1. Executive Summary

Mawuli Diagnostic & Treatment Centre is a duly registered private enterprise strategically formed to empower health care delivery, assuring the patients that diagnostic and therapeutic tools will be made available for them for the first time in Ghana and the West Africa sub region, improving their health and saving the lives of millions of people.

It is duly registered on 11th February, 2015 at the Registrar-General's Department in Accra with the registration number BN910372015. In the future as part of the vision, we will have sister companies registered in other countries of the region.

With your collaboration, we seek to provide quality health care that will make a difference by improving the health of the people of Ghana and Africa at large.

This proposal seeks to achieve extraordinary improvements in human health by providing a central diagnostic center in Accra where Ghana and the West Africa sub region can send their samples/patients for diagnosis and/or therapeutics. We shall also operate in strategic locations in all the regional capitals and densely populated cities of Ghana, where patients can access these diagnostic and therapeutic tools. We are also proposing a partnership with the government to establish/refurbish the existing facilities on their premises all over the country, collaborating in the Clinical Laboratory, Pathology, Telemetry, Cardiovascular, Gastroenterology, Genetic, Neurophysiologic, Pulmonary, Allergy, Surgical and Imaging Diagnostic and Treatment Centers, so that patients do not see themselves crisscrossing town in search of those infrequently needed tests and treatments and many times having their samples sent abroad or they themselves going abroad because those tools are either broken in the government facilities or non-existing in our country. A percentage of the profit goes to the government facility in which we operate and this will help strengthen its auto sustainability.

As the experience becomes successful in Ghana we will extend our tentacles to disseminate to the entire continent of Africa where except for South Africa, health care delivery in general, including hospitals, diagnostic tests and pharmacies operate at the lowest levels in the world. The payment capacity of individuals in most African countries is on the increase as most economies develop to enter the lower middle class range. African economies are among the fastest growing in the world. Today the continent is poised to transform the global economic landscape. Annual growth is expected to average 7% over the next 20 years.

We are proposing to your organisation to have a joint venture with us to help solve the deficiencies in the area of diagnostics in the health care delivery not only in Ghana but also in Africa as a whole.

Your organization will leave an indelible legacy and ever be remembered in the annals of history for the good they have done to elevate the quality of health care in Ghana and Africa as a whole.

The Board of Directors of Mawuli Diagnostic & Treatment Centre, led by Dr. Emmanuel Yao Voado, MD., the Founder, and your organization will both select the Management Committee that will see to the day to day administration of these centers.

2. About Ghana

Ghana is located in Western Africa and borders Burkina Faso, Cote d’Ivoire, and Togo. This country occupies a total area of 238,533 square kilometers and has a population of approximately 29,786,408 as of January 5, 2019. The population of West Africa is estimated at 387,246,061 people as of January 8, 2019.

Formed from the merger of the British colony of the Gold Coast and the Togoland trust territory, Ghana in 1957 became the first sub-Saharan country in colonial Africa to gain its independence. Ghana endured a series of coups before Lt. Jerry RAWLINGS took power in 1981 and banned political parties. After approving a new constitution and restoring multiparty politics in 1992, RAWLINGS won presidential elections in 1992 and 1996 but was constitutionally prevented from running for a third term in 2000. John KUFUOR of the opposition New Patriotic Party (NPP) succeeded him and was reelected in 2004. John Atta MILLS of the National Democratic Congress won the 2008 presidential election and took over as head of state, but he died in July 2012 and was constitutionally succeeded by his vice president, John Dramani MAHAMA, who subsequently won the December 2012 presidential election. In 2016, however, Nana Addo Dankwa AKUFO-ADDO of the NPP defeated MAHAMA, marking the third time that the Ghana’s presidency has changed parties since the return to democracy.

