translated from Spanish: IMSS should distribute medicines without infrastructure and budget

The Mexican Social Security Institute (IMSS) will have to distribute thousands of drugs against cancer, diabetes, hypertension, HIV-AIDS, and other conditions, without having to date a specific budgetary heading for it, and without having of a specialized transport infrastructure, or logistics, to carry the drugs to the whole republic.
The Treasury’s mission to the IMSS to create a new strategy for distributing medicines and healing materials in all its hospitals came after the federal government changed the model of purchases of medicines, and accused the distribution companies of Acts of corruption to inexpensive the prices of health supplies.
The new head of the Mayor’s Office of the Treasury, Raquel Buenrostro, was the one who asked the IMSS to carry out this new task through a trade directed to Flavio Cienfuegos, Director of administration of the Institute, according to published The Universal On a note last Tuesday.
Despite the fact that the Institute has the largest network of public hospitals throughout the country, it has not had its functions to distribute medicines. So it does not have, for example, trucks to ensure the cold chain required by many drugs, nor the personnel needed to transport and protect a distribution network of this type.  
This was explained in an interview with the IMSS consulted, civil society organizations of the health sector, and representatives of the business sector, who showed their concern about a possible shortage of drugs for the second semester This year, both for the delay in purchases consolidadadas of more than 3800 medical keys, as for the lack of a concrete plan to distribute them.
However, both the President of the Republic, Andrés Manuel López Obrador, and the senior officer, Raquel Buenrostro, have insured on several occasions that the supply is guaranteed, despite delays.
Even Buenrostro accused last May 24 that the shortage of drugs and healing equipment in some parts of the country is due to local problems, and that pharmaceutical companies do not want to sell their products due to the change in the model of government purchases.
«The supply is guaranteed at 100%,» the official stressed.
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Without infrastructure or technology
In this regard, Patrick Devlyn, president of the Health Commission, of the Business Coordinating Council (CCE), said in an interview with Political Animal That the private sector is concerned that it is being asked to an institution as important as the IMSS, which serves nearly 80 million Mexicans, divert attention from its main function, to develop a logistic capacity, which does not have, for the distribution of medicines throughout the country.
«The IMSS does not have the infrastructure or technology to comply effectively and consistently with the distribution of medicines throughout the Republic,» he said.
This institution, added Devlyn, was not created as a drug distributor, was created to provide health services to workers and to give them access to social security.
«If they have failures in this, because they have bottlenecks in their first level of health care and have no capacity in many of the services they must provide, now we are concerned that they divert part of the employer dues and their attention to carry out the day Stribución of drugs, «stressed Devlyn.
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In the distribution of drugs there are three critical aspects: the drugs have to be controlled in batches, because if there is any risk with them, you should be able to identify where each piece of each lot to be able to recover it.
The second aspect is the expiration dates, you have to have control of this so that it is not selling product that is close to its expiration date or already expired.
And three, the cold chain. Many drugs require a point-to-point control, even in-place, of their temperature.
«If a drug is dispatched and there is no control of the expiration date, many expenses will be delivering drugs already deciduous. If the temperature is not taken care of, it can cause damage or not have the expected effect. »
Those are the risks, underlined Devlyn. «If we ask the (moving) beavers or the ADO buses to distribute drugs right now, they could, but the question is at what cost, with what level of efficiency, and effectiveness.»
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Luis Adrián Quiroz, coordinator of the civil organization entitled IMSS Living with HIV who has been struggling for 16 years to ensure the supply of drugs in social security, said in an interview that, while no one can oppose the fight against the Corruption, and less in the health sector, is also concerned that the result may be similar to that of the first months of combat against Huachicoleo; When a number of measures taken by the Government provoked the shortage of fuel in much of the country.
«In this case of drugs, the problem is that there are lives in the middle,» emphasized the activist, who added that, so far, the commission of the IMSS to distribute medicines leaves many questions in the air.
«For example, how will they increase the operational capacity and infrastructure of the IMSS to safeguard the quality of the transportation process, and so that all the beneficiaries of all parts of the country receive their medicine on time and in good condition. What’s the plan?  Will the social security be endowed with more resources for this? «said Quiroz, who recalled that in the Institute’s budget there is not, until now, a specific heading to distribute medicines throughout the country.
Following these questions, Political Animal He sought out the Ministry of Finance and the IMSS to learn more about the plan for Social security to become, in addition to its functions, a distributor of medicines. But, until the time of posting this note, there was no answer.
«Distributing drugs is a very sophisticated thing»
For his part, Juan de Villafranca, executive director of the Mexican Association of Pharmaceutical Laboratories (AMELAF), said that they could not say if the IMSS has the ability to assume the distribution of medicines or not.
«We don’t know whether they can do it or not, because the manufacturers don’t get into the distribution. The manufacturers sell it to the distributor and sell it to the government, «he explained.
So it is the distributor, he added, who is in charge of organizing the batch medicine, delivering it to the different places, pays the manufacturers, and then takes charge of charging the government.
«If we are told give us the drug, it will be quoted by delivering at one point, but as manufacturers we do not have the ability to send it to the whole country, because distributing is something very sophisticated: the distributors collect the drugs of all Laboratories, they put them in a large winery, and robotically they choose the lots, for example, for a clinic in San Luis Potosí, and send them in controlled temperature transport and so for the whole country. »
Delay in drug purchases
In addition to the issue of distribution by the IMSS, Villafranca and Devlyn are also concerned about the delay in the publication of the call for tendering the consolidated purchase of medicines to supply the health sector during the second half of the year.
According to what the government announced, the call would be published on May 7, after that date changed to 23, but not that day was published.
At the moment, there is no official definite date.
«We are hoping that at any time it will be done, and it is very important to consider the times, because no laboratory in the world has an inventory of medicines. It would be crazy if someone started making medicines without knowing if they won the bidding. Because if you don’t win, then what do you do with the medicine? You can’t keep them there, «said Villafranca.
This implies, he pointed out, that whoever wins the bidding for a certain key, «will have to ask for the raw material, manufacture the drug and that takes two to three months of time.»
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Original source in Spanish

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