Photo: Volodymyr Hryshchenko/Unsplash

By MARK LORENZANA

Even as Mexican President Andrés Manuel López Obrador (AMLO) confidently claimed that in 2023 Mexico is “going to have a first-rate health system, one of the best in the world, universal for all” on the morning of Monday, Aug. 22, during his daily morning press conference, state-run drug distributor Biological and Reagent Laboratories of Mexico (Birmex) admitted that it has not been able to run the government’s medicine-distribution program due to lack of resources.

“Due to the level of complexity involved in the development of the National Distribution System that covers the needs of a territory such as the Mexican republic, the development of the project has not been completed,” said Birmex in a statement.

The López Obrador administration authorized Birmex “to guarantee the production of vaccines, biological products, pharmaceutical chemicals, reagents, medicines and supplies.” Birmex, however, ran into a host of problems. For instance, the state-owned company failed to renew its Certificate of Good Practices — which is granted by the Commission for the Protection against Sanitary Risks (Cofepris) — to produce antidotes for the sting of venomous animals.

In 2021, Birmex’s spending on items restricted by the Federal Republican Austerity Law (LFAR) amounted to 63 million pesos, a figure almost 67 percent higher than in 2020. The majority of the spending, which was around 34.8 million pesos, was allocated to property maintenance and administrative expenses.

Likewise, expenditures on personnel services totaled 294.6 million pesos, 15.7 percent more than in 2020. According to Birmex, this allowed the hiring of temporary personnel to comply with the distribution of the vaccines and medicines against covid-19.

Rafael Gual, general director of Mexico’s National Chamber of the Pharmaceutical Industry (Canifarma), said that this year the Mexican Social Security Institute (IMSS) opened a bidding for the distribution of its medicines, and Birmex was disqualified.

According to Gual, the distribution of medicines requires the right infrastructure and specialized means of transport that takes decades to build, so the presidential order for Birmex to distribute drugs seemed practically impossible.

“The distribution of medicines requires specialization, and it is very complex. You have to have computerized warehouses,” Gual said. “We knew that it would be impossible for Birmex to build these warehouses and have the specialized means of transportation in a year or two or four.”

In addition to Birmex’s failures, the Mexican government ended up paying 20 percent more for medicines in 2021 as half of those procured had to be acquired through direct purchases.

For his part, Enrique Martínez, director of the National Pharmaceutical Institute (Inefam), agreed that despite the mandate of López Obrador for Birmex to be in charge of the distribution of medicines in the public health system, it is far from a logistics operator.

“Birmex does not have the system or the infrastructure for that. That is why it has also hired third-party logistics operators,” Martínez said.