Caught in the Middle

The first three years of the López Obrador administration have passed and the country stands in the middle of the presidential term. It is an “eye of the storm” moment. We are starting the second half with a greatly shuffled Cabinet that strengthens the president’s so-called inner circle, and with the aim of consolidating his so-called 4th Transformation. 

We have a new minister of the interior (Adán Augusto López) who is likely to be a stronger negotiator of the country’s internal politics and governance; a stronger finance minister on board (Rogelio Ramírez de la O) who will try to improve the tax recovery process, as well as establishing economic policies favoring consumption and trade; a recently announced new governor of the Bank of Mexico (Arturo Herrera) who will be ever more vigilant of managing inflation and maintaining a strong peso despite the downswing of our economy, and another close adviser on legal matters will surely be appointed soon as a result of the resignation of Julio Scherer.

Caught in the middle of all this, just like many other key economic and social sectors, is the pharmaceutical industry, which continues to strive despite this uncertain and critical moment. We are in the middle of the COVID pandemic with a vaccination process that is still very much behind what the country needs. We are caught in the middle of a public healthcare system that has not been able to provide universal health coverage as promised, with the Institute of Health for Well-Being (INSABI) and other institutions that are not operating as best practices recommend, with hospitals that have a seen a supply rupture in the availability of medicines, devices and equipment and a shortage of manpower to support our nation’s healthcare need and well-being.

We are caught in the middle of having the UNOPS manage the Acquisition of Medicines for the Health System, with only approximately 46 percent of the approved codes delivered and accepted within our national formulary — the remaining 54 percent has been executed via direct purchases at potentially higher costs. Critical patients in the fields of oncology, transplants, degenerative illnesses and many others stand in the middle of a real tragedy, not knowing if treatments for life-threatening diseases will be delivered in time and in the quantity required.

We do know that our public healthcare officials are working hard to revert this status quo but it remains fully unsolved. Time is running out and it is a call to duty for all our private and public healthcare systems to continue to work together more than ever, to drive and build the necessary flows to assure that universal coverage is granted as a fundamental right for all our population and that our systems are accountable for that.

We hear our president saying that in the past there was corruption within the healthcare systems and among some of its stakeholders. It is likely that, yes, to some extent, some people participated in corrupt practices but there were also many players (most of them, in fact) who worked and continue to work, produce, research, develop and bring to the market goods that are in line with all the ruling guidelines and in accordance with the highest ethical and compliance structures and organizations (internal and external), while following the most rigorous best practices. In the past, despite the so-called “corruption monster” that reigned over the systems, medicines were available and within reach of most of the population, and these medicines also had no cost, or at least not an out-of-pocket expenditure.

The public and private healthcare stakeholders will need to continue their joint efforts to release the health system from the current crisis. It is time to build discussions, plans, actions, resources, access and innovation to build a more predictable and promising scenario for the three coming years. It is time to step away from being caught in the middle of the current scenario of low and scarce availability of medical-related products and services, which negatively and continuously impacts our society and its well-being.