Mexican Central Government Takes Action Against Irregular Ambulances
The central government of Mexico plans to take serious measures to raise the efficiency of domestic EMS, as operations continue to spark criticism from local people and patients.
In spite of Mexico’s recent economic boom from nearshoring, the country’s healthcare and EMS sectors are far from being a standard in Central America.
One of the reasons is a lack of funding allocated for development. The population of Mexico has almost doubled in four decades, but spending on health has been decreasing. The World Health Organization (WHO) recommends a minimum of 9% of GDP; Mexico’s healthcare budget is estimated at about 5.5%. This puts Mexico far from the health expenditure of Denmark—used as a reference by former President López Obrador—which is 9.5% of GDP, among the highest in the world. Mexico’s spending trend has been downwards in the last 16 years, contrasting with other Latin American countries such as Cuba, Brazil, Argentina, and Chile.
The pandemic became a terrible test that Mexico and its EMS sector had to go through, as staff shortages, lack of budget, and several wrong decisions, resulted in the country being ranked fourth for deaths and first in terms of deaths of health workers.1
Former president Andrés Manuel López Obrador included among the 100 commitments of his government the establishment of a first-class, universal, free and quality health and EMS system, with sufficient general practitioners and specialists, diagnostic studies in health centers and ambulance departments improved technical equipment. As part of the plans of the former Mexican government, the country’s healthcare and EMS sector are poised to reach standards of the world’s best health and EMS systems like those in the Nordic countries, although the exact timing for achievement of these targets was not disclosed.
Obrador stepped down in 2024 unable to fulfil many of his promises. Claudia Sheinbaum, a well-known Mexican politician was elected into the office as the first woman to hold the titles in Mexico. She has announced major healthcare sector improvements with plans to launch the first phase in early 2027 and a goal of completion by 2028.2
As part of the plans of the new president and the Mexican government, particular attention will be paid for the rise of the quality of EMS in the Mexico City, the capital and largest city. There are plans to complete the digitalization of ambulance dispatch—a personal initiative of President Sheinbaum—and to bring the technical organization of the entire Mexican EMS sector to a new level.
The wait time for a free ambulance in Mexico’s largest cities is 15-20 minutes. This is an improvement from 2018, where waits could extend to 45 minutes. One of the priorities for the government ensuring 15-minute response for at least 80% of emergency cases.
As the number of free and certified ambulances in the Mexico City and other large cities is limited, “irregular” ambulances have filled the gap, albeit poorly. As a rule, the quality of services provided by their crews are poor, which has led to several deaths. Patients are also forced to pay extra costs for these ambulances even before aid is rendered.
According to an investigative report from N+Focus, a Mexican online news outlet, only 116 public ambulances (including those of the Red Cross) service Mexico City. Five hundred more belong to health institutions such as IMSS and ISSSTE, but are only used for inter-hospital transfers. This means that, according to figures from the capital's government, at least 300 irregular ambulances work the territory, creating serious health risks for local citizens. There are also some private ambulances that operate within the city; however, their number does not exceed 70 units.3
According to the WHO standard, there should be four ambulances for every 100,000 inhabitants. Mexico City, with more than 9 million inhabitants, should have 360 licensed units. To improve the quality of EMS services provided and to combat illegal service providers, the authorities of the City of Mexico and the central government have approved the establishment of a register of ambulances.
The situation is also complicated by historical staff shortages. According data from the World Bank, the country’s ratio of nurses to doctors is among the lowest among Organisation for Economic Co-operation and Development (OECD) states,4 and the situation continues to deteriorate. The Sheinbaum administration is expected to push more reforms, particularly around active training of medical personnel to create leading medical institutions. The administration is also expected to create special incentives for providers to work in the most marginalized places of the country with a high crime rate, where, so far, quality EMS have been practically inaccessible.
References
1. Benita, F., & Gasca-Sanchez, F. (2021). The main factors influencing COVID-19 spread and deaths in Mexico: A comparison between phases I and II. Applied geography (Sevenoaks, England), 134, 102523. https://doi.org/10.1016/j.apgeog.2021.102523
2. Meriguet, P. (2026, April 14). Mexico moves toward a universal health system. Peoples Dispatch. https://peoplesdispatch.org/2026/04/14/mexico-moves-toward-a-universal-health-system/
3. Barriguete, A. (2022, August 22). Ambulancias irregulares: lucrar con la emergencia. N+ Focus. https://investigaciones.nmas.com.mx/ambulancias-irregulares-lucrar-con-la-emergencia/
4. World Bank. (n.d.). Physicians (per 1,000 people) – Mexico. World Bank Open Data. https://data.worldbank.org/indicator/SH.MED.PHYS.ZS?end=2022&locations=MX&start=2017
