Failing the Stress Test: What the Measles Resurgence in Mexico Reveals About a Fragmented Health System - Abolish Capital!
We’re now 13 months into the most recent outbreak of measles in Mexico, and the
numbers remain alarming. In a recently published report
[https://www.gob.mx/cms/uploads/attachment/file/1065270/INFORME_DIARIO_SARAMPION_20260313.pdf],
the Secretary of Health acknowledged a total of 33,892 probable cases in the
country, 13,408 of which have been confirmed, along with 35 confirmed deaths. >
Efforts to mitigate the current crisis will be temporary and superficial so long
as the federal government does not seriously rethink and retool its health
system to prioritize its most marginalized and most vulnerable populations.
Chihuahua, where the first cases emerged, leads in the number of deaths by a
wide margin with 21. The next closest is Jalisco with 4, while Mexico City and
Durango each have 2. But the data only tell part of the story. The demographic
profiles of the deceased and the uneven distribution of infection and
vulnerability point to a systemic problem—not just an epidemiological one. Its
roots go back decades and demonstrate deep and widespread social inequality,
ones that the government seems unwilling, or at least too dysfunctional, to
attend to. The country will almost certainly succeed at keeping this epidemic
from ballooning into a full-blown, COVID-style emergency (if only because
measles is a known quantity, a vaccine for it already exists, and the campaign
to stamp it out has already been underway). Even so, all efforts to mitigate the
current crisis will be temporary and superficial so long as the federal
government (in tandem with the states) does not seriously rethink and retool its
health system to prioritize its most marginalized and most vulnerable
populations. And that, as many experts are saying, will take a degree of
coordination heretofore unseen.
[https://mexicosolidarity.com/wp-content/uploads/2026/03/mennonite-wheel.jpg]
The Usual Victims in All-Too-Familiar Territory
----------------------------------------------- The shortcomings of the existing
healthcare system were brought into sharp relief in the earliest days of the
outbreak, in Chihuahua. Members of the Mexican Mennonite community brought the
infection back with them after attending an international Mennonite conference
in Canada in 2024. They spread it on their passage through the US via Seminole,
Texas, before finally returning to Chihuahua—which is home to the largest
Mennonite communities in the country. “In this community, they essentially
decide to let the rest of the children get sick naturally, because they believe
this will give them natural immunity,” says Leticia Ruiz, Director of Prevention
and Disease Control in the Chihuahua State Health Department. According to Ruiz,
the Mennonite community let the infection ride its course—not out of religious
but rather personal conviction against vaccines and an erroneous confidence in
“natural immunity”. (At least in the United States, the Mennonite Church has no
central doctrine condoning or condemning vaccines, but defers to the individual
[https://www.mennoniteusa.org/measles/].) That said, Ruiz estimates that general
vaccine coverage is “well below 50%” in the community. “It’s only when a child
needs to be hospitalized that we realize these beliefs among families and within
the community—that vaccination isn’t necessary and that natural immunity is part
of nature.” Though Ruiz and her team swiftly and effectively attended to the
more densely concentrated affected zones (overcoming barriers to communicating
with the primarily German-speaking Mennonites), the outbreak eventually escaped
containment and quickly spread through the migrant day laborer
population—starting with those workers in the employ of the Mennonites. “These
[Mennonite] communities rely on hiring people from outside to work in the
fields, and they get sick.” The Mennonites’ insularity disintegrates at the site
of labor transaction, as Jose Luis Gonzalez and Cassandra Garrison have observed
[https://www.shorenewsnetwork.com/in-mexico-a-decade/]: “[Their] interaction
with the outside world is mostly restricted to their relationships with local
people who work for them as laborers in the community or to trips into town to
buy goods.” That means that, like essential workers in the United States, these
farm workers and day laborers found themselves on the frontlines of the
emergency, unprepared and un-cared for. > As the unvaccinated are at particular
risk of contracting and suffering complications and death from measles, the
disparity between the Indigenous and non-Indigenous population illustrates major
policy flaws. And, as Dr. Andrés Castañeda Prado, Federal Coordinator of the
National Coordination of the National Public Security System (SNSP), emphasizes,
this population is structurally positioned to bear the brunt of all kinds of
social pressures, but specifically medically-related ones. “They’re…people in
vulnerable situations because they face issues of malnutrition, deprivation, of
course, lack of social security, and years of neglect by the system.” Hailing
overwhelmingly from the country’s south and southeast, these internal migrant
workers go where the work is, often at the mercy of exploitative employers and
hazardous conditions. “They have a higher risk of infection,” as they confront
compounding risks: traveling in crammed trucks, on trains, and overcrowded work
and living arrangements. To reach the immediately affected workers, many of whom
are Indigenous, Ruiz and her team deputized community leaders as coordinators
who could facilitate the vaccination of “60,000 day laborers, 20,000… on the
move.” And that was in the early days. Ruiz’s team ramped up vaccination to
“almost 700,000 over those three critical months—that’s what triggered a
significant drop” in infections. But physically reaching the most vulnerable, as
well as targeting messaging to them, was no easy task, considering their
transient behavior and the geographic remoteness of the population. The
Indigenous population in Mexico is often the first to suffer at the hands of
state violence, and the last to receive any kind of social benefits that might
justify the existence of big government, and medical attention is no different.
