Ghana faces a growing breast cancer epidemic marked by late diagnosis, financial barriers to treatment, and inadequate screening infrastructure, challenges that the government’s newly approved Ghana Medical Trust Fund aims to address though experts question whether current funding mechanisms sufficiently bridge access gaps. The disease remains the leading cancer among Ghanaian women, affecting thousands annually while survival rates lag far behind high-income countries due to systemic healthcare constraints.
The statistics underscore urgency. More than 4,000 Ghanaian women receive breast cancer diagnoses annually, with nearly 70 percent identified at advanced stages when treatment becomes complex and expensive. The three-year survival rate in Eastern Ghana reaches only 52 percent, compared to over 80 percent in developed nations. Across West Africa, five-year survival ranges between 35 and 48 percent. This disparate outcome reflects not cancer biology but healthcare system capacity—women diagnosed early in Ghana achieve survival rates equivalent to developed countries, yet early detection remains uncommon.
The barriers to early detection operate across multiple levels. Access to screening technology remains geographically concentrated. Mammography machines, essential for early detection, exist in extremely limited numbers, with only small percentages of hospitals and diagnostic centers providing access. Research indicates Ghana would need substantially more fully functional mammography equipment to support even basic population screening, yet capital investment constraints limit expansion. Breast ultrasonography, more widely available and less expensive, offers partial solution though trained personnel and equipment limitations persist.
Rural areas face particular disadvantage. Radiologists concentrate overwhelmingly in urban centers, particularly Accra and Kumasi, leaving rural women with limited access to imaging interpretation. The journey for screening involves transportation costs, time away from agricultural or domestic work, and uncertainty about service availability. These practical barriers compound medical ones, with awareness of breast self-examination and early warning signs remaining low even among educated populations.
When diagnosis occurs, financial burden becomes catastrophic. Studies of breast cancer patients at Ghana’s leading teaching hospitals found that 87 to 93 percent bore diagnostic costs entirely out-of-pocket rather than through insurance. Treatment costs exceeded what most households could absorb, forcing families into impossible choices between medical care and basic necessities. Many patients abandon therapy partway through when costs become unsustainable, converting potentially survivable cancers into terminal illnesses through economic constraint rather than medical necessity.
The National Health Insurance Scheme, while providing baseline coverage for some services, contains critical gaps. NHIS benefits include many treatment elements but explicitly exclude routine screening tests like mammography and pap smears, meaning prevention remains unaffordable for most women. Additionally, NHIS coverage for specialized treatments remains incomplete, leaving expensive interventions like immunohistochemistry testing and targeted therapies inaccessible to poor patients despite their clinical necessity.
Into this constrained environment, Ghana’s government launched the Ghana Medical Trust Fund, popularly known as Mahama Care, in April 2025. The initiative, approved by Parliament in July 2025 following contentious debate, aims to provide dedicated financial support for chronic disease treatment including cancer, kidney failure, cardiovascular disease, and diabetes. The fund dedicates resources specifically toward specialist-level care that NHIS does not fully cover, including chemotherapy, radiotherapy, and surgical interventions.
The funding mechanism immediately generated controversy. The bill allocates 20 percent of National Health Insurance Fund revenues to Mahama Care, creating parliamentary tension over whether this strengthens or undermines existing health financing structures. Opposition members questioned whether the fund represents genuine expansion of capacity or merely redirection of scarce resources from basic healthcare toward specialized treatment. They argued the government should explore alternative funding through mechanisms like the COVID-19 levy rather than diminishing NHIS allocations.
The government secured 9.9 billion Ghana cedis (approximately $584 million) for healthcare initiatives including Mahama Care in the 2025 budget, though debate continues about whether this adequately funds operations. Implementation depends partly on private sector contributions, with officials appealing to Ghanaian corporations to allocate corporate social responsibility budgets toward the fund’s sustainability. This reliance on voluntary private support introduces uncertainty about long-term financial stability.
Beyond financing, structural barriers to care access remain substantial. Distance from treatment facilities, limited diagnostic capacity outside tertiary hospitals, and healthcare worker shortages constrain what funding alone can overcome. Research recommends systematic interventions across screening, diagnosis, and treatment pathways rather than financing solutions alone. Early detection costs per life-year saved remain far lower than late-stage treatment, suggesting prevention investment would yield superior health outcomes compared to expensive tertiary interventions, yet prevention receives minimal attention compared to treatment support.
The Mahama Care taskforce, chaired by healthcare professionals and policy experts, faces demanding timelines. They were given five weeks to develop comprehensive operational frameworks, eligibility criteria, and sustainability plans for a fund designed to serve potentially millions of Ghanaians chronically ill with expensive conditions. Rapid policy development risks inadequate stakeholder consultation and implementation challenges typical of hastily designed programs.
For breast cancer specifically, Mahama Care potentially improves access to chemotherapy, radiotherapy, and surgical care for economically disadvantaged patients. A woman able to access early diagnosis through improved screening and affordable diagnosis could potentially benefit from fully financed treatment through Mahama Care, creating genuine care pathway from detection through recovery. However, this scenario remains conditional on prior achievements in screening expansion, radiologist training, and diagnostic capacity that remain unrealized.
The reality for Ghanaian women remains that most will continue facing delayed diagnosis, incomplete treatment, and high mortality unless systematic reforms address the entire care continuum rather than financing alone. Mahama Care represents policy acknowledgment that financial barriers drive unnecessary deaths and that government intervention can reduce this burden. Whether the fund succeeds depends on implementation quality, sustainable funding mechanisms, stakeholder clarity about roles and responsibilities, and parallel investments in diagnostic infrastructure and healthcare workforce development.
Source: newsghana.com.gh
