Health Minister’s address to Parliament on CSM, cholera outbreak

A. INTRODUCTION
1. Right Hon. Speaker and Honourable Members of Parliament, I appear before you today to brief you and the people of Ghana on ongoing outbreaks of cholera and meningitis and, more importantly, provide an update on measures
being taken by government to contain the spread of these diseases.

2. Mr. Speaker, as you are aware, Ghana is currently facing outbreaks of cholera and meningitis. Additionally, a single case of human metapneumovirus has also been detected in the country.

3. Before I go further, Mr. Speaker, I want to express my sincere gratitude to all our health workers for their unwavering dedication and resilience. In the past week, I had the privilege to interact with health care workers in health facilities
and communities in the Upper West, Greater Accra, and Central Regions. Their tireless efforts on the frontlines of these outbreaks are truly commendable and we, as a nation, are deeply indebted to them.

4. Mr. Speaker, His Excellency John Dramani Mahama’s Government, in the face of limited resources, came to office with a pledge to build a more robust healthcare system that, among other objectives, will prevent diseases and promote good health. Mr. Speaker, we remain fully committed to this, and the leadership and support for these disease outbreaks in the past few weeks is a clear demonstration of government’s commitment.

5. Mr. Speaker, I will now share the updates on the specific diseases and the measures taken to bring the outbreaks under control.

B. CHOLERA OUTBREAK

6. Mr. Speaker, cholera, is caused by the bacterium Vibrio Cholerae. Affected individuals may experience a sudden onset of profuse watery diarrhoea, often accompanied by vomiting. This can lead to rapid dehydration and further complications if not treated promptly.

7. Mr. Speaker, the time between exposure to the bacterium and the appearance of symptoms, called the incubation period ranges from 12 to 48 hours, with an average of 2 to 3 days.

8. Mr. Speaker, cholera transmission occurs primarily through consumption of water or food contaminated with faecal matter. This contamination can happen in various ways, including:

 Direct contamination of drinking water sources with sewage.

 Consumption of raw fruits and vegetables that have been irrigated with contaminated water.

 Poor food handling practices that allow for cross-contamination.

9. Mr. Speaker, several factors contribute to the persistence of cholera in our
communities. These include:
 Poor sanitation and hygiene practices, particularly open defecation, which, unfortunately, is still prevalent in many areas.

 Inadequate access to safe drinking water, especially in rural and peri-urban communities, as well as erratic water supply, which compels people to rely on unsafe sources.

 The presence of street food vendors who may not adhere to proper
hygiene standards.

10. Mr. Speaker, I must put on record that the current cholera outbreak, began over 5 months ago – in October 2024 in Ada West in the Greater Accra Region.

11. Mr. Speaker, since the outset in October 2024, it has unfortunately spread to other districts in Greater Accra and four other regions namely Central, Western, Ashanti, and Eastern Regions.

12. Mr. Speaker, as of 13th February 2025:

 we have recorded 6,145 cases
 719 confirmed cases and unfortunately, forty-nine (49) deaths.

 In all, five regions have reported cases since the outbreak began. These are: Greater Accra, Central, Western, Ashanti, and Eastern Regions.

13. Mr. Speaker, it is worth noting that the situation is improving with active cases now concentrated in the Central Region only.

14. Mr. Speaker, allow me to elaborate on the situation in the Central Region:

 This region has been particularly affected by the current outbreak, with a
significant number of cases reported in recent weeks.

 The districts of Agona West and Effutu have been particularly hard-hit.

In the past week alone, these two districts reported 133 cases, twenty-three (23) admissions, and unfortunately two (2) deaths.

15. Despite the worrying situation in the Central Region, Mr. Speaker, I bring encouraging news. New cholera cases are decreasing, and the districts of Agona West and Effutu, which were initially hard-hit, are now showing a decline
in new cases.

16. Mr. Speaker, as of 16th February, only the Central Region has active cases. The region reported a total of 28 active cases on admission.

 Effutu – 18 cases,

 Cape Coast – 6 and
 Agona West – 4 cases,

17. Mr. Speaker, this positive shift is a testament to the relentless efforts of our healthcare workers and partners, who have been diligently implementing a robust response plan. This plan includes heightened surveillance to swiftly identify and manage cases, strengthened laboratory capacity for accurate and timely diagnosis, and environmental assessments to pinpoint and address risk factors. We have also established cholera treatment centres and are conducting
public awareness campaigns to educate communities. The strategic deployment of oral cholera vaccines in high-risk areas is further contributing to this positive trend.

18. Mr. Speaker, please permit me to now highlight the measures that have been taken to respond to this outbreak in order to bring it under control. In doing this, I must add, Mr. Speaker, that the response to Cholera is multisectoral. The Ministry of Health, in collaboration with various partners, has a comprehensive response plan in motion.

The actions are as follows:

 Coordination: We have activated Regional and District Public Health Emergency Committees in all affected regions to ensure a coordinated response.

