Mexican lawyers respond to populist government’s shortages of medical products and services

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Leopoldo Burguete-Stanek

Gonzalez Calvillo, Mexico City

lburguete@gcsc.com.mx

Crises destabilise and challenge the entrenched routines and processes that make up the systems that govern daily life. Disruptive in nature, crises push structural weaknesses that were once easy to overlook to breaking point. In the case of Mexico’s healthcare system, the pandemic has unraveled the changes to the Mexican healthcare system instituted by the current government; however, more broadly, the pandemic has showcased the threats posed by populist policies and has exemplified the importance of law and the use of legal safeguards by lawyers to make governments accountable to its citizens.

The populist government of the Mexican president Andres Manuel Lopez Obrador (nicknamed AMLO because of his initials) came into power 1 December 2018 with the promise of leading Mexico through a historical transformation on par with Mexico’s independence from Spain, the reform laws that separated the church and state and the Mexican Revolution which produced Mexico’s modern state: La Cuarta Transformación (the fourth transformation or 4T) is an ambiguous reform of the Mexican state seeking to eradicate corruption and create an equitable society.[1]

The President has set out to achieve 4T by eliminating ‘la mafia del poder’ (mafia inside the power), an amorphous elite made up of politicians, bureaucrats, business leaders and the institutions and businesses which they lead.[2] AMLO’s populist disdain for the government institutions and business leaders that he perceives to be tied to this group of individuals has led him to walk back on the work of previous administrations, including energy reforms, infrastructure projects and, in regards to the healthcare sector, the Seguro Popular, a financing mechanism that provided healthcare to Mexicans not covered by the private or public sector.[3] [4]

The pandemic struck Mexico as the government sought to replace the Seguro Popular with the Instituto Nacional de Salud para el Bienestar (INSABI), in which the latter would fill the role of the former.[5] Already weakened by austerity measures that had led to an institutional ‘brain drain’ of many medical professionals and administrators, and combined with the populist hostility towards experts, the Ministry of Health lacks the know-how to purchase and source medical supplies.[6] This has led the government to waive the registration and authorisation requirements for importing much-needed medicines. This is a decision that eases regulatory safeguards and does not guarantee the quality, safety, efficiency nor availability of medicines and medical equipment.[7]

On 28 April 2020, Doctor Ricardo Villalobos Valencia, the president of the Colegio Mexicano de Oncología Médica (Mexican School of Medical Oncology), sent a letter to the Mexican Minister of Health warning him of the shortage of oncology medicines in both public and private healthcare centres. Valencia mentioned that this is a problem that dates back to 2018 but has been exacerbated by the Covid-19 crisis, and asked the Minister to take action towards remediating this issue. In addition to the human and economic toll of the coronavirus, the pandemic has disrupted the supply and distribution of medicines and medical equipment, endangering health professionals and placing people with life-threatening conditions and diseases – like cancer, HIV and diabetes – at risk.[8] [9] [10]

In response to the shortage of medicines and medical protection equipment, multiple lawyers across Mexico who are taking the cases on as pro bono – through Fundación Barra Mexicana de Abogados[11] – have pursued legal actions against the government through the courts by filing over one hundred ‘amparos’ – actions for constitutional relief. The amparos have pressured the government to step up in the provision of healthcare by ensuring medical care for non-COVID-related illnesses continues and ensuring personal protective equipment is provided to staff at government hospitals.

One example is a suit against the Minister of Health and the President himself for failing to provide children with medicines so they can receive cancer treatments. Thus, Covid-19 has changed the healthcare sector from a legal standpoint as it has become a recourse and ballast against the mismanagement of important government services in times of crisis –mismanagement that is ultimately rooted in the enactment of populist policies and the repudiation of experts.

In the long run, once Covid-19 passes, amparos may continue to be employed to ensure that the government is fulfilling its obligation of providing healthcare to all Mexicans, changing the Mexican healthcare sector from a legal standpoint.