Mexico's president inaugurated a huge "super pharmacy" Friday in a bid to help patients throughout the country who are told they need a specific medicine, but their hospital doesn't have it.
President Andrés Manuel López Obrador's solution was to outfit a big warehouse on the outskirts of Mexico City to centralize a supply and send it to hospitals throughout the country.
"The pharmacy is going to be big, big, big, and it is going to have all the medications that are used in the health system," López Obrador said Friday.
The pharmacy is intended to complement local health facilities. If a patient can't get needed medications at a local hospital, the patient, the patient's doctor or the pharmacist would be able to have it delivered from the 40,000-square-meter Mexico City warehouse.
The armed forces, or the government-run pharmaceutical company Birmex, will ship the drugs by land or air "within 24 to 48 hours," López Obrador pledged.
The question is whether Mexico can overcome its history of being bad at regulating the pharmaceutical industry, bad at buying medicines, bad at storing them, and bad at distributing them. Extreme centralization also hasn't helped Mexico much in the past in many areas.
The most visible face of this problem are the parents of children with cancer, who frequently stage protests because they say that in recent years chemotherapy and other drugs have been impossible to obtain.
The problems have killed otherwise healthy people. Because Mexico has had problems in obtaining enough morphine, anesthesiologists in Mexico have had to carry around their own vials of the sedative, drawing multiple doses out of a single vial for routine procedures.
That has led to contamination of the vials, triggering outbreaks of injection-induced meningitis in two Mexican states that have killed dozens of people, including some Americans who sought treatment at clinics in the border city of Matamoros, across from Brownsville, Texas.
In the United States, where there is no shortage of morphine, doctors are advised to draw a single dose from a vial and throw the remainder out.
López Obrador mounted a major effort to obtain COVID-19 vaccines in 2021, using the armed forces to distribute them and volunteers to administer them. By the end of that year just about anybody in Mexico who wanted a vaccine got one, for free.
But trying to replicate that model of centralized government purchasing and army distribution on a national scale for thousands of medications is not the same, according to Mauricio Rodríguez-Dorantes, a professor at the School of Medicine at Mexico's National Autonomous University.
"This is crazy," said Rodríguez-Dorantes, noting the government is opening the centralized warehouse without answering how the system will operate, especially for urgently needed medications. He noted that concentrating all the drugs at one site increases risks and could sideline some existing distribution systems.
For decades, there have been scandals involving millions of dollars’ worth of medicines that have expired at warehouses while hospitals couldn't get them.
The country's medicine regulatory agency, known by its Spanish acronym as Cofepris, was so riddled with corruption before López Obrador that regulators would hide applications for approval of new medicines for years and demand bribes to approve them.
And with alarming frequency, regulators in Mexico send out alerts about falsified or knock-off medications being sold for treating everything from cancer to heart disease. Boxes, labels, vials and certifications are copied with amazing accuracy, but the bottles often contain little or none of the medication.
The fake medicine trade is so common and so lucrative in Mexico because patients or their relatives are often told by doctors to buy medications at private drug stores when they are unavailable at government hospitals.
The civic group Zero Shortages said there was a 142% increase in the number of alerts about falsified medicines between 2021 and 2022.
But some of the problems are of López Obrador's own making. Angry at what he claimed were inflated profits made by drug distributors and importers, the president simply cut the private companies out and decided the government should directly buy all medications.
Because the government did not have much infrastructure, contacts or experience in such a massive effort, López Obrador signed an agreement with the World Health Organization to help Mexico in purchasing. But even with that help, Mexico was unable to obtain some specialized medication.
Zero Shortages said the number of prescriptions that went unfilled in Mexico rose from 1.5 million in 2019 to 22 million in 2021; disruptions because of COVID-19 probably played a role.
But even in 2022, about 12.5 million prescriptions went unfilled.
