MedAccess Community Watch

The Mexican Constitution guarantees the right to health protection for all citizens. Although the country's legal framework ensures access to vaccines, medical supplies, and medicines for everyone, a discrepancy often exists between what is legally mandated and the everyday reality faced by millions of people seeking to maintain their health or treat and prevent illnesses.

The Mexican healthcare system is complex, consisting of various public and private payers and providers. Three primary public subsystems—IMSS, ISSSTE, and INSABI—operate simultaneously, bearing responsibility for funding, service provision, and regulation.

Moreover, access to health services is limited. From 2018 to 2020, there was a reported increase of 15 million individuals excluded from healthcare access, causing the percentage of the population without access to healthcare to rise from 16% to 28%. This equates to a growth from 20.1 million to 35.7 million people lacking healthcare services.

For those who do have access to healthcare, obtaining medicines and health supplies is also a challenge. Our 2021 publication, "Radiography of Shortage: Health Transparency Report 2017-2021," revealed that nearly 24 million patients were unable to obtain all prescribed medications through social security health services during 2021. In recent years, the prescription fulfillment rate has decreased across all Mexican health subsystems. For instance, in Aguascalientes State, the prescription fulfillment rate was only 33% during 2022. Consequently, patients resort to purchasing medications from private pharmacies or markets or even forgoing treatment entirely. This results in increased out-of-pocket expenses and a denial of their right to health protection.

While the Mexican government is working to address this issue, there are no clear communication channels with patients and healthcare professionals. Real-time information on missing medicines or health supplies is essential for developing effective solutions.

To address the pressing issue of limited access to healthcare, medicines, and health supplies in Mexico, we propose a comprehensive solution based on three key pillars:

1. Citizen Participation Mechanism: We will create a user-friendly platform that empowers citizens to monitor effective access to medicines, supplies, and health devices. Accessible through a web app or a WhatsApp chatbot, this system will encourage public involvement and foster transparency in the healthcare sector. By giving citizens a voice, we can better identify areas that need improvement and address shortcomings in the system.

2. Integration with Health Institutions and Data Analysis: By linking our citizen monitor directly to health institutions, we can facilitate a timely response to reported issues. In addition, the data collected will be analyzed to generate valuable statistics that will help health decision-makers evaluate and plan better policies. This data-driven approach will enable us to identify trends, address systemic issues, and allocate resources more effectively.

3. Targeted Communication Campaigns: Recognizing the importance of raising awareness about patient rights and the mechanisms available to guarantee them, we will launch communication campaigns in both rural and urban communities. These campaigns will focus on populations at greater risk or vulnerability, ensuring that all citizens are aware of their rights and the resources available to them. By empowering individuals with knowledge, we can help them advocate for their own health and well-being.

In conclusion, our three-pillar solution aims to bridge the gap between policy and reality by encouraging citizen participation, fostering collaboration between health institutions, and raising awareness about patient rights. By implementing these strategies, we can work towards a more equitable and accessible healthcare system that truly serves the needs of all Mexican citizens

Our proposed solution is essential for several reasons, primarily focusing on the patient as the primary beneficiary:

1. Improved Patient Outcomes: By addressing the issue of limited access to medicines, our solution directly impacts patients' health and well-being. Timely access to necessary medications and supplies can significantly improve patient outcomes, reduce complications, and ultimately save lives.

2. Reduced Financial Burden: Patients who cannot obtain prescribed medications through the healthcare system often resort to purchasing them from private pharmacies or markets, leading to increased out-of-pocket expenses. Our solution aims to improve access to medicines, thereby reducing the financial burden on patients and their families.

3. Empowerment of Patients: The citizen participation mechanism allows patients to report and monitor effective access to medicines, supplies, and health devices, giving them an active role in their own healthcare journey. This empowerment fosters a sense of ownership and control, leading to better self-advocacy and improved patient satisfaction.

4. Enhanced Patient-Healthcare Provider Communication: By linking the citizen monitor to health institutions, our solution facilitates better communication between patients and healthcare professionals. This improved dialogue enables healthcare providers to better understand and address patient needs, fostering a more patient-centered approach to care.

