Health

Scarcity of Medicines in Mexico Leaves Trail of Suffering

MEXICO CITY—Soon after President Andrés Manuel López Obrador was elected in 2018, he said the existing system of medication purchases for public hospitals was riddled with corruption that benefited greedy healthcare firms. He promised an overhaul that would lower prices and make Mexico’s public healthcare system look like Denmark’s welfare state.

But the government has struggled to find a fix. Instead, it has ended up buying fewer drugs at higher prices, according to Cero Desabasto, an umbrella group representing 80 organizations of doctors and patients, which recently released a 100-page report detailing widespread shortages. Mexico has now turned to hiring a United Nations agency to buy all the country’s pharmaceuticals.

For some families, the revamp has been catastrophic. Evan Omar Polina Aguilar was a chubby 2-year-old when he was diagnosed with malignant neuroblastoma cancer in May 2019, said his mother, Lorena Aguilar. He began chemotherapy, improved quickly, and was on his way to being cured, doctors told his desperate parents of him.

Then the public hospital in Monterrey, the industrial city in northern Mexico where he was being treated, ran out of his chemotherapy medicine, Ms. Aguilar said. Evan’s family used their savings and got donations to buy part of the missing medicines—some of which cost as much as $2,000 a dose—from private hospitals and online. But Evan missed several sessions, relapsed and died a day after Christmas of 2019, his mother said.

“My son would be alive if he had received proper treatment. He it’s criminal, ”said Ms. Aguilar, a 35-year-old sales agent at a security company.

Evan Omar Polina Aguilar, right, with his parents Lorena Aguilar and Omar Misael Polina at a restaurant in Monterrey in 2018, around a year before he was diagnosed with cancer.


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POLINA AGUILAR FAMILY

Spokespeople for Mr. López Obrador and the country’s health ministry didn’t respond to requests for comment on Evan’s death, or on other criticisms leveled by healthcare experts and members of the public about his prescription-drugs policy. The hospital declined any comment and referred questions to Mexico’s health ministry.

The president has, however, admitted there are shortages of medications.

“We have to solve the problem of scarcity [of medicines] once and for all,” Mr. López Obrador said in public comments in November. “I do not want to hear that there are no medicines, I do not want more excuses of any kind,” he said, chastising top health officials.

Mexican President Andrés Manuel López Obrador addressed the lack of medicines for children suffering from cancer at a January 2020 press conference in Mexico City.


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Sashenka Gutierrez/Zuma Press

Despite the president’s words, Ms. Aguilar and many others blame him for the shortages of medicines, including lifesaving insulin treatments, chemotherapy drugs and hypertension medicines. The overhaul has hit the poorest Mexicans hardest because they can’t afford to pay for private healthcare.

The number of prescription medicines that patients were unable to get filled at public hospitals has soared nearly 10-fold since the president took office almost four years ago, to 24 million in the past year, according to Cero Desabasto, which cited government data from 2018 to 2021 obtained through Mexico’s transparency agency. That translates to about one in 10 prescriptions going unfilled, Zero Shortages said. The group’s figures were corroborated by a Wall Street Journal review of records from the Mexican Social Security Institute, or IMSS, Mexico’s largest public-health agency.

“It was a self-inflicted wound that has caused immense suffering across the country,” said Denise Tron, a consumer-protection lawyer who studied the impact of Mr. López Obrador’s actions.

Even though the president remains popularthe drug shortage has hurt his standing among many poor people and is often mentioned in surveys as one of the worst problems of his presidency so far.

Evan Omar Polina Aguilar at the public hospital where he was treated in Monterrey, Mexico, in 2019.


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POLINA AGUILAR FAMILY

The mother of Evan, Ms. Aguilar, has filed a criminal complaint against Mr. López Obrador and top health officials, accusing them of homicide by negligence for the death of her child. Mexico’s attorney general’s office said it is investigating.

To raise attention to their plight, families of children with cancer who couldn’t get medicines began in 2019 blocking roads and the Mexico City airport, with protests continuing every few months.

