Corporate elites co-opt public health in Mexico

03/21/2023

Translated from Spanish

From telemedicine to nutrition and healthy habits, these are just a few of the areas of the health industry where the Mexican Health Foundation (Funsalud, in Spanish), a private organization, influences public policy through different strategies, such as lobbying, agreements with public hospitals, and contracts with public universities for research and development. Driving Funsalud’s influence are some of Mexico’s most powerful, elite families, as well as national and multinational companies that seek to benefit from their position in the Foundation.

By Claudia Ocaranza and Omar Escamilla

A far cry from the Mexican Health Foundation’s (Funsalud) narrative of “being a technical-scientific reference in the generation of ideas, reflections, and formulas to raise the standard and equity in health,”¹ the Foundation interferes in public health, according to experts interviewed by Empower. Its interlock with business elites, as well as its close relationships with current and former public officials in the health sector, has allowed it to promote policies that benefit the private interests of its associates over the health of the Mexican people.

The key industries for Mexico that participate in Funsalud include pharmaceutical, hospital, commercial, food, and insurance interests. People related to them, companies, institutions, and civil society organizations comprise the Foundation’s associates, including the Slim and Baillères families, two of the most powerful families in Mexico with companies in several of these industries.

“There are several risks posed by an organization represented by the industry and with the weight of Funsalud insofar as its participation in the development of public policies, because it does things its way and for its benefit,” stated Christian Torres, who coordinates the Conflict of Interest area of El Poder del Consumidor, a Mexican organization that recently screened a new documentary, El peor de los mundos (Worst of all Worlds), about the corporate capture that, driven by Funsalud, has stopped legislation to regulate tobacco, alcohol, and processed foods.

Incorporated in 1985 by 21 Mexican and foreign businessmen, the General Assembly of Associates (AGA, in Spanish) is the most important body within Funsalud, where decisions are made and where private interests and public policy initiatives converge.

There are several ways to participate in the AGA, whether as a founding associate, active associate, honorary associate, as a company, or as a civil society organization. In 2021, associates donated 12,654,442 Mexican pesos to Funsalud, 4.97% more than in 2020, representing the Foundation’s largest source of income. In its annual report it mentions that COVID-19 is not a factor that affects its operations, since its associates, who do business in the health sector, “increased their commercial activity”.²

In recent years, the AGA has experienced departures due to deaths and replacements of representatives from elite companies and families. As of February 2023, it is comprised of 61 founding, active, and honorary members, 22 companies, and 4 organizations,³ including major companies such as Bimbo (BMV:BIMBO), Nestlé (BMV:NESN), Nadro, Sanofi Aventis de México (BMV:SNY), and Novartis Farmacéutica (BMV:NVS), among others.

In addition, there are companies that have indirect representation in Funsalud through individual associates, such as Grupo Empresarial Ángeles through Olegario Vázquez Aldir, son of businessman Olegario Vázquez Raña; Grupo Nacional Provincial (BMV:GNP) through Alejandro Baillères; Grupo Financiero Inbursa (BMV:GFINBUR) through Marco Antonio Slim; and Kimberly-Clark de México (BMV:KIMBER) through Claudio X. González, among others.

Alberto Baillères González, founder of Grupo Bal, which includes the mining company Industrias Peñoles, the insurance giant GNP, and retail stores such as Palacio de Hierro, was a member of the AGA until his death in 2022. Currently, Alejandro Baillères Gual, his son, is an active associate of Funsalud.

Regarding the Slim family, both the founding magnate of América Móvil (BMV:AMX), Carlos Slim Helú, and his son, Marco Antonio Slim Domit, chairman of Inbursa, are active members of the AGA.

Carlos Slim was involved in a case of public policy interference through Funsalud when, in 2004, Julio Frenk, an associate of the Foundation and then secretary of Health (2000-06), tried to reach an agreement with tobacco companies, including Philip Morris, so that for each pack of cigarettes one Mexican peso would be donated to Seguro Popular, a public program aimed to guarantee universal access to health services. At that time, Slim owned a stake in Philip Morris. The scandal cost Frenk his candidacy to lead the World Health Organization (WHO), although he later joined the ranks of Slim’s Carso Institute for Health.⁴

Claudio X. González Laporte, chairman of Kimberly-Clark and a director of several companies in Mexico, including Grupo Carso (BMV:GCARSO) for the past 28 years, is also part of the AGA, which he helped found in 1985. González Laporte is one of the major representatives of corporate interlock in Mexico, the trend whereby companies share board members and shareholders in order to gain more power and influence over the country’s economic and political decisions, according to the organization PODER.⁵ This interlock has helped Funsalud to consolidate its position in the public health sector.

For Adriana Rocha Camarena, who coordinates civil society projects at the public policy consulting firm Polithink, the fact that Funsalud brings together companies from different industries means that its priority is to protect the sale, marketing, or distribution of its members’ products.

“The fact that Funsalud is an organization or a group of industries from different sectors trying to influence or participate in the development of public policies shows us, based on evidence over the years, that this is exactly what it’s done, but with the intention that the different products of each of the businesses that comprise it are not affected or damaged by public policies. It is a very clear example of industry interference in the development of regulations, programs, etc.,” she said in an interview with Empower.

