Final

Ghana’s Healthcare
Sector Report

November 2022
Contents

01
Why invest in
02 Sector
03 Sector
Ghana overview opportunities
Page 3 Page 6 Page 36

04 Key
05
Testimonials
06Contact us
investment
highlights

Page 38 Page 41 Page 43

07 Appendix

Page 45
01
Why invest in Ghana
 Why invest in Ghana
Country overview

o Formerly known as the Gold Coast, Ghana was the Internal infrastructure
first sub-Saharan nation to gain independence from
colonial rule in 1957.
o Ghana is credited as being one of the most stable Total land Overview: Ghana has total land area of 238,537
democracies in Africa, having successfully area sq.km
conducted 8 national elections and recorded no Ghana has 16 administrative regions and 261
incidence of a coup d'état since 1992.
district assemblies.
The area is currently connected to the following
Airports
• Ghana’s electricity supply is derived from
Electricity hydropower generated from the Akosombo, Bui
► 1 international airport supply Power and Kpong dams, and 10 thermal plants
► 5 domestic airports at Aboadze in Western Region.
• According to World Bank, Ghana has an 86.63%
Railway (2021) access to electricity rate.

Water Water is provided to citizens through the Ghana

► 3 major railway networks with a supply Water Company Limited, Community Water and
total track length of 1,300 km
Sanitation Agency and private water producers.

Dry ports o Ghana is geographically closer than any other

Locational country to the center of the earth.
advantage o Ghana has 2 harbors with one being the
► Tema Port largest in West Africa, making Ghana the
► Takoradi Port gateway to West Africa.

Road network

► Main roads: 67,291 Km

► Main arteries : 12,800 Km
► Paved roads: 3,800 Km

Source: Oxford Economics, Ghana Statistical Service, UNCTAD, Bank of Ghana, Doing Business Report (2020), World Bank
Page 4
Why invest in Ghana
Investment attractions
2nd largest economy in West
Rich in natural resources Preferred tourism destination Youthful population
Africa

o Ghana has an active retail market and o Ghana was the largest (No.1) o International arrivals of tourist o Ghana is blessed with a very youthful
healthy consumption levels. Fitch producer of gold in Africa and 6th increased from 932,579 in 2016 to population, about 67% of the
reports, household spending is largest in the world in 2021. 1,130,307 in 2019, however 2020 population is within the ages of 15 to
expected to increase from US$55bn o 13,000 metric tonnes of manganese saw a reduction to 355,108 due to 64 years.
in 2021 to USD81bn in 2025. reserve. lockdown measures in response to
o 16.86 million tonnes of high-grade Covid -19. o Government initiative such as free
o AfCFTA presents an opportunity for trihydrate bauxite mined since 1997. basic and secondary has ensured a
intra-regional growth by leveraging o Newly discovered deposits of lithium o As at September 2021, international 69.8% literacy rate for citizens who
access to common markets and in 2021 amounting to 30.1million tourist arrivals increased by 18% are 6 years and older as at 2021.
knowledge transfer through labour tonnes, setting Ghana up to become while domestic tourists grew by 58%.
mobility, thereby attracting foreign West Africa’s first lithium producer.
direct investments into the region.

o The AfCFTA secretariat is located in

Ghana.

Investor-friendly government
Stable political environment Top investment destination Agrarian economy
initiatives

o Ghana is ranked the second most o Government has initiated a plethora o Foreign Direct Investment (FDI) has o Ghana is endowed with vast arable
peaceful country in Africa and the of incentives to ensure a conducive averaged $2.72b from 2017 to lands rich in agriculture.
38th most peaceful country in the and enabling business environment.
world as per the 2021 Global Peace 2021, suggesting stability in the
Index. o Government incentives include tax inflow of capital with investment o In 2020, Ghana was the 2nd largest
holidays, rebates, provision of focus in oil and gas, mining (including producer of cocoa in the world, the
o Due to provisions made in the industrial parks, provision of finance gold and manganese), and agriculture 4th largest producer of cassava in the
constitution of Ghana (article 20) and through partnering agencies and
Free Zones Act (Act 504) there is a interest subsidies. (cocoa). world.
reduced threat of nationalism of o Ghana attracted US$2.65bn in FDI
private businesses. o Ghana has double taxation o Ghana is blessed with fertile land for
agreements with the United Kingdom, inflows in 2020, one of the highest
South Africa and other EU countries. the production of maize, tomato, rice
amount in West Africa.
among many other food crops.

Page 5 Source: Oxford Economics, Ghana Statistical Service, United States Geological Service, Global Peace Index, World Bank, Visit Ghana (Tourism Report 2020), Ghana Investment Promotion Centre, Ghana Bauxite
Company Ltd
02
Sector overview
Sector Overview: Snapshot of the health sector in Ghana (1/2)

$75bn 2.2% 1 • Ghana is the 8th largest economy in Africa, with an estimated GDP of US$75
GDP as at 2021 Population Growth Rate 2020
1 62.2% billion in 2021 and a population of 30.8 million in 2021.
Youth Population as

30.8m $2.4bn of 2021e

Population as at 2021 Health Spend 2021e

2 • Healthcare market size of US$2.4b in 2021 with a total of 2,857 health

928 facilities.
11,079 28,080
Health Facilities Private Health Facilities Outpatient Visits

2
1,625 18,155 7 3 • Pharmaceutical market size of US$0.44b in 2021 with over 1000
Public Health Facilities Hospital Beds Deaths per ‘000
pharmacies and 30 pharmaceutical manufacturing companies.

3 1000+ 30 13.69m ($191.05*m)

Pharmacies Pharmaceutical Pharmaceutical exports Pharmaceutical trade
Manufacturing (USD) 2021 balance 2021
Companies
4 • Health insurance: There are about 12 licensed private health insurance
4 schemes in Ghana, with 7 being private commercial health schemes.
12 7 1
Licensed Private Health Licensed Private Licensed Private Mutual
Schemes Commercial Health Health Schemes
Schemes

5 • Diagnostics & ambulance services: There are 500 diagnostic centers

500 available in Ghana and 337 ambulances, making the ambulance to
5 Diagnostic Centers in 337 1:84,000
Ghana Ambulances Ambulance to population population ratio 1:84,000
ratio

1 $71.2m 6 • Medical devices & supplies has a market size of US$71.2m in 2021, with
6 $23.8m $1.2m Medical Device Market 2021
Local medical device consumables having the largest share of $23.8m.
Consumables 2021 Dental Products 2021 manufacturer

$15.3m $0.8m
Page 7 Orthopedics & Prosthetics
Diagnostic Imaging 2021 Source: National Health Insurance Authority, The World Bank, Statista, Fitch Solutions, Ghana Statistical Service
2021
Sector Overview: Snapshot of the health sector in Ghana (2/2)

GHS10.9bn $75 11,079 0.10 0.58 1.2

$ Healthcare budget Healthcare spend Number of public Doctor per ‘000 Hospital beds Nurses per “000
2022 per capital (2021) health facilities (2020) per ‘000 (2020) (2020)
(2022)

Medical Device Market 2020 (USDM)

Public Other Medical Devices 23.9

Spend, $2.4b
Healthcare Spend (2021)
42% Private Patient Aids 4.4
Spend 194 91 516
4,254
58% Registered Private Hospitals Public Hospitals Surgical
procedures/Year
Orthopaedics & Prosthetics 0.7
physicians ‘000
Dental Products 1.2
It is estimated that health expenditure reached USD2.3bn in 2020, Registered Private Public Surgical
representing 3.0% of GDP. Health expenditure has fallen,with a CAGR physicians Hospitals Hospitals procedures Diagnostic Imaging 14
of -3.4%, since 2015. It is estimated that per capita health expenditure
reached USD61.4 in 2020. Around 58%of expenditure is met by the Consumables 22.5
private sector. Private health insurance only accounts for less than 1% of
private spending. Source: Fitch reports as at 2020
0 20 40

