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Challenges in the Era of Globalization - iaabd

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Abstract<br />

<strong>Challenges</strong> <strong>in</strong> <strong>the</strong> <strong>Era</strong> <strong>of</strong> <strong>Globalization</strong><br />

Edited by Emmanuel Obuah<br />

Global Fund and Tuberculosis Management <strong>in</strong> a Ghanaian Public Hospital<br />

Mercy Akosua Akortsu 5 akomercy@yahoo.com<br />

Department <strong>of</strong> F<strong>in</strong>ance University <strong>of</strong> Ghana Bus<strong>in</strong>ess School, Legon, Ghana.<br />

Joshua Abor 6 joshabor@ug.edu.gh<br />

Department <strong>of</strong> F<strong>in</strong>ance, University <strong>of</strong> Ghana Bus<strong>in</strong>ess School, Legon. Ghana<br />

The Global Fund is expected to contribute to <strong>the</strong> management <strong>of</strong> tuberculosis (TB) and to w<strong>in</strong> <strong>the</strong> fight aga<strong>in</strong>st<br />

tuberculosis. The objectives <strong>of</strong> <strong>the</strong> Global Fund <strong>in</strong>clude achiev<strong>in</strong>g higher cure rates, <strong>in</strong>crease treatment success<br />

rate, reduce mortality rates, higher TB case detection and notification rate and reduce TB patient default rates. This<br />

study exam<strong>in</strong>ed <strong>the</strong> impact <strong>of</strong> <strong>the</strong> Global Fund on <strong>the</strong> management <strong>of</strong> TB <strong>in</strong> a public hospital <strong>in</strong> Ghana. A case study<br />

approach was adopted. The f<strong>in</strong>d<strong>in</strong>gs <strong>of</strong> <strong>the</strong> study revealed that <strong>the</strong> Global Fund has made some significant<br />

contribution <strong>in</strong> <strong>the</strong> management <strong>of</strong> TB at <strong>the</strong> hospital under study. However, a lot more is required <strong>in</strong> order to<br />

achieve greater success outcomes <strong>in</strong> <strong>the</strong> future. A number <strong>of</strong> useful recommendations are provided.<br />

Introduction<br />

The economic development <strong>of</strong> any nation is said to be closely related to <strong>the</strong> health status <strong>of</strong> its citizenry.<br />

Theoretically, <strong>the</strong>re is a l<strong>in</strong>kage between health and wealth; <strong>the</strong>refore healthier nations should be able to<br />

create more wealth which should translate <strong>in</strong>to growth and development. Ghana is challenged with so<br />

many health conditions and diseases. These health conditions <strong>in</strong>clude HIV/AIDS, Tuberculosis (TB) and<br />

Malaria. These predicaments which affect <strong>the</strong> population may mean that <strong>the</strong>se people are not able to work<br />

and <strong>the</strong>refore <strong>the</strong> nation looses valuable productivity.<br />

Ghana is not among one <strong>of</strong> <strong>the</strong> 22 high burden tuberculosis countries yet <strong>the</strong> disease is a major public<br />

health concern <strong>in</strong> <strong>the</strong> country (TB CAP, 2010). With an estimated 46,000 new TB cases <strong>in</strong> 2007, Ghana<br />

ranks 19 th <strong>in</strong> Africa for <strong>the</strong> highest estimated number <strong>of</strong> new cases per year (TB CAP, 2010). The World<br />

Health Organization estimates that Ghana is detect<strong>in</strong>g only 26% <strong>of</strong> all cases and 38% <strong>of</strong> smear positive<br />

TB cases (WHO 2009). This means that only a third <strong>of</strong> <strong>the</strong> cases are detected annually and many more<br />

undiagnosed TB cases <strong>in</strong> <strong>the</strong> community are cont<strong>in</strong>uously transmitt<strong>in</strong>g <strong>the</strong> <strong>in</strong>fection to susceptible people.<br />

Sadly, TB accounts for 40% <strong>of</strong> mortality cases after post mortem at <strong>the</strong> hospital under study. It is sad<br />

because TB is curable once it is detected early and <strong>the</strong> patient rigorously follows <strong>the</strong> treatment<br />

adm<strong>in</strong>istered. Accord<strong>in</strong>g to Lambert and Stuyft (2002), early diagnosis and treatment <strong>of</strong> smear-positive<br />

pulmonary TB cases are <strong>the</strong> key to <strong>in</strong>terrupt<strong>in</strong>g <strong>the</strong> cha<strong>in</strong> <strong>of</strong> transmission. Also, late case detection is<br />

related to poorer outcomes not only for T.B, but for severe malaria, or HIV-related morbidity.<br />

Floyd et al (2002) estimated that to achieve <strong>the</strong> World Health Organization's tuberculosis control targets,<br />

<strong>the</strong> 22 high-burden countries (HBCs) that collectively account for approximately 80% <strong>of</strong> <strong>the</strong> world's<br />

tuberculosis cases require about $1 billion per year dur<strong>in</strong>g <strong>the</strong> period 2001 to 2005. They also estimated<br />

that a fur<strong>the</strong>r $0.2 billion per year is needed for low and lower-middle <strong>in</strong>come countries outside <strong>the</strong> 22<br />

HBCs. The Global Fund to fight Aids, Tuberculosis and Malaria has generated passionate debates s<strong>in</strong>ce<br />

5<br />

MercyAkosua Akortsu is an Executive MBA F<strong>in</strong>ance Graduate from <strong>the</strong> University<strong>of</strong> Ghana Bus<strong>in</strong>ess School and a<br />

Pr<strong>in</strong>cipal Accountant <strong>in</strong> Health Care Service.<br />

6<br />

Joshua Abor is a Pr<strong>of</strong>essor <strong>of</strong> F<strong>in</strong>ance at <strong>the</strong> University <strong>of</strong> Ghana Bus<strong>in</strong>ess School.<br />

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