Read the Conversation
Conversation highlights:
- AMIIF successfully repositioned pharmaceutical innovation by shifting the conversation from medicine access to health system strengthening over the past decade.
- A groundbreaking productivity study with Guanajuato's automotive cluster revealed that health issues cost the industry 7.1% in annual economic losses through absenteeism and presenteeism.
- Women's health represents an untapped opportunity for systemic change, with almost 30% of households maintained by women who spend twice as much time on healthcare responsibilities.
- The current health investment in Mexico remains among the lowest in OECD countries, with 20% of last year's budget going unused while out-of-pocket expenses continue rising.
- New leadership must learn from previous generations while adapting strategies to an evolving environment rather than repeating outdated approaches.
- Nuevo León's health secretary demonstrates how integrated public-private collaboration can deliver measurable results without additional funding.
EF: Looking back over the past decade, what would you identify as the two biggest successes for Mexico's life sciences ecosystem, and what should be the priority target for the next four years?
CT: One of the major successes was positioning pharmaceutical innovation as valuable and important. AMIIF took a leading role in the sector and became probably the most important voice beyond the chamber because we had a strategy. We had a vision and a 10-year plan developed with PricewaterhouseCoopers. The key difference was recognizing that we couldn't keep talking only about medicines because the health system wasn't responding. We had to focus on how we help the health system. That was the first big change, talking about the health system rather than just our needs for medicines.
This led us to ask why health wasn't a priority for the private sector in general. Why weren't the CCE, COPARMEX, or other major employer groups prioritizing health? They talked about energy, labor, and regulation, which is fine, but health is a detonator of growth and development.
The turning point was conducting a productivity study with the automotive cluster in Guanajuato. The study showed they were losing 7.1% in annual economic gains because of health issues. One percent was absenteeism, easy to measure when people don't come to work. Six percent was presenteeism; people coming to work but not feeling well and underperforming. The automotive cluster was buying private insurance for everyone because they thought the public system wasn't working, which increased the cost of doing business. We projected this would rise to 8.5% ten years later, which happened last year.
This raised awareness, and the president of the CCE at the time agreed that health had to be at the top of the agenda because it affects all sectors. It's transversal. The automotive sector was Mexico's largest sector, and this was the only study of its kind. It was presented at the OECD. When we first presented the study to my colleagues and company leaders, they had long faces, asking why we weren't talking about COFEPRIS instead. But that's the trap: we focus on short-term issues and forget about having a vision.
EF: What should be the next priority target for Mexico's life sciences ecosystem?
CT: Four years ago, we anticipated having our first female president, which was almost obvious. We started talking about health with a focus on non-communicable diseases as a gender issue. If we don't elevate this as a gender issue, we're always fighting about the cost of medicines. Health investment in Mexico is still the lowest among OECD countries, just above Turkey. Compared to Argentina and Chile, we're low. Public investment is around 2.8%, private investment about 3.1%, so our system is more than 50% out-of-pocket. In the government's first year, the health budget was reduced by 12%. Last year, about 20% of the budget went unused.
We started talking about this because half of Congress are women, half of the governors are women, we have women in the press, and significant female leadership. Why don't we talk about health as a women's issue? Women's voices can make a change.
AMIIF conducted a study with the National Institute of Public Health and partnered with the George Institute, which operates in Australia, Sydney, and England. The study concluded that almost 30% of households are maintained by women. Of total care in households, women spend 75% taking care of themselves or relatives. This obviously limits their development and career advancement. Women also experience non-communicable diseases for longer periods.
With a female president, if we make this a gender issue and bring everyone together, it becomes much harder for the government to cut budgets that affect women, and you elevate health as a priority. The study was completed, and we held presentations in 2023, during the week of Innovation with international experts. We had successful events with women leaders. But after I left AMIIF in March 2024, I believe there is a great opportunity to open the discussion.
The study exists, and we're trying to get others to recognize this opportunity. If leaders don't take this and see it as an opportunity, it's a missed chance. The study shows this is a gender issue limiting women from developing in the workforce. If we want to develop Mexico, with 52% of the population being women, this has to be at the top of the agenda.
EF: What key advice would you give to the new generation of leaders taking over major positions in the life sciences industry?
CT: The first thing is: what can you learn from past experiences? I learned a lot from previous generations. That doesn't mean I haven't evolved. I've evolved from what my father was, but I always learn from those who came before. People say we're probably in the toughest and worst time in our history, but it depends on how many decades you've been in this world. I can tell you about price controls, strikes, import substitution, hyperinflation, and very tough times in the 1970s/80’s in my home country, Argentina.
I would say go back to basics and recognize that current leaders have the opportunity to make real changes. Even if you're right, the environment changes, so you have to change. What I said five years ago, I have to change now, not because I was wrong, but because you have to evolve.
Studies are sitting there. Productivity studies, demographic analyses. We're at the peak of the demographic bonus with 92 million people in the workforce. These studies could be updated instead of just talking about tactical issues like COFEPRIS approvals. Clinical research investment is important, but I said that 10 years ago. We need to change the dialogue.
EF: Can you share an example of effective leadership and innovation happening in Mexico's health sector?
CT: There's a great example in Nuevo León. I interviewed the Secretary of Health, Alma Rosa Marroquín. What she's doing and the results are spectacular. She came from the public sector, where she led hospitals, then studied at Universidad Autónoma de Nuevo León, and worked for TecSalud, giving her both public and private experience.
She arrived in the middle of the pandemic, and the first thing they did was take all the workers in buses to the border for vaccination in Texas so they could restart the economy. Then she created a program for universal health coverage for children with cancer, establishing a trust fund of 500 million pesos to take care of those kids. She's getting results.
For breast cancer and other initiatives, if you read about her work, you'll see she doesn't have more money than others. She had to work with existing resources, but she integrated information from the health institutions and brought everybody together. She asks the fundamental question: if you put the patient at the center, what do we have to do to take care of them? It's patient first.
She's working on early childhood programs, cochlear transplants for kids who can't speak, and addressing overweight issues. She has many things pending, but what they've accomplished together is state-of-the-art. She truly believes that if you know a patient is at the center, you have to do everything to take care of them.
EF: What trends do you see emerging in Mexico's healthcare landscape?
CT: You're going to see tons of new private hospitals with different models and new insurance options. The insurance landscape is changing dramatically because you can no longer deduct VAT. All insurance premiums are going up an average of 28%, regardless of age. My case will be higher. People are leaving the traditional system and looking for new models.
The public sector is currently surpassing in many areas. I think they have goodwill, but unfortunately, they are lagging behind the needs of patients. The reality is that 20% of resources last year were underutilized, shifting more costs to out-of-pocket expenses. The adoption of digital health tools to make follow-ups with patients will be a key improvement.
I would also highlight the work of Tere Cantú, who leads the Alianza Cooperativa de Salud. This alliance was created several years ago and brings together all the different sectors. They had meetings with patients, different groups, and launched an app for patients to navigate the system. They had representatives from the health council and different groups working together. This integration represents an important part of the total healthcare environment.
