The Country Director of PharmAccess, Dr Maxwell Antwi, has warned that hypertension and diabetes are consuming an increasingly unsustainable portion of Ghana’s health budget, putting the long-term stability of national healthcare financing at risk.

Speaking on Innovative Financing Models for Healthcare Sustainability at the 2025 Annual General Meeting of the Ghana Medical Association (GMA), Dr Antwi revealed that the National Health Insurance Scheme (NHIS) now spends about 25 percent of its budget on managing the two conditions and their complications.

“This will threaten the national health budget and the future sustainability of the NHIS if health promotion and preventive lifestyle measures are not prioritised now by health professionals in caring for patients,” he cautioned.

A national economic threat

Beyond clinical concerns, Dr Antwi stressed the economic toll of the chronic disease burden, noting that 30 percent of Ghana’s adult population lives with hypertension or diabetes. He argued that better disease control translates into preserved productivity and reduced household economic pressure.

“We must protect our fragile domestic and national economy,” he told the GMA, warning that continued inaction will come with overwhelming future costs.

Private capital waiting for viable health projects

Contrary to the notion that Ghana’s health sector is underfunded, Dr Antwi said private capital is available — but only for well-structured and bankable ventures. He presented financing profiles from institutions including Oasis Capital, Golden Palm Investments, Investment Funds for Health in Africa, and Medical Credit Fund, offering everything from health SME loans to multimillion-dollar equity for hospitals, diagnostics and pharmaceutical infrastructure.

“These financiers are ready to invest where there are bankable projects and efficient models,” he emphasized.

Partnership models to unlock value

Dr Antwi proposed a range of partnership arrangements that allow the health sector to expand capacity without draining public funds. These include:

• Build–Finance–Operate–Transfer (BFOT) structures
• Management contracts
• Lease or concession models for laboratories and imaging centres
• Joint ventures for new hospitals and pharmaceutical plants
• Performance-based outsourcing, particularly for maintenance and diagnostics

“These are not privatisation schemes; they are pathways to efficiency, strengthened services and shared risk,” he clarified, noting that such models can revive idle public assets without transferring ownership.

NHIS positioning itself for value-based reforms

Dr Antwi commended the NHIS’s decade-long digital transformation from early credentialing tools and biometric enrolment to the digitisation of more than 90 percent of claims which now enables better purchasing decisions grounded in real-time data.

With the NHIA’s newly established Data Analytics Unit, Ghana is moving toward value-based care (VBC), he said, enabling a model where “we pay for outcomes rather than utilisation”, improving both quality and cost-effectiveness.

Promising pilot results in hypertension and diabetes care

A central part of his presentation was the ongoing value-based care initiative for hypertension and diabetes, implemented with the NHIA and the Christian Health Association of Ghana (CHAG).

The programme, spanning 22 facilities, has already enrolled 2,534 of the targeted 2,750 patients — a 92% achievement rate.

Regional baseline data revealed stark disparities, with Ahafo recording an average systolic blood pressure of 191 mmHg, far exceeding other regions. However, adherence to standardised care protocols and consistent monitoring is producing measurable improvements, with about 54% of enrolled patients maintaining controlled blood pressure — compared to just 6% in the general population.

“A combination of virtual and in-person care achieves faster hypertension control for patients and helps avoid costly complications,” Dr Antwi said.

Remaining challenges and the path forward

He acknowledged persistent hurdles staff turnover, policy gaps, compliance with care standards, and patient incentive structures but maintained that the investment case for health is still strong.

With hypertension now the leading cause of adult deaths in Ghana and health resources stretched thin, Dr Antwi argued that value-based care is no longer optional.

“It is essential for efficiency, outcomes and sustainability,” he insisted.

Dr Antwi concluded with a call for unified action across government, private investors and medical professionals.

“We cannot solve Ghana’s health financing crisis by working in silos. Partnerships, data and innovative models are the only way forward,” he urged, challenging the GMA to lead the reforms.