Economy:

Ghana has a market-based economy with relatively few policy barriers to trade and investment in comparison with other countries in the region, and Ghana is endowed with natural resources. Ghana's economy was strengthened by a quarter century of relatively sound management, a competitive business environment, and sustained reductions in poverty levels, but in recent years has suffered the consequences of loose fiscal policy, high budget and current account deficits, and a depreciating currency.
Agriculture accounts for about 20% of GDP and employs more than half of the workforce, mainly small landholders. Gold, oil, and cocoa exports, and individual remittances, are major sources of foreign exchange. Expansion of Ghana’s nascent oil industry has boosted economic growth, but the fall in oil prices since 2015 reduced by half Ghana’s oil revenue. Production at Jubilee, Ghana's first commercial offshore oilfield, began in mid-December 2010. Production from two more fields, TEN and Sankofa, started in 2016 and 2017 respectively. The country’s first gas processing plant at Atuabo is also producing natural gas from the Jubilee field, providing power to several of Ghana’s thermal power plants.
As of 2018, key economic concerns facing the government include the lack of affordable electricity, lack of a solid domestic revenue base, and the high debt burden. The AKUFO-ADDO administration has made some progress by committing to fiscal consolidation, but much work is still to be done. Ghana signed a $920 million extended credit facility with the IMF in April 2015 to help it address its growing economic crisis. The IMF fiscal targets require Ghana to reduce the deficit by cutting subsidies, decreasing the bloated public sector wage bill, strengthening revenue administration, boosting tax revenues, and improving the health of Ghana’s banking sector. Priorities for the new administration include rescheduling some of Ghana’s $31 billion debt, stimulating economic growth, reducing inflation, and stabilizing the currency. Prospects for new oil and gas production and follow through on tighter fiscal management are likely to help Ghana’s economy in 2018.
GDP (purchasing power parity): $134 billion (2017 est.)
GDP (official exchange rate): $47.02 billion (2017 est.) (2017 est.)
GDP - real growth rate: 8.4% (2017 est.)
GDP - per capita (PPP): $4,700 (2017 est.)

GDP - composition, by end use:

household consumption: 80.1% (2017 est.)

government consumption: 8.6% (2017 est.)

investment in fixed capital: 13.7% (2017 est.)

investment in inventories: 1.1% (2017 est.)

exports of goods and services: 43% (2017 est.)

imports of goods and services: -46.5% (2017 est.)

GDP - composition, by sector of origin:
agriculture: 18.3% (2017 est.)
industry: 24.5% (2017 est.)
services: 57.2% (2017 est.)

Agriculture - products: cocoa, rice, cassava (manioc, tapioca), peanuts, corn, shea nuts, bananas; timber
Industries: mining, lumbering, light manufacturing, aluminum smelting, food processing, cement, small commercial ship building, petroleum
Industrial production growth rate: 16.7% (2017 est.)

Labor force: 12.49 million (2017 est.)

Labor force - by occupation:
agriculture: 44.7%
industry: 14.4%
services: 40.9% (2013 est.)

Inflation rate (consumer prices): 9.6 % ( July,2018.)

3. About Africa

Africa is the second-largest continent about 30.2 million km2 (11.7 million sq. mi), after Asia, in size and population. The continent is surrounded by the Mediterranean Sea to the north, both the Suez Canal and the Red Sea along the Sinai Peninsula to the northeast, the Indian Ocean to the southeast, the Atlantic Ocean to the west and Europe to the north. The continent includes Madagascar and various archipelagos.

The population of Africa is estimated at 1.17 billion people as of 2015 accounting for about 16.7% of the world's human population.  Africa's population is the youngest among all the continents; 50% of Africans are 19 years old or younger. Algeria is Africa's largest country by area and Nigeria is the largest by population.

Africa, particularly central Eastern Africa, is widely accepted as the place of origin of humans and the Hominidae clade (great apes), as evidenced by the discovery of the earliest hominids and their ancestors, as well as later ones that have been dated to around seven million years ago.

History:

At about 3300 BC, the historical record opens in Northern Africa with the rise of literacy in the Pharaonic civilization of Ancient Egypt. One of the world's earliest and longest-lasting civilizations, the Egyptian state continued, with varying levels of influence over other areas, until 343 BC.

Climate:

Africa straddles the equator and encompasses numerous climate areas; it is the only continent to stretch from the northern temperate to southern temperate zones.

The climate of Africa ranges from tropical to subarctic on its highest peaks. Its northern half is primarily desert, or arid, while its central and southern areas contain both savanna plains and very dense jungle (rainforest) regions. In between, there is a convergence, where vegetation patterns such as Sahel and steppe dominate. Africa is the hottest continent on earth and 60% of the entire land surface consists of dry lands and deserts.

