Ghana battles deadly meningitis outbreak amid shrinking foreign aid and health system struggles

In Vuuyiri, a village in Ghana’s Nadowli-Kaleo district, 47-year-old farmer Fuuro Logo watches as his chickens peck at the dry ground outside a thatched house.

A month ago, his younger brother stood there too — a 37-year-old father of four, selling smoked fish to provide for his family. 

Then, suddenly, he fell ill.

“He complained of a stomach ache, diarrhea, and later, headaches, fever and a stiff neck. We rushed him to the hospital, but he died a few hours later,” Logo said.

Today, his brother’s grave lies behind their mud-brick home — one of many fresh spots among the community’s burial grounds.

It marks the deadly grip of a meningitis outbreak sweeping through Ghana’s Upper West region that’s seen more than 200 reported cases and a death toll of at least 17 people. The region lies within Africa’s “meningitis belt” — a stretch of 26 countries from Senegal to Ethiopia where the dry, dusty harmattan seasonal winds weaken respiratory defenses and allow the bacteria to further spread.

“Losing a loved one is hard. It weighs on you, and my brother’s children are struggling to understand. But it’s not just grief,” Logo explained. “We also face gossip and judgment. People see us as the family of the one who died from the disease. It’s really tough.”

Just a few blocks away, Richard Bmailah also lost his sister-in-law, Faakuu Danyagre, to meningitis three weeks ago.

“At the hospital, she couldn’t eat, drink or even say a word. In just five days, she was gone. Just like that,” he said.

Danyagre left behind a husband and five children.

Meningitis is a deadly infection that inflames the membranes surrounding the brain and spinal cord. It spreads through coughing, sneezing and close contact, making crowded households particularly vulnerable.

The symptoms, which include fever, severe headache, vomiting and a stiff neck, can escalate in hours. Without treatment, it can lead to seizures, comas and even death. Survivors often also experience long-term complications, including hearing loss, brain damage or even paralysis.

Living conditions in Ghana’s Upper West region make the situation worse.

The region is one of the country’s poorest. Many families live in small, poorly ventilated mud houses, with few windows. Experts say these cramped, sweltering, airless spaces create the perfect conditions for bacteria to thrive.

But there’s another challenge too: misinformation.

“Some are thinking it is a disease brought by their ancestors, a curse from the gods into the community,” explained Ernest Siepele, a district health promotion officer.

This belief, deeply rooted in tradition, causes people to delay seeking medical care. Instead of heading to hospitals, some turn to prayer camps or traditional healers, hoping for divine intervention instead.

Siepele said it is difficult to change these deeply held beliefs.

“When people see illness as a curse, they don’t just refuse treatment — they also hide the sick, fearing their family will be shunned,” he said. “By the time they seek help, it’s often too late. And if someone dies, it only strengthens their belief that medicine doesn’t work. It’s a cycle we are trying hard to break.”

One of the early casualties of this year’s outbreak was 17-year-old Catherine Bo-ib Beyir-viel.

Her brother, 31-year-old Victor Beyir-viel, has been struggling to make sense of her sudden death.

“I don’t think meningitis killed her. It was a spiritual attack,” he said. “Meningitis was just the means used to take her away.”

Another contributor to the frequency and severity of the outbreaks is rising temperatures and shifting weather patterns. Each year, meningitis cases surge between November and April.

But this current outbreak comes as Ghana’s health system is also on the ropes. Battered by economic struggles, shrinking foreign aid and fragile infrastructure, health authorities are at their wits’ end.

At the Nandom District Hospital, Dr. Mark Padmore Awudi, clinical care coordinator, says hospital staff are under a lot of pressure.

So far, eight people have died at his facility.

“It is worth noting that most of those that died lasted less than 24 hours,” he said. “They come in in distress, some of them come in unconscious, some of them would be gasping for their breath.”

The hospital lacks life-saving equipment, including steady oxygen supplies and functional ventilators.

Until a month ago, when the government made meningitis care free, many couldn’t afford treatment. Patients even had to front the cost of ambulance fuel.  And almost all those who died didn’t have insurance. For those who do have health insurance, it only covers basic treatment, leaving critical medications and procedures out of reach.

Faustina Kuube-ia, a 37-year-old trader and mother of five, recovered inside an isolation ward. Unlike many others, she sought medical help early.

“I was scared I would die and leave my children behind. But now, I feel fine and free of all pains. I am really grateful to God and the doctors for saving me,” she said.

But while doctors fight to save lives, researchers are racing to understand how this new strain of meningitis has evaded immunity.

Past outbreaks were caused by  the Neisseria meningitidis bacteria, which could be controlled with vaccines. But this outbreak is caused by the rare Streptococcus strain, for which there is no vaccine yet.

Instead, doctors rely on antibiotics like ceftriaxone for treatment. But antimicrobial resistance has become a growing concern. Resistance could make the disease spread faster, increase hospitalizations and cause more deaths.

WHO Emergency Preparedness Officer Dr. Sally-Ann Ohene says scientists are studying whether existing vaccines could be updated to offer protection.

“Streptococcus has multiple strains, and current vaccines target specific ones. WHO is now bringing experts together to assess the evidence,” Ohene said. “In the future, they may recommend that when outbreaks like this occur, a modified vaccine could be used.”

At the Noguchi Memorial Institute for Medical Research in the capital of Accra, immunology professor Kwadwo Asamoah Kusi explained the importance of keeping vaccines updated and adhering to strict protocols.

“When bacteria mutate, they can develop new surface proteins and carbohydrates that the immune system no longer recognizes. Vaccines are effective against the older strains, but these new variants evade detection and become dominant,” he said.

He described it as a game of hide-and-seek. Vaccines train the immune system to find and fight specific bacteria. But if those bacteria mutate, the immune system can’t recognize them. That’s why updating vaccines is crucial — to stay one step ahead of the disease.

Even as scientists explore ways to adapt existing vaccines, Ghana’s ability to respond effectively also depends on sustained funding for public health interventions.

A recent freeze on US foreign aid as part of the Trump administration’s America First policy has abruptly halted critical research financing. Once the WHO’s largest state donor, providing about 18% of its funding, the United States has also withdrawn from the agency.

According to government data, Ghana now faces a $156 million funding shortfall due to the aid freeze — a gap that threatens to derail vital health programs.

Last year, USAID pledged $25 million over five years to strengthen Ghana’s health system, but that funding is now suspended. The Ghana Health Service warns of stockouts of essential supplies, disruptions in procurement and setbacks across multiple programs.

“It is a tragedy because around the world, if you talk about research funding, the US NIH (National Institutes of Health) is about the biggest,” Kusi said. “Now that this funding has been cut, we will have disease resurgence, we will have re-emergence, you will have a reversal of some gains that have been made.”

Back in the Upper West region, health workers are fighting the outbreak with whatever they have left. 

Educational posters line the streets, while radio jingles in various local dialects urge residents to avoid crowded places, practice good hygiene, stay hydrated and maintain proper nutrition to reduce the risks.

But experts say awareness alone won’t stop the outbreak. Without urgent medical supplies, a stronger health system, and a vaccine that works, outbreaks like this will keep coming back.

This story was produced with support from the Pulitzer Center on Crisis Reporting.