Consumables Market 2020 (USDM)

3.2% Other Consumables 3

68%
Healthcare spend % 2021
GDP
Syringes, Needles & Percentage of health
8.5 insurance coverage (2021)
Catheters
Suturing Materials 0.4

Bandages 10.6
Total healthcare spend in Ghana accounted for about 3.2% of Ghana’s
GDP in 2021.
0 5 10 15

Page 8 Source: Ministry of Health, Fitch Solutions, The World Bank, World Health Organization, Ghana Health Service
 Sector Overview: Ghana’s healthcare value chain

Regulators Associations

Demand/ Population Healthcare Diagnostic Centres Pharmaceutical Medical Devices &

Health Insurance
Laboratories Manufacturing Supplies
Patients Hospitals Packaging & National Health
Illness & Clinics Imaging Insurance Medical
Distribution
Diseases Maternity Homes Radiology Scheme Supplies
Wholesale
Well Being Community Health Centres Pathology Retail Private Health Medical
Practitioners Insurance Devices
$2.4bn
Health Spend 2021e
Public Hospitals Market Size
US$15m Market Size US$433m Market Size US$15m Market Size US$71m
91
“Ghana was one of the
first African countries to Private Hospitals
implement a universal
health insurance
system, the National
194
Health Insurance
Doctors Retail Brands
Scheme (NHIS), in order
to make health care 4,254
more accessible to all
citizens”
Nurses Nurses

642 66,097
Page 9
Source: Fitch Solutions & Market Analysis
Sector overview: Ghana’s population disease burden
Healthcare Diagnostic Centres Pharmaceutical Health Insurance Medical Devices

Top 10 causes of death - Global Top 10 causes of death - Africa Top 10 causes of death - Ghana

Ischemic heart disease 16%

Neonatal disorders 9% Malaria 10%
Stroke 11% Lower respiratory infections 9% Stroke 8%
Chronic obstructive… 6% Ischemic heart disease 8% Lower Respiratory Infections 8%
Lower respiratory infections 5% HIV/AIDS 8% Neonatal 8%
Alzheimer's disease 4% Diarrheal diseases 7% Ischemic Heart Disease 8%
Tracheal and lung cancer 3% Malaria 6% HIV/AIDS 7%
Neonatal disorders 3% Stroke 5% Tuberclosis 5%
Diarrheal diseases 3% Tuberculosis 5% Diarrhea 3%
Diabetes mellitus 2% Congenital birth defects 3% Diabetes 3%
Cirrhosis 2% Road injuries 3% Cirrhosis 3%
Others 44% Others 38% Others 35%

Source: GHDx:2019 Source: GHDx:2019 Source: GHDx:2019 0% 10% 20% 30% 40%
Non-communicable diseases Communicable diseases Others: Diseases such as lung cancer, Iron deficiency, Depression, etc .

Key healthcare indicators (Ghana/ Global)

Prevalence of tuberculosis disease Average maternal mortality rate per Incidence of HIV per ‘000 Prevalence of malaria disease
Average life expectancy Average of infant death per ‘000
per’000 ‘000 per’000

33 28 7.5 1.27 485 2 0.6 0.2 161 57

64 years 73 years per ‘000 per ‘000 per ‘000 per ‘000 per ‘000 per ‘000 per ‘000 per ‘000 per ‘000 per ‘000

Infant mortality remains a An average of 0.6 people per ‘000 get

Ghana’s life expectancy of 64 Ghana is ranked twentieth among Ghana is also the country where According to a WHO report, six
persistent public health challenge infected with HIV in Ghana compared
years is the seventh lowest in the the 30 high TB burden countries nearly 20% of all global maternal countries, including Ghana,
in in Ghana with an average of 33 to 0.2 per ‘000 globally.
world, according to the WHO. and second in Africa. deaths occur, according to the WHO. accounted for around 50 percent of
This is significantly lower than infants per ‘000 in Ghana who die According to UNAIDS, Ghana has one malaria deaths worldwide in 2020.
at an early age compared to the The prevalence of TB disease of This is reflected in the high mortality of the highest rates of new infection in
the global average of 73 years. Ghana has an average of 161 cases
global average of 28 infants per 7.5 per ‘000 remains high compared rate of 485women per ‘000 sub-Saharan Africa with 19,000 cases
compared to 2 women per ‘000 per ‘000 compared to the global
‘000. to the global average of 1.27 per recorded in 2020.
‘000. globally, dying during childbirth. average of 57 cases per ‘000.

Page 10 Source: WHO, Fitch Solutions, GHDx 2019

Sector overview: Healthcare
Healthcare Diagnostic Centres Pharmaceutical Health Insurance Medical Devices

Number of public health facilities by region (July 2022) Total Hospital Beds

Western North 410

Western 733
Volta 652 18,419 18,436
Upper West 533
Upper East 680
Savannah 235 18,276
Oti 311
Northern 578
North East 165
Greater Accra 1,445
Eastern 1,435 18,155
Central 817
Bono East 426
Bono 512
Ashanti 1,922 2017 2018 2019 2020
Ahafo 225

Health Personnel In Ghana Number of Nurses

4,424 66,097
4,254
4,016 4,017 58,608
52,605
48,939

594 674 610 617 625 671 642 593

2017 2018 2019 2020 2017 2018 2019 2020

Dentists Physicians Pharmacists

Page 11 Source: Fitch Solutions, Ghana Health Service

Sector overview: Healthcare
Healthcare Diagnostic Centres Pharmaceutical Health Insurance Medical Devices

Categories of Healthcare in Ghana Key Players

► The primary healthcare system is the Basic health

and nutrition
lowest level and the entry point into
the healthcare system, they Medical treatment for
comprise health post and clinics, common diseases
health centers with the primary role and injuries
of providing basic healthcare Ante-natal care
services such as immunization, and family planning
Primary malaria treatment, antenatal care, Prevention and
Healthcare infant and young child feeding etc control of locally
endemic diseases

► Secondary healthcare covers the Cardiology

services of specialists. Players in the 30 Cardiologists
primary healthcare segment usually
refer patients to this segment to Neurology
handle cases requiring more 6 Neurologists
specialization e.g., cardiology, Nephrology
endocrinology, neurology, ENT, and
Secondary general surgery.
30 Nephrologists

Healthcare Oncology
40 Oncologists

► Tertiary healthcare involves higher Endocrinology

levels of specialty (usually in-patient) care 50 Endocrinologists
specialized e equipment and expertise e.g.
kidney dialysis, neurosurgery, cardiology Orthopedics
and cardiac surgery interventions, 24 Orthopedic surgeons
assisted reproductive technologies i.e., IVF
Infertility treatment
and cancer care.
Tertiary 150 Fertility centres

Healthcare Urology
50 Urologists

Page 12 Source: Fitch Solutions

Sector Overview: Diagnostic centres
Healthcare Diagnostic Centres Pharmaceutical Health Insurance Medical Devices

Leading players in the Diagnostic center market

Health laboratories are facilities where medical investigations are carried out
to deduce information on a patient to assist proper diagnosis, treatment and
monitoring of the patient’s condition.

