Andean Group - June 2026

Ecuador’s health system is in crisis, with the country facing shortages of medicines and having cycled through seven health ministers since President Daniel Noboa took office in November 2023. In his state of the nation address on 24 May, Noboa said that an agreement with India would soon open the doors to a “great purchase” of medicines. This cannot come soon enough. As well as being felt in public hospitals, the shortages are now also spreading to health centres which are focused on treating less serious conditions.

A long list of health ministers have successively failed to get a grip on the crisis in the public healthcare system. A 3 December article by local media outlet GK outlined the various causes of the problem, highlighting a steadily decreasing budget for the public health ministry from 2023 to 2025 (falling from US$3.22bn to US$2.80bn); a failure to use the full allowance in these budgets to purchase medicines and equipment; and a lack of forward planning that has been compounded by the regular rotation of health ministers. One minister in particular was roundly criticised for lacking any experience in the health sector; Édgar Lama, who held the role from February-May 2025, had previously been employed as a legal adviser at the Noboa family’s business conglomerate, Corporación Noboa.

The medicine shortages, which have been escalating for months, are growing increasingly acute. Local media outlet Primicias reported on 10 March that the shortages, which were already being felt in hospitals, are now trickling down to health centres that offer more basic care. This suggests that the shortages are expanding from specialised or expensive drugs and are now affecting more day-to-day healthcare products. Primicias previously reported on 2 March that the public health ministry needed around US$687m for purchases of medicines and equipment as outlined in its 2026 operating budget, but that it had been awarded just US$300m by the finance ministry. Of the US$687m total, 72.4% related to medicines, 22% to medical devices, and the rest to surgical equipment.

During his 24 May state of the nation address to congress, President Noboa said that his administration had reached an agreement with India to import “top-level” medicines that have been approved by the US Food and Drug Administration (FDA). He blamed the shortages on “mafias” who he said had been skimming funds destined for medicines whose value they had inflated. In its analysis of Noboa’s speech, Ecuadorean radio station Radio Centro stated that some public hospitals, such as the Teodoro Maldonado Carbo in Guayaquil, had been overpaying by as much as 1,088% in some medicine purchase contracts.

Noboa did not expand on the deal he said his government has reached with India. And he certainly did not elaborate on whether the medicine shortages are being compounded by the trade war he opened with Colombia at the start of the year in response to Colombia’s alleged failure to confront criminal groups in the border region.

A 20 April analysis of central bank (BCE) import statistics by Ecuadorean newspaper Expreso stated that medicine imports from Colombia, which account for around 14% of Ecuador’s medical supply, began falling sharply in February, when the 30% tariff rate came into force (it was subsequently raised to 100% in May before falling to 75% in June). The article highlighted an 87% drop in imports from Colombia of anaesthetics, an 81% drop in penicillin, and a 55% drop in vitamins in comparison with February 2025.

Noboa meets Vance

President Noboa met US Vice President JD Vance at the White House on 13 May, while President Donald Trump was travelling to China for talks with President Xi Jinping. After the meeting, Noboa wrote on social media that “Ecuador and the US are fighting against enemies that don’t recognise borders”. He said that “today we continued to strengthen an alliance based on strength and the decision to confront drug trafficking together”. According to a statement from Ecuador’s presidency, Noboa and Vance “reaffirmed strategic cooperation ties on security, trade, human mobility, energy, and other issues which Ecuador and the US have in common”.