Starting in 2019, the federal government implemented new centralized drug and healing material procurement schemes to promote greater competition and reduce corruption risks. However, in the area of sexual and reproductive health, market concentration continues, although with other actors, and instead of more public tenders, direct awards rose to 97%.
This is revealed by the study Finding the way, budget and purchase of medicines for women’s sexual and reproductive health, prepared by the civil organization Fundar.
According to the document, although the states also make purchases of medicines and supplies for sexual and reproductive health, 75% of the budget is exercised by the Federation, and then sends the products to the entities.
Between 2016 and 2018, direct adjudication was the most used mechanism for the acquisition of these drugs; by contract amount, 88% was allocated so and only 12% by public tender. The percentage of purchases in that period was concentrated in Grupo Medicamentos Especializados (78%), Farmacéuticos Maypo (12%) and Farmacéutica Althos (4%), “which opened the door to corruption risks with overpricing, conflicts of interest or tax privileges,” says Fundar’s analysis.
Starting in 2019, the federal government implemented new centralized procurement schemes to promote competition and reduce risks. The processes of purchase and distribution of medicines were concentrated in the Chief Officer’s Office of the Ministry of Finance (SHCP). Then, in 2020 and 2021, two new schemes were tested, with purchases made by the United Nations Office for Project Services (UNOPS) and/or Insabi.
In sexual and reproductive health, in 2020, these new schemes had ambivalent results. Among the positives, Matilde Pérez, researcher of the Accountability and Fight against Corruption program of Fundar, highlights, a reduction in prices of medicines and supplies was achieved, with percentages between 18% and 224%.
However, market concentration was maintained, now in three pharmaceutical companies: Merck Sharp & Dohme Comercializadora (64%), Bayer de México (21%) and Janssen-Cilag de México (10%). For its part, direct awarding continued to be used and even grew: by amount of contracts, up to 97% was made with this figure.
By 2021, Fundar could not have information on purchases of drugs for sexual and reproductive health, due to the pulverized nature of the acquisitions and because it did not have access to the information even through transparency requests.
Read more: The government commissioned Birmex to distribute the medicines, but it does not have the resources to do so; the IMSS failed it in a tender
The risks in purchases in the states
When analyzing the purchases of six drugs for sexual and reproductive health for population without social security, the study found that some states do not indicate the exact number of pieces purchased, which prevents knowing the exact quantity purchased and the unit price and / or determining if the amount of drugs can meet the required demand.
In addition, the purchase prices of medicines have an important variation between entities and, in some cases, this is considerable (up to 900% more) with respect to the price of the entity that bought it cheaper or that of other instances such as the Mexican Institute of Social Security (IMSS).
For example, explains Janet Oropeza, also a researcher at Fundar, Colima bought a box of mifepristone in 2017 for 2,476 pesos, while Nayarit bought it for 1,299 pesos, a difference of 105%.
In 2016, Chihuahua acquired misoprostol for 231 pesos, while Baja California bought it for 916 pesos, a variation of 297%.
“That is why we say that it is necessary to strengthen the control and control mechanisms in the states and at the federal level to prevent cost overruns,” Oropeza said in an interview.
Also, the study highlights, the number of pieces acquired by the entities can vary or decrease a lot between years, without there being clarity on how this relates to the demand for medicines. For example, the decline in the number of pieces purchased of mifepristone and misoprostol — drugs that allow for safe abortion — can be worrisome.
Lack of resources
In addition, the analysis of the resources exercised for the purchase of medicines from the components of violence, maternal and perinatal health, family planning and contraception in the period 2016-2020 revealed that there has been no progressivity in spending, as marked by international human rights standards.
In 2016 they exercised, both for the Federation as for the states, one thousand 397 million pesos. In 2017 (one thousand 210 million), 2018 (one thousand 178 million) and 2019 (one thousand 111), total spending decreased. And although in 2020 it increased 8.7% compared to 2019 (one thousand 207 million), it did not reach the levels of 2016 again. This decrease occurs in a context in which insabi proposed, since 2020, to cover and guarantee the sexual and reproductive health of a greater number of women.
The research also showed that most resources for the purchase of medicines are exercised for the family planning and contraception component, followed by maternal and perinatal health, and finally, violence.
In a context in which women continue to face challenges to guarantee their sexual and reproductive health, it is necessary for the Mexican State to allocate greater resources to the different components that would guarantee this, concludes Fundar.
What we do at Animal Político requires professional journalists, teamwork, dialogue with readers and something very important: independence. You can help us keep going. Be part of the team.
Subscribe to Animal Político, receive benefits and support free journalism.#YoSoyAnimal