5. Greater Awareness of Patient Rights: The targeted communication campaigns educate patients about their rights and the mechanisms available to guarantee them. Increased awareness empowers patients to advocate for their own health, ensuring their rights are respected and upheld.

6. Health Equity and Social Impact: Our solution aims to create a more equitable and accessible healthcare system by addressing the gap between policy and reality. By involving patients, fostering collaboration, and providing data-driven insights, we work towards a system that truly serves the needs of all citizens, regardless of their socioeconomic background. This promotes social cohesion and contributes to a healthier, more inclusive society.

In summary, our solution is crucial because it places the patient at the heart of the healthcare system, promoting better health outcomes, reduced financial burden, and patient empowerment. By enhancing communication, raising awareness, and driving health equity, we can create a more patient-centered and accessible healthcare system that has a lasting positive impact on the lives of millions of Mexicans.

Our team at the Zero Shortage Collective, driven by Nosotrxs, is uniquely positioned to deliver this solution, as we have a solid foundation in citizen empowerment projects, with more than 6 years of experience. The collective itself has been active since 2019, and it brings together a diverse group of over 100 patient organizations, health professionals, and health activists, with local representation in nine different Mexican states.

Our collaborative approach involves working closely with patients, their families, health professionals, academia, and government authorities to ensure effective access to vaccines, medical supplies, and medicines, safeguarding the human right to health.

Throughout our four years of operation, we have successfully legitimized the collective's information and earned the respect of the community, demonstrating our unwavering commitment to upholding the right to health as our primary objective.

Our web app, “cerodesabasto.org,” has been instrumental in collecting more than 9,700 drug shortage reports from patients and health professionals across the country. Our team has published over 10 documents that analyze the causes and trends behind these shortages, pinpointing problem areas and establishing communication channels with relevant authorities to tackle the issue. Furthermore, our web app automatically sends alerts to responsible authorities whenever a new report is registered, ensuring a swift response to address medicine, medical supply, and vaccine shortages.

To date, we have collected over 9,700 shortage reports, which have been forwarded to various health institutions across all 32 states in Mexico. We are actively collaborating with local organizations in 9 states, and our social media presence reaches more than 30,000 individuals.

In addition to our efforts, the information generated by our collective is the sole reliable source that encompasses all the different health subsystems in Mexico. Media outlets and patients often turn to us when seeking information on this subject.

We are applying to Solve for three primary reasons, based on the information and achievements of our collective so far:

1. Technical Support: We aim to strengthen our platform and expand the reach of our solution to a greater number of Mexicans. By obtaining technical assistance, we can enhance our platform's effectiveness and ensure it continues to address the needs of the community.

2. Financial Support: To grow our initiative and include more local organizations, we require financial backing. This support will enable us to scale our efforts and have a more significant impact on the Mexican healthcare system.

3. Increased Knowledge and Legitimacy: By participating in Solve, we hope to gain further knowledge and expertise in the field, which will in turn boost the legitimacy of our initiative. This increased credibility will help us establish stronger relationships with stakeholders and promote more effective solutions to the challenges faced by the Mexican healthcare system.

What makes our solution innovative is the combination of several key factors, drawing from the information provided earlier and the additional points mentioned:

1. Crowd Sourcing: Our solution actively involves health professionals, patients, and patient organizations, creating a diverse and engaged community working together to address medicine shortages.

2. Accessible Technology: By leveraging accessible technology, we connect users with decision-makers, facilitating the resolution of specific shortage issues in a streamlined and efficient manner.

3. Collaborative Approach: In Mexico, there are limited social participation mechanisms within the health sector. Our solution stands out as one of the few initiatives created and maintained by citizens, fostering collaboration with health authorities to improve the healthcare system.

4. Comprehensive Coverage: Our solution is designed to cater to all the different health subsystems in Mexico, ensuring that no sector is left behind in our efforts to guarantee the right to health for all citizens.

By integrating these elements, our solution offers an innovative approach to tackling the challenges faced by the Mexican healthcare system, ultimately promoting the right to health for all citizens.