► Ghana Association of Biomedical Laboratory Scientists (GABMLS) is the main

regulatory body for diagnostic centres and was established at 1971, and fused under
the Professional Bodies Registration Decree (NRCD143) in 1973.
► Following research in 2011 by the Ghana Health Service for the World Health
Organization, carried out in hospitals and private laboratories, it was deduced that
Ghanaian health laboratories provide adequate and timely results (Some even within
Licensed and unlicensed medical laboratory technicians 2019
two hours).
► Ghana boasts of over 100 health laboratories working towards providing quality
results for use by doctors and nurses during treatment.

40%

60%

Licensed Unlicensed

According to the Ghana Association of Biomedical Laboratory Scientists (GABMLS), 40% of laboratory
technicians employed by health facilities all around the nation lack valid operating permits. This implies
that 1 in 4 of the more than 5,000 technicians who perform lab tests of any kind do not have the authority
to do so. However, both commercial and governmental health facilities have hired them.

Page 13 Source: SynLab, Ghana Association of Biomedical Laboratory Scientists

Sector Overview: Pharmaceutical value chain
Healthcare Diagnostic Centres Pharmaceutical Health Insurance Medical Devices

Pharmacy
Manufacturing Wholesaler /
Patients /
Distributors Retailers consumers
Importation Hospitals

Key Players in the Pharmaceutical Industry

One stop shop

Manufacturers* Wholesalers Retailers
wholesaler

* Mainly contract manufacturers

Page 14 Source: UNIDO, Fitch Solutions
Sector Overview: Pharmaceuticals
Healthcare Diagnostic Centres Pharmaceutical Health Insurance Medical Devices

Market Size(US$bn) & Growth

0.59 0.59
0.54
0.47 0.46 0.49
0.45 0.44 0.45

2018 2019 2020 2021e 2022f 2023f 2024f 2025f 2026f

Industry Growth Drivers

Population & Ghana’s population has increased from about 24.6 million people in 2010 to a current population of 30.8 million people in 2021. This rapid population
demographics growth has caused demand for pharmaceutical products to increase as chronic illness prevail.

Prevalence of chronic Ghana has witnessed a rise in the incidence of chronic diseases such as heart diseases, stroke, diabetes and cancer, which have resulted in growth in the
diseases pharmaceutical industry, as companies are continuously developing patented and generic drugs to tackle the incidence of these diseases.

Government support One of the most important steps taken by the Government to promote the local pharmaceutical industry was to ban the imports of finished formulations of
for local 14 widely used products that could be produced locally, including ampicillin, tetracycline, chlordiazepoxide, indomethacin, paracetamol, aspirin and
manufacturing diazepam. Domestically manufactured formulations also benefit from being exempt from the 10% import duty on finished formulations.

Prevalence of generic The generic drugs segment accounts for the second largest share of the pharmaceutical market in Ghana and its growth is driven by the demand for
drug options relatively cheaper alternatives to patented drugs. Cost containment measures by government further drive this growth.

Plans to create a In line with Government support for a more developed pharmaceutical industry, the Ghana National Chamber of Pharmacy (GNCP) signed a Memorandum
pharmaceutical of Understanding with construction firm LMI Holdings Ltd for the creation of a pharmaceutical industrial park in Ghana's Dawa industrial zone. The GNCP
industrial also called on the government to facilitate access to affordable investment capital by subsidising interest payments and granting tax breaks for players in
manufacturing park the pharmaceutical industry.
Page 15 Source: Fitch Solutions Report, Ghana Statistical Service
Sector Overview: Pharmaceuticals
Healthcare Diagnostic Centres Pharmaceutical Health Insurance Medical Devices

Prescription vs Over the Counter Drug Market Generic Drug Market

0.38 0.37
0.34
0.16 0.15 0.31
0.13 0.30 0.30
0.28 0.28 0.29
0.12
0.12 0.11 0.12
0.12 0.11

0.43 0.45
0.37 0.41
0.35 0.33 0.33 0.33 0.35

2018 2019 2020 2021e 2022f 2023f 2024f 2025f 2026f

2018 2019 2020 2021e 2022f 2023f 2024f 2025f 2026f
Sales US$’b Prescription market OTC market Sales US$’b

• Ghana’s prescription drug market was valued at US$0.33b in 2021 driven by the
▪ In 2021, US$0.28b was recorded as sales from generic drugs in Ghana, accounting for
rise in chronic conditions within a growing population and government’s push for
86% of prescription sales and 64% of total sales.
wider healthcare coverage.
▪ Generic medicine sales are forecasted to continue to grow over the long term as
• Local manufacturing is expected to grow as Government is targeting local
government increases spending directed towards locally produced generic drugs and
companies to gain WHO approval and GMP certification to boost domestic
efforts to curb the country’s rising chronic disease burden while keeping costs low
production of essential drugs.
intensifies.
• The Over-The-Counter (OTC) market accounts for average of 25% influenced by
▪ The United Nations Industrial Development Organisation has created projects to fund the
majority of the population living on a low income. Growth in this sub-sector has
domestic production of essential generic drugs in both Ghana and Kenya, which should
been inhibited by the proliferation of counterfeit drugs, lack of healthcare awareness
help boost domestic generic drug manufacturing capabilities.
among the population and the widespread use of traditional remedies.

Page 16 Source: Fitch Solutions Report

Sector Overview: Pharmaceuticals
Healthcare Diagnostic Centres Pharmaceutical Health Insurance Medical Devices

Locally manufactured product categorization

▪ While Ghana’s pharmaceutical industry is highly import dependent, local Category Product
production is expected to improve in the long term as government increases Tablets
support in the industry through incentives and policies that will support local Analgesics Syrup/suspension
production.
Ointments/Balms
▪ Such interventions include, the introduction of VAT exemption on importation of
Tablets
raw materials used in pharmaceutical production in 2021
Antimalarials Capsules
▪ Significant domestic manufacturing capacity exist in Ghana but is largely
Syrups
underutilized, as most of the raw materials (Application Programming Interface and
Excipients) used for basic pharmaceutical products are imported and high Tablets
importation tariffs make it prohibitively expensive Antibiotics Capsules
▪ The determining factor for local production of pharmaceutical products in Ghana is Syrups
the prevalent disease pattern within the country. Common diseases experienced Tablets
in the country include Malaria, HIV/AIDS, and tuberculosis. In addition, heart- Antiretrovirals
Syrups
related diseases are also on the increase.
Tablets
▪ Consequently, prescription medicines such as analgesics, antimalarials and
Vitamins Capsules
multivitamins make up a large share of the market. Antiretroviral (ARV), artemisinin
combination therapy (ACT), anti-TB and antimicrobial antidiarrheal agents are also Syrups
considered essential drugs for patients in Ghana. Antitussive syrups N/A
▪ A major challenge faced by local producers is the cost of importing all their active Infusions N/A
pharmaceutical ingredients and virtually all their pharmaceutical excipients, which Tablets
is further exacerbated by the recent cedi devaluation. Antacids
Syrups
Antiseptics / Disinfectants N/A
Injectables N/A

Page 17 Source: Fitch Solutions Report, The Economist Intelligence Unit Limited
Sector Overview: Health insurance
Healthcare Diagnostic Centres Pharmaceutical Health Insurance Medical Devices

Ghana has 13 insurance companies • The government launched the NHIS in 2003 to focus on treatments for malaria, respiratory diseases, diarrhoea, diabetes,
hypertension, and other local needs.
• Ghana’s 2021 census results report 68.8 % of the population is covered by either the National Health Insurance Scheme
(NHIS) or private health insurance schemes. There is a higher rate of health insurance coverage for females (72.6%) than
males (64.5%).
• Public hospitals in Ghana are typically funded by the government. Additionally, religious groups play a key role in providing
medical assistance to the local population.
• Expats living in Ghana typically opt for private healthcare facilities. Private clinics and hospitals in the country often provide a
higher standard of treatment and have more modern equipment than public alternatives.
• While the standard of facilities varies even among private hospitals in Ghana, the ones found in large expat communities are
well-equipped. Waiting times are also significantly shorter at private facilities and English-speaking doctors and medical staff
are available.