 Surveillance: We have heightened surveillance in all districts, with active community case search and contact tracing to identify and manage cases promptly.

 Laboratory: We have strengthened laboratory capacity to test and confirm suspected cases, ensuring accurate diagnosis and timely treatment.

 Environmental Assessment: We have conducted environmental assessments in all affected districts to identify and address risk factors, such as poor sanitation and water supply.

 Case Management: We have set up cholera treatment centres in affected districts and provided training to healthcare workers on case management and infection prevention and control.

 Risk Communication and Community Engagement: We have launched public awareness campaigns to educate communities about cholera prevention and control measures.

 Vaccination: We have deployed oral cholera vaccines in high-risk areas to protect vulnerable populations and prevent further spread.

19. Permit me, Mr. Speaker, to provide additional details on cholera vaccination:

 Phase 1 and 2 subnational oral cholera vaccine campaigns were completed in 5 districts in the Central and Western Regions (Awutu Senya Ease, Sekondi-Takoradi, Effia Kwesimintsim, Shama and Ahanta West). A total of 596.205 people, representing 92.9% of the target population were vaccinated.

 Subsequent to the Phase 1 and 2 vaccinations, OCV were approved for Accra Metro and vaccination just ended; the period was from 14-17th. As of Sunday, February 17th, a total of 257,370 people had been vaccinated in Ablekuma, Ashiedu Keteke, OkaiKoi, and Accra Metro areas.

 We have also secured approval for vaccination for Agona West and submitted an application for Effutu.

20.Mr. Speaker, despite our efforts, we continue to face challenges in our response to the cholera outbreak. These challenges include poor sanitation and hygiene practices, and limited access to safe water. 21. As you can see, Mr. Speaker, Cholera persists in our country for a reason. It persists because of poor sanitation, including open defecation, unsafe water,
and unhygienic food. As a result, Mr. Speaker, cholera requires a multisectoral approach in our efforts to bring it under control. I use this opportunity to thank our local authorities who have been supporting the response and call on them
to do more.

22.Most importantly, Mr. Speaker, in the long term, we will need to improve our sanitation situation; food and water safety; and personal hygiene to rid our environment of cholera and ensure that even when there is an outbreak, it does not have suitable conditions to facilitate spread.

C. MENINGITIS OUTBREAK
23.Mr. Speaker, meningitis is an inflammation of the meninges, the protective membranes that surround the brain and spinal cord. It is characterized by a range of symptoms, including:

 Fever

 Headache
 Nausea
 Vomiting
 neck stiffness
 confusion, convulsions, and
 in severe cases, coma.

24.Mr. Speaker, meningitis outbreaks in Ghana typically occur in the northern regions and neighbouring districts in the Bono and Oti regions. These areas lie within the meningitis belt of Africa – which stretches from Senegal/Gambia in the West to Ethiopia in the East. The meningitis belt experiences seasonal outbreaks during the dry and hot weather conditions, often referred to as the “meningitis season”. In Ghana, this meningitis season extends over the harmattan months from October up to March.

25.Mr. Speaker, it is worth noting the following which informs the response to the meningitis outbreak:

 there are a number of organisms that may cause meningitis including viruses, bacteria etc. some of these can be prevented by vaccination.

 In Ghana, two main types of pathogens cause outbreaks: Neisseria and
Streptococcus.

 Based on the type of Neisseria, the population can be vaccinated. However, vaccination does not apply to Streptococcus which is the strain currently causing havoc in the Upper West Region. This means that, currently, vaccination is not one of the measures we can use to control the ongoing outbreak.

 It is worth noting, Mr. Speaker, that Streptococcus is very fatal and usually starts early in the meningitis season only to be followed by Neisseria, which is less fatal but spreads wider, and responds to vaccination.

26.Mr. Speaker, I must put on record that the current meningitis outbreak in the Upper West Region is rightly a cause for serious concern. This concern is not just because of the current outbreak, but because the Upper West region has
consistently recorded high numbers of meningitis cases during the dry season in recent years.

27.Mr. Speaker, in the current season, as of Sunday, 16th February, we have recorded over 129 cases and unfortunately sixteen (16) deaths while twenty-nine people are currently admission.

28.The districts most affected, Mr. Speaker, are Wa Municipal, Nadowli, Wa West. Jirapa and Nandom.

29.Mr. Speaker, despite the substantial number of cases and unfortunate deaths, I wish to assure the House and the good people of Ghana that we have made considerable efforts to keep the outbreak under control.

30. Our efforts are paying off, Mr. Speaker. Already, a wave of improvement is evident in the Upper West Region, where new meningitis cases are decreasing. This positive change follows the Ministry of Health’s swift and decisive actions, which included deploying experts to support local health teams, conducting a high-level visit to assess the situation and providing support, and ensuring free treatment for all affected individuals. We also activated the Emergency Operations Centre for coordinated response efforts and engaged in consultations with international experts. The mobilization of essential antibiotics and targeted public awareness campaigns have further bolstered our efforts in controlling the outbreak.

