By way of instruction, not flattery: great legacies are rarely the work of a single headline—they are architectures of policy, courage, and moral imagination. If President John Dramani Mahama seeks to be remembered not just as a politician but as a nation-builder whose name sits in gold, he should pursue a small number of transformative, deliberately sequenced projects that change how Ghanaians live, feed themselves, heal, and trust their institutions.
“Sankofa: We must go back and fetch what we need.” — Akan wisdom
A single signature hospital—planned as a centre of excellence, linked to teaching and research, and accredited to international standards—can shift perceptions of an entire health system. Think beyond a building: an ecosystem of specialists, intensive care, oncology, cardiac surgery, transplant and advanced diagnostics, coupled to telemedicine nodes that extend expertise to district hospitals and diasporic patients.
- Thailand’s Bumrungrad International Hospital: Attracts over 500,000 international patients annually, generating billions in medical tourism revenue and retaining top medical talent.
- South Africa’s Netcare Group: Developed specialized centers for cardiac and cancer treatment, creating Africa’s leading private hospital brand.
- India’s Apollo Hospitals: Combined affordable care with cutting-edge technology, making India a medical tourism hub.
Practical steps:
- Commission a rapid feasibility and market study (demand, visa flows, insurance markets, partnerships).
- Structure as a PPP with international clinical partners (academic medical centers), and target Joint Commission International (JCI) or equivalent accreditation.
- Prioritize training: scholarships and fellowships for Ghanaian specialists, surgical fellowships, nursing academies attached to the hospital.
- Make telemedicine and remote diagnostics core from day one; export expertise digitally to West Africa and the Ghanaian diaspora.
- Offer fast-track patient visas, transparent pricing, and international patient liaison services to attract higher-margin medical tourism.
Why this matters: Ghana has long aspired to regional medical leadership. If all politicians and public officials pledge to use this facility—and if it is stocked with
every diagnostic and treatment equipment needed for all ailments—it will restore public confidence and keep scarce foreign exchange within Ghana.
2) Make Ghana the breadbasket of West Africa — irrigation, processing, storage, and markets
A nation that feeds its region builds wealth, food security, and pride. The “breadbasket” is not a slogan; it is an industrial plan: irrigation across strategic basins, greenhouse clusters for high-value horticulture, silos and cold-chains, and agro-processing factories that turn raw cereals, legumes and fruits into exported value.
- Israel’s Negev Desert: Transformed barren land into an agricultural powerhouse through drip irrigation, water recycling, and greenhouse farming.
- Vietnam’s Mekong Delta: Became the world’s second-largest rice exporter through strategic irrigation, farmer cooperatives, and agro-processing.
- Ethiopia’s floriculture sector: Leveraged greenhouses, irrigation, and air- cargo infrastructure to become one of the world’s top flower exporters.
- Demarcate and license irrigable zones (Volta Basin-type anchors), paired with water management governance.
- Invest in pumps, canals, and solar-driven irrigation. Establish “agriculture service stations” for mechanization, inputs, and maintenance.
- Create agro-processing corridors—rice, maize, cassava, legumes, fruit canning—that guarantee offtake through anchor buyers and ECOWAS trade deals.
- Offer long-term land leases to youth cooperatives and agribusiness incubators, de-risking investment through blended finance.
- Build modern silos and buffer stocks to stabilize prices and prevent post- harvest loss.
A breadbasket program that is climate-smart, digitally monitored, and market- oriented will create jobs, stabilize prices, and position Ghana as West Africa’s food hub.
The environmental damage of uncontrolled artisanal and illegal gold mining— riverbed destruction, mercury contamination, and loss of arable land—is plain and undeniable. A legacy that saves rivers and land requires a dual approach: (A) hard remediation and strong enforcement where criminality persists; (B) humane and economically sensible formalization for artisanal miners, with demarcated ASM zones and alternatives for livelihoods.
- Mongolia: Created legal frameworks for artisanal miners to work under cooperatives, eliminating mercury and improving incomes.
- Peru: Piloted “responsible gold certification,” linking artisanal miners to ethical global markets.
- Tanzania: Built centralized mineral trading centers to formalize small-scale gold sales and reduce smuggling.
Policy instruments that work:
- Map and demarcate ASM zones; create legal, licensed cooperatives with mandatory environmental standards.
- Provide low-cost, clean-tech wash plants that eliminate mercury, subsidized through output-linked grants.
- Institute mandatory land rehabilitation bonds and community monitoring committees.
- Build gold traceability and formalized buying centers, while pairing enforcement with alternative work programs (agriculture, infrastructure, training).
- Partner with international agencies to clean waterways and rehabilitate floodplains.
Principle: “Force without reason breeds resistance; reason without force breeds neglect.” Enforcement must be paired with pathways out of poverty.
4) Tackle corruption — institutional reforms that outlast any single administration
Durable legacies require trust in institutions. Weak anti-corruption outcomes reduce investment, slow infrastructure delivery, and erode the moral claim of governance.
- Estonia: Digitized procurement and government services, making corruption nearly impossible in daily transactions.
- Botswana: Maintained one of Africa’s best anti-corruption records through strong institutions and diamond revenue transparency.
- Georgia: Reformed its police and public procurement systems, moving from one of the most corrupt to one of the least corrupt post-Soviet states.
- Deepen e-procurement and open contracting, with real-time public dashboards.
- Strengthen independence of anti-corruption agencies and the Auditor- General with protected funding.
- Publicly publish asset declarations and accelerate corruption prosecutions.
- Reward whistleblowers and protect them.
- Tie extractives, procurement, and infrastructure sectors to performance contracts with KPIs and transparent reporting.
Transparency is not a slogan—it is the foundation for every other reform.
Financing, sequencing and metrics
- Financing: Blend concessional finance, PPPs, diaspora bonds, and targeted development loans. Use catalytic public equity to attract private anchor investors.
- Sequencing: Quick wins (telemedicine expansion; pilot greenhouses; formalization pilots for ASM) build credibility while big-ticket projects (hospital, irrigation estates) move through construction.
- Metrics:
o Hospital: JCI accreditation, inbound medical tourists/year, specialist retention.
o Agriculture: hectares irrigated, yield/ha, export volumes, post-harvest loss reduction.
o Galamsey: hectares rehabilitated, % licensed ASM operators, mercury levels in rivers.
o Governance: CPI score, number of prosecutions, procurement savings.
Final reflection — legacy as moral architecture
A political life can be measured by speeches or by the institutions left behind. President Mahama’s moment—if he chooses it—could be to stitch together four legacies: human dignity (healthcare), food security (agriculture), environmental stewardship (water and land), and moral governance (anti- corruption).
When a nation’s hospitals are safer, its fields are full, its rivers clean, and its institutions trusted, the memory of leadership becomes more than a slogan—it becomes the story parents tell their children.
As the wisemen say, “To whom much is given, much is expected.” Ghana has given H.E. Mahama a resounding victory; if he delivers beyond expectations, his name will be cemented in crystal gold.
“If you want to go far, go together.” — West African proverb
If President Mahama binds these projects to credible institutions, clear metrics, and shared purpose, he will not merely seek a place in history; he will have built it.