Before Ghana Buys 400 New Ambulances, Let’s Account for the Ones We Already Bought

When the government announced plans to procure 400 new ambulances to strengthen emergency medical services, many Ghanaians welcomed the news. Emergency response is literally life or death. But in Ghana’s long ambulance history, there’s an inconvenient pattern: we celebrate procurement, then struggle with maintenance and usage. Before we embark on the next big purchase, we must honestly account for what we already have, how it has been managed, and why so many ambulances end up idle or improperly used.

A System Born from Tragedy and Early Success

Ghana’s formal National Ambulance Service (NAS) was established in 2004 as part of a deliberate effort to build a structured pre-hospital care system in a country where previously most emergency transport was informal and uncoordinated. The service began as a pilot with 9 ambulances, seven stations, and 69 trained emergency medical technicians (EMTs). Over the next decade, this expanded significantly: by 2014, the NAS operated 199 ambulances at 128 stations and employed 1,651 EMTs and support staff, extending coverage from 9% of the country to roughly 81%. This was real system development, not just truck distribution, as ambulances began to attend roadside emergencies and inter-facility transfers alike.

Alongside vehicles came EMT training, dispatch protocols, and incremental funding. This foundational decade showed that Ghana could build an emergency response system from scratch, an achievement often overlooked amid later procurement controversies.

The “Big Batch” Era: 307 Ambulances and the One Constituency Promise

The political spotlight on ambulance procurement intensified in the late 2010s. In January 2020, President Nana Addo Dankwa Akufo-Addo commissioned 307 new ambulances under the “One Constituency, One Ambulance” initiative, a 2016 campaign promise aimed at placing a vehicle in every one of Ghana’s 275 constituencies. The Ministry of Health noted that before this delivery, there were only about 50 functioning ambulances nationwide, highlighting how stretched the fleet had become.

Government spokespeople also cited improvements in ambulance-to-population ratios after the deployment, contrasting earlier times when one ambulance served approximately 524,000 people with a ratio closer to one per 84,000 after the 307 were introduced.

This was undeniably a landmark moment. Hundreds of vehicles were delivered and distributed, digital dispatch systems were touted, and recruitment of additional EMTs was promised.

But What Happened After the Commissioning?

Unfortunately, the story does not stop at distribution.

In late 2023 and early 2024, multiple sources indicated that a significant number of the 307 ambulances were non-functional. Reports suggested that as many as 91 of the 307 vehicles commissioned under the initiative were already broken down or unserviceable, raising immediate questions about durability, maintenance arrangements, and fleet sustainability.

Separate media reporting around the same period captured interviews and briefings from NAS officials noting that only a portion of the national fleet was operational, with one report citing that out of 155 ambulances, only about 50 were active, illustrating that challenges persisted even after the 307-unit expansion.

In practical terms, this means Ghana may have spent millions importing ambulances that are no longer on the road, trucks parked in yards or out of service due to wear, parts shortages, or systemic maintenance issues.

Maintenance: The Silent Crisis in Emergency Care

The problems aren’t just mechanical, they’re managerial.

Ambulances are specialised vehicles. They require routine servicing, parts replacement, trained mechanics, and predictable funding. Yet in Ghana, maintenance has often been treated as an afterthought, paid lip service only after the next purchase is announced. Leaked reports and public debates over spare-parts contracts, including high-figure allegations involving after-sales servicing, point to governance gaps and a lack of transparency in how routine upkeep is funded and executed.

This disconnect isn’t unique to Ghana. Ambulance services worldwide emphasise lifecycle planning as much as procurement itself. But in Ghana’s case, the “procurement event” tends to overshadow the long, daily slog of keeping vehicles on the road.

Incidents of Misuse: Trust Erodes When Systems Are Abused

Compounding the maintenance issue is public perception and occasional misuse. Viral footage and local reporting have shown ambulances being used for purposes unrelated to emergency response, for example, transporting cement or goods. While investigations sometimes reveal these to be misattributions or vehicles awaiting integration (as National Ambulance Service representatives have occasionally clarified), the very fact such footage circulates erodes trust and highlights weak control systems around fleet usage.

National legislation, including the National Ambulance Service Act, criminalises misuse and false representations that divert emergency resources. But laws without enforcement are window dressing. Ambulances must be treated operationally as critical health infrastructure, not logistical conveniences.

Why the Government Must Account Before Buying More

Ghana should not shy away from expanding emergency medical capacity. Ambulances are essential. But expansion must be justified, transparent, and sustainable.

Before the proposed procurement of 400 new ambulances, government should commission a public, auditable fleet inventory showing how many ambulances were bought in prior batches, how many are currently operational, how many are non-functional, and why they are off the road. This report should not be compiled behind closed doors, it should be published, indexed by region and constituency, and subject to parliamentary and civil society scrutiny.

Maintenance costs should be clearly accounted for, with multi-year plans that show not just purchase price but projected expenditures over the vehicles’ useful lives. After-sales service contracts must be transparent, with penalties for non-performance, and incentives for uptime.

Crucially, enforcement mechanisms against abuse and misuse must be strengthened. Ambulances should be fitted with GPS tracking, monitored for authorised use only, and tied into national dispatch systems that prioritise emergency calls.

A Survival Story, Not a Partisan One

This is not about politics. It is about survival, mothers in labour, accident victims on the roadside, families calling for help in the middle of the night. They do not care which government bought an ambulance. They only know whether it arrives when they need it.

Ghana does not have an ambulance procurement problem. Ghana has a fleet sustainability problem. Until we fix the underlying governance, maintenance, and accountability systems, we will keep repeating the cycle of flashy commissions followed by silent breakdowns.

If 400 new ambulances are coming, that is good news. But before the ribbon is cut, the country deserves answers. Because emergency response is not about politics. It is about whether, at 2:17 a.m., when someone dials for help, the siren actually sounds.