Sustainable Immunization Financing: Mexico Country Brief

Executive Summary

Context 

• Mexico health care services are provided by more than six public insurance institutions – five social security institutions and Seguro Popular – offering unequal access, services, and prices to the Mexican population based on their employment status.
• This fragmented health system is under-performing, with challenges in terms of equity of access to quality health care and efficiency in spending.
• Despite the need for reform and modernization, the government of Mexico has not prioritized investing in health and spends very little on health compared to peer countries from the OECD.
• As a result, Mexico still shows poor health results, with high maternal mortality and the lowest life expectancy of all OECD countries.

Immunization Financing and Performance

• Mexico has traditionally been considered a regional leader for immunization but is now facing challenges to expand the National Immunization Program (NIP). The current Mexican schedule offers 16 vaccines for 14 diseases, less than the Latin American average of 17.
• Immunization performance is also falling behind, with DTP3 immunization coverage below 90%. With a complex service delivery system, monitoring of the program is challenging, with no accurate information on coverage rates limiting the understanding of under-performance drivers.
• In addition, current global vaccine shortages from multiple manufacturers are negatively impacting Mexican access to the internal supply market.
•  Mexico does not participate in the PAHO Revolving Fund. The country has multiple institutions procuring vaccines. This creates difficulties for Mexico in exhibiting strong negotiating power in the international vaccine market.
• Immunization financing is in transition, with the recent pass of the immunization law. The new immunization law prioritizes the NIP in the overall health budget by creating a single line item budget for immunization. The legal requirement for increasing funding to immunizations may create some space to revitalize the program and should provide protection from ad hoc cuts, as happened in 2015.

Key Trends and Takeaways

• It will be important to leverage the uncertainty of the new administration’s health reform platform to advocate for increased access to immunization.
• There is an active civil society advocating for more investment in health and health system reforms which struggled to get its message across in the past.
• The coming change in Mexico’s administration will transform the political landscape and offers both opportunities and risks for reforms.
• Expanding the resourcing of financing beyond governmental revenue could provide the budget headroom required to expand the NIP.