cases, the military established a mobile hospital for the management of COVID-19 patients.
Consultation and community engagement
Broad consultations with a range of stakeholders – viz political parties, the trade unions and professional bodies, the private sector, traditional authorities, faith-based organisations, traders, transport operators and the National Students’ Union – made it possible to get buy-in for the COVID-19 mitigation and response strategy, and minimised the instrumentalisation of the crisis for political gain. The engagements also facilitated the provision of support from a wide range of actors. Religious institutions availed retreat centres and church premises for use as isolation centres; managers of public transport terminals agreed to provide for and promote COVID-19 prevention etiquette; traders, especially in markets, designed systems to facilitate and enforce social distancing measures; and transport operators agreed to practice social distancing measures by limiting the number of passengers aboard vehicles.
The imposition of culturally sensitive restrictions enabled a fine balance to be struck between the public health emergency requirements and traditions and customs. For instance, even though funerals, which are ordinarily large social gatherings, were suspended, private burials with no more than 25 people in attendance were allowed.
Financial planning and relief
A comprehensive financial plan to support the prevention, response and mitigation of the socio-economic impact of COVID-19 was presented by the Ministry of Finance for Parliamentary approval. Frontline healthcare professionals were insured, and doctors and nurses received tax exemptions on their salaries. Personal protective equipment (PPE), as well as materials for enhanced hygiene, were procured and supplied to healthcare facilities across the country. A COVID-19 Alleviation Programme business support scheme was designed to support small, medium and micro enterprises (SMMEs) that were hard hit by the disease. The support provided enabled local industries to produce hitherto imported essential prevention and management materials such as PPE, face masks and sanitisers, among others.
A National COVID-19 Trust Fund was established to receive contributions to support needy and vulnerable members of the population during the period of the health crisis. The trust fund, which is a public trust, was established by an Act of Parliament and is managed by an independent body of trustees. The fund has received donations from a wide section of individuals, and public and private corporations. The establishing of the fund has also inspired the establishment of formal and non-formal non-state mechanisms at the community level, particularly by traditional authorities, to complement the efforts of the state.
Challenges and vulnerabilities
It was clear from the outset that the country was ill-prepared for a health pandemic, as it did not have adequate numbers of facilities and equipment for the effective management of large-scale health emergencies. Initial response efforts were not sufficiently inclusive, as provisions were not made for the mentally ill, for example, whose conditions require specialist care in addition to COVID-19 care. Also, the challenges encountered with the distribution of food during the lockdown revealed the limitations in the usability of the country’s data for emergency planning.
As part of the containment measures, institutions of learning were shut down. As it became evident that there was a need for extended restrictions on all public gatherings, remote learning programmes were developed for schools. Most private schools in the country provided interactive online education options for their pupils. The Ghana Education Service developed television and radio broadcast programmes for pupils in basic, junior high and secondary schools. However, although these were good, most of the programmes for basic schools were broadcast multiple times, and none had options for the instructor evaluation of the pupils’ learning.
The rising number of infections raises questions on current developments in the country, particularly with the decisions to undertake voter registration during this period and the gradual reopening of schools and universities for exit students, especially as some returning students have tested positive for COVID-19.
The challenges posed by COVID-19 are unprecedented in Ghana. Efforts to manage the pandemic have tested the country’s response mechanisms and provided an opportunity for a comprehensive assessment of the various frameworks of response required to enhance its resilience to emergencies. Even though the case management efforts have resulted in a low fatality rate, one of the lessons identified from Ghana’s management of COVID-19 is the need for a national strategy on pandemics.
The largely bipartisan and rule of law-based approach to managing COVID-19, including broad consultations with civil society and the private sector, have strengthened Ghana’s resilience and prevented political and social unrest To maintain the current situation, efforts must be made to ensure that the government does not take undue advantage of the restrictions for political gain in the upcoming elections.
Dr Linda Akua Opongmaa Darkwa is a senior research fellow of the Legon Centre for International Affairs and Diplomacy, currently on leave and serving as the coordinator of the Secretariat for the Training for Peace Programme in Addis Ababa, Ethiopia. Her research interests are in the areas of peace and security, with a particular focus on the implications of global security paradigms on continental, regional and local processes of governance, human rights, development and security. Her contribution is made in a personal capacity. She tweets at @LindaDarkwa.