Breathe
By Juana Ramírez
A month has passed since the President was sworn in and her new cabinet was put in place. There are many political, economic and security concerns, but as far as health is concerned , the signs are very positive. Let me tell you my reasons and you will judge.
First of all, I have to say that the six-year term that has just ended can be considered by far the worst in terms of health. To be fair, we will also have to admit that no government has ever faced a pandemic like the one we are living through, because we cannot compare the N1H1 influenza crisis with the worldwide tragedy of Covid-19. However, it is also true that, far from falling "like a glove" to former President López Obrador -remembering his sadly famous expression- the pandemic really put the government and the health system to the test, which, except for the honorable role of the health personnel and some successful cases such as the reconversion of the National Institute of Nutrition, the Temporary Unit of the Citibanamex Center or the public-private alliance with the Consortium and the Association of Private Hospitals, AMLO and his then Secretary, Dr. Jorge Alcocer, came out of the crisis better off than they were before. Jorge Alcocer, failed more than failed.
Given the visibility that health had during the past six years, the government succumbed to the temptation to politicize and polarize issues that really should have been discussed only in the light of scientific evidence, regulatory provisions and the recommendations of international organizations. Far from that, we went through the use of protective stamps, the anti-contagion moral force, the invitation to go out and embrace each other while the world repeated "stay at home", the irrational resistance against the use of masks or the reorganization of the Secretariat, in which, for example, COFEPRIS was subordinated to Dr. López Gatell's Sub-Secretariat, the General Health Council was dismantled and even the headquarters of the Federal Secretariat was moved to Acapulco. The icing on the cake: all the failed attempts to purchase and distribute medicines, which only aggravated the crisis of access to medical care and the shortage of medicines became so deep that patients and their families took to the streets to protest. The disappearance of Seguro Popular, the shameful failure of INSABI -and with it the disappearance of funds and trusts- or the bad joke of the mega-pharmacy that would have all the medicines in the world, we don't even talk about it anymore.
This whole disaster, beyond political philias or phobias, should be measured in years of life lost or in patients who should not have died. Behind every prescription not filled, there is a Mexican who was unable to treat his or her disease or who complicated his or her condition in the absence of treatment.
However, in the first four weeks in office, the appointments and first actions of Dr. David Kershenobich make it clear that we have a Secretary and that as long as he is allowed to do so, he will honor what is surely the most important position for a physician: to lead his country's Health System. And what I say is well founded: as soon as he was confirmed as head of the entity, Dr. Kershenobich dedicated himself to visiting all the public hospitals he could. He did so unannounced and without protocols. He did not want to be told, as a good scientist he preferred to go to the source, talk to his colleagues, listen to the patients. In the same way he led the so-called "dialogue tables for transformation" which, at least in health matters, far from being political rallies, the current Secretary listened and took careful notes.
There are many and very convincing signs in these first weeks to be optimistic or at least to give the new Secretary of Health the benefit of the doubt: prioritizing knowledge, trajectory and talent in all his appointments, which for many years have not enjoyed such a high level of consensus and acceptance by the medical community, -for a good example, the appointment of Dr. Armida Zúñiga Estrada as head of COFEPRIS-, returning to the entity the steering role of the Health System, reinstating the General Health Council, entrusting it with the technical review of the technical compendium of the Health System, reinstating the General Health Council, giving it the responsibility of the technical review of the technical compendium of the Health System. Armida Zúñiga Estrada as head of COFEPRIS, returning to the entity the steering role of the Health System, reinstalling the General Health Council, entrusting it with the technical review of the national compendium of medicines and even declaring the inoperative headquarters in Acapulco closed in order to return the Secretary to the historic building on Lieja Street.
While it is true that prevention and primary care will be the central focus of his project, unlike in the past, when the lack of services and medicines was justified by the argument of wanting to focus on prevention and not on attending to illnesses, for Dr. Kershenobich and his team, the supply of medicines, medical devices and supplies is a fundamental part of prevention, diagnosis and early attention to illnesses in order to avoid complications. For this reason, Undersecretary Eduardo Clark presented an ambitious biannual procurement plan that will be led for the first time by the Ministry of Health, with the use of technology integrated to all the processes of request, purchase, distribution and dispensation, providing more information and transparency to the process; in addition, the purchase of two years of supply will give greater certainty to the national and international pharmaceutical industry. Although Birmex will be the legal entity that executes the purchases, the logistics will be operated by specialized private companies. Apparently, international purchases of medicines without sanitary registration will be left behind and it is even known that his team is working together with the Ministry of Economy -which, by the way, has appointed another physician of wide experience, Dr. Javier Dávila, as responsible for the coordination of the relations with the pharmaceutical and medical devices industry, considering it as a strategic sector- in the development of an industrial health policy, which seeks to strengthen the national industry.
The mega-pharmacy will only be used in cases of emergencies or specific product shortages, but according to the officials themselves, if everything goes well, it should not be used. Subtle recognition of its inoperability. In addition, the importance of strengthening the national vaccination system and giving priority to children and vulnerable groups has been made clear.
There is a Secretary and he is working. It won't be long before we will know if the reconstruction of the health system has a clear course. In time.
The opinions expressed are the responsibility of the authors and are absolutely independent of the position and editorial line of the company. Opinion 51.
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