Introduction to the Problem
The team responsible for procuring medications and supplies for Mexico’s public health system seems to be clueless. Their model has failed to ensure adequate supply, leaving the process mired in a cycle of blunders, irregularities, and unclear justifications. Patients continue to suffer the consequences of a lack of experience and the 4T administration’s inability to learn from its mistakes, making the healthcare crisis seem endless.
New Administration’s Attempt to Fix the Problem
Upon taking power in October 2024, the new administration decided to start anew, disregarding the accidental experience of the previous six-year term. A November 2024 bidding process for acquiring 3,900 medication keys and supplies promised transparency and efficiency. However, errors were soon acknowledged, and the process collapsed in April 2025 when the Secretariat Against Corruption and Good Governance (SABG) annulled the bidding due to detected overpricing of 13,000 to 15,000 million pesos in 6% of the keys. The attempt to correct course with reverse auctions has not yielded results; the new ruling, now scheduled for May 30, keeps deliveries uncertain, with states like Veracruz reporting critical shortages, especially in oncology medications.
Lack of Coordination and Planning
The AMIIF (comprising innovative pharmaceutical companies) has fallen into desperation amidst this procurement chaos for 2025-2026. In their May 16 statement, they highlighted critical issues: 40% of contracts awarded since March have not been formalized, one-third of the medications have not been requested by the government, and storage space shortages exacerbate distribution delays. These points underscore uncertainty and risk for serious disease treatments, reflecting the magnitude of disarray and the urgency for solutions that the government has yet to formulate.
Birmex: A Symbol of Improvisation
Birmex, tasked with leading this debacle, embodies improvisation. Lacking prior experience in consolidated purchases of this scale, its historical role in vaccine production did not prepare it for managing such a complex process. The removal of director Iván Olmos and other officials in April, following irregularity revelations, left command in the hands of Carlos Ulloa, a Morena diputado with no health sector background. Lacking knowledge of the national health system, Birmex has struggled to make accurate purchasing decisions, leading to widespread criticism. Meanwhile, allegations of “coyotes” offering contracts in exchange for bribes reinforce the perception of opacity and disarray.
Subsecretary Eduardo Clark’s Struggles
Subsecretary Eduardo Clark initially brought hope when he took charge of procurement coordination. However, his initial enthusiasm now appears naive and contributes to frustration. He first presented an “innovative” model guaranteeing supply by March 2025, but these promises vanished when the bidding was annulled. In February, he acknowledged “critical moments”; by May, he admitted they were “not where we should be.” Although he reports delivering 435 million pieces, the unadjudicated 30% of keys still poses risks, as reported by Cero Desabasto. Clark’s credibility has plummeted, reflecting the team’s lack of understanding of a complex sector.
The Road Ahead
It’s clear that the procurement team was wholly unprepared for the magnitude of the challenge. Eight months of errors, delays, and opacity have deepened the shortage crisis, leaving patients in a desperate wait. The experience and capacity to rectify these missteps will take years, making it difficult to turn the page.
Key Questions and Answers
- What is the current state of healthcare procurement in Mexico? The process is mired in a cycle of blunders, irregularities, and unclear justifications, causing patients to suffer from a lack of essential medications and supplies.
- What actions has the new administration taken to address these issues? The new administration launched a bidding process promising transparency and efficiency, but it collapsed due to overpricing allegations. Reverse auctions have not yielded results, with critical shortages reported in some states.
- What role has Birmex played in this situation? Birmex, tasked with leading procurement, has struggled due to a lack of experience and knowledge of the national health system, leading to criticism and allegations of opacity.
- How has Subsecretary Eduardo Clark’s performance been? Initially enthusiastic, Clark’s credibility has plummeted due to unfulfilled promises and the team’s lack of understanding of the complex healthcare sector.
- What is the way forward for Mexico’s healthcare procurement? The road ahead seems long and challenging, requiring experience and capacity to rectify the ongoing missteps.
