India Plans to Accelerate Reform of National EMS Sector

India plans to accelerate the reform of the national EMS over the next year, with an eye to service improvements and better healthcare for citizens.

A September 2025 article in the Indian Express cited some of the country’s senior officials in the field of EMS who said that despite the ongoing boom of the Indian economy, the country’s EMS sector continues to deteriorate.

Ambulance services in India operate primarily as patient transportation services. In recent years, local authorities have made serious attempts to launch more comprehensive EMS services focused on prehospital emergency services, however without any significant results.

Local analysts say the current situation in the country’s EMS is complex. A 2020 study from the All India Institute of Medical Services and the government think tank Niti Aayog found that about 90% of ambulances lack essential medical equipment, 95% are operated by untrained personnel, and 98.5% are primarily used to transport the deceased rather than respond to emergencies.

The 2024 report “Going Beyond Patient Transfer” by consultancy firm Primus Partners, said better efficiency of local EMS is an acute need for India, giving the country’s high road traffic fatality rate at 18.9 per 100,000 population, significantly higher than the global average of 8.7 in high-income countries.

As of 2024, 17,495 ambulances were in operation in the country and only 3,441 were equipped with modern equipment. Data also showed that one in 10 patients die during transport to the hospital. In the Northeastern states of the country, only 26 ambulances, 19 of which are BLS only, are in service.

One of the reasons of the current crisis is the shortage of funding. In fact, the entire system of public health in India has always been heavily underfunded, which has led to shortages of other healthcare professionals. India spends a little over 2% of its GDP on public healthcare, one of the lowest in the world. The country’s citizens bear significant costs on EMS and healthcare spending. These high costs are reflected in official reports that only 14% of Indians call for ambulance services; during the pandemic, that number dropped to single digits. The import of Russian oil to be refined and exported to India slightly improved funding, but EMS leaders continue to call for reform.

One goal of improvement involves the development of private ambulances in the country, reducing overall utilization with more options for patients. According to recent statements made by the Family Welfare Secretary Aswathy S. of Odisha State, the government has outlined plans for a standardized regulatory framework for domestic EMS, with a focus on the development of private EMS operators. As part of these plans, all private ambulances will be integrated into a unified platform, while their operators will receive serious subsidies from the state.

According to Odisha Transport Secretary Usha Padhee, these measures will significantly improve emergency response times, particularly in remote areas of the country. This is especially important given that a significant part of the Indian 1.4 billion population (up to 65% of the overall population) still lives in poor, rural areas where an access to quality EMS is complicated and limited.

The Indian government also plans to take measures to prevent strikes of Indian EMS and healthcare workers like those in 2023-24. These were strikes were instigated by a poor level of safety of the local medical personnel, including ambulance doctors. In recent years the Indian EMS and healthcare sectors have faced numerous attacks on paramedics and doctors in healthcare facilities throughout the country, which sparked serious criticism from the public.

The most high profile case took place in the summer of 2024 when a medical trainee at a government hospital in Kolkata was raped and murdered. That led to massive protests in the country mostly from representatives of the Indian medical community, which accused the authorities in the inability to ensure their safety. The government has promised to take action to increase the level of safety of domestic medical personnel; however, attacks on doctors and paramedics are ongoing.

Local analysts predict the demand for high quality EMS will continue to grow in India in years to come, which is also due to the country’s growing middle class. Thanks to the ongoing cheap oil supplies from Russia, the Indian government plans to continue spending on the development of domestic healthcare and EMS infrastructure, particularly new hospitals and ambulance departments and the modernization of existing facilities. In addition, there are also plans to attract private investments to the industry. Part of this investment is expected to be allocated in the purchases of new ambulances. Of these, particular attention will be paid for the more active purchases of high-tech ambulances with telemedicine facilities, which will be crucial for providing EMS in difficult terrain.