Language and location barriers, lack of medical coverage and education, and
stigma make it hard for medical workers to reach this group, as was seen notably
with COVID vaccination distribution and uptake). To this day, the government
isn’t doing nearly enough to bridge the gap. And, as the unvaccinated are at
particular risk of contracting and suffering complications and death from
measles, the disparity between the Indigenous and non-Indigenous population
illustrates major policy flaws in the federal and state governments response,
ones that put the entire population at risk. Slipping Through Ever-Widening
Cracks: The Jalisco Case -------------------------------------------------------
If the outbreak’s path through Mennonite communities and migrant workers exposed
socioeconomic vulnerabilities, its spread to Jalisco revealed another kind:
political negligence. > Lemus and company can tout their state-of-the-art
IMSS-Bienestar-insulated teaching hospital & Social Security alternative until
they’re blue in the face, but it won’t do a bit of good if they don’t put them
to use in a timely, efficient manner. As the infection spread from state to
state along commercial and migratory routes, it revealed in its wake the
“inequality gaps [in]…vaccination, failed campaigns, [and] failed
epidemiological surveillance,” in Jalisco, says Deputy Mariana Casillas
Guerrero. For her, the measles resurgence in her state (which, as of late
February, has reported 2,662 cases or 59% of all cases in the country
[https://www.vax-before-travel.com/2026/02/27/jalisco-measles-outbreak-spikes-667-new-cases-one-week-after-civil-unrest-mexico])
is not “just bad luck,” but a powder keg that’s been waiting to blow. Insofar as
Jalisco has become the new epicenter of the outbreak, Casillas Guerrero does not
mince words: the ruling center-left Movimiento Ciudadano (MC), the current
Governor Pablo Lemus Navarro, and its previous governor Enrique Alfaro (who
resigned from the MC a week into his governorship) are all to blame, at least in
part, for putting inter-party politics above the wellbeing of the jaliscienses.
“There is public evidence that the state executive, in this case Pablo Lemus,
has refused to join the IMSS-Bienestar program, and Congress itself has also had
to urge the governor to sign this agreement to guarantee medications and care
for the entire population right now.”
[https://mexicosolidarity.com/wp-content/uploads/2026/03/Mariana-Casillas-Guerrero-Jalisco-Deputy-scaled.jpg]
Deputy Mariana Casillas Guerrero, Photo: @MarianaCasGe
[https://x.com/MarianaCasGe] Casillas Guerrero is referring to Governor Lemus’s
renewed rejection (following in his predecessor’s footsteps) to participate in
the federal agency Health Services of the Mexican Social Security Institute
(IMSS-Bienestar) opened by former president Andrés Manuel López Obrador in 2022
in his attempt to extend universal medical access to those who don’t receive
coverage through their employers or the state (like the day laborers working the
Mennonite farms). Lemus points to a perceived lack of medication (hardly the
case
[https://www.gob.mx/presidencia/prensa/rutas-de-la-salud-hospitales-y-centros-de-salud-del-imss-bienestar-tienen-100-de-abasto-con-entrega-de-28-millones-de-medicamentos])
and dignified working conditions for medical professionals (debateable
[https://observador.mx/protestan-trabajadores-del-imss-bienestar-por-precariedad-y-abandono-del-sistema-de-salud/])
in the agency as his justification for keeping Jalisco’s system separate and not
committing a “historic error
[https://udgtv.com/noticias/pablo-lemus-rechaza-ceder-hospitales-al-imss-bienestar/286926].”