31. Mr. Speaker, please permit to highlight some of the specific measures by the Ministry of Health and its partners in response to the meningitis outbreak:

 Deployment of Experts: We have dispatched a team of experts from the national level to support the regional and district health teams in managing the outbreak.

 Free Treatment: We have exempted all individuals affected by meningitis from paying for treatment, ensuring that everyone has access to the care they need.

 Emergency Operations Centre: We have activated the Emergency Operations Centre at the national and regional levels to coordinate the response efforts.

 Coordination Meetings: We are holding weekly coordination meetings with meningitis experts from the World Health Organization to ensure that our response is aligned with international best practices.

 Mobilization of Antibiotics: We have mobilized additional antibiotics to support the Regional Medical Stores while the ICG has also approved 10,000 vials of Ceftriaxone, the antibiotic used in treating meningitis, to ensure that there is no shortage of essential medicines.

 Public Awareness: We have launched intensive public education campaigns to raise awareness about the signs and symptoms of meningitis and encourage early reporting to health facilities.  Community Engagement: We have engaged with community leaders and opinion leaders to solicit their support in raising awareness and
encouraging community participation in the response.

 High-Level Visit: The Minister responsible for Health and the Director- General of the Ghana Health Service have conducted a high-level visit to the affected communities to assess the situation and provide support.

 International Assistance: We have also secured technical assistance from the WHO through the delegation of an expert to help us improve on our management of the Meningitis outbreak in the Upper West Region.

D. Human Metapneumovirus (HMPV).

32.Mr. Speaker, we have also identified a single case of Human Metapneumovirus (HMPV) in the country.

33.Human metapneumovirus (HMPV) is a respiratory virus that can cause a range of respiratory illnesses, from mild cold-like symptoms to severe pneumonia. While it can affect people of all ages, it is most commonly seen in young children, older adults, and those with weakened immune systems.

34.In response to recent increases in respiratory cases in China and some temperate countries in December 2024, as part of our routine surveillance, we commenced testing for human metapneumovirus HMPV this year, January 2025.

35.So far, a total of ninety (90) samples have been selected for testing, and only one positive case has been detected for HMPV. This was detected from an elderly person.

36.Mr. Speaker, I want to assure the House that the risk of HMPV in Ghana remains low. As you can see, we have robust surveillance systems in place to monitor for respiratory viruses, including HMPV. In fact, these systems have
been strengthened in recent years, particularly following the COVID-19 pandemic. We therefore assure the country that any case of HMPV will be quickly identified and managed to prevent spread.

E. Conclusion

37.Mr. Speaker, the Ministry of Health is fully committed to working with our partners to control these ongoing outbreaks and to protect the health of all Ghanaians. We have implemented a range of measures to address these challenges, including:

 Strengthening surveillance to detect and track cases.

 Providing timely and effective treatment to those affected.

 Raising public awareness about prevention and control measures.  Collaborating with local and international partners to coordinate our
response.

38.In addition to these technical interventions, in line with the aspirations of His Excellency, President John Mahama’s Government, I would like to emphasize that effective control of these outbreaks is of utmost importance to my office.
It is for this reason that in the past week alone, I joined health workers at health facilities and in communities to better appreciate the issues on the ground in order to provide a more informed support. 39.Mr. Speaker, together with my team we have been to the following places:

 Upper West (Meningitis Response)
o Regional Health Directorate
o Wa Na’s Palace
o Nadowli District Hospital
o Queen of Peace SHS
o Wa Regional Hospital  Greater Accra and Central Regions (Cholera Response)
o Mamprobi hospital
o Martyrs of Uganda School
o Winneba Municipal Hospital
o Winneba Township
o Winneba Beach front
o Swedru Municipal Hospital

40.Mr. Speaker, at this juncture, I would like to encourage all health workers – especially those in the hard-hit districts – to support the ongoing response to the outbreak. Similarly, I would like to call on the Municipal/District Assemblies
including local authorities responsible for water, sanitation, and food safety, to actively play their part in enforcing local bye-laws, ensuring access to safe water and food, and supporting awareness creation. In addition, I also appeal to our friends in the media to support the public education and awareness some more to fully prevent any further spread of these outbreaks.

41. Mr. Speaker, as I end, permit me to call on my fellow Members of Parliament to support the local authorities and health workers to educate on our fellow country men and women, on how to prevent these diseases and the important
need to report early to health facilities when they have symptoms suggestive of any of these diseases. This helps to prevent further spread and complications including unfortunate loss of lives.

42.Mr. Speaker, finally, I want to reassure the House that we are doing everything in our power to contain these outbreaks and safeguard the health of our nation. We will continue to monitor the situation closely and provide regular updates to
the House