By KELIN DILLON 

While the National Advisory Committee for Public Health Standardization of the Mexican Secretariat of Health’s decision to eliminate 35 key Official Mexican Standards (NOM) from the Mexican healthcare system, as published in the Official Gazette of the Federation (DOF) on June 1, has caught criticism from local and international health experts, both Undersecretary of Health Hugo López-Gatell and President Andrés Manuel López Obrador (AMLO) have defended the eliminated NOMs – which include diagnostic standards for breast, prostate and cervical cancer, diabetes and numerous sexually transmitted diseases – as “unnecessary” and “unimportant” to the health of the Mexican population.

At their core, NOMs establish a best-practices standard of care in the diagnosis and treatment of its specified illnesses, meaning both private and public health institutions must follow this same course of medical care for its patients regardless of funding level. 

Conversely, without established NOMs for potentially fatal or life changing diseases, like the aforementioned cancers, there is subsequently no standard of care for their diagnosis and treatment, leaving Mexican nationals suffering from said illnesses up to the arbitrary decisions of their attending physicians – a potentially life-or-death decision by the López-Gatell-chaired committee, considering that breast cancer is the leading cause of death in Mexican women over the age of 25.

“It is not necessary to have official norms to regulate the prescription, the therapeutics and the diagnosis of each one of the disease, since medical care has always and will continue to be provided to cover these 35 or more diseases, and to provide comprehensive care to the Mexican people,” said López-Gatell on June 2.

López-Gatell went on to claim that those who criticized his decision to eliminate these NOMs were likely benefiting from “commercial interests” surrounding the illnesses’ corresponding medication treatments and “perpetuating the scheme of dedication to private interests instead of protecting, defending and promoting the public interest.”

For his part, member of the National Action Party (PAN) and Secretary of the Health Commission in the Chamber of Deputies Éctor Jaime Ramírez Barba denounced López-Gatell’s actions on social media, saying that “the cancellation leaves millions of Mexicans in uncertainty regarding the diagnoses and treatments of breast cancer, both in the public and private sectors.”

“What will happen to them and their families as they face this terrible disease? What will happen to the work that more than 300 medical experts have done to help more people survive breast cancer?” continued Ramírez Barba.

According to medical director of the Breast Cancer Foundation (Fucam) Felipe Villegas, eliminating the standards of care associated with the eliminated NOMs – specifically NOM-041-SSA2-2011 and NOM-041-SSA2-1994 for breast and cervical cancer – puts lives at risk.

“It is nonsense to cancel the noms, rather the course of action would be to update them because they are from 1994 and 2011, and they are obsolete, and for that exact reason we doctors are orienting ourselves with the support of international updates,” said Villegas, noting that cancer specialists in the Mexican healthcare system have proposed updates to these specific NOMs that have yet to be approved. “However, it puts patients at risk by not demanding a higher standard of care and are now left without official or government backing.”

“The fact that López-Gatell says that the NOMs are not necessary shows a lot of ignorance on the part of the undersecretary. Of course they are necessary, because there are issues related to health protection that need to be standardized,” said health lawyer David Sánchez Mejía.

Sánchez Mejía went on to note that since the eliminations were published without corresponding scientific research to validate the decision, the cancellation of the 35 NOMs may be subject to legal injunctions and lawsuits in the court of law as they are “without legal justification.”

Despite clear pushback from the medical community, López Obrador took to his daily press conference on the morning of Tuesday, June 6, to defend López-Gatell’s decision and reiterate the idea that any condemnation of the situation could only stem from critics’ commercial interest in the healthcare system, claiming “we would never do anything that would harm” the Mexican public.