Juan Manuel Sotelo, Country Representant of PAHO/WHO, spoke to Mexico Health Review on what improvements could further advance Mexico’s health system.
Q: How does WHO work to promote a better health system in Mexico?
A: The specific objective of WHO and PAHO is to cooperate with national authorities to attain the highest possible level of health and to promote the creation of strategies in line with the 2030 Agenda for Sustainable Development that benefit the health of the population. In Mexico, the biggest area of concern that we have identified is noncommunicable diseases. Diabetes, obesity and diseases related to tobacco consumption are the most critical.
National and international data clearly indicates that Mexico is undergoing a diabetes epidemic, with 15.9 percent of its population suffering from the disease, while on average OECD countries barely reach the 7 percent threshold. This is a clear result of bad eating habits. Kids are also facing this danger as one in every three children is overweight. Tobacco adds risks of other noncommunicable diseases, like cancer and cardiovascular diseases, to the detriment of the population’s life expectancy.
Q: What actions should Mexico take to alleviate both obesity and tobacco consumption?
A: The country has made the courageous decision to declare overweight and obesity as national health emergencies, allowing for an increase in taxes on sugary drinks, for example, as well as banning the use of specific advertising elements that promote the consumption of candy and junk food by kids. Taxes are an important tool to de-incentivize the consumption of tobacco and sugar. Although the law states that closed environments should be 100 percent smoke-free, it is not being respected.
Q: What improvements could further advance the country’s health system?
A: Mexico’s health system should adopt strategies that enhance its efficiency and efficacy, and it should also promote a more determined approach on social determinants of health. For example, education must go hand in hand with health promotion because if it is properly implemented, kids can then provide a way to reach parents and help raise awareness in relation to health issues.
Q: How can universal access and coverage be implemented in Mexico?
A: Ideally, universal health coverage and access should be guaranteed by the health system and should be provided by the public sector. My initial recommendation is to delink the employment status from access to healthcare. Anyone requiring health services should not need to have a job to access the care that is needed. This is even more important in Mexico, where the job market is precarious and the number of workers in the informal sector is growing.
Universal health coverage and access is not in conflict with the private health sector. It means that the public sector has the responsibility to ensure that everyone has access to people-centered, timely, high-quality healthcare. Meanwhile, the private sector should operate according to the existing regulatory framework and services at an affordable price.
Q: To which areas should Mexico direct investment in its health system?
A: Mexico is investing about US$200 per capita in the first level of care, which is a very low amount. An increase in health expenditure on the first level of care is difficult to implement because it usually implies a decrease of investment in the second and third levels, which is where hospitalization and other specialized care is carried out. However, we must remember that taking care of the population at the first level reduces the need to spend money on the second and third levels of care, and this, in turn, results in more benefits for the population. For people to see the advantages of a stronger first level of care it is critical for public institutions to work closely with communities and the population in general, so they can understand the direct benefits they can get from a higher investment in the first level of care.
This is a fragment of the complete interview published on Mexico Health Review 2018. For more information on this publication and where to find it, please click here.
Industry Analyst and Journalist at Mexico Business Publishing