Politics:

Today, Africa contains 54 sovereign countries, nine territories and two de facto independent states with limited or no recognition. Connected with the Indian Ocean the islands of Africa are the Union of the Comoros, Republic of Madagascar, Republic of Seychelles, and Republic of Mauritius. In the Atlantic Ocean we have Republic of Cape Verde, Democratic Republic of São Tomé and Príncipe. Others are Djibouti, Equatorial Guinea, and Eritrea.

The vast majority of African states are republics that operate under some form of the presidential system of rule. The improved stability and economic reforms have led to a great increase in foreign investment into many African nations, mainly from China, which has spurred quick economic growth in many countries, seemingly ending decades of stagnation and decline.

Some seven African countries are in the top 10 fastest growing economies in the world. If you look at countries like Mozambique, Angola, Ethiopia, Zambia, and Togo – all of those markets have shown exceptional growth and real stability and with that you almost get a new investment climate for these countries. This allows you to have a new emerging middle class and with that comes a very vibrant entrepreneurship culture, businessmen or women who want access to technology and to innovate.

Several African economies are among the world’s fastest growing as of 2011. As of 2013, these are some of the Africa countries growing by more than 5.0% in real Gross Domestic Product (GDP). These are South Sudan, Sierra Leone, Liberia, Cote d’Ivoire, Ghana, Rwanda, Mozambique, Eritrea, Tanzania, Ethiopia, Gabon, Burkina Faso, The Gambia, Mauritania, Niger, Congo, Zambia, Angola, Uganda, Togo, Nigeria, Morocco and Kenya.

4. Personal Profile

Born in 1971 to a Christian family of scarce resources in Tefle, Volta Region, Ghana, he always dreamed of breaking the back bone of poverty though education. At the age of 12, he received a prophecy that he would be going abroad to further his studies. In 1985, at 14, the prophecy was accomplished but not without difficulties. After taking the exams to send students to Cuba, he placed first in his district but was replaced by the son of the most powerful politician of the district. A concerned citizen sent him to the office of President Jerry John Rawlings, when he was allowed to participate in the national test in which he became first. This event was indeed a shock to many.

He was in Cuba for 17 years, right from the junior high school to the medical school and subsequently to the postgraduate specialist course of Neurosurgery. While in Cuba as a student, he continued the brilliant academic work; he won many awards including best student in Chemistry at the Cuban National Level Quizzes for 3 consecutive years where students from 35 countries then studied. He wrote an Organic Chemistry book which was meant for the preparation of the high performance students who aspired to participate in the World Olympiad of Chemistry. He was summa cum laude in all the levels of education including the medical school and the Specialty of Neurosurgery. At the end of the neurosurgical training, he wrote another book in the field of Spinal Surgery called Lumbosacral Discopathies.

When he completed the Neurosurgical course in 2001, the people of Belize found him and took him to that country as they needed Neurosurgical Services which they had never had the privilege of enjoying locally. He performed simple and complex surgeries on many people including the elite of Belize with no surgical mortality in his 5 consecutive years of practice.

In the US, under Dr. Robert Grossman, a well-known neurosurgeon, he worked as a Clinical Research Specialist where he was invited by the Congress of Neurological Surgeons of America to present six papers in their international conferences.

He is Belizean and American citizen by naturalization.

After 28 years, he has decided to come back to Africa to help his people as he has come to the convincing realization that he is more needed here than in the United States.

5. Track Record

Dr. Emmanuel Voado, MD., is a Ghanaian neurosurgeon trained in Cuba. He was the medical doctor who first opened a neurosurgical service in the country of Belize. He practiced there for 5 years before going to the United States where he resided with his family for 6 years before relocating to Africa in September, 2013.

In Cuba, he was directly involved in the educational system for 17 years and impacted by their health care delivery for 11 years which can all be emulated by third world countries like Ghana who have more natural resources and foreign exchange earners than Cuba.

He lived in Belize where he contributed to the health care delivery in that nation. Once in the USA, he was personally impacted by all the good things of the American system.

While in Cuba as a student, he won many awards including best student in Chemistry at the Cuban National Level Quizzes for 3 consecutive years where students from 35 countries then studied. He wrote an Organic Chemistry book which was meant for the preparation of the high performance students who aspired to participate in the World Olympiad of Chemistry. He was summa cum laude in all the levels of education including the medical school and the Specialty of Neurosurgery. At the end of the neurosurgical training, he wrote another book in the field of Spinal Surgery called Lumbosacral Discopathies.

