Inside Mexico’s Regulatory Thought Process

We began 2026 with both literal and metaphorical shakeups. From ongoing geopolitical tensions around the world to a 6.5-magnitude earthquake that jolted a large part of Mexico awake on Jan. 2, the year started with a reminder that stability, both physical and institutional, is never guaranteed. 

For those of us working closely with Mexico’s healthcare and regulatory ecosystem, one particular announcement stood out far more than tremors in the ground.

The most surprising news came from Mexico’s Minister of Health, Dr. David Kershenobich, who announced that Dr. Víctor Hugo Borja would assume leadership of COFEPRIS, Mexico’s primary regulatory authority. For those who don’t know, COFEPRIS functions as Mexico’s equivalent of the FDA, overseeing food safety, medications, medical devices, clinical research, and broader public-health protections. Any leadership change at this level sends ripples across the entire healthcare sector.

This appointment also meant the removal of Dr. Armida Zuñiga, who had been leading COFEPRIS since late 2024. While I have no doubt that COFEPRIS remains in capable hands under Dr. Borja, I was, and remain, deeply shocked by the decision itself.

Dr. Zuñiga is not only a respected chemist and researcher, she is also a seasoned academic and regulator with a reputation for transparency, technical rigor, and ethical leadership. I know her personally, and I know firsthand the seriousness with which she approached the role. In a country where regulatory opacity has historically been one of the greatest obstacles to innovation and compliance, her tenure represented something rare: institutional credibility built on knowledge rather than politics.

Leadership changes are not inherently problematic. In fact, renewal can be healthy. What is troubling is how and when these changes occur, especially in environments that desperately need continuity. Regulatory bodies do not function like political campaign teams; they require long learning curves, technical depth, and institutional memory. Abrupt shifts at the top risk dismantling progress before it has time to consolidate, something we’ve known well enough in Mexico, especially when it comes to healthcare.

This concern extends beyond a single bureaucratic appointment. It reflects a broader pattern we continue to observe in Mexico’s public health discourse: inconsistent messaging, reactive policymaking, and a tendency to favor prohibition over regulation, even when evidence clearly points to the opposite.

A clear example is the government’s stance on vaping devices. Instead of pursuing strict regulation, such as age controls, quality standards, traceability, and enforcement, we ended in outright prohibition. Worse still, early versions of proposed legislation included language that criminalized not only manufacturers and distributors but also end users. That alone should have triggered alarms.

History has taught us, repeatedly, that prohibition does not eliminate demand. It merely displaces it into informal and criminal markets, where safety, quality, and accountability disappear. We are already seeing this play out. The black market for vaping products continues to grow, unregulated and untaxed, while legitimate actors are pushed out. From a public health standpoint, this is not just counterproductive; it is downright negligent.

What worries me most about sudden regulatory shifts and prohibitionist impulses is not their political cost but their human one. In healthcare, inconsistency translates directly into harm. Patients delay treatment. Physicians hesitate. Ethical companies hold back investment. Meanwhile, illegal markets thrive precisely because the legal pathway is unstable or unclear.

As someone who has spent years building within the legal medical cannabis space, I can say this without exaggeration: progress in healthcare is fragile. It depends on trust. Trust between regulators and industry. Trust between doctors and patients. Trust that the rules will not change arbitrarily and that expertise will be valued over optics.

For years, Mexico oscillated between silence, prohibition, and legal ambiguity around medical cannabis. Patients were left in limbo. Doctors were unsure how, or whether, to prescribe. Regulators issued partial frameworks that were difficult to operationalize. Only recently has the system begun to move toward something resembling a functional model, primarily through regulated compounded medications (“medicamentos magistrales”) under medical supervision.

Yet, even now, we see contradictory signals. On one side, recognition that medical cannabis is legal and regulated. On the other hand, persistent narratives, sometimes from within the government itself, blurring the line between therapeutic use, supplements, and illicit products. This inconsistency fuels confusion, misinformation, and opportunism.

It’s discouraging to learn that the fewer of us who continually fight for a regulated market are at a crossroads between what is ethically right and what the government is pushing forward; learning that permits and regulatory processes for bringing innovative medications, much needed for refractory patients, are in a self-imposed limbo due to political and ideological views, rather than that of the care of the general population.

If we want safer patients, better science, and legitimate access to innovation, we must demand regulatory consistency, respect technical leadership, and stop mistaking prohibition for protection. The cost of getting this wrong is not abstract. It is measured in delayed treatments, lost trust, and missed opportunities to do better.

Removing a technically solid, transparent regulator without clear public reasoning undermines that trust. Pushing prohibition where regulation is needed further erodes it.

This is not an argument against change. It is an argument for thoughtful change. For continuity where continuity is necessary. For reform guided by data, not fear. And for recognizing that modern public health challenges, whether cannabis, vaping, or emerging therapies, cannot be solved with blunt instruments. Regulatory credibility is not built through headlines or hardline positions. It is built through coherence. Through stable leadership. Through policies that acknowledge complexity instead of denying it.

Mexico has the talent, the institutions, and the scientific capacity to build a world-class regulatory environment. But doing so requires resisting short-term political reflexes and committing to long-term institutional maturity.