The Mexican government defended on Monday the continuity of its agreement with UNOPS, the UN agency specialized in logistics, for the purchase of medicines. Despite the accolade, both parties have recognized “deficiencies” in a process sown with delays and have promised changes in the calendar and in the distribution system for the next tender, to avoid falling into shortages again. The order for the second half of 2022 will be considerably less than that of 2021: UNOPS will buy just 31% of what it was asked for this year.

UNOPS will launch the tender for medicines and healing supplies in December and deliveries will start from July 2022. The supply for the first part of the year, officials have insisted several times, is already secured with the contracts signed so far. “The message I want to send is that we are on time to launch the tender,” said Giuseppe Mancinelli, the deputy regional director of the international agency, at a press conference after the delays in the purchase for this year.

President Andrés Manuel López Obrador presented the agreement with UNOPS as the definitive solution to the supply problems that have worsened since his arrival in government. However, a year and a half after signing, the ambition of the agreement has been reduced. By the second half of 2022, UNOPS will be tasked with acquiring 634 keys or types of products -361 medicines and 273 healing materials-, compared to the 2,034 that it was seeking to supply with its previous purchase. Although the new tender covers only one semester and not an entire year, as in 2021, it is a considerable difference.

The Institute of Health for Wellbeing (Insabi) will purchase the proprietary or single-source medicines previously handled by UNOPS. “The purchasing procedures for us are more agile”, the director of the institution, the anthropologist Juan Antonio Ferrer, explained briefly. UNOPS is also slashing the number of cancer drugs, from 155 in 2021 to 28 by the second half of 2022. Constant disruptions in the supply of chemotherapies have sparked a broad protest movement from parents of children with cancer. Recently, López Obrador admitted the shortage and asked the health authorities for a solution “without excuses.”

This reduction in key volume comes after the 2021 purchase launched by UNOPS left 48% unallocated. The Government pointed out that 13% of the keys did not receive offers, 12% obtained proposals above the reference price, and 7% received responses from providers disqualified by the Executive, among other explanations. In any case, this percentage far exceeds the standard achieved during purchases in previous six-year terms – in 2018, only 9% of the keys were left unallocated. To fill the void, this year the government has had to rush out to buy the remainder.

In addition to cutting the number of keys, the Government and UNOPS are seeking to correct some errors by 2022. Labs will be given more time between signing contracts and the delivery date, a demand from the sector. The UNOPS deadlines for this year called for suppliers to deliver two months after signing, when on average it takes three to four months to produce a drug. “The industry is asking for a planning period of at least three months,” Mancinelli said.

They also want to speed up payment to suppliers, an issue that caused friction between the Government and UNOPS, as well as discontent in the industry. To reward the laboratories, the international agency has to wait for the receipt of the drugs in state warehouses to be confirmed. These warehouses were “overloaded”, according to Insabi, which delayed remuneration. Now, Insabi is exploring with the Treasury the possibility of making partial payments to distributors before they have delivered the full load. “We have to become more efficient,” recognized Juan Antonio Ferrer.

In parallel, the Executive has affirmed this Monday that the laboratories will be able to deliver the medicines directly to the patients. This represents a partial return to the previous scheme, in which the distribution was in charge of a handful of large companies, in alliance with the laboratories. López Obrador considered that this fostered corruption and returned distribution to the government, a responsibility that has strained the capacities of the public sector to the maximum and caused supply problems.

Despite the setbacks, the Executive has defended the virtues of the agreement. UNOPS estimates savings of 10 billion pesos, about 500 million dollars, if the maximum reference price of previous purchases is taken into account. They attribute the savings, in part, to opening up to the international market, although 94% of the suppliers are Mexican. The agency ensures that 97% of the drug keys for 2021 have already been delivered according to the schedule.

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