Casillas Guerrero doesn’t buy it. For her, Lemus’s resistance isn’t about
policy—it’s politics. “Jalisco has been holding onto this administrative
exemption as if it were a political banner—but more than political, it’s an
electoral banner,” implying the MC party’s a priori resistance to Morena’s
platform. (Incidentally, the MC party’s victories can in large be attributed to
longstanding anti-AMLO sentiment in the region.) Moreover, Lemus’s tough talk
rings hollow considering that he and his state had plenty of lead-time before
the outbreak to assemble a preventative program—and they failed to take
advantage of it. “The Pan American Health Organization did warn us that there
was a massive spike in cases in this specific region from 2025 to 2026, and it
was a problem we’d been grappling with since late last year.” The National
Committee for Epidemiological Surveillance sent out a warning in February of
2025
[https://www.nmas.com.mx/nacional/crece-sarampion-mexico-2025-secretaria-salud-pide-incrementar-vigilancia-hospitales/]
on the brewing crisis that should have sounded alarm bells, and yet they
officials sat on their hands for months. So Lemus and company can tout their
state-of-the-art IMSS-Bienestar-insulated teaching hospital
[https://politica.expansion.mx/estados/2024/08/13/seguro-salud-jalisco-que-es-que-servicios-da]
and Social Security alternative until they’re blue in the face, but it won’t do
a bit of good if they don’t put them to use in a timely, efficient manner.
[https://mexicosolidarity.com/wp-content/uploads/2026/03/imss-centro-medico-cdmx-jacarandas.jpg]
Centro Médico Nacional Siglo XXI, Mexico City Photo: Jay Watts
[https://jay-watts.com/] A Far Cry from How Things Used to Be, and a Long Way to
Go ---------------------------------------------------------- The truth is that,
viewed in its historical context, IMSS-Bienestar—while by no means a perfect
institution—still represents a huge leap forward for Mexico’s healthcare system,
one accomplished in a very short period of time. “What we have done,” says
Ulises Rangel Cruz, former deputy director of Strategic Information Coordination
at IMSS-Bienestar, “is make the largest investment in medical infrastructure in
the last 36 years.” He goes on to enumerate: “IMSS-Bienestar reclaimed more than
100 hospitals that had been abandoned, since the PRI and the PAN paid for
hospitals and left them as unfinished structures, half-built; they left 300
hospitals unfinished, and during the COVID pandemic, we reclaimed them. We
equipped them, put them into operation, and continue to open new hospitals. We
have granted permanent positions to more than 56,000 healthcare workers who
previously had precarious contracts in the states. In other words: no
administration had ever granted permanent positions to doctors. Today, they earn
a salary three times higher than what they received when state governments were
in charge. This is the first time the Mexican government has created a health
services institution for people without social security. Previously, there was
no federal institution of this kind.” In the 80s, long before AMLO and Morena’s
ascent to power and the rollout of the Fourth Transformation, the Mexican
healthcare system was subject to a punishing regime of neoliberalism known as
the “Washington Consensus” [https://www.intechopen.com/chapters/1231915]. The
mandate’s enforcers carried out decentralization en masse of an already
fragmented healthcare system, outsourcing the national project to 32
subnational, under-resourced, uncoordinated health systems whose level of care
differed dramatically from state to state. The uninsured population who came to
depend on the balkanized institution were hardly in a better place when it comes
to access and quality of care than they were before. Then in the 90s and early
2000s, the federal government doubled down on decentralization, footing the bill
of the decades of fragmentation through technocratic and “market-oriented”
reforms. Things like per capita financing to persuade and assuage state
governors, and a benefits package (CAUSES) that prioritized medical intervention
over prevention—eschewing the, arguably, most critical phase of healthcare.
AMLO, through the IMSS-Bienestar program, sought to reverse this process without
having to rebuild the structures from scratch. The program offers states the
option to voluntarily enter into agreements to transfer to the federal program
the full responsibility for providing healthcare to the uninsured, including
infrastructure, personnel, and financial resources. And for all the strides the
IMSS-Bienestar has made in centralization, it is still guilty of privileging
specialists and hospitals at the expense of preventative community care
[https://ecosur.repositorioinstitucional.mx/jspui/bitstream/1017/2205/1/61631_Documento.pdf]—creating
internal medical care deserts that exist in the shadows of the national
institution.
