The cost of staying alive: diabetes, hypertension and the price of a working life in Ghana

Diabetes and hypertension pose significant threats to the health, livelihoods, and productivity of working-age individuals in Ghana. These chronic illnesses can disrupt employment, financial stability, and overall wellbeing. Two personal accounts illustrate the human impact and the urgent need for early detection, accessible treatment, and supportive work environments.

Trudy Nartey, a 45-year-old, was diagnosed with diabetes in her twenties. Her condition requires ongoing care, leading to challenges in maintaining employment. She frequently requested permission to attend medical appointments and receive treatment at a private company, which eventually led to her termination. She remained unemployed for nearly two years while struggling to afford her medication before securing a position in the government sector.

Kwesi Yeboah Nketiah, a 31-year-old, discovered he had hypertension during a frightening medical emergency. After being hospitalized for managing his blood pressure, Kwesi now takes medication regularly. He worries about the long-term commitment of taking drugs throughout his life and the psychological adjustment that comes with managing a chronic disease diagnosis.

The World Health Organisation (WHO) reports a concerning trend globally. The number of people living with diabetes has risen from 200 million in 1990 to 830 million in 2022, with approximately 14 percent of adults aged 18 and older affected. Hypertension is equally alarming, with around 1.4 billion adults aged 30 to 79 living with the condition in 2024, and 44 percent unaware of their diagnosis, while only 23 percent have their blood pressure under control.

Ghana's figures echo this urgency, with nearly 22 percent of adults aged 18 to 69 having hypertension and nearly 5 percent with raised blood glucose levels, according to the 2023 WHO STEPwise Approach survey.

Dr Abdul Wahab Agbeve, Director of Agbeve Hospital, warns that diabetes and hypertension can severely impact workplace productivity, increase healthcare expenditures, and impose financial and psychological burdens on patients and their families. He emphasizes the potential for these conditions to damage vital organs like the kidneys, leading to chronic kidney disease and even kidney failure. Regular medical monitoring is crucial to prevent complications, as early stages often show no symptoms.

The economic consequences of these chronic illnesses extend beyond medical bills. Medical appointments, periods of illness, and hospital admissions can disrupt work schedules, and serious complications may impair a person's ability to perform usual duties. Employers may face staffing pressures and additional costs, while workers may worry about lost earnings, job security, and long-term treatment affordability.

However, chronic illness does not necessarily equate to unproductivity. With appropriate care and reasonable workplace support, many people living with diabetes or hypertension can continue to work effectively. Trudy's experience highlights the difficulties that can arise when employment arrangements do not accommodate continuing healthcare needs, while Kwesi's concerns showcase the emotional adjustment required in managing a chronic disease diagnosis.

Dr Agbeve's observations underscore the importance of early diagnosis and appropriate treatment to reduce the risks associated with these conditions.