The Ministry of Health continues to try to advance the national agenda of attaining Universal Health Coverage by 2030,
including by conducting extensive community outreach in cities and rural areas.

Distribution of Health Insurance Coverage Population Covered by Health Insurance in Ghana 2021 Population with National Health Insurance (NHIS) membership
In 2021 by region millions

Ashanti 3,903,961 16.2

Greater Accra 3,729,444

Eastern 2,145,892 12
11.03 10.58 10.8
31.20% Central 1,655,259

Northern 1,494,698

Western 1,308,056
68.80% Volta 1,123,690

Upper East 1,121,934

Bono 1,033,765

Upper West 753,732 2016 2017 2018 2019 2020

Covered Not Covered
Page 18
0 1,000,0002,000,0003,000,0004,000,0005,000,000
Source: International Trade, Pacific Insurance, National Health Insurance Authority, 3 News
Sector Overview: Medical devices and supplies
Healthcare Diagnostic Centres Pharmaceutical Health Insurance Medical Devices

Projected medical device market

6 Medical tourism

88.6
• Ghana is a small medical device market that will record a 12.2% CAGR in local 81.2
currency terms and a 9.2% CAGR in US dollar terms over the 2021-2026 period. 75.7
71.2

• A bright economic outlook, after facing headwinds in 2020, will benefit market
growth. The large population, ongoing healthcare projects and increasing Covid-19
vaccine rollout will also drive the market. However, decreasing health expenditure
and limited domestic production will be constraining factors.

• Ghana's medical device market will expand by a 2021-2026 CAGR of 12.2% in local
currency terms and 9.2% in US dollar terms, which should see it rise to GHS742.6m
(USD110.7mn) by 2026.
2.2 2.3 2.5 2.6

2021e 2022f 2023f 2024f

Total (USD mn) Per Capita (USD)

Key device suppliers Medical device market by product area

70,000 27.1
Other Medical Devices 23.9
25.4
60,000
5.1
50,000 Patient Aids 4.7
4.4
40,000 0.9
Orthopaedics & Prosthetics 0.8
0.7
30,000
1.3
20,000 Dental Products 1.2
1.2

10,000 16.1
Diagnostic Imaging 14
15.3

25.3
Consumables 22.5
23.8

0 2022f 2021e
10 2020 20 30
Page 19 Source: Fitch Solutions Report
Demand and supply analysis
Demand Healthcare Diagnostic Centres Pharmaceutical Health Insurance Medical Devices

Demand of healthcare Public (Gov’t) expenditure and private expenditure (billions)

Outpatient Admissions Inpatient Admissions

52
977 52
1.53
1.42
949 1.28 1.27 1.33
935 50

1.04 1.11 1.05

904 49 0.98 1.01

2018 2019 2020 2021e 2022f

2017 2018 2019 2020 2017 2018 2019 2020

Outpatient Admissions '000 population Inpatient Admissions '000 population

Public Health Spend Private Health Spend

• More than half of all services utilized by Ghanaian customers are offered by private providers, and the • Despite NHIS coverage, consumers continue to spend money out of pocket

share of services provided by the private sector appears to be increasing. SFP (Self Financed Private) at GHS, CHAG (Christian Health Association of Ghana), and SFP

providers account for the majority of privately offered services. Users of all types, regardless of financial providers. Because of NHIS coverage, customers are now paying nothing

level, geography, or sex, pick private providers for a significant amount of their health-care needs, at all more frequently.

roughly 50% of the time. • However, the amount of out-of-pocket spending in those circumstances

• Coverage under the National Health Insurance Scheme (NHIS) appears to promote customers to use where it is still required has remained unchanged. SFP providers are

GHS (Ghana Health Services) services over privately offered care, however this could be due to SFP preferred for quality services, customer service, and fast wait times; GHS

providers' inadequate accreditation. providers are preferred for quality services, reasonable pricing, and doctor
availability; and CHAG providers are preferred for quality services,
courteous service, and doctor availability.

Page 20 Source: The World Bank, The Ministry of Health, National Library of Medicine, Fitch Solutions Report
Demand and supply analysis

Supply of healthcare

Availability of primary healthcare facilities as of 2021

• Urban centres are well served and are where most hospitals, clinics, and pharmacies
in the country can be found. Rural areas often have no modern healthcare services.
11%
Patients in these areas either rely on traditional African medicine or travel great
distances for healthcare.
• The Christian Health Association of Ghana (CHAG) and chemical dealers are
2% 17% concentrated in rural and urban-poor areas, whereas SFP and government (Ghana
63%
Health Service) providers are concentrated in metropolitan areas.

34% • Chemical dealers or pharmacies tend to be the largest and most accessible provider
1%
17% of services in rural and urban-impoverished communities, based on their number and
8%

Private or Public Polyclinics Clinics & Health Community-based geographic distribution.

Hospitals Centres Health Planning and • In both SFP and Ghana Health Service (GHS) hospitals, human resources for health
Urban Rural Services
are concentrated in urban areas, particularly in government hospitals.
• In 2020, nurses were the highest number of health personnel available in the country
Healthcare personnel as of 2020
66,097 with a value of 66,097 whereas physicians came in second with a number of 4,254.
Dentists however were the lowest with only 642 in the country.

4,254
593 642

Pharmacists Physicians Dentists Nurses

Page 21 Source: Fitch Solutions report, The World Bank, International Trade, Ghana Registered Nurses and Midwives Association
Key developments

1
Ghana's President Nana Akufo-Addo attended the sod cutting ceremony at the EU55.0 million Obuasi trauma and accident
The Obuasi Trauma & Accident hospital on October 4, 2021. The initiative, which is being funded by Deutsche Bank, will increase the hospital's capacity by
Hospital around 100 beds and will be used to redesign and renovate three other public hospitals in the country.

2 President Nana Akufo-Addo declared the start of the Agenda 111 Hospital Project in August 2021. A total of 101 district hospitals,
seven regional hospitals, and two specialized hospitals will be built as part of the project. Each hospital in the Agenda 111 project
Agenda 111 will cost roughly USD16.88 million to build. In addition, the project seeks to renovate the Western Region's Effia-Nkwanta Regional
Hospital. The project will take 18 months to complete.

3
The Food and Drugs Authority (FDA) reported in August 2021 that it has established a Centre for Laboratory Services and
The FDA’s Centre for Laboratory Research and a Centre for Import and Export Control as part of strengthening its regulatory function to deliver improved services to
Services support the implementation of the African Continental Free Trade (AfCFTA) regime.

4 The Ghana National Chamber of Pharmacy (GNCP) signed a Memorandum of Understanding with construction firm LMI
Holdings Ltd for the building of a pharmaceutical industrial park in Ghana's Dawa industrial zone, in line with Ghanaian
The Ghana National Chamber of government backing for a more developed pharmaceutical industry. The GNCP also called on the government to make
Pharmacy investment capital more affordable by subsidizing interest payments and providing tax benefits to pharmaceutical companies.

