Collective Action for HIV Progress in Ghana: Addressing Delays and the Need for Community-Led Responses

By Richard Agodzo

As we approach World AIDS Day 2024, the theme, Collective Action: Sustain and Accelerate HIV Progress, is a timely call for nations, stakeholders, and communities to re-energize efforts to fight the epidemic. In Ghana, while notable strides have been made, particularly in access to testing and treatment, there remain critical challenges hindering the country’s ability to fully achieve its HIV response goals. One of the most pressing issues is the government’s recurrent delays in clearing life-saving HIV medication donated by the Global Fund. Alongside this, the persistent failure to meaningfully involve communities in leading the response remains a major barrier to progress.

The Medication Crisis: A Government-Induced Setback

Over the years, Ghana’s HIV program has benefited immensely from the support of international partners like the Global Fund. The provision of antiretroviral drugs (ARVs) by such organizations has been crucial in sustaining treatment for people living with HIV (PLHIV). However, an alarming trend has emerged in the form of government delays in clearing these donated medications at the ports. This delay has left many Ghanaians on treatment vulnerable to stockouts, interruptions in their medication regimen, and increased health risks.

In 2023, there were multiple reports of drug shortages, with health facilities across the country unable to meet the medication needs of patients. For PLHIV, consistent treatment is non-negotiable—it is a lifeline. Interruptions in treatment can lead to drug resistance, deterioration of health, and even death. Moreover, such inconsistencies feed into stigma and discrimination, as those on treatment may feel targeted and forgotten.

The government's failure to prioritize the swift clearance and distribution of these drugs not only undermines the progress made but also reflects poorly on its commitment to ending HIV by 2030. While collective action is the theme, the lack of urgency in these actions speaks to a disconnect between government policy and the real needs of PLHIV.

The Need for Community Leadership in Ghana's HIV Response

Another significant issue holding back Ghana’s HIV response is the limited role that communities, particularly key populations and PLHIV, play in leading initiatives. Across the world, it is well-recognized that community-led responses are more effective in addressing the localized challenges of HIV. Communities understand their own needs best and are better equipped to tailor interventions that fit their context. Yet, in Ghana, there remains a top-down approach in which decision-making and implementation are largely controlled by the government and health institutions, often excluding the voices of those most affected.

                  

For example, key populations such as sex workers, men who have sex with men, and transgender individuals are disproportionately affected by HIV in Ghana. Despite being central to the epidemic, they are often sidelined in planning and decision-making processes. Without their active leadership, efforts to reduce new infections and improve treatment outcomes will continue to fall short.

The Digital Health and Rights Project, which I have been a part of, highlights the power of involving youth and marginalized groups in the HIV response. Initiatives that focus on the digital space—providing access to information and empowering young people with the knowledge of their health rights—have demonstrated the importance of community-driven solutions. Unfortunately, such programs are the exception rather than the norm in Ghana.

Reimagining Ghana’s HIV Response

As we look ahead to World AIDS Day 2024, it is essential to reflect on how collective action can be better harnessed in Ghana’s HIV response. To truly sustain and accelerate progress, the government must:

Prioritize the Clearance of Donated Medication: The government must streamline the clearance process for HIV medications donated by international partners. A lack of urgency in this area endangers the lives of PLHIV and threatens the gains made in treatment and care. HIV cannot wait, and neither should lifesaving medicine.

Embrace Community-Led Solutions: A successful HIV response cannot be achieved through a top-down approach alone. It is time for the government to fully integrate community leadership into the national response. Key populations, youth, and PLHIV must be at the forefront of decision-making and implementation. Only by addressing the specific needs of these communities can Ghana hope to reduce new infections and improve treatment outcomes.

Commit to Long-Term Sustainable Funding: While external donors like the Global Fund are crucial, Ghana must also invest in its own HIV response infrastructure. Ensuring the sustainability of treatment programs, prevention campaigns, and community-led interventions requires a commitment to long-term domestic funding.

Conclusion

The theme for World AIDS Day 2024, Collective Action: Sustain and Accelerate HIV Progress, challenges us to rethink how we approach the fight against HIV in Ghana. Progress is not just about the availability of medication or the implementation of policies; it is about ensuring that those most affected by HIV are leading the charge. Ghana’s HIV response cannot afford to be slowed down by bureaucratic delays or a lack of community leadership. To meet our goals and ensure that no one is left behind, we must act now, together.

The time for excuses has passed. Now is the time for action. Now is the time to truly sustain and accelerate our collective fight against HIV.