Transcript Diapositiva 1

Biosciences and Healthcare
Dr. Francisco Medina Gómez
Jalisco State Council of Science and
Technology (COECYTJAL)
San Antonio , Texas, November 16th, 2012
Did NAFTA Deliver?
• In manufacturing, YES:
– Mexico is a manufacturing powerhouse, on par with
Germany and China
– Productivity soared 80% (but has become stagnated)
– Mexican exports tripled
• But in the pre_NAFTA hype, it was the services
which were expected to grow
• The results are in some cases poor and, in others,
disastrous
The Services Sector
• Growth in FDI in retail, banking, tourism
• BUT:
– Local investment has declined
– The wage gap is wider, Mexicans are poorer
– Mexico has been unable to grow at an average
accumulated rate of over 2% in the last 20 years
– Mexico is as dependent as ever on the U.S. economy,
in spite of a flurry of FTA´s
– Mexico was the worst hit Latin American economy
during the recent world crisis
Is NAFTA to blame?
• NAFTA´s founding fathers were carried away by trade
hype
• Underestimated the stubborn reality of everyday life,
not subject to flimsy, trendy economic models of market
vs State
• But if NAFTA did fail to meet the main objective of
improving the lives of the majority of Mexicans on the
street, it was also because of the dismal failure of four
consecutive Mexican Federal Governments to date, to
implement sound public policies to promote economic
growth, that effectively channels the benefits from
trade into other parts of the economy.
México Economy in Perspective
GDP change 2004-2009
Valor Agregado Censal Bruto (~PIB)
81 OTROS SERVICIOS EXCEPTO ACTIVIDADES DEL GOBIERNO
72 SERVICIOS DE ALOJAMIENTO TEMPORAL Y DE PREPARACION DE…
71 SERVICIOS DE ESPARCIMIENTO CULTURALES Y DEPORTIVOS, Y …
62 SERVICIOS DE SALUD Y DE ASISTENCIA SOCIAL
61 SERVICIOS EDUCATIVOS
56 SERVICIOS DE APOYO A LOS NEGOCIOS Y MANEJO DE DESECHOS …
55 DIRECCION DE CORPORATIVOS Y EMPRESAS
54 SERVICIOS PROFESIONALES, CIENTIFICOS Y TECNICOS
53 SERVICIOS INMOBILIARIOS Y DE ALQUILER DE BIENES MUEBLES …
52 SERVICIOS FINANCIEROS Y DE SEGUROS
51 INFORMACION EN MEDIOS MASIVOS
48 -49 TRANSPORTES, CORREOS Y ALMACENAMIENTO
46 COMERCIO AL POR MENOR
43 COMERCIO AL POR MAYOR
31 -33 INDUSTRIAS MANUFACTURERA
23 CONSTRUCCION
22 ELECTRICIDAD, AGUA Y SUMINISTRO DE GAS POR DUCTOS AL …
21 MINERIA
11 AGRICULTURA, GANADERIA, APROVECHAMIENTO FORESTAL,…
Crecimiento % VACB 04-09
49.6%
70.2%
2009
2004
97.5%
60.6%
32.4%
87.4%
60.6%
45.1%
2.5%
47.4%
3.3%
48.9%
6.9%
10.0%
59.6%
101.0%
56.7%
139.5%
22.6%
0
1,000
2,000
Miles de Millones de Pesos
Source: INEGI. Economic Census, 2004, 2009
0%
50%
100%
150%
The exceptions that prove the rule
• Two services sectors have shone brightly of
their own accord:
– ICT
– Health Care
• With, without or even in spite of NAFTA, IT in
México is blooming:
– From 200 MM USD in 2002 to % Billion in 2012
– Over 400,000 jobs created, 100,000 of them
though PROSOFT
ICT
• Has created wealth
• Has created a burgeoning middle middle C+ and
upper middle class B (50% growth from 2008 to
2010 in Guadalajara alone)
• Uses Mexican brainpower, Mexican talent,
availability of plentiful young Mexican IT trained
professionals and
• YES!
– A Sound Economic Policy: PROSOFT
• Will continue growing at an accelerated 12 – 14%
annual rate for the next 10 years
What about Health Care?
• Although this success story is a midget by ICT
standards, Health Care is alive and well and
poised to become one of the fastest growing
sectors in the context of NAFTA
• What are the causes underlying this success?
• Specially in a country where Health Care is
considered socialized?