Our impact goals for the next year and the next five years are ambitious but achievable, focusing on addressing medicine shortages and improving communication between patients, health professionals, and authorities.

Over the next five years, our primary objectives are:

1. To eliminate general shortages in every Mexican state and health subsystem.
2. To establish a clear mechanism for resolving shortages when they occur, where patients, health professionals, and health authorities know what to do and maintain open communication.

To achieve these goals, we plan to:

1. Establish local representations of the collective in all 32 Mexican states, which will support the platform and strengthen relationships with local patients, health professionals, and health authorities.
2. Develop an easy-to-use, user-friendly, and bidirectional community participation mechanism that enhances access to healthcare and facilitates effective communication.
3. Gain recognition and adoption by all health subsystems in Mexico, becoming a trusted and reliable resource for addressing healthcare challenges.

By focusing on these strategies, we aim to make a substantial impact on Mexico's healthcare system, ensuring that patients have the necessary access to medicines and that communication between all stakeholders is seamless and effective.

To measure the progress of our solution towards achieving our goals, as well as its alignment with the UN Sustainable Development Goals (SDGs), we can develop the following progress indicators:

1. Number of drug shortage reports collected and analyzed: This indicator helps measure the effectiveness of our platform in capturing relevant data on medicine shortages and informing subsequent actions. (Related to SDG 3: Good Health and Well-being)

2. Number of successful collaborations between patients, health professionals, and authorities: This indicator reflects the extent to which our solution fosters cooperation among stakeholders and facilitates the development of targeted solutions. (Related to SDG 17: Partnerships for the Goals)

3. Reduction in the prevalence of medicine shortages: This indicator tracks the impact of our solution on the overall availability of medicines, medical supplies, and vaccines in the Mexican healthcare system. (Related to SDG 3: Good Health and Well-being)

4. Number of states and healthcare subsystems actively using our platform: This indicator assesses the reach and adoption of our solution by health authorities and stakeholders across Mexico. (Related to SDG 9: Industry, Innovation, and Infrastructure)

5. Number of awareness campaigns and capacity-building initiatives conducted: This indicator evaluates our efforts to educate patients, health professionals, and the general public about their rights and the available resources to address medicine shortages. (Related to SDG 4: Quality Education and  SDG 3: Good Health and Well-being)

6. Increase in the number of local representations of the collective in Mexican states: This indicator monitors the expansion of our presence and influence across Mexico, which is crucial for achieving our long-term goals. (Related to SDG 17: Partnerships for the Goals)

7. Proportion of persons with a diagnosed chronic condition receiving appropriate treatment and management: This indicator measures the extent to which our solution contributes to improved access to healthcare for individuals with chronic diseases. (Related to SDG 3.4: Reduce mortality from non-communicable diseases and promote mental health)

8. Proportion of the population with access to essential medicines for chronic diseases: This indicator evaluates the impact of our solution on the availability of necessary medicines for the management of chronic conditions. (Related to SDG 3.8: Achieve universal health coverage, including access to essential medicines)

9. Number of healthcare facilities with adequate stocks of essential medicines and supplies for chronic diseases: This indicator helps assess the effectiveness of our solution in addressing shortages of critical resources for managing chronic conditions across the healthcare system. (Related to SDG 3.8: Achieve universal health coverage, including access to essential medicines)

By tracking these progress indicators, we can continuously assess the effectiveness of our solution and its alignment with the UN Sustainable Development Goals, allowing us to refine our approach and maximize our impact on the healthcare system in Mexico.

Our theory of change revolves around empowering citizens, health professionals, and patient organizations to take an active role in monitoring and addressing medicine shortages, which will ultimately result in a more effective and accessible healthcare system in Mexico.

1. Inputs: We leverage our collective expertise and the collaboration of over 100 patient organizations, health professionals, and health activists, as well as our local representation in various Mexican states, to develop and maintain our platform "cerodesabasto.org."

2. Activities: We collect and analyze drug shortage reports, engage with healthcare stakeholders, and develop communication channels to facilitate the exchange of information and solutions between patients, health professionals, and authorities.

