“Mexico’s healthcare system is good, and we aspire to improve it.”

ByMexico Solidarity

This article by Angeles Cruz Martinez originally appeared in the August 18, 2025 edition of La Jornada, Mexico’s premier left wing daily newspaper.

David Kershenobich, head of the Secretariat of Health (SSA), acknowledges the sector’s problems: “I don’t avoid them. There’s a lack of medicines and better services.” Still, the Mexican health system is good. “It needs fine-tuning, it’s true, but often we only talk about the bad things and forget the good things,” such as free services and medicines.

In his first interview with a print media outlet and in an evaluation of his first year in office, the official emphasized: “We aspire to provide a free public service that is equal for all, as best as possible, with quality, safety, and efficiency.”

He is concerned about diabetes, one of the leading causes of illness and death in the country, and announces that a program will soon be launched to address it with an approach based on Mexican genetics and culture.

Kershenobich is a gastroenterologist, a renowned specialist in liver diseases, and a driving force behind strategies that are now part of national health policy. In the late 1990s, he promoted vaccination against hepatitis B and later access to antivirals to cure hepatitis C.

His career is marked by his work as a physician and researcher. For 10 years, he directed the Salvador Zubirán National Institute of Medical Sciences and Nutrition, and now, as Secretary of Health, he explains his vision of health in detail, relying on examples, which he constantly refers to. He says the sector must be understood in its evolution, needs, and from different perspectives, which change depending on the position held.

The second floor of the Fourth Transformation also promotes changes, such as in the existing relationship with the private sector, which until recently did not exist.

The most important thing is to listen to patients, to the pharmaceutical industry, to everyone. We must listen and engage in dialogue.

Below is the interview with La Jornada.

What is your vision for the health sector?

That’s how I see the future: a single, comprehensive system with all institutions; with equal care for all people; with quality, safety, and efficiency, and indicators to monitor progress. This entails challenges such as incorporating technology. Everything is digital now. We must take advantage of this to simplify processes.

In addition to treating illnesses, people must live better and healthier lives. This requires medicines, health services, and other services.

Technology offers things that weren’t available before. Let me give you an example: telemedicine, digital management of artificial intelligence. Everything should be included in a modern healthcare system, but it’s very complex because the needs are daily, in real time.

In many states, technology is non-existent…

Yes, there is, through cell phones. I don’t have a complete picture of what the healthcare system was like 20 to 30 years ago, but it’s very diverse now. Mexico is heterogeneous. More than 120 million people in a vast territory, with almost 20 percent of the population Indigenous and with different living conditions.

The health system must be public and strong. We did that at the Institute of Nutrition, which is world-class. It can be done. I used to practice private medicine, but it doesn’t solve the country’s health problem. A well-developed, strong public sector is needed.

What have you encountered, what has surprised you while traveling around the country?

There are factors that have a different impact. A clear example: the number of women who worked 20 or 30 years ago has increased. Daycare centers are needed as spaces for education and healthcare. One obvious issue is the aging of the population. Previously, we didn’t have the need for geriatric care. That’s why the House-to-House Health program is so important. Another issue is mortality, how it varies according to a person’s age.

Being in the Secretariat offers me, as a doctor, an opportunity to broaden the image of what healthcare is in the country. It’s a much greater responsibility than being a doctor or director of an institute.

What do the country and its people need?

I’m not avoiding problems; we need a supply of drugs and services. Within that, there are strategies to move forward with greater quality, safety, and efficiency. For example: in terms of medications, there are essential ones that we can’t do without. Others are optional. You can have one or the other.

Has Mexico jumped on the innovation train?

The healthcare system is good. It needs some fine-tuning, but I’ll give you an example of medication. The number of people who previously couldn’t access drugs, either through Seguro Popular [Editor: A means-tested insurance scheme developed during the Vicente Fox administration which enrolled people for three years period, delivering funds to the state level by enrollment, beset by profiteering from private contractors and inaccountability] or with catastrophic expenses. If they earn the minimum wage, it’s difficult for them to afford them. Today, they can get them. The real problem is early detection of the disease. Few countries have what Mexico has in free medications, such as those for chronic hepatitis and HIV/AIDS.

We talk about the bad things, but we forget the good things, which are more common. That doesn’t mean we forget what’s missing. We forget that 19 percent of the population has diabetes, and we have medicines.

We’re going to present a program to combat this disease that focuses on the culture and customs of the population. We’ve seen communities where the understanding that it can be prevented hasn’t been understood.

We need to think outside the box to see how we address the mentality of many people who drink sugary drinks knowing they’re harmful, and if they have diabetes, they view it as an illness ‘that was their lot,’ not a disease they can prevent.

Will we be like Denmark?

No nation has a single healthcare system with a complete solution. Each one is different; there are factors such as the country’s size, population, and social determinants, so saying that a healthcare system should be the same for everyone is difficult. We aspire to provide the best possible service, with quality, safety, and efficiency.

In Mexico, as a result of COVID-19, we are carrying a great burden due to the impact it has had on many medical aspects. We have to address it and try to resolve it.

On the other hand, there are other opportunities, such as professional midwifery. We live in big cities and we don’t have any exposure to that kind of work. The midwives’ skills are amazing. They know how to manage births very well, how to change the position of the baby.

What is the stewardship of the health system?

One of the secretary’s responsibilities is to strive to harmonize institutions, understand people, and serve them. It’s about promoting the health of both healthy and sick people and identifying priority actions, such as vaccination. We’ve worked hard to close the gap and are working toward a nominal record of doses administered. Mexico has the opportunity to make progress in global health, such as in dengue control. We have a national strategy for this.

Are the government and the SSA closer to the private sector?

Yes, it’s part of the healthcare system, and we’re committed to innovation. It’s a bilateral relationship, where the industry must have social responsibility and consider, for example, the cost of innovative medicines. It’s very high, and sometimes the investment is recovered with a year’s worth of sales worldwide. We need to listen and engage in dialogue.

Don’t you see the risk of the private sector influencing public policy decision-making?

I don’t think so. It should be clear what each person is responsible for. The management and oversight of the sector falls under the Ministry of Health.

What are the plans for Birmex?

It will continue as a drug purchasing, distribution, and manufacturing entity. It has the infrastructure, and under this administration, we will see it as part of the President’s plan to have a national pharmaceutical industry. The goal is to lower the cost of innovation for the government and, if an emergency arises, have a facility that allows us to be independent.

When will there be a Patria vaccine for COVID-19?

It doesn’t depend on the government. Its availability depends on the manufacturer, Avimex, deciding whether to produce it. Previously, it was an emergency purchase; now, we need national coverage. The Secretariat of Health (SSA) has offered to purchase the vaccines, 10 million doses. This secures the company’s investment, but they must be delivered on time and, first, comply with health regulations. If they don’t have it available, we can’t buy it.