Read the Conversation
EF: What are the executive functions you perform for COMED?
GM: I run the organization, but my background is not in health. I was the executive chairman of Mexico’s meat council in the past and have participated in many organizations, which helped me develop the skills necessary for my role in COMED. In 2016, three big firms approached us: Grupo Proa, Grupo Aries, and Polanco, all of which include several brands. They told us their sector was not represented by a chamber or an association and asked for help developing such a model in diagnostics. As far as I know, COMED is the only organization run by a third party. Starting the organization in 2017 was providential because a few years later, the pandemic hit Mexico and the world, and it would have been chaotic if the lab sector had not had a focal point for dialogue with Mexican authorities. By then, fortunately, we were well organized to face the challenges; we serviced a channel to manage the PCRs and antigen tests, and our members' count jumped to eighty. We deal mainly with membership, advisory, and consulting. We establish strategic alliances with Funsalud, the National Public Health Institute, and several firms and organizations, such as the Mexican Certification Agency.
EF: You mentioned having learned a lot in this role. How have you applied this knowledge in diagnostics in Mexico?
GM: Advances in big data, research, genetics, molecular biology, appliances, and things like smartwatches that track someone’s vital signs are changing the industry at an enormous speed. COVID accelerated the change while presenting a series of challenges, for example, the competition from drug stores, which are now performing some of the functions of laboratories. We have petitioned the authorities, demanding the drugstores comply with similar standards expected from laboratories, but the fact is we will have to adapt to these changes. The main lesson from COVID was that genetic and molecular biological tests and all the appliances and devices that keep track of conditions will represent a great opportunity and challenge. The fact that an individual can self-monitor is great; however, they should understand they do not have all the information on how to interpret the data provided by the devices, so specialized knowledge is also needed.
EF: You touched on certain barriers, such as the appropriate use of data and fair competition. Are there more barriers to diagnostics in Mexico, and how is COMED working to overcome them?
GM: A lack of communication with the government, the regulatory backlog, and the lack of education focused on providing the industry with trained personnel are all huge obstacles to a robust, innovative, and prosperous health industry. We need a robust public health system, as still, many people lack the resources to pay for private services and are stranded without proper health assistance. The few who can somehow pay also have access issues due to the regulatory backlog in approval certification. Although we have seen some progress in public information, the lack of communication in the sector is still a problem for the industry. For example, at COMED, we have a thousand contact points with people with proper training, facilities, cold storage, etc., and we offered them for public use during the pandemic, however, proper coordination was unsuccessful. Summing up, we face a tough public environment, difficult and unfair competition, obstacles to innovation, recruitment, training, and quick clearance for innovative tests.
EF: Can you put a dollar value on effective diagnostics, and what makes one dollar invested in diagnostics today worth two dollars next year?
GM: The latest available public information dates from 2019, when the diagnostics industry’s GDP was MXN$ 26.08 billion. According to the same source, by the end of 2022, there were 15,152 economic units in the sector, meaning points of contact with the public. As there is no updated information from public sector diagnostics, we have been trying to build databases to establish the exact value ratio of investment versus the impact on the public’s out-of-pocket costs. It is very hard to pinpoint what conditions are more prevalent in what regions to create a national epidemiologic map because we have sensitive information on the patients. It is a complex issue, but clinical information and data management are even more complicated without clear details.
EF: As little as 2% of healthcare expenditure reaches diagnostics. How can investment in diagnostics be increased?
GM: The public and private sectors would save a lot of money if more investment would go into prevention and proper diagnosis. According to a study by The Economist covering various countries, Mexico was by far the country with the highest costs and debts. Regardless, Mexico’s situation has the potential for improvement; the diagnostic situation in the public sector is one of those areas we should focus on improving. It should not take seven months for a possible cancer patient to get a diagnostic appointment.
EF: Can you elaborate on the importance of local business to COMED and the diagnostic industry in Mexico, especially regarding talent and production capabilities?
GM: The 80 firms in COMED include all the big labs, but we also have medium, small, and very small-sized labs as members, so we know what problems they face. Small labs in less populated cities are crucial for access, though most of them are managed by scientists who do not necessarily have management skills. At COMED, we have focused on business education, providing a certified course to teach management skills to those needing it. We provide lessons on financial administration, human resources management, and location, amongst others. We need to have small businesses in the communities. Out of the 80 member firms, big holdings have kept growing through acquisition, which means we are seeing a significant market concentration. Some concentration is needed due to the atomization of the sector; however, all small businesses should not be commoditized. Small local laboratories should continue to exist and have the trust and confidence of the local doctors and medical community.
EF: What initiatives is COMED taking to increase awareness of preventive approaches and diagnostics, and how are you educating healthcare professionals and communities in Mexico?
GM: In January last year, we launched Universidad COMED. We signed an agreement with a banking and commercial school in Mexico, a historically prestigious administration and management school. We chose them because they comply with all the regulations to certify educational programs, and for us, this was a simple solution to the complex task of starting a new school. They have the technological base we need, and we aim to enforce the business capabilities of our professionals. There is a serious lack of phlebotomists, medical professionals who take blood from patients, and a severe scarcity of radiology technicians. Mexico will not be able to grow if we can’t attract young talent or help people transition laterally. We plan to launch a revamped communication program in social networks communication with the aim of attracting talent. Covid helped to raise awareness of the importance of spending money on oneself; diagnostic testing is an investment in one's life. We are working with information technology companies to develop digital communications to contact people to do preventive tests. I hope the next administration will lend us their ear because we cannot work alone; we need help from the authorities to devise intelligent, far-reaching campaigns to encourage people to go to their local lab and do preventive tests.