When he completed the Neurosurgical course in 2001, the people of Belize found him and took him to that country as they needed Neurosurgical Services which they had never had the privilege of enjoying locally. He performed simple and complex surgeries on many people including the elite of Belize with no surgical mortality in his 5 consecutive years of practice.

In the US, under Dr. Robert Grossman, a well-known neurosurgeon, he worked as a Clinical Research Specialist where he was invited by the Congress of Neurological Surgeons of America to present six papers in their international conferences.

6. The Problem

With the booming economy, health care delivery which is one of the faces of economic growth needs to improve in Ghana. When those who have the resources need to get medical care, they go to South Africa, India, America and other developed countries because there is no facility in the West African sub region to find an appreciable level of quality health care.

Considered a regional model for political and economic reform, Ghana has to appear as a flag bearer of health care delivery not only for its people but also for West Africa as many patients from the sub region flock to Ghana looking for a better medical care. Meanwhile, Ghana itself does not have facilities like those in the developed countries and the countries with emerging economies.

Why the need for an International Diagnostic Center? Simply because our West African neighbors still come to Ghana for medical care.

The leading government hospitals in Ghana are not fully equipped. In the areas in which they are well-equipped, maintenance of equipment is problematic. This is because this is not done in a timely manner, or there are no government funds available in that moment in time to carry out the maintenance/repair. We lack some specialties and medical equipment which will ultimately prevent the flock of patients abroad. Most of the diagnostic equipment of the government hospitals are broken and they are in need for investors to come on board and partner with them to permit them function well because the hospitals void of diagnostic tools can simply not execute their mandate from diagnosis to treatment. If they cannot diagnose, they cannot always treat and complete the diagnosis-treatment chain.

In this moment the Government of Ghana has come to the conclusion it cannot assure the efficient running of the diagnostic facilities in its premises because she does not have the budget to do it at a time when all their health facilities are highly indebted and cannot generate the funds to purchase new equipment or to maintain/repair existing ones. They now have offers to private sponsors to come and refurbish and operate the government diagnostic facilities. Please, refer to Appendix 1 and 2.

The private clinics/hospitals and other medical laboratories in the country are not interested in investing in all available laboratory tests because it is not profitable for them as they argue that there are not many patients demanding for them and they would run at a loss when they invest in the equipment and the reagent. Because of this, when a doctor sees a patient who needs one of these unusual tests they have to send the sample to South Africa for diagnosis, sometimes two weeks before the patient is definitely treated.

If it were a condition that needs prompt medical attention, then the patient’s hope of recovering without disabilities is in jeopardy. This is true for a patient with brain aneurysm1 who needs angiographic test which can also treat him/her by coiling through the same angiography by an Interventional Radiologist or a Vascular Neurosurgeon. This condition has claimed the lives of many or rendered them neurologically disabled.

DNA test was not done in Ghana but rather in South Africa, it was few months ago that the SSNIT Hospital brought DNA equipment to Ghana. We know the importance of this test in modern criminology and the resolution of many social and family conflicts.

There are some diagnostic tools that are at the same time therapeutic like endoscopy and angiography for the treatment of a vast group of diseases which only in this part of the world are still being treated by performing an open surgery making the recovery process longer. These diagnostic and therapeutic tools are practically not existent in Ghana. The cases in which they exist, they are sub utilized because of lack of specialized personnel in the country.

Having all our health care needs locally is the only way we can stop the efflux of the rich abroad for a better health care when they are also dying in their numbers if it is an emergency condition that does not allow for a sufficient waiting window for its transfer outside the country. We do not have local experts on the diagnosis and treatment of brain aneurysm [1] which is an emergency condition that continues to claim the lives of many in this country. A patient who needs a complex spinal surgery to avoid or improve the condition of paralysis due to a spinal cord injury is in a similar situation because whether the person can pay or cannot pay there is no amount of money that can save his life since emergency treatment is not available in this country.

The efforts of having a strategic plan for training human resources, especially specialists, and other allied health workers at home or abroad for the challenges the health sector is facing or will face in the short term or long term have not yet yielded the expected outcomes. A sustained plan of training the adequate quality and quantity of the new generation that will take the baton when the current generation is gone does not seem to be yielding the expected results.