Coming of Age
• Our medical doctors and our specialists are
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extremely professional,
extensively trained in clinical practice
A significant number trained abroad
Well versed in applying modern scientific knowledge
technologicaly savvy
Young and sexy
Open to change
And they smile at you!
Investment and Certification
• Our hospitals, both public and private have
invested heavily in new equipments, new
technologies, including ICT and good practices
• Growing trend to become certified, e.g. the
Joint Commission
• Public policies have been successful in
promoting health, increasing life expectancy
Major Achievements
• All the major health indicators have improved
substantially, infant mortality has dropped
• Compared to the appalling failure of Mexico´s
public (and even private) education system, the
Health Care Sector has delivered.
• Mexicans now live longer to get the same kind of
chronic diseases that US and Canadian citizens
have.
• Our morbidity and mortality indicators are not
very different from those of our two NAFTA
partners.
Seguro Popular
• And a sound public policy!
• Enter Seguro Popular
– With all its shortcomings, a major achievement
• From the Harvard School of Public Health:
– Despite periods of economic downturns and crisis, Mexico
recently achieved a significant milestone – enrolling 52.6
million previously uninsured Mexicans in public medical
insurance programs and thereby achieving universal health
coverage in less than a decade.
– Sure, the public coverage is more basic, and Mexican
facilities generally less advanced than their US
counterparts. Yet it’s notable that a middle income country
made this health policy a priority even when it’s rich
Northern neighbor has not.
HEALTHCARE IN MEXICO
Competitive Private Health Care
System
• The cost of medical care services vary by hospital, by
physician, or by the seriousness of one’s condition.
• On average, an office visit to a doctor, including a specialist,
could cost between 250 and 500 pesos (US$21 to $40).
• Lab tests could cost about one-third of the comparative cost
in the United States.
• CAT scans are 25% cheaper than in the US.
• Overnight stays in a private hospital room start at about $500
pesos (US$40) only.
• Visiting the dentist for a regular teeth cleansing will cost
about three hundred pesos (US$22).
Number of Hospitals in Mexico by sector
5,000
4,500
4,000
3,978
4,067
4,103
4,161
4,264
4,309
4,088
3,055
3,039
3,020
3,082
3,131
3,140
3,500
3,000
2,500
2,959
Private
Public
2,000
1,500
1,000
500
1,019
1,033
1,028
1,083
1,079
1,133
1,169
2001
2002
2003
2004
2005
2006
2007
0
+ 50% of hospitals in Mexico are certified
+ 8 private hospitals are certified by the Joint
Commission International (JCI)
Source: Health Ministry
Beds in Mexico by sector
140,000
120,000
100,000
114,756
115,680
115,767
117,919
120,511
38,437
39,479
40,140
40,214
41,992
117,101
41,737
122,810
42,744
80,000
Private
Public
60,000
40,000
76,319
76,201
75,627
77,705
78,519
75,364
80,066
2001
2002
2003
2004
2005
2006
2007
20,000
0
Source: Health Ministry
Physicians in Mexico by sector
250,000
211,477
197,572
200,000
162,169
150,000
217,320
40,515
164,953
42,972
172,252
182,551
55,173
48,730
62,339
64,754
50,375
Private
Public
100,000
50,000
121,654
121,981
123,522
132,176
2001
2002
2003
2004
142,399
149,138
152,566
2005
2006
2007
0
Source: Health Ministry
Nurses in Mexico by sector
250,000
223,315
200,000
31,269
225,958
33,206
223,899
34,152
228,053
34,258
234,372
238,357
37,697
37,587
247,824
39,212
150,000
Private
100,000
192,046
192,752
189,747
193,795
196,675
200,770
208,612
2001
2002
2003
2004
2005
2006
2007
Public
50,000
0
Source: Health Ministry
Biosciences
• Unfortunately, Biosciences as a business are
linked to Big Pharma
• Big Pharma could not care less for helping
Mexico grow
– Mexico is a market to be exploited: huge
population, wide social security coverage, dubious
and bureaucratic purchasing systems
– Mexicans make excellent clinical case study
subjects, if you can deal with the socialized
medical system
Mexico Pharmaceuticals Trade
(MUSD)
Pharmaceutical Exports of Mexico
Medicines
Medical devices
Pharmaceutical Imports of Mexico
Diagnostic reactives
Medicines
1,000
1,000
Logarithmic scale
10,000
Logarithmic scale
10,000
100
10
1
1
2004
2005
2006
2007
2008
Diagnostic reactives
100
10
2003
Medical devices
2003
2004
2005
2006
2007
2008
Market Liberalisation
• Automedication: 70 % of population takes drugs not
prescribed by their doctors
• Low integration levels for production chains: no
access to competitively priced raw materials
• Illegal imports through Tijuana
• Imports of antiretrovirals released in August 2008.
