Ghana rates among the world’s poorest countries and struggles under a heavy disease burden typically associated with an equatorial location and low income levels. The health care delivery system in Ghana is complex and is composed of many interlinked functions and activities among sectors and organizations. Although some improvements in basic drug management and use have been realized in recent years due to concerted efforts on the part of the Ministry of Health, significant gaps in access to medicines exist, particularly in relation to affordability of products in all sectors and quality of service in private retail outlets and in rural areas.

Strategies that combine strengthening of existing systems and the introduction of innovative concepts have been formulated to address the most significant access gaps that are amenable to change. By using a multifaceted approach to work both within the existing interlinked health care delivery system and outside the existing system using commercial-sector influences, the strategy package has the potential to significantly address this access gap.

The main components of the intervention strategy include

1. strengthening the mission-sector drug management systems;
2. strengthening Pharmacy Council regulatory functions and training delivery capacity for chemical sellers; and
3. promoting a franchising operation for chemical sellers.

These components combine to produce a very powerful intervention, considerably beyond the simple sum of the component parts. The proposed interventions have been formulated in partnership with the proposed implementing partners and have been discussed in detail with the community of involved stakeholders, where they enjoy widespread support. In addition, they are consistent with the Government’s strategic aim to shift the burden of health care to the private sector. Real and potential constraints and threats to the interventions have been explored, and they are not considered serious impediments to implementation. All proposed interventions are formulated so as to achieve self-sufficiency during the life of the proposed intervention.