Mexico, OPS/WHO Set 2026–2031 Health Plan as System Gaps Persist

Mexico and the Pan American Health Organization/World Health Organization (PAHO/WHO) presented the 2026–2031 Cooperation Strategy, reaffirming a long-term partnership focused on primary care, prevention and system strengthening, at a moment when the country faces structural challenges in access, financing and health outcomes.

David Kershenobich, Ministry of Health said the administration has placed health at the center of the national agenda, aligning the new cooperation strategy with the government’s objective of building a “healthy republic.” Citing recent reforms, he emphasized the government’s efforts to expand community-based care and reinforce evidence-based public policy. “Our president noted that not everything is medical care. Prevention and primary care are very important concepts, and that is reflected in the priorities presented today,” he said.

The new strategy sets joint priorities that include reducing mortality from noncommunicable diseases, strengthening regulatory capacity, improving health security, promoting well-being across the life course and advancing regional self-sufficiency in science and innovation. José Moya, Representative in Mexico, PAHO/WHO said the document provides a coordinated framework for technical cooperation. “This strategy is a valuable instrument because it defines clear priorities and aligns technical cooperation with national and regional goals,” said Moya. “Cooperation has meaning only if it transforms people’s lives.”

The strategy launch comes as Mexico faces persistent gaps in access, quality and outcomes. According to the OECD’s Health at a Glance 2025, the country performs below OECD averages in multiple indicators. Life expectancy stands at 75.5 years, 5.6 years lower than the OECD average, while preventable and treatable mortality rates remain among the highest in the bloc. Héctor Valle, Executive President, FunSalud, warned that Mexico risks further deterioration if current trends continue. “By the end of 2030, Mexico could face a dramatic decrease in life expectancy. We are witnessing a concerning decline,” he said.

The OECD report also highlights lower screening and vaccination coverage, high pollution exposure, and limited emergency care capacity. Spending remains constrained: Mexico invests US$1,588 per capita in health, compared with the OECD average of US$5,967. While the country aligns with OECD averages in prevention spending as a share of total expenditure, infrastructure and workforce shortages persist. Mexico has 2.7 physicians and three nurses per 1,000 inhabitants, far below OECD levels, and hospital capacity remains limited at one bed per 1,000 inhabitants.

Budget pressures continue to shape the sector. The 2026 federal health budget will rise 5.9% to MX$965 billion, driven mainly by increases for IMSS and IMSS-Bienestar. However, analysts note that even with the increase, investment remains below WHO recommendations and insufficient relative to population needs. Cuts are planned for ISSSTE, PEMEX health services and SEDENA, while the Ministry of Health will also see a reduction. The government aims to consolidate programs across health institutions, reducing fragmentation, but concerns persist about underfunding, high out-of-pocket spending and the capacity to deliver services.

Valle said Mexico’s investment continues to lag behind regional and international benchmarks. “We are among the countries that invest the least in healthcare, and our life expectancy is not good. Next year’s health budget appears likely to remain very challenging,” he said.

Fiscal debates extend to health taxes. The government has proposed increases in Special Taxes on Production and Services (IEPS) for sugary drinks and cigarettes. Opposition lawmakers, including Héctor Jaime, Deputy, PAN, argue that revenue management lacks transparency and should directly support the National Health Fund for Well-Being. “In 2025, MX$81 billion (US$ 4.42 billion) are expected to be collected from tobacco and sugary drink taxes, yet none of these funds are allocated to health,” he said.

International pressures add to domestic constraints. WHO recently issued new guidance to help countries respond to global reductions in external health financing, which have strained essential services in many low- and middle-income countries. Tedros Adhanom, Director General said the cuts jeopardize health gains but present an opportunity to strengthen self-reliance. The guidance emphasizes efficiency, prioritization and integration of externally funded programs into primary care models, an approach aligned with Mexico’s stated objectives.

The health system also faces operational challenges. President Claudia Sheinbaum has criticized delays in medicine and supply deliveries by private companies, but industry leaders say long-standing government debts and saturated warehouses contribute to bottlenecks. Patrick Devlyn, President of the Health Commission, Business Coordinating Council (CCE), said pharmaceutical companies face payment delays far beyond contractual timelines, reaching up to 18 months. He noted that validated debts exceed MX$40 billion (US$ 2.184 billion) across laboratories. Firms also report logistical issues at state-run distributor Birmex, where full warehouses have forced shipments to be returned.

The government has committed to settling outstanding payments and is shifting procurement policy to favor companies with local manufacturing capacity as part of the Plan México initiative. Sheinbaum said the goal is to reduce dependency on imports from major producers such as India and China while maintaining oversight from COFEPRIS. Authorities report improvements in supply rates across IMSS, ISSSTE and IMSS-Bienestar, supported by new infrastructure, distribution routes and digital tracking systems, though civil society organizations continue to warn of shortages in critical drugs.

As Mexico and PAHO/WHO align cooperation priorities for 2026–2031, the broader challenge remains balancing ambition with fiscal and operational realities. The strategy’s focus on prevention, primary care and regulatory strengthening reflects areas where system gaps are most pronounced. Whether these commitments translate into improved outcomes will depend on sustained investment, coordinated implementation and the ability to address structural constraints across the health sector.