3. Outputs: Through our platform, we generate reliable and timely data on medicine shortages, create opportunities for dialogue and collaboration between stakeholders, and increase awareness of patients' rights and available resources.

4. Outcomes: The increased transparency and collaboration lead to a better understanding of the causes and trends of medicine shortages, enabling stakeholders to develop targeted solutions and policies. This also results in a more efficient allocation of resources and improved communication between patients, health professionals, and authorities.

5. Impact: Over time, these outcomes contribute to a significant reduction in medicine shortages, ensuring that patients have access to the healthcare they need. This translates into a more equitable and effective healthcare system that upholds the human right to health for all citizens.

By focusing on citizen engagement, data-driven decision-making, and collaboration between stakeholders, our theory of change aims to address the complex issue of medicine shortages and create a more resilient and accessible healthcare system for all Mexicans.

The core technology that powers our solution is a web-based platform and a WhatsApp chatbot that enables easy and efficient citizen participation. This technology serves as the foundation for the three main pillars of our solution:

1. A citizen participation mechanism: The web-based platform and WhatsApp chatbot allow users to report shortages of medicines, supplies, and health devices in real-time. These tools are designed to be user-friendly and accessible, encouraging public monitoring of effective access to essential healthcare resources.

2. Integration with health institutions: The platform is linked to health institutions, enabling a timely response to reported shortages. Additionally, our system generates valuable statistics that assist health decision-makers in evaluating and planning more effective policies.

3. Communication campaigns: The technology supports the dissemination of information on patients' rights and mechanisms to guarantee them, reaching both rural and urban communities and focusing on populations at greater risk or vulnerability.

Overall, our solution leverages a combination of web and mobile technologies to facilitate communication between patients, healthcare professionals, and authorities. By utilizing these accessible tools, we empower citizens to monitor healthcare access and directly contribute to addressing the issue of medicine and supply shortages across Mexico.

Our approach to incorporating diversity, equity, and inclusivity into our work is multifaceted, focusing on both our internal team composition and the way we design and implement our solution:

1. Diverse team and partners: We strive to create a diverse and inclusive team, made up of individuals from different backgrounds, with varied experiences and perspectives. Our collective includes patient organizations, health professionals, health activists, and local representatives from various states across Mexico, ensuring diverse perspectives are considered in our work.

2. Inclusive solution design: Our solution is designed to be accessible and user-friendly for people with different levels of technological literacy, language abilities, and educational backgrounds. We aim to ensure that our web app and WhatsApp chatbot can be easily used by a wide range of individuals, regardless of their socioeconomic status or location.

3. Focus on vulnerable populations: We prioritize reaching out to and supporting vulnerable populations, such as those living in rural areas, marginalized communities, or individuals with chronic health conditions. Our communication campaigns target both urban and rural communities, ensuring that information about patients' rights and mechanisms to guarantee them is accessible to everyone.

4. Collaboration with local organizations: We work closely with local organizations in different states across Mexico to ensure that our solution is culturally appropriate and sensitive to the unique needs and challenges faced by diverse communities.

By incorporating diversity, equity, and inclusivity into our work, we aim to create a more effective and impactful solution that benefits everyone, regardless of their background, location, or socioeconomic status. We believe that empowering a diverse range of voices and ensuring equal access to healthcare is essential in promoting health equity and upholding the human right to health.

Our business model is centered around providing value to the populations we serve in terms of impact, while leveraging partnerships and funding opportunities to sustain our operations. We primarily focus on patients, their families, health professionals, and health authorities as our key customers and beneficiaries.

1. Products and Services: a. Web app and WhatsApp chatbot: We offer an easily accessible platform for users to report drug shortages and receive timely information on the availability of medicines, medical supplies, and vaccines. b. Data analysis and insights: We generate valuable data and insights on drug shortages through our platform, which we use to inform decision-makers and design targeted interventions. c. Communication campaigns: We run campaigns to raise awareness about patients' rights and mechanisms to guarantee them, focusing on both urban and rural communities, and especially on vulnerable populations. d. Collaboration and partnerships: We collaborate with local organizations, health authorities, and other stakeholders to develop and implement solutions that address drug shortages and improve healthcare access.