A pharmaceutical company, Atlantic Lifesciences Limited, has inaugurated a large scale plant for the production of intravenous
5 (IV) fluids, antiserums and vaccines for the West African market. The $35m specialised factory, with a sterile pharmaceutical
plant for producing infusions, eye drops, vaccines, serums, injections and general anaesthesia drugs, was financed by the Ghana
Atlantic Lifesciences Export Import (EXIM) Bank and the Standard Chartered Bank and from the company’s own resources.

6 The African Medicines Agency (AMA) officially began operating in November 2021, to coordinate and strengthen ongoing
initiatives on the harmonization of medical products regulation and enforce Good Manufacturing Practices (GMP). This will
improve the overall registration process of new medicines for member states, by facilitating a much quicker process.
The African Medicines Agency
The treaty for the establishment of the AMA has been ratified by 17 member states of the African Union, including Ghana.

Page 22 Source: Fitch Solutions Report

 Overview of key players

Market segment Year of

Key Players Location Company Profile
focus establishment

Komfo Anokye
Teaching • A public tertiary healthcare facility
Hospital • About 4,000 employees
• One of the biggest healthcare facilities
Public Adum, Kumasi 1954 • Affiliated to the Kwame Nkrumah University of
Science & Technology
Healthcare Key Players

Korle Bu Teaching
Hospital • A public tertiary healthcare facility
• About 5,022 employees
• Affiliated to the University of Ghana Medical
School
Public Guggisberg Ave, 1923 • Specialities include Neonatology, Cardiology,
Accra Oncology, Radiography, etc.

37 Military Hospital
• A public healthcare facility
• A 700 bed facility
• Over a 1,000 employees
Liberation road,
Accra 1941 • Specialities include Anaesthesia, Orthopaedics,
Public Neurosurgery, etc.

Page 23 Source: Company Websites

 Overview of key players

Market segment Year of

Key Players Location Company Profile
focus establishment

Christian Health
Association of Ghana • CHAG is a network organisation of 344 health
facilities and health training institutions
• Owned by 33 different Christian church
Private Jubilee St, Accra 1967 denominations.
• CHAG has about 12,584 employees

Centre for Plant Medicine

Research • Centre for Plant Medicine Research (CPMR)
Healthcare Key Players

produces it’s own herbal medications.

• Runs an out-patient clinic which serves about
16,000 patients.
Public Mampong, Akuapem 1976 • CPMR currently has about 400 employees

Medical and Dental Council

Ghana • The Ghana Medical and Dental Council is an
agency responsible for regulating the standards
of training and practice of medicine and
Public Kwame Nkrumah Ave, dentistry.
Accra 2013 • The council currently has 400 employees across
all of its locations.

Page 24 Source: Company Websites

 Overview of key players

Market segment Year of

Key Players Location Company Profile
focus establishment

Syn Lab Ghana • Synlab is one of Europe’s biggest diagnostic centre

and is available in 5 regions in Ghana
• The laboratory has about 200 employees currently
Private 17 Ridge Rd, 1995
Accra • The first medical laboratory in West Africa to
achieve accreditation under ISO 15189 in 2008.
Diagnostic Centers Key Players

MDS Lancet Laboratories

• MDS-Lancet Laboratories Ghana Limited currently
operates in 15 locations in the country.
• MDS- Lancet Laboratories became a member of the
Lancet Laboratories Group, in 2008 and has since
Private Museru Rd, Accra 2008
then opened over 18 satellite laboratories and
patient care centres across the country.

Metropolis Laboratory • By January 2015, Metropolis took over operations of

Wellness Laboratory to form Metropolis Healthcare
Ghana Limited.
• It is one of India’s biggest laboratory chains with
1000+ collection centres
Private Tafawa Balewa St, 2015 • The lab has about 5000 employees in Ghana.
Accra

Page 25 Source: Company Websites

 Overview of key players

Market segment Year of

Key Players Location Company Profile
focus establishment

Apex Health Insurance • Apex Health is private health insurance company.

• Apex Health Insurance currently has 50
employees
Private Boundary Rd, 1990 • They provide healthcare benefits to their
Accra members through a network of 650 healthcare
providers across Ghana.
Health Insurance Key Players

Acacia Health Insurance

• Acacia Health Insurance (Acacia) is a private
commercial health insurance company.
2012 • The company has about 26 employees in total
Private Garden Rd, Accra • Provides services in over 500 hospitals in
Ghana.

Phoenix Health Insurance

• Phoenix Health Insurance, a member of the

Intermarket Ghana Group and is a private
commercial health insurance scheme.

Private Tafawa Balewa St, 2012 • Phoenix health insurance has about 200
Accra employees presently.

Page 26 Source: Company Websites

 Overview of key players

Market segment Location Year of

Key Players Company Profile
focus establishment

Becton Dickinson • BD is one of the world’s largest medical

technology companies
• It serves over 160 countries
Accra 2008
Private • They currently have 200 employees in Ghana
• Globally they generate $ 20.25 billion in revenue.
Medical Devices Key Players

Canon • Africano Healthcare is an agent for Canon and is

responsible for the servicing and maintenance of
Canon and Toshiba machines in Ghana.
Asylum down, • Africano has provided six MRI machines, eight
Private 2014 CT scanners and 64 ultrasound machines in the
Accra
country.
• Canon currently has 197,673 employees globally.

GE Healthcare
• GE's activities in Ghana are co-ordinated through
GE Africa. The company does not have a
dedicated office in Ghana.
• GE currently has 205,000 employees globally.
• The global financial performance stood at about
Private Airport City, Accra 2010 $74.2 billion in revenue as at 2021.

Page 27 Source: Company Websites

 Overview of key players

Market segment Factory Year of

Companies Key products Company Profile
focus location establishment

• Mentel • Antel
Danadams • Anfen Forte • Danadams commissioned its first
• Dangyl
manufacturing facility in 2005
• Camosunate • Anfen
Prescription/ 67 Nungua
• Danmether (200/400 mg)
OTC Link, Accra 2005 • The first pharmaceutical manufacturer to
• Anapain • Anapain attain the authorization to produce
• Dafenac generic anti-retroviral drugs.
Extra
• Deptrin (50/100 mg) • It currently has about 155 employees
• Daneiflox
DAS Pharma Ltd • Dannex Limited, Ayrton Drug
• Durol Tonic
Pharmaceutical companies

• PMF (200 g) Prescription/ Manufacturing Limited and Starwin

Dadeban Rd, 1965 Products Limited, merged their
• Gluco-Naf OTC Accra operations to form Dannex Ayrton
• Koffex Starwin PLC.
• Danrub
• The company was incorporated on
• Duril Junior December 19, 2019 and subsequently
• Oral Rehydration Salts listed on the Ghana Stock Exchange on
(ORS January 15, 2020 under the trade name
DASPHARMA

Ernest Chemist • Anthelmintic • Expectorants • Ernest Chemist commenced as a sole

• Anti-Bacterial • Gastrointestinal proprietorship in 1986.
• Prescription/ Airport, Accra 1986
Anti-Diabetic • Omron • The company was later reincorporated as
• OTC
Anti-Fungal • ORS a limited liability company, a wholly
• Anti-Histamines • Vitamins, owned by Ghanaian company.
• Anti-Malarial Minerals & • The company currently has 116
• Antiseptics Tonics employees.
• Anti-Asthmatic and
Nasal Decongestants