In response, Mr. López Obrador has said such families are part of a political conspiracy organized by the political opposition and private drug companies affected by their policies.

Before Mr. López Obrador became president, the IMSS, the country’s main operator of public hospitals, bought the country’s medicines, which were then distributed to federal public hospitals and clinics. By 2017, the IMSS also bought medicines for 22 of Mexico’s 31 states and the federal district of Mexico City.

In a 2018 report, the IMSS estimated the centralized purchases saved more than $1 billion in the 2013-2018 period.

But the president argued that the system was rotten. He said three distribution firms that in turn bought medicines from hundreds of individual pharmaceutical companies and accounted for the bulk of purchases were overcharging the Mexican state. He barred the government from buying from those firms and handed purchases to the Finance Ministry, which was tasked to negotiate directly with drug companies to get discounts.

His government shut down several manufacturing plants of one of the main producers of anticancer drugs in the country, also alleging corruption. No charges, however, were ever brought against the drugmaker or the three distribution companies, and the president never offered evidence of graft.

Relatives of children with cancer blocked the entrance to a terminal for several hours at Mexico City International Airport in June 2021, delaying passengers with flights scheduled at the time.


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Gerardo Vieyra/Zuma Press

Meanwhile, the Finance Ministry struggled to complete the deals, securing just 36% of needed medicines for the second half of 2019, the president’s first full year, according to a pharmaceutical-industry research firm called Inefam, which provides data and advice to the industry . State governments stepped in to strike their own supply deals. In mid-2020, Mr. López Obrador hired the UN Office for Project Services to handle the process until 2024, the year he leaves office.

The UN agency says that it secured 97% of the needed medicines for the public sector in 2021. And Mr. López Obrador’s government said it saved some $500 million in drug purchases last year compared with 2018, without explaining how.

Zero Shortage and the pharmaceutical industry dispute those figures, however, saying the government has offered no evidence to back up its claims of savings. Inefam, the research firm, said the government paid 53% more last year for medicines on average and bought 38% fewer types of medicines. It estimates the government spent 64,000 million pesos in 2021 ($3.2 billion) compared with 67,000 million pesos in 2018, paying more for fewer drugs.

“It has been a total disaster from an economic point of view. There has been a lot of improvisation,” said Enrique Martínez, the general director of Inefam.

The UN Office for Project Services didn’t respond to requests for comment.

Getting medicines distributed to public hospitals and clinics has been a big logistical problem, analysts say. Just 44% of medicines purchased by the UN agency had been distributed to hospitals across the 31 states and Mexico City by mid-April, according to Insabi, a new agency created by Mr. López Obrador to provide healthcare to those who don’t have access to social security.

Rosa Mendoza outside the IMSS clinic in Mazamitla, a small town in western Jalisco, showing her prescription, where a worker at the clinic wrote in the margin: ‘Undispensed.’


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JOHN MONTES

Among the affected patients, there is a sense of helplessness, rage and grief. Rosa Mendoza, a 69-year-old widow who lives with her de ella five cats in Mazamitla, a picturesque town in western Jalisco state, has rheumatoid arthritis and said she was n’t able to get her prescribed medicine, methotrexate, for six months. She said she has increased joint pain and fears she could lose mobility soon.

“It’s always the same story. They tell you: ‘Come next month, we don’t have your medicines,’” she said outside the town’s IMSS clinic.

Benito Serrano, a 52-year-old shopkeeper in Mexico City with Type 1 diabetes, said he got just two month’s worth of his medicines in 2021. He said he spent about $650 out of pocket last year buying his medication on the private market.

“It is disgraceful. I had never experienced this level of scarcity,” he said at the entrance to a Mexico City public hospital.

Ms. Aguilar, Evan’s mother, said she and her husband keep celebrating their child’s birthday each year. They buy a birthday cake in his honor and take out the presents the boy could not open for Christmas in 2019. His mom preserves his clothes and toys from him.

“I talk to him every day,” she says. “To forget him would be like accepting he died, and he will always live with us.”

Write to Juan Montes at juan.montes@wsj.com

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