Mexican Pharma’s Actions in Times of Shortage, Pandemic

In the last three years, we have experienced extraordinary changes. I would even say unthinkable.

On the one hand, the incoming government’s intention to qualify the Mexican pharmaceutical industry as "corrupt" was neither disclosed nor understood at any time; but because President Andrés Manuel López Obrador already had that very established idea, the government made bad decisions that led us to experience a serious shortage of medicines in the health sector, which we continue to suffer today.

The fact of having contracted UNOPS to purchase medicines for the health sector speaks of a total ignorance of what it means to manufacture medicines: buying raw materials, transporting them, analyzing them and manufacturing is a process that takes months. After manufacturing, analyses must be carried out before the final product can be released, which can include stability tests to guarantee the shelf life of the drugs. A typical process can take between six months and one year, depending on global conditions.

In short, the government had the vague idea that buying medicines from other parts of the world would be like going to a pharmacy and shopping for everything that was needed, taking as an example the similarity of going to a convenience store located on the corner. Nothing could be further from reality, which, unfortunately, overcame us in a few months. Finally, the government came across a fact they had little knowledge of: drug manufacturing processes take a long time of planning, production and control, in addition to a process of final logistics (with controlled distribution and storage), which includes last-mile delivery. Today, this problem still has not been solved.

To this fact, we can add the elimination of the Popular Insurance (Seguro Popular) entity in favor of  INSABI, which has not served any purpose at all since it was never able to start. It is unfortunate that today, after three years of discussions and a search for solutions, the decision was made to return to IMSS, adding the burdensome title of "IMSS - Bienestar"

Adding to this illogical and unexpected decision, at the beginning of 2020, the COVID-19 pandemic hit us, along with increased medicine shortages at hospitals that were already totally insurmountable, and the problem increased significantly. As a result, it became necessary to go out and "buy" medicines at whatever cost and from wherever, without the most elementary reviews, such as a registration with COFEPRIS, an entity that was independent, but today, is operating under the tutelage of a medical subdirectorate within the Health Ministry, so its decisions are being monitored and evaluated by authorities who probably still do not understand the impact of these changes.

However, I dare say that the Mexican pharmaceutical industry has not remained "asleep" in the face of these exclusions and bad decisions made by the government. The reality is that various national and multinational companies have looked for valuable alternatives, which are helping to counteract the effects of a shortage as lethal as that which we have been experiencing for several months. This fact can be confirmed by the parents of all the children who were undergoing cancer treatment, which ended from one moment to the next, and who today add up to a list of thousands of children who have died due to lack of medication for their cancer treatment.

Every day, I follow a specialist who writes in the El Economista newspaper, Maribel Ramírez Coronel. I want to summarize some reports from recent months:

- Nov. 8, 2021. The government accepts the failures in the supply of medicines and will take control, leaving UNOPS aside.

- Nov. 15, 2021. What if the 4T government turned to the national pharmaceutical industry to collaborate and take advantage of its expertise, and also loosened its ties to COFEPRIS for better regulation of medical supplies?

- Nov. 17, 2021. Substantial budget increase for the purchase of health supplies.

- Nov. 29, 2021. The associations of the Mexican pharmaceutical industry (ANAFAM; AMELAF, ANDIS and DILAMEG) delivered a document two months ago to INSABI, offering detailed solutions to solve the problem of drug shortages. This document has not been reviewed or addressed.

- Dec 8, 2021. The entry of the Army to Birmex can be of help, as long as they allow them to organize, but not execute.

- Dec. 15, 2021. A performance audit was carried out on INSABI and it is confirmed that it has no idea how to perform its medicine supply functions.

- Jan. 17, 2022. The recently approved anti-COVID medications will not be available in Mexico in the health or private sectors.

- Feb. 9, 2022. COFEPRIS opens the door to Grupo PISA, so that it can once again manufacture oncological medicines and put an end to the three-year shortage.

- Feb. 16, 2022. Drug shortages now at private pharmacies and all therapeutic groups.

- Feb. 21, 2022. Mexico can be a good manufacturer of basic generic drugs, which can become a historic advantage.

- March 9, 2022. Birmex is forced to be a distributor, despite the fact that it is originally a manufacturer of biological products. Now, it is trying to become a mixing center (central de mezclas).

- March 23, 2022. The unknowns of the new IMSS-Bienestar scheme. The 4T admits that INSABI could not solve the distribution problem, so this new IMSS scheme will address the health of the most unprotected population, meaning without any social security service.

- April 4, 2022. The US wants to organize the chain of medicinal supplies with Mexico but the 4T government prefers to turn to India. The proposed cluster for Indian pharmaceuticals remained on paper.

- April 13, 2022. AstraZeneca has a new treatment against COVID, a combination of antibodies that will serve the immuno-reduced population.

- May 16, 2022. Probiomed, a Mexican biopharmaceutical, changes hands; today it will become part of the Sanfer group.

- May 22, 2022. The Mexican pharmaceutical company Stendhal recovers ground with new alliances.

Finally, it is worth commenting that in the president’s daily news conference on June 7, the dismissal of 32 people from COFEPRIS was confirmed for participating in acts of corruption at different levels. This operation began on Oct. 21, with the Army and Navy entering the COFEPRIS facilities.

Today, the head of COFEPRIS, Alejandro Svarch, had a different tone as he spoke about the pharmaceutical industry in Mexico, mentioning that he is working with both — the industry and the cameras —  after two years of silence and a total absence of communication. Let's hope that this dialogue continues on the right track.