Page 28 Source: Company Websites

 Overview of key players

Market segment Factory Year of

Companies Key products Company Profile
focus location establishment
Ayrton Drug • Samalin
Manufacturing • Ayrton Drug Manufacturing Company Limited
• Heptamin is a pharmaceutical company in Ghana
Ltd
• Adco-Atenolol supplying anti-hypertensives, dermatological,
Prescription/ Nii Atta St,
• Virol Blood Tonic 1965 antibiotics, deworming, pain killers and anti-
OTC Accra
• Clobet Dermatological products inflammatory drugs.
• Allergex • The company has about 348 employees
• Amoxycillin
• Cotrimoxazole
• Kwik Action
Pharmaceutical companies

• APC Fast-Acting Tablets Akroma Loop • Kinapharma manufactures and markets over
Kinapharma Ltd • Martins Liver Salt Prescription/ North 150 efficacious drugs which ranges from
1986
• Magacid OTC Industrial generics to over the counter and branded
• Magacid Plus Area, Accra ethical products.
• Rhizin • The company has over 500 employees
• Noworm • Generates $53.69 million in sales
• Primadol
• Menthox
• Aspanol Plus Cough syrup

• Blopen 100mg tab • Tobinco Pharmaceuticals Limited is currently

Tobinco • Blopen 50mg tab Prescription/ Kotobabi, the leading pharmaceutical marketing and
Pharmaceuticals • Blopen Gel Accra 1989 distribution company in Ghana
OTC
• Artenate 30mg injection • The company currently has about 136
• Lufart suspension 20/120 employees
• Lufart ds
• Generates about $ 7 million in revenue.
• Lufart Forte
• Sulfadoxine500mg+pyrimethamin
e25mg
• Nifin 20mg
Page 29 Source: Company Websites
Sector investors

► President Nana Akufo-Addo visited the Luxembourg headquarters of the European Investment Bank (EIB) and welcomed EUR

01
82.5 million Team Europe support for new investment to strengthen healthcare, provision of specialist medical equipment and
medicines across Ghana under the national COVID-19 Health Response Plan.
► The concessional Team Europe financing package comprises a EUR 75 million loan from the EIB and EUR 7.5 million European
Commission grant.

► Ghana is made one of the largest healthcare investments in many years and is expanding and developing regional healthcare.
The investment consists of a brand new, modern hospital and the modernization of an existing hospital, as well as state-of-the-art
medical equipment. The hospitals will provide high-quality specialist care that will improve the lives of millions of people in the

02
region.
► SEK is financing the hospital project with an export credit of EUR 186 million. The transaction is guaranteed by the Swedish
Export Credit Agency (EKN) and arranged by Investec Bank Ltd. Bluebird Finance & Projects has acted as lead financial advisor
to the EPC (Engineering, Procurement and Construction) company Amandi Investment Limited.

► In June 2021, the World Bank approved the Ghana Covid-19 Emergency Preparedness and Response Project Second Additional

03
Financing, worth USD200mn. In collaboration with the Covax Facility Covid-19 vaccine acquisition, the project will provide financing
to support the Government of Ghana to procure and deploy Covid-19 vaccines for 13mn people in Ghana.
► The project will also strengthen the resilience of Ghana’s health systems to better prepare for future pandemics and to secure the
continuation of essential health and nutritional services, including routine childhood immunisation.

► Africa Health Holdings, a healthcare start-up running several hospitals, has secured $18 million in a Series A round, funds that will go

04 ►
toward building its “tech-forward healthcare system” across Ghana, Kenya and Nigeria.
The funding round, led by Asia Pacific Land and Natural World Limited, saw the participation of a number of investors including TRB
Advisors, Breyer Capital, M3, Inc., Valiant Capital, Kepple Ventures and SUNU Capital.

Page 30 Source: Fitch Solutions, TechCrunch, SEK, European Investment Bank

Sector investors

► The Novartis Foundation has a community-based project in Ghana to improve healthcare access with more readily available
treatments.

01 ►
►
Besides malaria awareness programs, the Novartis Foundation is involved in telemedicine trials in remote communities of Ghana.
'ComHIP' has been designed to evaluate the impact of an innovative healthcare model on hypertension management and control
in Ghana.

► Johnson & Johnson is present in Ghana through its subsidiary Janssen Pharmaceuticals. Its products are imported and it

02
primarily uses the local representative Abba Scientific Promotion as well as Ernest Chemicals. Johnson & Johnson distributes its
products through locally appointed partners.
► Johnson & Johnson has announced its plans to position Ghana as its regional pharmaceutical hub for West Africa.
► The company also plans to launch public health units in Ghana and Kenya over the coming years.

► Pfizer is represented in Ghana through its regional office, with its products being imported.
► Pfizer rolled out a training program for GPS in Ghana, Kenya, and Nigeria using technology to strengthen the link between patients

03 ►
and healthcare providers
In 2021, the Pfizer Foundation donated US$6.4mn in grants to address critical infectious disease challenges in Nigeria and Ghana.
The donation forms part of the organization’s long-term commitment to help protect underserved people around the world and
support programs to reduce childhood mortality, etc.

► Roche's representative office is located in Accra. The Ghana Medical Association collaborated with Roche on a five-year cancer care

04
project across the country (2015-2020).
► All healthcare practitioners are being trained on early detection and timely referral of suspicious cases to specialists in a bid to
improve cancer care in the country.
► Roche regularly carries out cancer screening and awareness campaigns in Ghana, and in January 2019, Roche Ghana, in
collaboration with the MoH and the Ghana Health Service, launched the first National Guideline for Cancer Management.

Page 31 Source: Fitch Solutions Report

Regulatory overview

Through the establishment and implementation of proactive policies that will ensure enhanced health and vitality, the Ministry of Health, in collaboration with its agencies and
stakeholders, intends to strengthen human capital, thereby "building wealth through health”. They work hand in hand to improve the health status of Ghanaians.

Nature of activity
Scope of
Regulatory agency Responsibilities Oversight Inspection/ Policy
activity
function licensing making
Oversees formulation, evaluation and implementation of policies
related to health, strategies on food and drugs

Ministry of Health General

Responsible for creating awareness on reproductive, maternal
neonatal and child health among other topical health issues √ √
Ensures ethical delivery of pharmaceutical services within the
industry

√
Ghana Health
Service
General The Health service primarily administrates the health services
provided by the government and in implementing government √
policies on healthcare.
To provide and enforce standards for the sale of food, herbal
medicinal products, cosmetics, drugs, medical devices and
household chemical substances.
Food and Drugs
Authority
General Advise the Minister on measures for the protection of the health
of consumers;
√ √
Approve the initiation and conduct of clinical trials in the country;

Page 32 Source: Company Website

Regulatory overview

Nature of activity
Scope of
Regulatory agency Responsibilities Oversight Inspection/ Policy
activity
function licensing making
The mission of the Agency is to transform the regulation of
health care facilities through quality standard setting,
enforcement and client focused partnerships.
Health Facilities
Regulatory Agency
General
To work in partnership with stakeholders across the public and
private sectors, so that health care is delivered within well √ √
designed and structurally appropriate facilities .
To contribute to developing and supporting identified professions
to improve the management of Ghanaian health facilities.
The Registration Directorate registers nurses, nurse assistants
and midwives who have completed their nursing and midwifery
Nursing & Midwifery
Council Ghana
General education.
√ √
Conducts licensing examinations for qualification of nurses,
midwives and nursing assistants
Ensure equity in health care coverage
National Health access by the poor to healthcare services
√ √
Insurance Scheme
General protection of the poor and vulnerable against financial risk
√
Register members of the National Health Insurance Scheme
Ensure that courses of study and training in pharmacy at any
institution in Ghana guarantee the necessary knowledge and
Pharmacy Council
Ghana
General
skills needed for the efficient practice of Pharmacy.
Registration of pharmacists
√ √
Regulation of the practice of pharmacy

