Public-Private Dialogue is Crucial to Guarantee Medical Supplies
Public medicine and medical device supply has been one of the main issues for the health industry since the Acquisition Law was changed. A path to improve and guarantee treatment for patients will only be possible if the public and private sectors have open dialogue and work together on planning, processes and monitoring, agreed industry experts.
“Public-private collaboration is required to have conversations regarding inventory control and institutional strengthening. The pharmaceutical industry is a strong, important sector for the country and all actors involved in the value chain have the need to work with legal certainty. We all share the same end goal, which is to deliver medical supplies to the patient,” said Karla Báez Ángeles, Director of Access to Innovation, AMIIF.
An early sign of inconsistencies with public medicine supply came with changes to the Acquisition Law for medicines and medical supplies, as reported by MBN. The new regulations involved a consolidated purchasing model that would centralize operations through INSABI. The move was meant to bring savings and support the current federal administration’s austerity and anti-corruption policies, as a single institution would be acquiring medicines for all states.
However, the federal government removed distribution companies from the equation and, as a result, each public institution and state had to send its own orders. The complexity of this change drove the government to implement new adjustments, leading the Mexican government and UNOPS to sign a “technical assistance” agreement for the administration and management of projects and the acquisition of goods and services. Later, on July 31, 2021, INSABI and UNOPS signed a new agreement, called “Acquisition of medicines and healing materials,” which empowered the UN-backed organization to carry out the bidding procedures to supply medicines to the Mexican health system between 2021 and 2024.
The industry’s main worry with the transition to these new models is that while “the international scheme places us in a healthy competition, which can bring benefits,” large transitions and process modifications usually are difficult and take time to absorb, said Báez. Although the government has said that the healthcare system is saving money while guaranteeing supplies, the media reported several medicine shortages at public institutions during the past two years.
“The results [of the changes to the Acquisition Law] have been frankly bad. The processes carried out by UNOPS have also not been positive. The lack of planning has led to shortages. We have an enviable industry in Mexico, with the capacity to supply the entire market. For instance, 97 percent of allocations given by UNOPS were previously handled by companies established in the country,” said Rafael Gual, Director General, CANIFARMA.
The main catalyst to work toward securing medicine supply is to collaborate as a sector with effective, permanent communication channels with the government, said Báez. “We need planning, clarity of processes, certainty of times and traceability to enable this monitoring of supplies reaching the end goal, which in turn will create a virtuous circle to allow correct, strategic planning.”
Although communication is key for successful planning, the public sector is not considering the private sector in the conversation, said Gual. “[At CANIFARMA] every six years we elaborate a development program for the pharmaceutical industry. We play a crucial role within the health ecosystem and unfortunately, we were excluded from the conversation. There must be a dialogue in which we can contribute with our knowledge and experience to have a win-win situation between the private and public sectors.”
Mexico is Fertile Ground for Clinical Research, Innovation
Open dialogue between the public and private sectors must include innovative initiatives, such as clinical research, to attract investment to Mexico. While the country has potential to become the top research hub in Latin America, Mexico is not taking advantage of it, agreed industry experts.
Logistic chains across the world are experiencing severe problems and North America is facing challenges to supply certain pharmaceutical chemicals due to its dependence on the Asian market, said Gual. “We are not exploiting the potential of the country in the research field. We are promoting the production of pharmaceutical chemicals in Mexico to avoid depending on the Asian production chains and taking advantage of the US’s need to boost collaboration between the two countries.”
Mexico has all the needed ingredients to attract investment to the country to foster innovation and clinical research, from researchers to facilities and well-designed processes, said Báez.
With its large population, closeness to the US, well-trained physicians, large network of public hospitals and responsive regulatory entity, Mexico looks on paper as an ideal destination for clinical trials, reported MBN. Moreover, the country is the largest exporter of medical devices in Latin America and the eighth largest in the world. Mexico is also the leading exporter of pharmaceutical products in Latin America and the second-largest market for pharmaceuticals in the region. However, only 1.1 percent of all clinical trials done in the world were carried out in Mexico. Although this figure seems to be consistent with Mexico's population, which represents 1.6 percent of the total world population, the US has only 4.2 percent of the population and 40 percent of all clinical trials in the world.
The path to solve medicine supply shortages and guarantee treatment for Mexican patients must start with communication, planning and certainty, said Ana Riquelme, Executive Director, AMID. “We are all in the same boat. Everyone is susceptible to becoming a patient and we must work together with authorities to find solutions. If we do not achieve this in the following three years, we will continue experiencing problems.”
Improving acquisition processes and guaranteeing treatment for patients will need all actors to get involved. The life sciences industry, both medicine and medical devices, must be seen by the government as part of the solution rather than the problem to advance toward a better healthcare system.