Following an interview request from Empower, América Móvil replied by e-mail that, “on the part of the Carlos Slim Foundation, the collaboration with Funsalud is as associates.” Grupo Bal and Kimberly-Clark did not respond to interview requests.

Business network

In addition to powerful families, Funsalud has a close relationship with other powerful economic groups, such as the Mexican Business Council (CMN, in Spanish), which also includes the Slim family, the Bailléres family, and Claudio X. González — who has presided over the CMN on four occasions —, among other businesspeople.

Five men who have pass away already, and who were part of the CMN as members of families that founded large companies or as their chairmen, were also founders of Funsalud.

These men were Gilberto Borja Navarrete, former chairman of Empresas ICA (BMV:ICA) who died in 2007; Jerónimo Arango Arias, the founder of Grupo Cifra who died in 2020; Lorenzo Servitje Sendra, the founder of Grupo Bimbo who died in 2017; Ignacio Aranguren Castiello, part of the founding family of Grupo Arancia and who died in 2022; and Enrique Robinson Bours, of the founding family of Industrias Bachoco who died in 2020.

Currently, Funsalud and the CMN conduct a joint project called the “Commitment to Health.” meanwhile, in addition to Claudio X. González, Alejandro Baillères, Carlos Slim Helú, and Marco Antonio Slim Domit, who are members of both Funsalud and CMN. Pablo Escandón Cusi, executive chairman of the firm Nadro and chairman of the board of Funsalud,⁶ is also a member of the CMN.⁷

In 2016, Escandón was involved in a simulated triangle scheme between Nadro and Marzam, two of the largest pharmaceutical distributors in Mexico, when Marina Matarazzo, Escandón’s wife, lent 83 million dollars through an offshore company to the Dutch fund Moench Coöperatief and to Luis Doporto, who during the pandemic made a deal with the Mexican government to sell the CanSino vaccine in the country, in order to buy Marzam. The process was halted following journalistic inquiry and an investigation by the Federal Economic Competition Commission (COFECE)⁸, as it would have meant that Escandón Cusi would effectively control both Nadro and Marzam, thus creating a monopoly.⁹

In another case, in August 2021, COFECE fined both distributors, along with three others and 21 individuals, for simulating competition among themselves for over a decade in order to overcharge the Mexican market.¹⁰ The magazine Proceso reported that Pablo Escandón Cusi was fined and that Héctor Valle Mesto, CEO of Funsalud, as well as Alejandra Escandón Matarazzo, marketing director of Nadro,¹¹ a Funsalud associate and daughter of Escandón Cusi and Marina Matarazzo,¹² were legally notified in the investigation.

Olegario Vázquez Aldir, chairman of Grupo Imagen, is another businessman who is part of Funsalud’s AGA at the same time that he is a member of CMN, as chairman of Grupo Empresarial Ángeles, the parent company of Hospital Ángeles.

In addition to the business community, another pillar of Funsalud’s operation is its relationships with government and health officials. Five former secretaries of Health have been associates of Funsalud, including José Nadro Robles and Mercedes Juan López.

Of 19 high-profile former public officials detected by Empower who have been associated with Funsalud since 1985, four are still members of the AGA: Fernando Cruz del Bosque, former executive director of International Cooperation at PROMÉXICO; Eduardo González Pier, exdirector of finance at the Mexican Social Security Institute (IMSS) in 2010 and formerly the executive chairman of Funsalud in March 2013, two months after leaving the public sector; Mercedes Juan López, former secretary of Health; and Patricio Enrique Caso Prado, director of administration at IMSS in 2017 and currently the director of government affairs at the Coca-Cola Company.

Additionally, Ricardo Bucio Mujica, former president of the National Council to Prevent Discrimination (CONAPRED) and the current president of the Mexican Center for Philanthropy (CEMEFI), and Jesús Reyes-Heroles González Garza, director of Petróleos Mexicanos (Pemex) from 2006-09, were associates of Funsalud until recently.

Areas of work, in addition to the Nestlé Fund

Beyond its associates, the Foundation has been known for its relationship with the Nestlé Fund for Nutrition regarding issues of eating habits, breastfeeding, and child health. Nestlé was one of the first companies to partner with Funsalud to design curricula for medical and nutrition schools at public universities. The relationship continued and grew stronger. Carlos Eduardo Almeida, the liaison between Nestlé and the Foundation, left Funsalud’s AGA, but the closeness between both entities persists.

According to El Poder del Consumidor in the documentary El peor de los mundos, Funsalud and its partners, specifically Nestlé, have blocked initiatives in Mexico such as the International Code of Breastmilk Substitutes, which seeks to counteract the massive sale of products such as powdered milk for babies, one of Nestlé’s leading products.

Nestlé was not available for the interview requested by Empower for this article.

With the help of its members, Funsalud also works in five other strategic areas: new technologies, quality of care, universality and competence in health, nutrition and healthy habits, and the Mexican Observatory for Health Intelligence and Research (OMINIS). In some of these areas Funsalud has been active researching and lobbying in favor of diverse public policies for the health sector in Mexico, including staffing promotional councils with Funsalud associates from public and private entities, as well as public officials from the health sector and academics.

