Asa Cristina Laurell: The National Development Plan 2025-2030

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As a background, it is important to remember that the legislation on the National Development Plan (NDP) dates back to the Miguel de la Madrid administration and was introduced into the Constitution in 1982. It was one of the responses to the crisis at the end of José López Portillo's administration. It was preceded by the bailout of Mexico with the intervention of the United States Treasury and the IMF, but in reality, it was the bailout of the international financial system and the beginning of neoliberal policies not only in Mexico and Latin America. It is important to remember the origin of the legislation because it largely explains its format, which is the so-called logical framework method, invented by USAID to discipline and evaluate countries. Thus, it is organized into axes, objectives, and strategies with their monitoring indicators.

It should be noted that while the strategies can be understood as " how to" strategies, they do not reveal the overall concept underlying the document and each of the objectives. In this sense, the document is rather normative, as it outlines " shoulds" rather than interventions that would resolve the current problems. This unfortunately results in the repetition of strategies that have already proven not to lead to problem-solving. Furthermore, strategies that are known to experts but have not been implemented are excluded. The reasons are likely external to a given problem and are often related to the economic restrictions arising from both the new external context under the Trump administration and the overriding economic objective of not implementing redistributive tax reform.

The health aspect is embodied in the Healthy Republic plan (page 48, Official Gazette , 4/15/2025). The general objective is seemingly unobjectionable, but it mixes concepts that are not always compatible. It states: Guarantee the right to health protection for the entire Mexican population through the consolidation and modernization of the health system, with a focus on universal access that closes gaps in quality and opportunity, protecting the physical, mental, and social well-being of the population. While the Constitution mentions the right to health protection in Article 4, the reform to Article 1 presents it primarily as a human right.

This is important because neoliberal health policy was based on a health protection model known as Seguro Popular (SP). Initially, it had a cost for people with salaries above 3 monthly minimum wages. This model considered health care a commodity to be exchanged on the market. It included various first- and second-level service packages, but none were fully provided. With the exception of the third-level package for children born during the Calderón administration, it was very restrictive for the rest of the population. These were the reasons for its elimination during the Fourth Transformation government, although the process to repeal it was inadequate. It should be noted that there were other alternatives that were not taken into account.

The need to consolidate and modernize the public system is well known, but there has been no clear understanding of how to achieve it. We have a public system fragmented into several subsystems, providing services of very different complexity and quality. This problem has long been recognized, but so far unresolved. Simply stating it does not resolve the issue due to the economic and political obstacles involved. There is also a question about whether universalization will be achieved with federalization and the strengthening of the IMSS-Bienestar OPD (National Institute of Social Welfare).

The issue of strengthening prevention and health promotion is also longstanding, but it has not been implemented. It would be highly commendable if this could be achieved through the Public Health System, since it was not implemented during the previous administration's formulation. It was essentially a construct of the central offices of the Ministry of Health, never truly implemented in existing health services.

A healthy Republic is a great need for the country and its people, but achieving it requires more than just putting your heart into it. It also requires financial resources and trained professionals for the task.