Pharmaceutical Supply, Regulation, Infrastructure, And Access In Ghana: A National, Regional, And District-Level Analysis

Ghana spent USD 275.8 million importing pharmaceuticals in 2022, yet 84 of 261 districts hold no licensed pharmacy as at 2024, according to Pharmacy Council Ghana's List of Pharmacies in Good Standing, and a further 15 serve populations exceeding 180,000 from a single outlet. This paper presents the first national analysis linking four administrative datasets-GSS trade microdata (2022), FDA (Ghana) product registrations as at 2026, Pharmacy Council Ghana's List of Pharmacies in Good Standing (2024), and the 2021 Population and Housing Census-to characterise Ghana's pharmaceutical sector from international import to district-level access. India supplied 55.3% of total import value (USD 144.2 million), and a single catch-all classification code (HS10: 3004909000) concentrated 62.6% of all import value; an analysis of FDA (Ghana) product registrations identified antimalarials, antibiotics, analgesics, NSAIDs, and supplements as the dominant therapeutic classes among registered drug products, providing indicative context for the therapeutic profile of unclassified imports. Of 18,292 FDA-registered products, 74.8% are imported and domestic manufacturers account for just 16.9% of drug registrations. The 3,745-outlet licensed pharmacy network delivers a national average of 12.1 pharmacies per 100,000 population; however, Pharmacy Council Ghana's List of Pharmacies in Good Standing revealed a 105-fold disparity between the Accra Metropolitan Area (220.6 per 100,000) and the most underserved districts (0.53 per 100,000). Greater Accra holds 52% of all licensed pharmacies despite comprising 17% of the national population. Five regions-North East, Savannah, Western North, Upper East, and Northern-exceed an HHI of 5,000, indicating near-monopoly pharmacy market conditions. These findings reveal a pharmaceutical sector structurally bifurcated between a heavily import-dependent supply chain and a geographically fragmented distribution infrastructure that systematically excludes large segments of Ghana's population from licensed pharmaceutical access.