Building Reform, Inclusion, and Drug Governance Equity in Ghana

Project Details

• Funder: Open Society Foundations (OSF)
• Implementer: WAPCAS Plus
• Period: June 2025 – May 2027 | Now in Year 2
• Reporting Position: Year 1 complete; Months 1–3 of Year 2 delivered

What the Project Seeks to Achieve

Inclusive, evidence-based and rights-centred drug policy reform in Ghana, bridging research, lived experience and policymaking for Persons Who Use Drugs (PUD).

STRATEGIC OBJECTIVES

Objective 1: Passage of a Harm Reduction Legislative Instrument under Act 1019

Objective 2: Creating an enabling environment for Opioid Agonist Therapy (OAT)

Objective 3: Shifting power — community voice and ministry engagement

Objective 4: Law enforcement and stakeholder capacity enhancement

OBJECTIVE 1: HARM REDUCTION LEGISLATIVE INSTRUMENT

What WAPCAS Plus has Done

• Supported NACOC to constitute an L.I. review committee and provide commentary on the Draft L.I.
• Convened stakeholders to resolve NACOC Legal Department comments, including on Needle and Syringe Programmes
• Presented progress to the National Human Rights Steering Committee to broaden institutional support
• Commissioned, reviewed and finalised two policy briefs and two technical memoranda
• Secured the L.I. agenda at the National Dialogue and disseminated all four knowledge products

Status of L.I. Now

• Forwarded to the Ministry of Interior, then to the Ministry of Justice / Attorney-General's Department (Apr 2026)
• Reviewed by the Attorney-General's Department, which returned comments and questions (Aug 2026)

"The Legislative Instrument is not simply an administrative requirement. It is the foundation upon which effective implementation rests. The time for prolonged discussion has passed."

Hon. Muntaka Mohammed-Mubarak, Minister for the Interior — keynote delivered on his behalf at the National Dialogue, 8–9 July 2026

OBJECTIVE 2: OAT ENABLING ENVIRONMENT

1. Learn

Ghana–Kenya learning visit, 21–27 Feb 2026

Delegation drawn from GAC, FDA, GHS Institutional Care, NACP, Mental Health Authority, NACOC, WHO and the PUD community. Engaged NSDCC and NASCOP; site visits to Mathari, Ngara, Kiambu County and Ruiru Prison MAT clinics.

2. Assess

National OAT Readiness Assessment Jun-August 2026

Tools finalised. Facility-level data collection across Greater Accra, Ashanti, Central and Northern regions. Final report completed and submitted (Aug 2026). Regulatory and supply-chain assessment completed alongside it.

3. Plan

Draft National OAT Implementation Roadmap

Developed through the UG-SPH Executive Short Course (Apr 2026) and presented at the National Dialogue. WAPCAS Plus has written to Ghana Health Service seeking approval and collaboration to convene a validation meeting.

Result: Ghana now has a national evidence base on OAT readiness where none existed at the start of the grant, and OAT has been positioned inside the country's formal policy dialogue architecture rather than alongside it.

WHAT THE OAT ASSESSMENT FOUND

Foundational Readiness: Ghana demonstrates foundational readiness for a phased OAT pilot, with existing health systems providing a platform to build on.

Priority Gaps: Major gaps remain in OAT-specific workforce, medicine registration and financing.

Candidate Pilot Sites: Ankaful, Pantang, Accra Psychiatric, Komfo Anokye and Korle Bu identified, pending verified staffing.

A Phased Approach: A small, tightly controlled pilot is recommended over national rollout; safety and supply continuity determine the first sites.

Regulatory Foundation: Controlled-medicine systems already exist as a credible base, but OAT-specific product registration, a joint FDA–NACOC pathway and financing must still be established.

Community Base: WAPCAS Plus outreach and peer-support capacity gives any pilot an established community platform.

OBJECTIVE 3: SHIFTING POWER

Turning Capacity into Representation

• A PUD harm reduction advocate seated on the National PUD Harm Reduction Technical Working Group
• PUD community representation secured within the National Dialogue
• An advocate presented on stigma slowing implementation, and served as a panellist on community and youth voices — lived experience shaped the Dialogue's conclusions

Building the Cohort

• Advocates identified against criteria emphasising lived experience, gender and representation across drug-using communities
• Approximately 30 advocates trained 7–10 April 2026 in policy advocacy, public speaking and media engagement
• District-level engagement sustained through PUD project officers

Ministry and Regulatory Engagement

• The regulatory and supply-chain assessment brought FDA, NACOC, GHS Pharmacy HQ, the Mental Health Authority, the Pharmacy Council, hospitals and supply-chain actors into a single structured process on procurement, registration, importation, storage, distribution, governance and financing.
• The National Dialogue strengthened collaboration across the Ministry of Health, NACOC, FDA, Ghana Health Service, the Attorney-General's Office, Parliament, Police, civil society, PWUD networks and international partners.

