The implications of the Lack of Coordination and Self-Centered political Goals in Public Health: An insight into Mexicos Response to COVID-19: A Case Study Report

Introduction

High rates of COVID-19 transmission, an increasing number of death toll, crisis in the health system, underestimation of the COVID-19 pandemic, inadequate health polices and lack of coordination are some of the concerns that is still facing Mexico.

In that sense, it ought to be asked to what degree does the inadequate exercise of the political power has in some way contributed to this scenario. Despite the fact that the political factor is just one of the edges that should be analyzed, it is relevant to determine which actions have led that Mexico is currently ranking in third place worldwide in the number of deceases [1].

An interesting approach to the subject can be explored in the Report “Mexico’s response to COVID-19: A case study”, published by the Institute for Global Health Sciences of University of California, San Francisco, which offers some hints on the inadequate actions and policies taken by the Mexican State, among other topics. The aforementioned Report may reinforce the importance of human rights in the decision makin-process not only amid the pandemic crisis, but also to be prepared for future challenges.

For the above mentioned, this paper will describe briefly the scope of the “Mexico’s Response to COVID-19: A case study” Report, with special emphasis on Chapter 3, Leadership and Governance in order to explore the governmental actions and ommissions during the COVID-19 pandemic and the underlying problematic, that will lead to refer to some of the lessons that ought to be learned from the Mexican situation and the importance of the rule of law and human rights.

Overview of the “Mexico’s Response to Covid-19: A Case Study” Report

The “Mexico’s response to COVID-19: A case study” Report was commissioned by the World Health Organization Independent Panel for Pandemic Preparedness and Response and elaborated by a multidisciplinary team of academics under the leadership of the University of California, San Francisco’s Institute for Global Health Sciences. The Report is structured in nine Chapters referred to Introduction and Epidemiology, The National Environment, Leadership and Governance, Communications and Trust, Public Health Response, Preparation of Health System, Financing, Vaccines, Conclusions and Recommendations [2].

An interesting topic to analyze is the Chapter 3, Leadership and Governance, where the findigns pointed out at major deficiencies in decision-making procedures that led to failures in risk assessment, policy design and the adaptation of policy as the circumstances of the pandemic changed. The Report identified several flaws in the decision- making process and the model for emergency management, such as the excessive concentration of authority and capacity to make decisions over the management of the pandemic in a single unit of government within the executive branch; failure to implement effective mechanisms for the constant review of emerging scientific evidence; the politicization of technical aspects of risk assessment, planning, and implementation; marginalization of scientific bodies and universities, civil society organizations, and the private sector in several aspects of the pandemic response; lack of political will to facilitate coordinated and concerted action across levels of government in Mexico’s federal system, key decisions taken without sufficient evaluation and judgement of the risks.

In a further analysis, Chapter 3 of the Report describes three main issues to be taken into account, namely:

• Problems in the Emergency Response Model, reflected in the management centered in the President’s discretionary command, communication and control, whereas civil society organizations, other institutions, private sector and the scientific community tend to be alienated.
• Disregard for Scientific evidence and data in the design of public health policies, that failed to incorporate a precautionary approach of the pandemic, as could be appreciated in the health authorities’ public statements and decisions; absence of a national mask mandate, under-estimation of the asymptomatic and pre-symptomatic transmission; no changes in policies despite scientific evidence; low diagnostic test, considered as inefficient and wasteful use of resources; lack of regulation of travel and border control measures; unclear surveillance policy against new SARS-CoV-2 variants; disconnection between objective levels of epidemiological risk and public health restrictions.
• Delayed, Undecisive Action and Lack of Coordination, as shown in the slow reaction of the federal government; disagreements between federal and state governments; absence of collegiate institutions to provide national coordination; decision-making authority overly concentrated in a single unit of government that lack institutional checks and balances, and the federal government’s propensity to opt for non-consensual forms of decision-making.