Many big health facilities do not have the latest radiological and pathological investigations. The diagnostic tools like Computerised Tomography (CT) scan and Magnetic Resonance Imaging (MRI) are outdated and so are not the best to get sensitive diagnosis.

We see patients moving from one facility to the other trying to complete an investigation for diagnosis before their doctors are able to treat them. Some of the pathology samples have to be sent abroad for analysis. Some surgical treatments have to be done abroad because of lack of equipment and/or lack of the trained personnel to execute them.

The agents of change are coming into the system every year after undergoing training in the developed countries; but they are either absorbed by the status quo or they are marginalized to health facilities where they do not have the tools to effect those changes for the benefit of the people. They end up giving in to the status quo, so the teaching hospitals do not always experience the changes that the new brains coming into the system could contribute to.

The foreign personnel who live and work here and those on short visit to the region need the specialized health care facilities at the height of the developed countries to live/travel peacefully so that they do not die due to those emergency conditions whose treatment do not wait for transfer to specialized centers in the developed countries.

7. Societal Need

The inspiration came from the manner in which many patients fail to have an opportune treatment because of lack of diagnosis and the millions who, up till now, die irremediably because of lack of diagnostic and therapeutic tools.

Therefore, there is the need for a service that will serve to:

  • Improve the delivery of diagnostic services in Ghana and our West Africa sub region.
  • Have a central diagnostic center where the whole nation and the West Africa sub region can send their samples/patients for diagnosis and/or therapeutics.
  • Get these services on-site where the numerous general practice and specialist physicians are located in need of the services making the results faster and more convenient.
  • Make the patients have access to the diagnostic and /or therapeutic services and personnel not available at the moment in Ghana.
  • Partner with the government to establish/refurbish the existing facilities on their premises all over the country, collaborating in the Clinical Laboratory, Pathology, Telemetry, Cardiovascular, Gastroenterology, Genetic, Neurophysiologic, Pulmonary, Allergy, Surgical and Imaging Diagnostic and Treatment Centers, so that patients they do not see themselves crisscrossing town in the search of those infrequently needed tests and treatments and many times having their samples sent abroad or they themselves going abroad because those tools are either broken in the government facilities or non-existing in our country.
9. Technical Proposal

DESCRIPTION OF THE PROJECT:

A comprehensive diagnostic center with all the latest diagnostic tools and specialized personnel capable of using them correctly is what we need in Ghana. This will permit a more efficient medical attention to patients. It will not only save cost but also it will save thousands of the lives of both nationals and foreigners who die because they suffer from emergency conditions whose treatment is unavailable in the country at the moment.

The Mawuli Diagnostic & Treatment Centre is expected to be the number one in class diagnostic center in the West Africa sub region. Apart from patients of West Africa, it will also attract the USA and other developed countries' workers, United Nations (UN) workers, the diplomatic corps, corporate bodies in the region and other tourists who will come to Ghana to look for that medical service which is available only in our medical facility in the sub region.

We will also open branches in the different government hospitals and near some private facilities to get the samples to the central diagnostic center or process some samples locally in those facilities in the cases where those are tests in high demand.

The branches that we shall open in the government facilities are to be in partnership with those facilities where we will give the government facilities some percentage of the profits. This partnership with the government health facilities will help establish/refurbish the existing facilities on their premises all over the country, collaborating in the Clinical Laboratory, Pathology, Telemetry, Cardiovascular, Gastroenterology, Genetic, Neurophysiologic, Pulmonary, Allergy, Surgical and Imaging Diagnostic and Treatment Centers, so that patients they do not see themselves crisscrossing town in the search of those infrequently needed tests and treatments and many times having their samples sent abroad or they themselves going abroad because those tools are either broken in the government facilities or non-existing in our country.

We will have the following diagnostic facilities:

  1. Clinical Laboratory
  2. Pathology Laboratory
  3. Genetic Laboratory
  4. Imaging Center:
  • X-ray and Fluoroscopy including C-arm
  • Computerized Tomography (CT scan)
  • Magnetic Resonance Imaging (MRI)
  • Ultrasonography
  • Echocardiography
  • Endoscopy (diagnostic and therapeutic)
  • Angiography (diagnostic and therapeutic)
  1. Other medical diagnostic tests:
  • Electrocardiogram
  • Electroencephalography
  • Neurophysiologic Tests
  • Pulmonary Function Tests.
  • Allergy

As we can see in the lay out we are going to need specialist and other allied health personnel some of which are not available in the country at the moment. The vision of the diagnostic and treatment center is that it will be opened to doctors and allied health personnel from all walks of life, regardless of their country of origin and culture. This will create the necessary dynamism for a good medical team to take off.