[https://mexicosolidarity.com/wp-content/uploads/2026/03/imss-centro-cdmx-large.jpg]
Centro Médico Nacional Siglo XXI, Mexico City Photo: Jay Watts
[https://jay-watts.com/] The Federal Fix That Isn’t (Yet)
-------------------------------- That’s all to say that, as Castañeda Prado
points out, the existence of the IMSS-Bienestar is not a panacea. That’s partly
because, though it has played a major role in the fight against this outbreak of
measles, it can’t act in isolation. “The responsibility for setting public
policy lies with the different units,” he says. “Vaccination policy is under the
unit called CeNSIA [Centro Nacional para la Salud Integral de la Infancia y la
Adolescencia] epidemiological surveillance policy is set by the General
Directorate of Epidemiology; and the responsibility for public health lies with
the state health services and the health jurisdiction, and the provision of
medical care lies with the various providers.” > Really making good on universal
medical coverage comes down to a question of sufficient vision—that envisages
what community care looks like in practice—and the necessary will to implement
and defend that vision. So the healthcare landscape is still fragmented. But, as
Castañeda Prado assures, efforts are being made within the SNSP to coordinate
and connect the dots. “They’re called health coordination centers for
wellbeing—that aims to bridge the gap between the community’s healthcare needs
and healthcare providers.” He sees “incentives, a budget, and metrics” as being
three planks in that bridge to assure adherence to local, state, and national
objectives, and also that the resources, the hospitals, infrastructure,
medications, are all put to good and efficient use. But really making good on
universal medical coverage, he says, comes down to a question of sufficient
vision—that envisages what community care looks like in practice—and the
necessary will to implement and defend that vision. And ultimately that mandate
has to come from the top down, and translated and transmitted through
on-the-ground community work. Castañeda Prado concedes that community health
isn’t always a winning platform electorally: “it doesn’t win votes; it’s not
visible.” Invisible or not, it’s indispensable. And it “isn’t carried out by
doctors and nurses at the clinic,” as Castañeda Prado reiterates. “It’s done in
the community, with health promoters, social workers, and local governments. And
there really isn’t a strategy or policy in place to support that.” Of course,
this stymied interplay gets at the perennial tension between big government
central planning and local, grassroots implementation. The two are mutually
co-dependent, but, as we see in the case of the country’s response to the
measles, so often either in conflict or operating in siloes, to the detriment of
the most marginalized. If this current crisis is to serve as a “wake up call for
policy makers” as Casillas Guerrero says it ought to, it’s a call that will have
to be heard as much at the top as at the bottom, and heeded in concert.
[https://mexicosolidarity.com/wp-content/uploads/2026/01/seth-garben-1024x682.jpeg]
Seth Garben is a writer, poet, musician, filmmaker, playwright, and
activist/organizer based in the US and Mexico City. He is a member of the
Democratic Socialists of America and a core team lead with immigrant rights
group Danbury Unites for Immigrants. He composes and performs music in Mexico
City and internationally as Goldy Head. * Hit & Run: Tornel Rubber Company
Didn’t Attend Labour Conciliation Hearing
[https://mexicosolidarity.com/wp-content/uploads/2026/03/turnel-workers-strike-large-1024x683.jpg]https://mexicosolidarity.com/hit-run-tornel-rubber-company-didnt-attend-labour-conciliation-hearing/
Labor [https://mexicosolidarity.com/category/labor/] | News Briefs
[https://mexicosolidarity.com/category/news-brief/] #### Hit & Run: Tornel
Rubber Company Didn’t Attend Labour Conciliation Hearing
[https://mexicosolidarity.com/hit-run-tornel-rubber-company-didnt-attend-labour-conciliation-hearing/]
March 25, 2026March 25, 2026 On March 18, striking workers on the picket line at
a Tornel Rubber plant were attacked by an armed shock group of over sixty men.
Four workers were shot. * Failing the Stress Test: What the Measles Resurgence
in Mexico Reveals About a Fragmented Health System
[https://mexicosolidarity.com/wp-content/uploads/2026/03/imss-centro-medico-cdmx-large-1024x683.jpg]https://mexicosolidarity.com/failing-the-stress-test-what-the-measles-resurgence-in-mexico-reveals-about-a-fragmented-health-system/
Analysis [https://mexicosolidarity.com/category/analysis/] #### Failing the
Stress Test: What the Measles Resurgence in Mexico Reveals About a Fragmented
Health System
[https://mexicosolidarity.com/failing-the-stress-test-what-the-measles-resurgence-in-mexico-reveals-about-a-fragmented-health-system/]
March 25, 2026March 25, 2026 Surveying the land, 13 months into Mexico’s most
recent outbreak. * People’s Mañanera March 24
[https://mexicosolidarity.com/wp-content/uploads/2025/09/claudia-sheinbaum-press-conference-september-26-large-1024x682.jpg]https://mexicosolidarity.com/peoples-mananera-march-24/
Mañanera [https://mexicosolidarity.com/category/mananera/] #### People’s
Mañanera March 24 [https://mexicosolidarity.com/peoples-mananera-march-24/]
March 24, 2026 President Sheinbaum’s daily press conference, with comments on
electoral reform, PAN, femicide, and diesel prices. The post Failing the Stress
Test: What the Measles Resurgence in Mexico Reveals About a Fragmented Health
System
[https://mexicosolidarity.com/failing-the-stress-test-what-the-measles-resurgence-in-mexico-reveals-about-a-fragmented-health-system/]
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