Introduction
Alejandro Svarch’s ideological approach and the current administration’s stance, as expressed in his column “Rutas de la Salud y la selección idónea de fármacos,” fails to address the critical issue of medication access in Mexico and poses a risk to the most vulnerable population by distorting the principles of the General Health Law and neglecting established technical criteria internationally.
The Compendio Nacional de Insumos para la Salud (CNIS)
The National Compendium of Health Inputs (CNIS), published in 2025, lays out technical criteria for safety, efficacy, and quality to ensure that health inputs used in the national system meet minimum requirements and are accessible to all. Its structure, mandated by the General Health Council under Articles 17 and 28 of the General Health Law, aims to standardize medication distribution and prescription through a single key, ensuring transparency, rationality, and public control over acquisition and use. This approach allows for proper management, combats prescription scattering, ensures efficient resource use, and most importantly, addresses the constitutional right to health.
Svarch’s Proposed Paradigm
Alejandro Svarch, head of the SS-IMSS-Bienestar OPD, presented a proposal called “Rutas de la Salud,” emphasizing drug rationalization by prioritizing reduced lists of “essential” medications. This approach aims to counteract the commercialization of the sector and high costs resulting from ineffective innovation. The argument is that fewer, proven-safe, and effective active ingredients are better. However, the issue arises when this rationalization becomes restrictive and limits access to innovative, specific, or high-cost medications that are often the only therapeutic option for severe or rare diseases.
The Austericidal Model
This austerity-focused model disregards clinical complexity, equity principles, and scientific advancements by attempting to contain state expenses without considering direct impacts on vulnerable groups. The approach ultimately condemns the poorest to a paradox: denying access to modern, personalized treatments while an increasing number of expired patents could benefit affordable generic production.
International Perspective
The World Health Organization (WHO) updated its Essential Medicines List (EML) on September 5, 2025, integrating 523 adult medications and 374 pediatric ones after reviewing 59 proposals and applying strict criteria for efficacy, clinical evidence, safety, cost, and public impact potential. The WHO advises all countries to adopt adaptive lists based on local disease burden and clinical needs, never under ideological or budgetary containment precepts. Furthermore, the WHO includes high-impact drugs: new cancer treatments, diabetes with obesity, cystic fibrosis, hemophilia, and others, reinforcing the commitment to universal access based on evidence and public health rather than dogma.
Mexico’s Challenges
Mexico’s primary governmental weakness is the lack of an integral strategy: fragmented management, absence of clear industry rules, and prioritization of ideological criteria over technical and scientific ones. Without addressing regulatory, productive aspects and aligning with international standards (WHO, EU), the medication policy will remain reactive and unsuccessful, deepening inequality and shortages.
Key Questions and Answers
- What is the main issue with Svarch’s proposal? Svarch’s restrictive approach may condemn thousands of patients to receive only minimal treatment when modern and accessible options exist globally.
- What does the WHO recommend regarding medication lists? The WHO advises countries to adopt adaptive lists based on local disease burden and clinical needs, never under ideological or budgetary containment precepts.
- What are the challenges facing Mexico’s medication policy? Fragmented management, lack of clear industry rules, and prioritization of ideological criteria over technical and scientific ones contribute to the ongoing issues.
The author, a specialist surgeon, public health certified, and doctorate in health and public administration, is a Mexican legislator and public health advocate. As a reelected PAN group member in the LXVI Legislature, he emphasizes that austerity without evidence is abandonment, while responsible public policy is access and justice.
