Why does Mexico have a medicine shortage?
Mexico’s Health Secretary, David Kershenobich. Image credit: Sipa US / Alamy.
by David Agren, writer at large.
The president’s morning press conference returned to a subject common under predecessor this week: the shortage of medicines in Mexico. And like her predecessor and mentor, Andrés Manuel López Obrador, President Claudia Sheinbaum and her team insisted everything was under control; the annual consolidated purchase of medicines for the federal and state health system was unfolding as expected. And, just during the AMLO, they spoke ad nauseam of their progress in purchasing medicines under the guise of informing the population. (A less polite description might be gaslighting.)
Some 73.2 per cent of the mega purchase – worth 338,000 million of pesos – was complete, health undersecretary Eduardo Clark said. Another 24.4 per cent of the purchase was still being decided in the tendering process and 3.2 per cent of the needed medicines didn’t receive any offers.
Sheinbaum insisted – in classic AMLO style – that almost all the medicines were being purchased without intermediaries, theoretically driving down the cost. She also drew on the supposed horrors of the pre-AMLO past to insist, “The majority of purchases [then] were made from intermediaries who were responsible for providing and distributing them.” Sheinbaum continued, “That breaks from the previous sexenio [pre-AMLO] and now this complementary and biannual purchase … which guarantees medicines until 2026, is made directly from the laboratories making medicines.”
Sheinbaum has promoted a suite of promises christened “Healthy Republic,” which include everything from homecare to better training for medical staff to the digitization of documents. But she largely overlooked the shortcomings of the AMLO administration in presenting her health proposals.
The shortcomings start with the health budget, which was slashed by 11 per cent for 2025.
There’s also the matter of the ongoing shortages of medicines – a holdover from the AMLO administration and triggered by a slapdash attempt at getting supposed graft out of the purchase of medicines. The situation became so serious that families of cancer patients staged protests – drawing ominous responses from AMLO, who accused them of being manipulated.
Cero Desabasto (Zero Shortage), a collective of non-governmental groups, reported 7.5 million unfilled prescriptions in the federal health care system, which includes the Mexican Social Security System (IMSS), in 2023. That represented a 50 percent improvement over 2022. But the group’s director, Friday Romay Hidalgo, told El Universal that reports of cancer medication shortages increased again in November 2024. Shortages of mental health drugs have been reported, too.
Stories of hospitals in dilapidated conditions are also surfacing. The Dr. Aurelio Valdivieso hospital in Oaxaca cancelled surgeries over a lack of supplies – something IMSS Bienestar (the government health program for the uninsured founded by AMLO) denied. A PT lawmaker alleged the main public hospital in Oaxaca stopped feeding patients due to a lack of propane and diesel. An IMSS Bienestar hospital in Puebla also ran out of food.
Analysts attribute the shortages of medicines to changes in the consolidated purchase after AMLO took office in December 2019. It was a process which produced few shortages. But AMLO alleged corruption – not an unreasonable accusation, according to some analysts, who point to the antitrust watchdog COFECE fining pharmaceutical companies more than 1,000 million pesos for anti-competitive practices.
But AMLO’s initiatives lacked planning and failed to appreciate how the pharmaceutical companies worked. Critics pointed to the president’s insistence that distribution be done by the laboratories rather than distributors – “intermediaries” in AMLO’s view. The distributors, they said in interviews, had the infrastructure for handling sensitive merchandise and delivering across the country. AMLO also vetoed some suppliers, provoking shortages of certain cancer meds.
Prior to AMLO’s arrival, the IMSS carried out a consolidated purchase for federal and state health systems, which proponents say lowered prices and limited opportunities for corruption. AMLO initially put the purchase under the finance ministry. He then tapped INSABI – which replaced Seguro Popular and was succeeded by IMSS Bienestar – and signed an agreement with the UN Office for Project Services (UNOPS). But the shortages continued, though abated somewhat toward the end of his administration.
He eventually handed responsibility for distribution to BIRMEX, a government vaccine maker, which analysts said had limited capacity. The president also started a mega pharmacy, which was supposed to supply medicines to the entire country. El Universal reported in September that the mega pharmacy filled just six prescriptions daily since opening in late 2023.
Amid shortages, the president continues with her predecessor’s prescription for the health system: talk. Sheinbaum has abandoned much of AMLO’s trolling on the topic; she doesn’t insist Mexico will have a health system better than Denmark. But her administration is aggressively denying any stories of shortcoming. Such denials and endless talk on what they were doing – even if it amounted to little – worked for AMLO politically. It remains to be seen if it does the same for Sheinbaum.