I must state categorically that I sincerely want this Fund to work. That is my starting position, and I think it should be the starting position of anyone under forty in this country, because we are the generation that will spend the next fifty years either benefiting from a functioning chronic-care financing system or watching our parents and eventually ourselves liquidate everything we own to pay for a cancer diagnosis.
So this is not a paen or a hit piece. It is a stock-take. Ten points, roughly a year and a bit after the launch.
1. Ghana’s health financing architecture was built for a communicable-disease era: malaria, maternal care, childhood immunisation. Meanwhile the Fund’s own framing puts chronic non-communicable diseases at about 45% of all deaths in Ghana.
Whether that exact figure holds up to independent scrutiny I cannot confirm, but the direction is not in dispute. We have been financing yesterday’s epidemiology. Naming NCDs as a distinct financing problem, with its own statutory instrument, is overdue and correct.
2. MahamaCares could easily have been a foundation, a First Lady-style charity, a line item that dies with the administration. Instead, it is Act 1144, passed by Parliament in July 2025, with a Board of Trustees, a Secretariat, audit obligations and parliamentary oversight.
That does not make it permanent. Parliament can repeal what Parliament passes, but it raises the political cost of killing it considerably.
3. Free Primary Health Care at the base, NHIS in the middle, GMTF at the apex for high-cost specialist care. This is a legible structure that tells a patient, a clinician, and a Finance Ministry where a given cost is supposed to land. Very few African health financing systems have this clarity on paper.
4. A pilot treated 50 patients across 11 hospitals, ages six months to 85, at a reported cost of about GH¢4.8 million. By May 2026 reporting put it at roughly 54 patients and GH¢5 million. The nationwide Patient Support Programme (PSP) rolled out in June 2026. Small numbers, granted, but real ones, with a real audit trail. I would rather have 54 verified patients than a launch communiqué as we have seen in the past.
5. A Medicines List derived from the revised national Standard Treatment Guidelines and Essential Medicines List for cancers. Negotiated reimbursement prices. A Tariff Operational Manual approved by the Health Minister covering service costing, claims processing and provider reimbursement.
This is boring, unglamorous institutional work, and it is exactly the kind of thing whose absence kills funds like this in year three.
6. Money goes to enlisted hospitals, pharmacies and labs as vetted claims. This is a departure from doling cash into individual hands. Anyone who has watched a Ghanaian social intervention get hollowed out by ghost beneficiaries should recognise why this matters.
7. The Fund does not cover treatment abroad. Politically, this is unpopular with a certain class of applicant. Systemically it is correct: every cedi spent flying a patient to India is a cedi not spent building the capacity to treat the next thousand patients here.
The Korle Bu cardiac catheterisation lab commissioned in July 2026, replacing the one destroyed by fire in March 2025, is the visible expression of that logic. I await the Komfo Anokye and Tamale teaching hospital catheterisation labs and humbly propose that the KATH lab be named after the late Dr. Kwame Adu Ofori.
8. The Fund’s mandate includes equipment, infrastructure, specialist training and research alongside patient support. Fine. What is not public, as far as I can find, is the allocation formula between those four pillars. How much of the Fund goes to buildings versus patients? Who decides? A cath lab at Korle Bu is a good thing. It is also a highly visible thing in Accra, and visibility is not the same as need. Other underserved communities are watching and also deserve their fair share.
9. Dr Nana Ayew Afriye’s objection during the parliamentary debate that the allocation functions as a back-door cap on NHIA resources was treated largely as partisan noise. Ghana spent years fighting to uncap the NHIL precisely because capping starved the scheme. Uncapping in 2026 has reportedly brought claims payment down to under three months from nine to twelve. Building a new statutory claim on that same pot, in the same breath, needs a serious actuarial defence. I have not seen one published yet.
10. “MahamaCares” was smart politics and is bad institution-building. Some stakeholders have publicly urged de-emphasising the nickname precisely because a fund branded with a sitting president’s name invites the next administration to treat it as partisan inheritance rather than national infrastructure. NHIS survived multiple transitions partly because nobody’s name was on it. If this Fund is meant to outlive its founder and the whole point of Act 1144 is that it should; then the statutory name should lead and the nickname should quietly fade. Given what transpires in some jurisdictions, I look forward to the day we will have no qualms about naming critical interventions such as this after their pioneers.
In sum, roughly a year in, the Ghana Medical Trust Fund has done the hard institutional work: legislation, board, tariffs, medicines list, first disbursements faster and more competently than I expected. That deserves saying.
Author
Sekyi-Brown Reginald is a pharmacist, health policy researcher, and pharmaceutical business leader with interests spanning health systems strengthening, pharmaceutical policy, and healthcare financing. He serves as Chairperson of the Early Career Pharmaceutical Group (ECPG) of the Pharmaceutical Society.
He has co-authored peer reviewed publications on pharmacy policy and education in Ghana and regularly contributes to public discourse on health sector reform. His work focuses on advancing equitable access to healthcare, strengthening pharmaceutical systems, and promoting evidence-informed public policy.
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