In Ghana for instance, the Cuban trained medical practitioners could collaborate with their Ghanaian counterparts to candle the objective of this vision. This group will serve as the basis for those Ghanaian doctors who are undergoing training outside Ghana to join them on their return. The hospital will also attract Cuban health workers that can now travel outside Cuba for a period of 2 years on sabbatical holidays to come back to Ghana after one-month vacation in Cuba. The diagnostic center will also be reinforced by American doctors who will come to Ghana to treat patients and share their experience with their colleagues in Ghana. Some doctors and allied medical personnel are coming from Central and South America and Eastern Europe.

This private facility, one of its kind in Ghana will be the bridge between the inadequacies of the government and private facilities. The Diagnostic and Treatment Centre will be a Tertiary Health Care Facility with first class capacity to cater for all the health needs of the people.

 

Health Care Delivery

We shall also introduce the practice of telemedicine linking our centers with each other and our headquarters with sister mega hospitals in the developed world and at the same time with medical centers in Ghana which will refer patients to our facility in order to improve  our  health care delivery. We will use technology to televise/videotape procedures/surgeries in real time which are done in Ghana to the USA and other nations by networking both hospitals so that colleagues with their expertise in those countries can give us valuable opinion on difficult cases. Other methods of ICT will be applied in both surgical and nonsurgical specialties. We shall use ICT to make our distant services available to referring medical centers in Ghana so that before patients with head injury, spinal cord injury, heart attack and stroke come to our center they would coordinate with us and know the appropriate course of action they would need to execute initially before referring the patients.

The hospital will be fully computerized and the documents which at that time cannot be computerized will be scanned and kept in the computer so that patient information and other matters which pertain to the hospital will be well kept for future references.

Private Health Insurance Schemes have emerged and have come to stay as the booming economy has increased their demand. The hospital will be a provider for these private health insurances. The National Health Insurance Scheme of Ghana has the mission of providing financial risk protection against the cost of quality basic health care for all residents in Ghana. The International Hospital would be a provider for the National Health Insurance Scheme of Ghana as this would help increase the access of more people to our services. The rest of the patients will pay out of pocket fully or on payment plans.

The billing system of the diagnostic center and its branches will be fully computerized to avoid fraud.

Target Group

We target all patients independent of their origin, religion, culture, race, ethnicity and political affiliation seeking for medical diagnostic solutions.

Location

Accra, the capital of Ghana, is furthermore the anchor of a larger metropolitan area, the Greater Accra Metropolitan Area (GAMA), which is home to about 4 million people, making it the largest metropolitan conglomeration in Ghana by population, and the eleventh-largest metropolitan area in Africa. About 55% of the doctors of Ghana are concentrated in the Greater Accra Metropolitan Area. The headquarters of Mawuli Diagnostic & Treatment Centre will be located in Accra in order to get an easier access to human resources.

Branches will be located in the major cities of the country and will disseminate to other countries in the region during our growth.

Implementation plan

We will build the central diagnostic center and at the same time negotiate with the government hospitals who will be one of our main consumers for partnership. In our partnership with the government hospitals, we will have a physical presence with some of our equipment on site. We will also strive to locate our branches which will simply be sample extraction/collection centers at visible places/corners of the streets near to the consumers/private medical facilities.

10. Synergy

We are grounded on the values of Integrity, Compassion, Accountability, Respect and Excellence (I CARE) principle.

With your joint venture, we seek to provide quality health care that will make a difference by improving the health of the people of Ghana and Africa at large.

With your collaboration we both strive to meet the following expectations.