The Report includes Key Recommendations on the topic of Leadership and Governance, which consider that Federal authorities should readily shift to a collaborative and deliberation-based approach to the management of the pandemic that relies centrally on the General Health Council and broadly engages the health and scientific communities, top educational institutions, and relevant civil society actors; legal reforms strengthen the institutional architecture for health emergency management and build robustness into decision-making processes; channels for permanent and de- politicized communication between national and all state health authorities must be reconstructed, among others.

For the aforementioned topics, it can be seen that the “Mexico’s Response of COVID-19: A case Study” Report offers an interesting starting point to explore some of the difficulties that may be underlying the COVID-19 pandemic crisis in Mexico and that ought to be taken into consideration to effectively face not only this public health problem, but also future challenges.

In an attempt to answer the initial question on to what degree does the inadequate exercise of the political power has in some way contributed to the pandemic crisis in Mexico, it can be seen that indeed the decision-making process centered in the President and his one-sided political objectives and goals, have contributed to worsen the problematic that the COVID-19 pandemic has posed, which has affected the public health. Even though, the behavior of the Mexican Population was not the focus of the Report, it could be interesting to see how does the civic culture of some people has also taken some part of the problematic in the COVID-19 crisis and explore up to what point the underestimation of science and irresponsible statements and behavior of public officials have an impact on civic culture. In any case, the situation of Mexico points out at continues stressing the importance of the effectiveness of Human Rights to face the COVID-19 pandemic and other future challenges.

Fostering the Effectiveness of Human Rights to Face Covid-19 Pandemic

From the “Mexico’s Response of COVID-19: A case Study” Report, it can be seen that there are defficiencies in fulfilling the national and international commitments of the State related with the protection of human rights and an indifference to the delicate situation of the Mexican population aimid the pandemic crisis, in which the Mexican government has sought to achieve its own partisan objectives to the detriment of the Mexican population [3].

However, considering that the need for an enduring and healthier life is one of the elements of human developments and that every society should consider it as a universal right [4], it is necessary to demand that the government reinforces its commitment with human rights and seek for the its effectiveness in order to face the problem that COVID-19 pandemic has posed. Certainly, it is not only necessary to recognize the human rights in the Constitution and international instruments, but also to ensure that they can be a reality and be enjoyed by all people.

The human rights approach should aim to consider the importance of the Rule of Law, as it is significant to assure the duly recognition and protection of human rights and the adequate exercise of the public power. In this context, the State regulation should have reasonable grounds to establish dispositions regarding the mechanism to make rights effective [5] and specify the duty bearers for an acceptable requirement of claimability [6]. For Rocha and Hidalgo, a politically justice can be achieved in public health when it makes counterweight to regulations orientated to economic and contractual liberties, professional status and private property [7]. Moreover, it can be taken into account the perspective of Brieskorn for whom a right can best move towards and obligation, should it affects a general interest, life and liberty of a society and for that matter a right may imply to have a duty to one’s self and to the others [8].

The aforementioned conditions are significant to offer conditions that may favor the dialogue and collaboration with the private and social sector, whose needs and proposals are significant to find optimal solutions to face the crisis. In this scheme, the private and social sector have a significant role not only to pose questions and critics to the governmental action in order to assume its responsibility to protect human rights, but also to participate actively in the decision making process in order to achieve goals such as the public health.

Conclusion

The “Mexico’s Response of COVID-19: A case Study” Report offers an interesting insight on some of the flaws that could be seen regarding Leadership and Governance in Mexico, a country that is facing a severe public health crisis due to the excessive concentration of authority and capacity to make decisions, among other problems. Additionally, the Report concludes with some Key Recommendations which for example aim at seeking a collaborative and deliberation- based approach, with health and scientific communities, top educational institutions, and civil society actors, as well as legal reforms strengthen the institutional architecture for health emergency management and build robustness into decision-making processes.

It is uncertain if the government of Mexico will take into account the results of the Report. However, the problematic that Mexico is currently facing warns about the need to consider the human rights approach and the relevance of collaboration between the public, private and social sector in the decision-making process in order to find optimal solution to a given concern. For that matter, the society plays a significant role in facing problems such as the COVID-19 pandemic, not only as a critical actor on the actions or ommissions of the government, but also as an active agent to offer plausible solutions and different perspectives to face the present and future challenges.