On a hot Sunday morning in August, parents, patients, and nurses in white shirts walked from the Arco de la Calzada to León’s main square, hoisting plush toys and hand-lettered signs. “No hay quimio, nos están matando,” read one banner: there’s no chemo, you’re killing us. It wasn’t just León. Over the same weekend, marches erupted in Salamanca, Guadalajara, Oaxaca, and Villahermosa under the banner “Queremos Medicina”, a coordinated protest pushed by civil groups to force a solution to chronic shortages of oncology medicines in public hospitals.
For years, families have said the quiet part out loud: people are dying when cancer drugs don’t arrive on time. Proving a clean, numerical body count tied to each missing vial is nearly impossible in a fragmented system. But the evidence trail—policy shifts, canceled tenders, emergency purchases, and millions of unfilled prescriptions—shows how avoidable stockouts ripple into treatment interruptions, worse survival, and funerals that didn’t need to happen.
A crisis built by policy — and misfires
In 2019, the federal government upended drug purchasing in the name of anti-corruption. Private distributors were cut out; tenders went central; responsibility bounced among agencies and, later, to INSABI and then IMSS-Bienestar. The overhaul promised savings and transparency. Instead, oncology stockouts spread, as documented by clinicians and international observers.
INSABI was formally scrapped after poor performance; the new model consolidated service delivery under IMSS-Bienestar. Meanwhile, the administration built a 40,000-m² “Megafarmacia” meant to ship any missing medicine nationwide within 24–48 hours—an emblem of extreme centralization that critics warned wouldn’t fix procurement bottlenecks or last-mile distribution.
Then, this April, a tender led by state-owned Birmex was canceled over “irregularities,” triggering the first shortage crisis of the new government and hitting oncology especially hard. Veracruz raised the alarm; emergency reverse auctions followed; Birmex’s director was replaced. The episode laid bare how one failed purchase can cascade into hospital-level stockouts.
The human cost behind “unfilled prescriptions”
Independent monitors show the scale: 7.5 million prescriptions went unfilled across public systems in 2023 (down from ~15 million in 2022), and IMSS alone failed to supply 11.6 million pieces of medication in 2024. Oncology drugs are consistently named among the most affected. These are not just numbers; in cancer care, a delayed cycle can mean a poorer prognosis.
Clinical literature backs up what families sense. Mexican oncology teams have documented treatment interruptions and regimen modifications due to drug shortages, with associated drops in survival. Pediatric cohorts in Mexico and the broader region show worse outcomes when therapy is delayed, altered, or abandoned—exactly what happens when vincristine, methotrexate, or cisplatin isn’t on the shelf.
Mexico’s own pediatric leukemia studies point to stubborn survival gaps and state-level inequities, problems intensified when essential medicines aren’t reliably available. Some series report three-year overall survival near 58–62%, far below high-income benchmarks, with experts warning that logistics—stockouts among them—compound already heavy clinical burdens.
León is not an outlier
Over the protest weekend, national media tracked synchronized rallies. In Guanajuato, families repeated the same demand: abasto total of oncology medicines in public hospitals—especially for children. The chants and props were not theatrical flourishes; they are a language born of empty cabinets.
Nariz Roja A.C. and allied groups coordinated the “Queremos Medicina” actions across multiple cities on August 9–10, emphasizing that missing chemo is a life-threatening failure, not a nuisance.
Government: “We’re turning the corner.” Patients: “Not where it counts.”
The new administration says the tide is shifting. President Claudia Sheinbaum’s team claims 96% of required inputs for 2025–2026 have been acquired, that over 416 million pieces arrived in June–July, and that new platforms will let citizens verify availability. Even industry voices concede better purchasing, while warning that distribution remains the weak link—and that arrears to suppliers complicate the fix.
Those macro-numbers don’t comfort a parent told to buy vincristine privately or to “come back next week.” Nor do they answer why Veracruz, among others, saw oncology gaps widen after the April tender collapsed—only to be patched by emergency buys months later. The gap between pallets logged in warehouses and drugs hung on IV poles at the bedside is where patients live or die.
Accountability, not just logistics
This is not only a story about pallets and purchase orders. In April, anti-corruption officials flagged irregularities in Birmex’s buying—enough to cancel the process and swap leadership. That is accountability on paper. On the ground, it translated into empty carts on oncology floors and parents carrying debt. Emergency reverse auctions were the tourniquet; they were not the cure.
Experts who mapped Mexico’s health-system reforms argue the country suffered setbacks toward universal health coverage, magnified by the pandemic and procurement churn. Undoing that damage means building a boring, reliable supply chain: routine tenders that close on time, transparent inventories, and state-federal coordination that doesn’t collapse with each political cycle.
What would “no more funerals for stockouts” actually require?
- Procurement that survives audits and elections. Reverse auctions and emergency buys should be the exception, not the rule.
- Public, hospital-level dashboards linking orders to oncologist-verified clinical protocols, so shortages trigger automatic substitutions or transfers before a cycle is missed. (Today, families often discover stockouts at the pharmacy window.)
- A working cancer registry—beyond pediatrics—so policymakers can measure survival, abandonment, and the mortality impact of interruptions, rather than guess.
- Last-mile logistics contracts with performance penalties tied to oncology time-windows, not just “pieces delivered.” AP’s skeptics of one-hub centralization were right to worry: distribution, not only buying, is where Mexico keeps failing patients.
Until those basics are in place, the images from León will keep repeating: stuffed animals, quiet fury, and the bitter knowledge that timely chemo is the difference between remission and a funeral—a difference Mexico knows how to deliver, but too often doesn’t.