  • With your collaboration, we seek to provide quality health care that will make a difference by improving the health of the people of Ghana and Africa at large.
  • This collaboration will facilitate access to an affordable and trusted medical alternatives for patients, organizations and consumers on the Africa market.
  • Your organization will offer its leading, affordable, timely, high quality and latest diagnostic tools for Ghana and Africa at large to access best in class health care facilities.
  • This collaboration will continue to create opportunities in Africa thereby increasing market share while improving patient care.
  • Increasing the revenue and profitability base of the company for future developments and sustainability.
  • Impact investing, as it is a socially conscious form of investing that seeks to generate both a social benefit and a meaningful financial return. It is an investment that intentionally generates sound financial return as well as measurable social and environmental impact and this would help grow the global impact economy, especially that of Ghana and Africa, significantly.
  • We would have all the tests done locally in Ghana which has a population of almost 26 million people.
  • We would have many tests done for the first time in Africa locally.
  • We would have DNA test for the first in Ghana.
  • The government and private partnership would enhance health care delivery.
  • It would help save many lives of both our locals and our foreign brothers who live with us or are on a visit.
  • It would create jobs for thousands who will be directly and indirectly involved here at home.
  • Patients will be tremendously helped by avoiding their flock to South Africa, India and the first world countries.
Appendix 1

Korle Bu Teaching Hospital (KBTH) is the main teaching hospital in Ghana. Located in the city of Accra, it provides a range of clinical services to those living in Greater Accra Region as well as acting as supra-regional and national center of excellence. The hospital is the third largest in Africa with sixteen clinical and diagnostics departments and a bed capacity of 2000. The hospital reports that it has an average daily attendance of 1,360 out-patients and approximately 125 patient admissions. Both laboratory and imaging services currently face a number of challenges, such as frequent equipment breakdown due to inadequate maintenance regimes and insufficient budgets for replacing old equipment’s, facilities which are not “fit for purpose” (in the case of part of the current imaging center), unreliable power supplies and power surges and inefficient processes for sample collection and issuing results. These issues directly affect their levels of performance and ability to meet the needs of patients and clinicians. Given that this hospital is the most important tertiary referral hospital in the country, modern lab/ imaging services are essential.

The procurement of a new Public Private Partnership (PPP) to deliver laboratory and imaging services should provide a solution to most of the current issues. The construction of new, international standard, accredited facilities and the introduction through the PPP contract of robust performance requirements should ensure a well maintained and efficiently operated services capable of meeting stringent output specifications. The project will be designed to encourage private revenue generation to offset public costs. The estimated capital cost (including equipment) is US$24.5 million. This will further be defined once the pre-feasibility and full feasibility studies are concluded and upon determination of the exact list of services to be included.

Project Scope:

The private sector sponsor will be responsible for the following:

  1. The design, construction/ refurbishment, financing and operation of the facility for a period of around 15 years (2 years’ construction plus 13 years’ operation), after which the facility would be handed back to KBTH.
  2. The delivery of all laboratory and imaging services across the hospital (with the exception of the Cardiothoracic Unit, which operates independently to the hospital), including maintaining and operating the new facility and
  3. Maintain and operate existing “satellite” laboratory and imaging services currently within some of the hospitals departments.

It is envisaged that this new center should be able to provide laboratory testing services to patients from the 7 polyclinics in Greater Accra, and provide the specialist laboratory tests requirements for the government operated hospitals where feasible. A more integrated services is also considered where the private sponsor will provide phlebotomy services at key hospital departments and surrounding polyclinics, regular courier and pottering services, and electronic reporting of results.

Current Status:

The Transaction Advisor is currently working with the Ministry of Health and Korle Bu Teaching Hospital to implement the best option. A private sponsor is expected to be engaged in the first quarter of 2015.

Appendix 2

UROLOGY NEPHROLOGY CENTER OF EXCELLENCE

PROJECT DESCRIPTION

The Urology Center of Excellence project is a unit that will have 81 beds, 2 aseptic general operating theatres, 1 septic operating theatre in Diagnostic and Treatment Department, 4 intermediate care units, laboratory and other relevant facilities.

Current Status:

The Ministry of Health has appointed a Transaction Advisor to review the feasibility studies and ensure value for money for the implementation of the project.

NOTE: There is a possibility of negotiating a better deal of perpetual presence in the largest hospital in Ghana because the conditions of lack of government budget to repair/maintain the equipment will be the same or worse. The possibility of negotiating with the government to take over the financial and administrative operation of the diagnostic centers of all existing government facilities in Ghana is a huge possibility because there are 4 large teaching hospitals and additionally more than 3000 health facilities operated by the government and all of them have the same problem.