Interview: Sen. FCO. Salvador López Brito – President, Health Commission of the Senate of the Republic, Mexico

UntitledSenator Salvador Brito, President of the Health Commission at the Mexican Senate, talks about increasing access to quality healthcare services among the most vulnerable groups in Mexican society, improving and developing life-changing prevention policies, tackling corruption, and investing in health to ensure the country doesn’t compromise its growth perspective.

What have been the most important topics and issues on which the Commission has been working since you became its President, three months ago?

Constitutionally speaking; we must be able to provide efficient and high-level healthcare services to the totality of our population.

Over the past three months, the Commission’s efforts have been concentrated on four main priorities among the variety topics inherited from the months that predated my tenure. The first one is related to the regulation framing assisted reproductive technologies in our country, and – as a gynecologist – addressing this issue is particularly close to my heart. The Commission is notably concerned that not all the Mexican clinics and hospitals are duly certified to perform such medical acts, or don’t hold the required infrastructure and equipment – while we still lack the comprehensive regulatory framework that will bring more safety, certainty and hygiene to Mexican patients.

Secondly; we want to introduce and implement a wider and more complete vaccination program for Mexican children. In this regard, we should point towards a compulsory vaccination system that will be able to prevent a larger number of infectious diseases that are still massively affecting our children.

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Third in the list comes obesity; which stands a terrible epidemic in our country and leads to many other therapeutic complications. Although ambitious reforms were already implemented in 2015, there is still a long way to go, notably when it comes to prevention.

Lastly, we have arrived to several conclusions and advanced several steps regarding the medical use of cannabis. Although we reached an almost-unanimous consent on this side, there are still some differences and alternative viewpoints within the Senate that we need to take into consideration. As a result, this dossier will be discussed again by the Senate in September 2016.

How is the Health Commission working with the Secretariat of Health in its on-going effort to address the fragmentation of the Mexican health care system?

Our country already boasts a huge framework of human and medical resources to improve our healthcare system, while every time a new president takes office, health budgets increase in a very noticeable way. Nevertheless, remaining rooms for improvement revolve around the fragmentation and the diversification within our three main social security institutions. For instance; we have IMSS that provides health-related services to the majority of the formal workforce in Mexico; then comes ISSSTE is focused on state and federal employees; finally; we have the Seguro Popular, which takes care of the rest of the population. This latter covers 58 percent of the people, unemployed and underemployed who do not have enough resources to request private medical services. Among their main beneficiaries; you can find many citizens that belong to the informal economy of our country.

Constitutionally speaking; we must be able to provide efficient and high-level healthcare services to the totality of our population; however, it is widely acknowledged that both ISSSTE and IMSS represent a higher tier of quality in medical services and resources than Seguro Popular.

In terms of answers; we must then address administrative, financial, and medical fragmentation across these different health providers. I however believe in the path currently followed by the Congress and the Health Ministry: the three institutions should display more coordination and collaboration, which will in turn translate into major increase in financial and medical efficiency, alongside offering a more balanced and equitable health coverage within our country. I however want to add that this step forward should never become a pretext towards the total privatization of the Mexican public health system, nor stands a deterioration of the fundamental rights of the workers and employees of these three institutions in any way, shape or form.

Mexico displays one of the highest rates in the world for child obesity and adult obesity. What should be done to improve prevention measures’ efficiency and to tackle this epidemic threatening the future of Mexican children?

First of all, we have to adopt a mature approach and acknowledge that the youth of our country face a very serious situation. As a result, we should create public policies coordinated by institutions such as the Health, Education and Finance ministries and the Mexican congress to not only prevent this disease from expanding but also to treat the population already affected. Furthermore, the education system and the national sport commission have to become involved with awareness programs and campaigns if we want to become successful in these endeavors. In this regard, we should pay special and closer attention to the diet of the Mexican population and carefully assess the nutritional and caloric values of the food available to young Mexicans. In this regard, Mexico however displays some remarkable successes, as we have notably been able to decrease children’s consumption of the so-called “junk food”. The Senate also recently approved a policy to ease bariatric surgery for the most extreme situations and for patients that require immediate attention.

We have to adopt a mature approach and acknowledge that the youth of our country face a very serious situation.

Obesity is the first step toward a number of chronic, degenerative diseases such as diabetes, hypertension, cardiovascular and musculoskeletal problems that – if they are not early detected and treated – require huge health investments for our country. Nevertheless, we see that our legal framework is increasingly better aligned with the needs and requirements posed by these developing threats, and this will allow us to more properly prevent and treat these diseases.

We understand many health-related stakeholders, like AMIIF, the association for the top 40 pharmaceutical innovators, or the OECD, are advocating for a greater recognition of the importance of health in driving inclusive growth for Mexico. What is the position of the Commission in this regard?

In collaboration with UNAM, the most important university in Mexico, we have recently been conducting several studies in poor and rural areas of our country. The general perception from this part of the population is that the quality of the health services they can access should dramatically improve, while they consider Mexican health insurances mostly benefit to the most privileged Mexicans, while little attention is given to the least privileged. This situation generates a tremendous level of dissatisfaction, which leaves us with no choice but to improve the overall quality and efficiency of the healthcare structure in Mexico. There should absolutely be a higher level of social equity and balance among our society. In this vein, every peso invested in health should not be considered an expense but an investment because a sick country leads automatically to a weak economy. With healthy and active students and workers, our economy and country will undoubtedly develop in a healthier and faster way.

On the same vein, you have been recently advocating to reverse the public spending cuts announced in June 2016. What is the strategy of the Commission to ensure public health spending increase and health in general becomes a priority in the political agenda of the country?

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As a matter of fact, public budget allocated to Seguro Popular slightly decreased; while IMSS and ISSSTE saw their tax-based incomes increasing. Reducing public health spending does not only deteriorate the quality of the services provided, but also impact the overall quantity of medicines and medical services available to Seguro Popular’s beneficiaries, and this is precisely why we exhorted President Peña Nieto and the Finance Commission of the Senate to reconsider these budget cuts.

Furthermore, the Ministry of Health is also strongly indebted toward several drug manufacturers, the total amount due to these companies reaching seven billions Mexican pesos [USD 380 million]. As a result, the Health Commission advised to primarily concentrate budget cuts on non-essential health expenses, as we cannot afford to reduce our coverage of chronic and degenerative diseases without dramatically compromising the overall sustainability of our overall health system in a mid-term horizon.

What is your vision for the Mexican healthcare sector for the upcoming years?

We need to be able to offer universal healthcare to all Mexican citizens, notably by tackling the current fragmentation of our health system. Furthermore, we must further improve prevention policies and transition to a prevention-based health system, notably with regards to obesity, unwanted pregnancy, and cancer, while substantially continue to strengthen our primary care network. Finally, we need to better identify and severely punish all cases of corruption and resource diversion, within the health system in particular and among the overall political establishment in Mexico in general.

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