GHS Digital Health Systems Collapse Nationwide Over US$64,510 Cloud Bill

Ghana’s public health data infrastructure has been plunged into crisis after the Ghana Health Service’s cloud hosting provider switched off all ten servers supporting its electronic health information systems, forcing a nationwide return to paper records and exposing the fragility of the country’s digital health ambitions.

The shutdown, which took effect on October 29, 2026, has paralysed the District Health Information Management System (DHIMS2)—the backbone of national health reporting—along with a constellation of other critical platforms used for disease surveillance, budgeting, and birth registration. At the centre of the crisis is an outstanding cloud hosting bill of US$64,510.95 owed to Akamai, the Service’s United States-based hosting provider.

In an internal memo dated November 2 and addressed to regional and divisional directors, the Director-General of the GHS, Dr Samuel Kaba Akoriyea, confirmed that the provider had deactivated all ten servers. He moved swiftly to reassure staff that the incident had not compromised data security.

“There has been no security breach, and no data has been lost. Nightly encrypted backups of every system are held outside the suspended account and are current to 29th October 2026,” Dr Akoriyea stated in the memo .

A Cascade of Failures

The suspension has disrupted operations across the entire health sector. DHIMS2, which health facilities rely on for data entry, validation, analysis, and report extraction, is completely unavailable. The Planning and Budget Management Information System (PBMIS), used for accessing institutional plans and budgets, has also been affected.

Other platforms rendered inaccessible through their web interfaces include eTracker, the Family Planning and Health Care (FPHC) platform, Operational Training and Supervision Support (OTSS) assessments, and the Non-Communicable Disease (NCD) tracker. While their Android capture applications can continue operating offline, the data cannot be uploaded until service is restored .

The HIV and tuberculosis trackers, along with the ISRS sample tracker, have lost both web access and laboratory integration. The National Malaria Data Repository (NMDR), the Events system for inpatient morbidity and mortality, SMS alerts, the transport system, and the Community Health Information Management (CHIM) portal are also among the affected platforms.

Critically, the shutdown has interrupted the data-exchange gateway responsible for transmitting birth notifications to the National Identification Authority and the Births and Deaths Registry—a disruption with implications extending far beyond the health sector .

A Directive to Return to Paper

To prevent a complete collapse in health reporting, Dr Akoriyea has directed health facilities and districts to revert to paper-based systems. Staff have been instructed to complete registers and monthly summary forms manually so that data for October and November 2026 can be entered into DHIMS2 once access is restored.

“Facilities and districts should keep completing registers and monthly summary forms on paper so that October and November 2026 data can be entered once DHIMS2 is restored,” the memo directed. Regional and district health information officers have been asked to file the forms by facility and month .

Two Paths to Recovery

The Director-General outlined two options for restoring the affected systems. The first and quickest is to settle the outstanding balance and reinstate the existing Akamai account, which would restore all systems to their previous state without requiring them to be rebuilt from scratch.

The second option would involve procuring new servers and rebuilding the systems using existing backups—a process that could take up to six weeks after the required capacity is procured, leaving the systems offline throughout the reconstruction period .

Dr Akoriyea disclosed that the GHS was finalising arrangements with Akamai and seeking approval for the US$64,510.95 payment. He appealed to the sector minister to support efforts to expedite the approval process.

“Once services are restored, the Service will plan any move to a Ghana-based provider as a controlled project. That project will include a parallel run and a funded backup arrangement,” he stated, signalling a strategic shift towards local hosting to prevent a recurrence .

Background: A Troubled Digital Transition

The crisis unfolding at the GHS is not without precedent. It follows a separate and far more damaging incident involving the Lightwave Health Information Management System (LHIMS), which was shut down abruptly in 2025, rendering medical records dating back to 2020 inaccessible across public facilities. That disruption forced clinicians to rely on exercise books and patient folders, with specialists at Komfo Anokye Teaching Hospital warning that the loss of historical patient data was compromising their ability to manage chronic illnesses and conduct vital research .

The government subsequently announced a replacement system, the Ghana Health Information Management System (GHIMS), citing contractual breaches by the LHIMS provider. But the current DHIMS2 shutdown raises fresh questions about the sustainability and governance of the country’s digital health infrastructure.

DHIMS2 itself was deployed nationwide in 2012 to replace fragmented paper-based reporting, and has since become the central platform for routine health data collection across public, private, and faith-based facilities. It supports reporting from facility to district, regional, and national levels, informing planning and policy decisions . The system has previously faced server-related challenges, including data download and upload bottlenecks, and capacity constraints in cybersecurity and data management have been identified as areas requiring strengthening .

A Fragile Foundation

The shutdown has exposed a troubling paradox: a health system that has invested heavily in digital tools for disease surveillance, malaria tracking, and HIV monitoring is now dependent on a single foreign cloud provider—and vulnerable to a bill equivalent to roughly GH₵800,000 at current exchange rates.

For a service already grappling with resource constraints, the US$64,510.95 payment represents both a financial burden and a test of political will. The appeal to the sector minister for expedited approval underscores the urgency, but also the bureaucratic hurdles that stand between a suspended account and restored services.

Until then, health facilities across Ghana will continue to record patient data by hand, hoping that the paper registers and monthly summary forms will bridge the gap until the servers flicker back to life—and that the October and November 2026 data will find its way into a system that, for now, exists only in encrypted backups held outside a suspended account.