• Imports of vitamins, homeopathic medicines,
vaccines, sera, haemoderivatives, antitoxins and
biologic hormones released in February 2009.
• Producers of other biologics (eg insulin and
erythropoietin) export to Mexico since August 2009.
Market Liberalisation
• Narcotic or psychotropic drugs and OTC drugs liberated in
February 2010.
• Local manufacturing plant requirements phased out over
two year period: Market fully open by mid 2010
• Competition expected to grow from middle sized foreign
producers who did not have the resources to invest in
manufacturing in Mexico
• Only patented and bioequivalent generic drugs in the
market as from 24th February 2010.
• 17% of the 10,500 pharmaceuticals whose registrations
need to be renewed by the Federal National Commission
for Protection against Health Risks (COFEPRIS), will
probably exit the market
Forget about Big Pharma
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Bring in Middle and Little Pharma!
FDI
Strong European presence
Great Veterinary Market
Promote Joint Ventures with Mexican Pharma
Liaison with excellent national and local research
centers throughout Mexico
• The best research done in Mexico is in the Health
Sciences
• If there is again a Nobel Prize made in Mexico it will be
in Medicine/Physiology
Growing Number of Researchers in
Biosciences and Healthcare
Researchers in the National Researchers System
Biology and Chemistry
Biotechnology and Agricultural Science
Medicine and Health Science
6,000
5,000
1,445
1,429
4,000
1,343
926
3,000
926
1,043
1,168
1,711
1,586
846
2,000
1,131
1,257
1,441
1,011
1,011
1,767
1,776
2,179
1,436
1,661
1,891
2,443
1,661
2001
2002
2003
2004
2005
2006
2007
2008
856
1,000
0
Source: CONACYT
Federal Programs Supporting
innovation
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AVANCE
Fiscal Incentives
New Fund for Science and Technology
Incentive Programs for Innovation
IDEA
IBEROEKA
FONCICYT
Bilateral Technological Cooperation with Spain, France
Sabbatical Stay in Industry
Innovation Networks
Innovation Stimulus Programme and Fund
Sectorial Funds (CONACYT-Ministries of State)
Regional Funds (CONACYT)
Source: CONACYT
Research
Clinical Research in 2009
Private institutions
20%
Researchers
Protocols
2,120
650
Public institutions
80%
Source: CANIFARMA
Clinical Research
• Around 12 companies engage in clinical research
because it provides:
– Local experience
– Capability to meet with certain regulations.
• Around 10 pharmaceutical companies do research to
acquire local experience in the clinical area.
• To a lesser degree, four or five companies do research
after marketing their products, due to differences in
the pharmacogenomic profile of the local population
and because of differences in the medical practice.
• Small US presence
What next? Medical Tourism
• We have to demitify Medical Tourism
• More research needed
• Perhaps NADBANK can fund or help fund an
initiative between Guadalajara and San
Antonio
Arguments to promote
Medical Tourism to Mexico
• Most of the health care practitioners in Mexico have
been trained in Mexico and other western countries.
• Mid-sized and larger cities in Mexico have at least one
first-rate hospital and the cost of healthcare is
generally lower than one might expect to pay in the US.
• A lot of North Americans travel to Mexico for dental
work or minor surgeries (Medical Tourism)
• The same applies for prescription drugs. On average,
prescription drugs that are manufactured in Mexico are
about 50% cheaper compared to similar drugs
manufactured in the United States.
What Next: Research opportunities
in Mexico
• Pharmacologic applications of natural
compounds
• Biotechnology and genomics
• Improvement of known molecules
• Support of global research
• Technology research
The future
• The writing is on the wall
• Most of what could be accomplished through trade
has been done. Welcome to Diminishing Returns!
• Very little cooperation has taken place, whether at
the academic level or the SME level.
• Neither CONACYT or the National Science
Foundation have worked together to define a
common R&D Agenda and the Partnership for
Prosperity was a fluke
• Mexico City, Washington, D.C., Ottawa, move over! It
is time for the locals, specially the cities
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Knowledge about each other brings understanding.
Understanding brings agreements
Agreements bring actions
Actions bring results