2. Revenue and Funding: a. Grants and donations: Our primary source of funding comes from grants, donations, and sponsorships from national and international organizations, foundations, and individuals who support our mission and recognize the importance of our work. b. Partnerships: We establish strategic partnerships with public and private sector organizations, NGOs, and other stakeholders who share our commitment to ensuring equitable access to healthcare. These partnerships can provide resources, expertise, and support to help us scale our impact. c. In-kind support: We also receive in-kind support in the form of technical assistance, technology, or services that can help us improve our platform and expand our reach.

Our business model aims to create a sustainable ecosystem that enables us to provide value to our beneficiaries, drive impact, and improve healthcare access in Mexico, while ensuring that our operations are financially sustainable and able to adapt to the changing needs of the communities we serve.

Our plan for becoming financially sustainable involves diversifying our funding sources, leveraging strategic partnerships, and continuously improving our services to maximize our impact. Here's a breakdown of our approach:

1. Diversifying funding sources: a. Grants and donations: We will continue to actively seek and apply for grants from national and international organizations, foundations, and individuals who support our mission. b. Corporate sponsorships: We will explore opportunities to collaborate with corporations that share our commitment to improving healthcare access and are willing to provide financial or in-kind support. c. Crowdfunding campaigns: We plan to run crowdfunding campaigns to engage with our supporters and raise funds for specific projects or initiatives.

2. Strategic partnerships: a. Public and private sector collaborations: We will forge partnerships with public and private sector organizations, NGOs, and other stakeholders who can provide resources, expertise, and support to help us scale our impact. b. In-kind support: We will actively seek in-kind support in the form of technical assistance, technology, or services that can help us improve our platform and expand our reach.

3. Service improvements and scaling: a. Platform enhancement: We will invest in improving our web app, chatbot, and other technological tools to enhance user experience and increase the efficiency of our data collection and reporting. b. Expansion to new regions: We plan to establish local representations in all 32 Mexican states, strengthening relationships with local patients, health professionals, and health authorities, and increasing our impact. c. Capacity building: We will invest in capacity building for our team and local partners, ensuring that we have the skills and knowledge necessary to effectively address drug shortages and improve healthcare access.

By implementing these strategies, we aim to create a financially sustainable model that enables us to continue providing valuable services to our beneficiaries, drive impact, and improve healthcare access in Mexico. We will also regularly monitor and evaluate our progress to ensure that our financial sustainability plan remains relevant and adapts to the changing needs of the communities we serve.

Our plan to achieve financial sustainability has shown promising results so far, with successful collaborations, grant funding, and recognition from key organizations. Some notable examples include:

1. Grant from the Open Society Foundation: We received a grant from the Open Society Foundation, which provided crucial financial support to expand our operations and enhance our platform. This funding enabled us to increase our reach and impact in addressing drug shortages and improving healthcare access in Mexico.

2. Collaboration with Open Contract Partnership and Poder Latam: We partnered with Open Contract Partnership and Poder Latam to work on projects that promote transparency and accountability in public procurement processes, particularly in the healthcare sector. This collaboration has helped us strengthen our advocacy efforts and increase our visibility and credibility.

3. Partnership with the Citizen Observatory for Access to Medicines and Health Supplies: We joined forces with the Citizen Observatory for Access to Medicines and Health Supplies to share information, best practices, and resources. This partnership has allowed us to enhance our data collection and analysis capabilities and improve the effectiveness of our interventions.

4. Recognition from the Employers Confederation of the Mexican Republic (COPARMEX): COPARMEX, a voluntary membership business organization, acknowledged our efforts in addressing healthcare access issues in Mexico. This recognition has not only boosted our reputation but also provided us with opportunities to connect with potential partners, sponsors, and supporters who share our mission.

These achievements demonstrate the effectiveness of our approach to financial sustainability. We will continue to pursue diverse funding sources, establish strategic partnerships, and enhance our services to ensure our long-term success in improving healthcare access for all Mexicans.