Page 33 Source: Company Website

Sector Porter’s five forces

Power of Buyers

► Buyers in Ghana's health-care sector have limited bargaining power. Customers may have some
power due to the presence of other well-known health-care establishments.
Threat of New Entrants ► However, there is a cost associated with receiving treatment. Private hospitals would be the best
alternative for higher-quality healthcare in Ghana, but they are out of reach for the typical Ghanaian.
► Since this sector is dominated by a small number of enterprises, the threat ► In terms of pricing, public health care facilities would be the preferred option; however, clients may
of new companies entering the market is minimal. choose to pay a lower price for lower-quality treatments by purchasing Health Insurance
► These large corporations have been in business for a long time and are
well-known in the market. The Ghanaian health sector must prioritize
policies that can lower costs with a more efficient system while Competitive Rivalry
simultaneously maximizing value for customers in order for other firms to
survive and compete. ► The major competitors in the health sector, are Korle-Bu
Teaching Hospital, 37 Military Hospital and others. They
have high demand for their services, and this can be
attributed to the fact that they have been operating for a long
time in the country, thus they have gained good will and trust
from their clients over the years.
Power of Suppliers ► It is important that other smaller hospitals develop an
effective strategy that differentiates their services from that of
► Suppliers have very little power in the their competitors to give them a competitive advantage in the
pharmaceutical industry. The raw materials for market
manufacturing drugs are commodity products in
the chemical industry, which are available from
numerous sources.
Availability of Substitutes
► Most of the equipment used in manufacturing and
research is available from multiple manufacturers. Porter’s ► The market of healthcare in Ghana is not as diverse as
other markets. Thus, the threat of substitutes will be
Suppliers usually offer multiple products to the
manufacturer, which moderates pricing on rarer Five Forces based on the differentiating characteristics associated
with each competitor that provides the same service.
materials and unique equipment.
► The market has been dominated by the biggest
teaching hospitals in the country over the years.
► A patient deciding between these hospitals could be
based on the price range of receiving such services,
the relationship established between the service
provider and that of the client and based on how long
the service provider has been operating.
Page 34 Source: Fitch Solutions Report, Market Research
Sector SWOT analysis

WEAKNESSES
STRENGTHS
• Low incomes and limited out-of-pocket spending power.
• A local manufacturing sector that benefits from government
support. • Pharmaceutical market that is dominated by sometimes high-priced
branded generics from India.
• The National Health Insurance Scheme, which provides
basic care to majority of the population. • Highly dependent on pharmaceutical imports.
• The launch of the revised National Health Policy to provide a • Underdeveloped healthcare sector.

S W
clear policy direction to Government in the • Low per capita health expenditure. In 2021 per capita expenditure
provision of improved healthcare. was $76.7.
• Over 75 years in pharmaceutical manufacturing • Absence of universal health insurance.
• Robust and well-equipped Food and Drugs Authority to • Limited expertise within the pharmaceutical sector resulting in high
enhance drug surveillance reliance on foreign imports .
• No WHO GMP certified manufacturer
OPPORTUNITIES
• No/Lax legal framework

O T
• Ghana is open to foreign direct investment.
THREATS
• Investment in healthcare infrastructure, supported by
international funding. FDI in 2021 amounted to $1.3bn
• Financial sustainability will continue to limit the success of
• Domestic drug makers are moving towards achieving WHO over Ghana's National Health Insurance Scheme.
qualification and GMP certification, supported by the
government's policies. • Counterfeit drugs, mainly from abroad, threaten to undermine
sales from genuine pharmaceuticals.
• Ghana's evolving demographic and epidemiological profile
will provide increased revenue earning opportunities for • Corruption remains a concern in all aspects of governance.
pharmaceuticals. • Recurrent bouts of currency weakness could erode consumer
• Government’s willingness to support indigenous drug purchasing power.
manufacturers attain WHO qualification and Good • Immigration quota poses a risk for businesses wanting to
Manufacturing Practice (GMP) certification. import skilled labour.

Page 35 Source: Fitch Solutions

03
Sector opportunities
Sector opportunities

Establishment opportunity to establish a World Health Organization

certified pharmaceutical manufacturing plant as none currently exist

Manufacture opportunity for active pharmaceutical ingredient

manufacturing

Establishment of a CAT lab in Ghana

Establishment of research & development facilities

Community care facilities for the elderly

Advancement in specialized cancer care treatments

Page 37
Source: Ghana Investment Promotion Centre
04
Key investment highlights
Key investment highlights

High
Ghana’s Literacy Medical Drone
Standards of
Rate Delivery System
Health
• Ghana has the world’s largest medical drone
• Ghana’s current literacy rate is reported • The Ministry of Health (MOH) has laid delivery system providing millions of people
to be 79.04%, making it one of the best in guidelines for infection prevention and control with instant access to medicines.
the West African Sub Region (World in health care facilities ensuring high
Bank collection of development standards of health and safety measures are
indicators). • Ghana’s drone delivery service makes on-
maintained in the country. demand emergency deliveries to health
facilities in the country, 24 hours a day.

Political Stability Telecommunication

Visa Policy
Facilities
• Ghana has a simple and transparent visa • Ghana is considered one of the most • Telecommunication facilities in Ghana are
policy allowing for easier access to and politically stable countries in West Africa excellent with more private service providers
from many destinations. since its transition to multi-party offering telephone, internet and other
democracy in 1992. telecommunication services.
• There’s also a visa-free on arrival policy
with ECOWAS countries making access • This has been recognized by former
simpler for other west African nationals leaders such as US President George • Institutions in the health sector will be able to
seeking healthcare in Ghana. Bush who have expressed appreciation access swift internet services for their day-to-
for the political stability in Ghana day operations

Page 39
Source: GIPC, Ghana Free Zones Authority
Key investment highlights

Accessibility and
Investment Consumer proximity to
Incentives Behavior Market
• Ghana does not have any explicit import
restrictions or tariffs that apply to used or • Ghanaian consumers of manufactured
refurbished medical equipment in projects are very price sensitive in their • Ghana is geographically closer than any
general. pricing decisions. other country to the centre of the earth..
• Most hospital equipment including • The travel time to the European and
ambulances are exempt from duties and • This price sensitivity affords new entrants American markets will ensure the
taxes by the Ministry of Finance. Some to the Ghanaian market the chance to reduction in supply chain management of
pharmaceuticals are exempt from duties succeed by affordable pricing. exports and imports.
and taxes.

Legal System Currency Investment

Risk Guarantees
• The Directive Principle of State Policy in
Ghana’s constitution encourages foreign • It will be of interest on the part of • Free transferability of capital, profits and
investment subject to all relevant laws in investors to consider foreign exchange dividends.
force. risk for foreign direct investment in a
frontier economy like Ghana.
• Ghana is a signatory to the World Bank’s
• The Ghana Investment Promotion Centre Act Multilateral Investment Guarantee Agency
2013 Act 865) and Free Zones Act 1965, Act • Hedging strategies to guard against the (MIGA) Convention.
504), promote economic development and loss of value and increase in the cost of
regulate the activities of investors. • Double Taxation Agreements (DTAs) to
imported inputs during periods of rationalize tax obligations of investors in
• The Ghanaian legal system also provides currency depreciation. order to prevent double taxation.
independent courts as avenues to request for
adjudication of thorny legal issues.

Page 40 Source: GIPC, Ghana Free Zones Authority

05
Testimonials
Testimonials

“The healthcare space in Ghana presents myriad opportunities for

growth and development including; well-developed home care or
hospice system, emergency and urgent care centers, specialist
services, state of the art oncology units, vibrant and efficient
ambulance system, diagnostics centers with increased accessibility
and building a “one-stop-shop” health facility with all disciplines and
diagnostic facilities functional.”