OBJECTIVE 4: LAW ENFORCEMENT CAPACITY

Timeline and Progress

• Oct 2025: Police Technical Working Group agrees to collaborate on a manual referencing Act 1019 and commits to future sensitization
• Feb 2026: Manual Review Committee constituted with NACOC; Terms of Reference finalised
• Mar 2026: First Committee meeting: ToR adopted; consultant presents inception report, methodology and outline
• Apr–Jun 2026: Draft content reviewed and refined, integrating rights-based and public health frameworks
• Jul 2026: Final draft of the Standardized Training Manual submitted for technical review
• Aug 2026: Manual completed and validated by stakeholders

Result

A validated national instrument that operationalises Act 1019, embeds a public health approach and standardises future trainings across law enforcement institutions. Committee members include the Ghana Police Service, Ghana Prisons Service, Legal Aid Commission, Ministry of Justice, CHRAJ, IDPC, WADPN, GAC and NACP.

PROGRESS AGAINST THE WORKPLAN

CHALLENGES, ADAPTATION AND LESSONS

Stakeholder Availability Delayed Interviews (January 2026)

Challenge: Availability constraints slowed stakeholder interviews for technical memos under the evidence consultancy.

Response: Scheduling was reworked around stakeholder availability. Scope and quality were unaffected and all four knowledge products were received in February.

Flooding Disrupted the Manual Consultancy (June 2026)

Challenge: Heavy flooding affected the consultant's working files and the revision timeline.

Response: NACOC was informed and the completion target was formally revised to end-July rather than compressing the review. The manual was completed and validated in August — quality was protected and the delay absorbed.

Sustaining Structured Engagement for Advocates

Challenge: Keeping a trained cohort meaningfully engaged between national moments is a live programmatic risk.

Response: Engagement is sustained at district level through PUD project officers, with advocates included in engagements where their experience is relevant. Structured continuity remains a priority for Year 2.

WHAT COMES NEXT

Immediate Priorities (September / October 2026)

• Convene a two-day technical working session with stakeholders, including harm reduction advocates, to address the Attorney-General's comments and prepare the revised L.I. for resubmission
• Follow up with Ghana Health Service and convene the stakeholder validation meeting for the OAT Readiness Assessment Report and Implementation Roadmap
• Print the completed training manual and work with NACOC towards its formal launch
• Continue engagement with SPH, POS Foundation and IDPC on the Parliamentary Executive Short Course, including potential co-funding
• Sustain district-level engagement and participation of harm reduction advocates

Year 2 Delivery Agenda (to May 2027)

• Sensitization of 220 law enforcement officers using the validated manual
• High-level dialogues with the Parliamentary Select Committees on Health and Interior
• Facilitation of the passage of the Harm Reduction L.I. by Parliament
• Finalisation of the National OAT Implementation Roadmap on validated assessment findings
• Roundtable engagement with the Ministry of Gender and Social Protection and the Ministry of Agriculture
• Continued positioning of harm reduction within national policy and coordination structures

EMERGING OPPORTUNITIES

Piloting OAT, Not Only Preparing for It

The readiness assessment identifies candidate sites and recommends a small, tightly controlled pilot. Preparation is funded; piloting is not.

Closing the Gaps the Assessment Named

OAT-specific workforce, medicine registration and financing were identified as the priority gaps. Each requires dedicated technical work beyond the current scope.

Taking the Manual to Scale

The validated manual standardises national training. The grant funds sensitization of 220 officers; institutionalising it more widely is a natural next step.

Sustaining the Advocate Cohort

Structured engagement for the 30 trained advocates is an identified risk. Dedicated support would protect the investment already made.

Public Education on Harm Reduction and Related Stigma

Stigma remains a brake on implementation. No activity line/funds public-facing communication.

Accompanying the L.I. into Implementation

Passage is the milestone, but regulations require implementation guidance, institutional readiness and monitoring once made.

THANK YOU

Let's Get Social:

@wapcas_cso | @wapcascso

WAPCAS Plus / OSF BRIDGE Project
Building Reform, Inclusion, and Drug Governance Equity in Ghana