Accra Medical Centre

06
Contact us
Key contacts

Yofi Grant Edward B. Ashong-

Chief Executive Officer Lartey
Tel: +233 302 665 125-9 Director, Investor Services
Email: Tel: +233 302 665 125-9
yofi.grant@gipc.gov.gh Email:
edward.ashong-
lartey@gipc.gov.gh

Yaw Amoateng Eugenia Okyere

Afriyie Head of Research
Deputy Chief Executive Tel: +233 302 665 125-9
Officer Email:
Tel: +233 302 665 125-9
eugenia.okyere@gipc.gov.gh
Email:
yaw.afriyie@gipc.gov.gh

Page 44
 07
Appendix

Page 45
 Appendix I

Registration process for medical facilities in Ghana

To apply for a license, go to any HeFRA office in the After obtaining all of a facility's paperwork, the registrar
country and fill out an approved application form. The issues an inspection letter to the facility. The Agency and
facility must meet specific requirements, such as proof that the facility agree on a time and day for the inspection. The
it is registered as an entity, planning approval for the facility team of inspectors submits a report to the Agency after the
building, clearance from the Environmental Protection inspection is completed.
Agency.

The acts governing the health sector are

The board considers the registrar's The registrar examines, reports on, and makes
recommendations and makes the following recommendations to the board on the
•Ghana Health Service and Teaching Hospitals Act
decisions: following:
•GHS Act 525
1. Whether the facility should be granted a That a short-term license be provided to the
•HPRBA ACT 857 (2013)
temporary license facility (6months)
•Mental Health ACT 846 (2012)
2. Whether the facility should be granted a That a long-term license be granted to the
•National Health Insurance ACT 2012 (ACT 852)
long-term license institution (3 years)
•Pharmacy ACT- 1994 (Act 489)
3. Whether the facility will be denied a license
•Public Health Act 851
•The Health Institutions & Facilities ACT 829 (2011)

Page 46 Source: Health Facilities Regulatory Agency

Appendix II

The Pharmacy Council

The Pharmacy Act, 1994 (Act 489)

Application
The Council Registers 5 Types Pharmacies are Allowed to Type of Pharmacy Fee (GHS)
of Pharmacies: Supply All Classes of Medicine: Manufacturing Wholesale 1,000
Wholesale 1,000
► Class A: Being prescription only Wholesale/ Retail 1,000
► Retail Pharmacies medicines (POM)
Retail 1000
Types of Pharmacies

► Wholesale Pharmacies ► Class B: Being pharmacists list of Retail Cannabidiol Products(CBD) 1,000
medicines. i.e. medicines that may be
► Retail & Wholesale Pharmacies dispensed by a pharmacist without Wholesale Cannabidiol Products (CBD) 1,000
prescription. Over The Counter Medicine Sellers (OTCMS) 500
► Pharmacies Within Hospitals, Clinics, or
► Class C: Being over the counter (OTC)
any facility that requires pharmacies preparations
► Manufacturing Wholesale Pharmacies

Page 47 Source: The Pharmacy Council Ghana

Appendix III

GUIDELINES FOR PRIVATE HEALTH INSUANCE IN GHANA

The National Health Insurance Authority (NHIA) is responsible for regulating Private Health Insurance Schemes (PHIS) in Ghana under the National Health Insurance Act, 2012
(Act 852). The Authority registers, licenses, and oversees PHIS operations in Ghana as part of its regulatory functions. Two (2) types of private health insurance plans were
established by the law:

FINANCIAL REQUIREMENTS

•A PMHIS is a health-insurance plan that is run solely for the • Private Mutual Health Insurance Schemes
benefit of its members. A PMHIS can be formed and run by The minimum capital requirement for a PMHIS is one
any recognized group of people in Ghana. For example, million Ghana Cedis (GH1,000,000). This is a work in
Private Mutual Health Insurance membership can be based on a community, occupation, faith,
Schemes (PMHIS) progress. The capital requirement refers to an initial
or an organisation. Individuals (natural beings) and not
corporate organizations shall be members of PMHIS. An subscription that has been paid in full. A start-up PMHIS
employer may not require employees to join PMHIS under any must submit to the Authority a business plan describing
circumstances. the scheme's 7 planned business and a pro-forma
statement of operations for at least five (5) years. This
strategy must demonstrate the scheme's ability to stay
solvent for the specified time period.

• Private Commercial Health Insurance Schemes

• A PCHIS is a profit-driven health insurance company that A PCHIS is needed to have an initial capital requirement
operates on market principles. Premiums are generated of GH5,500,000.00 (five million and five hundred thousand
depending on the calculated risks of specific groups and Ghana cedis). This is a work in progress. Paid-up capital
Private Commercial Health Insurance individuals. The private commercial health insurance scheme is referred to by the capital requirement. Sixty percent
Scheme (PCHIS) is usually owned by a firm and its stockholders. The (60%) of a scheme's minimum capital requirement must
stockholders of a PCHIS will own it.
be in cash or near cash, with the remaining forty percent
(40%) in fixed assets.

Page 48 Source: National Health Insurance Authority

Appendix IV

Food & Drugs Authority Medical Devices, Cosmetics and Medical Devices Department
The Food and Drugs Authority (FDA), legal Household Chemicals Division
mandate is found in Public Health Act, Act The Medical Devices
▪ The Medical Devices Department is Department is made up of two
851 of 2012. There are five divisions:
responsible for the regulation of all units
▪ The Drugs Registration and Inspectorate
Division
classes of medical devices in Ghana ▪ Unit One is responsible for
and undertakes the evaluation of the regulation of all medical
▪ The Safety Monitoring and Clinical Trials
applications and registration of devices in Class I
Division
▪ Medical Devices, Cosmetics and Household
medical devices, both foreign and ▪ Unit Two is responsible for
locally manufactured. the regulation of all medical
Chemicals Division
▪ Food Registration and Inspectorate Division devices in Classes II, III and
▪ Food Safety Division IV.

Activities in Unit One and Unit Two Include:

Fees: Unit One Unit Two

Following parliamentary approval by ACT 793, dated • Receipt of all applications for • Receipt of all applications for
December 2009, the following fees apply for medical the registration and re- the registration and re-
devices to be registered in Ghana: registration of medical devices registration of medical devices
▪ Imported medical devices (applicable every three in Class I; in Classes II, III and IV;
years) USD1,500 • Evaluation and processing of • Evaluation and processing of
▪ Locally produced medical devices (applicable all applications received; all applications received;
every three years) USD600 • Management of the relevant • Management of the relevant
data on clients and products; data on clients and products

Page 49 Source: Fitch Solutions Report

Appendix V: List of abbreviations

AfCFTA African Continental Free Trade Area

ACT Artemisinin Combination Therapy
AMA African Medicines Agency
ARC Anti retroviral
CAT Lab Catheterization Laboratory
CBD Cannabidiol Products
CHAG Christian Health Association of Ghana
CPMR Centre for Plant Medicine Research
EIB European Investment Bank
FDA Food & Drugs Authority
FDI Foreign Direct Investment
GABMLS Ghana Association of Biomedical Laboratory Services
GHS Ghana Health Service
GMP Good Manufacturing Practice
GNCP Ghana National Chamber of Pharmacy
HeFRA Health Facilities Regulation Agency
POM Prescription Only Medicine
SFP Self Financed Providers
WHO World Health Organization

Page 50