These spaces also serve to position the messages and strategies of the companies and entrepreneurs represented by Funsalud. “They have shaped the discourse of public health policy in Mexico,” said Torres.

In the area of “new technologies,” Funsalud works on telehealth or telemedicine issues through a promotional council that includes Héctor Valle Mesto, executive chairman of Funsalud and director of the private equity firm XB Ventures;¹³ Guadalupe Guerrero Avendaño, director of the General Hospital of Mexico;¹⁴ Adrián Pacheco López, director of Telehealth at the National Center for Technological Excellence in Health (CENETEC),¹⁵ a decentralized body of the Secretariat of Health; Luis Calderón, director of Biogen Latam;¹⁶ and María Constanza Losada, CEO of the pharmaceutical company Pfizer México.¹⁷

In addition, Roberto Tapia of the Carlos Slim Foundation is also a member of the promotional council in the area of new technologies. On March 17, 2022, this council held its first meeting where it discussed a “telemedicine project for patients with prolonged COVID-19 and activities around regulatory issues of the digital health ecosystem, genetics, biobanks, regenerative medicine, data driven and genomic databases, among others.”¹⁸

In telemedicine, Funsalud, together with 63 companies, organizations, and institutions, including Fundación Carlos Slim, Google, Apple, Novartis, the Faculty of Medicine of the National Autonomous University of Mexico (UNAM), and Canifarma, wants to promote a “Digital Health Law” to add a chapter on digital health to the General Health Law,¹⁹ according to the Foundation’s 2021 report and 2022 work program.

“The fact that it has companies like Google, Apple, and the Carlos Slim Foundation makes us think that it has an interest in positioning the issue of telemedicine so that its associates can make a profit and have access to multimillion-dollar contracts to manage digital health,” Torres explained.

According to Polithink’s Rocha, the policies proposed by Funsalud are not always negative and are designed to help the population, but cannot be completely positive because of the origin of those who propose them. “What is not salvageable and is very questionable are their motivations because, in the end, the proposals will not be able to be taken further because the motivations with which they were made are inadequate,” he commented.

Another of Funsalud’s areas that stands out for its corporate interlock is that of food and healthy habits, which focuses on generating proposals regarding obesity and chronic non-communicable diseases to issue public policies on health and nutrition.²⁰ The Foundation’s 2021 annual report mentions that the promotional council of this area initiated “work to propose the ‘General Food and Nutrition Law’ and the ‘Food Guidelines.'”

Its promotional council includes Eric Hágsater, current chairman and associate of Funsalud and chairman of the pharmaceutical company Grupo Chinoin, S.A. de C.V.;²¹ Patricio Caso Prado of the Coca-Cola Company; Javier González, director of Bimbo; and Cecilia Atzimba Romero Gallegos, executive director of the Mexican Business Coordinating Council (CCE),²² another influential business group in Mexico.

The new associates

Over the last year, seven male associates and two female associates joined Funsalud. Some of them replaced associates who already represented certain companies within Funsalud, such as José Eduardo Silva Pylypciow, CEO of GNP.

Among the new associates are less-known profiles than those of the old guard and the business elite, such as Carlos Slim or members of the CMN. For Rocha, this is due to Funsalud’s branches of interest and the current political context in Mexico.

“Funsalud’s pivot to not flaunting its members has to do with the fact that this is not necessarily something that’s viewed positively by this government and rather could work against them. On the other hand, Funsalud is betting that its new members can contribute more to sectors such as technology, generation of vaccines, and the production of medicines. Now it is more attractive to be linked to a laboratory or pharmaceutical research sector,” he explained.

The new members of Funsalud are: Cristian Javier Mazza, president of the Latin American Association of Private Health Systems; Luisa Irma Suárez Bautista, general director of the pharmaceutical company Grupo Vitalmex; María Constanza Losada, CEO of Pfizer México; Agustín Eduardo Zabulanes, director of Boston Scientific de México; Jesús Eduardo de la Vega Bustillos, general sales director of TV Azteca; Julio Uribe Barroso, general director of Reliable de México; Salvador Villalobos Gómez, executive president of the Consejo de la Comunicación; and Mauricio Guizar Maguey, general director in Mexico of Biogen, a company that researches therapies for patients with neurological and neurodegenerative diseases.²³

Biogen responded to Empower that neither Guizar nor the company was part of any of the legislative initiatives promoted by Funsalud.

Agreements: income and research

Funsalud has agreements with the UNAM. Empower discovered through Freedom of Information requests that both entities signed seven collaboration and donation deals between 2000-21.

For example, in 2020, UNAM and the Foundation entered into an agreement to “review that the cleaning and sanitation protocols used by the company Airbnb comply with national and international standards issued by the respective health authorities.” Funsalud committed to contribute 100,000 Mexican pesos to the University.²⁴ The agreement is signed by Germán Fajardo Dolci, director of the School of Medicine, who has received recognition from Funsalud²⁵ and is an advisor to the Foundation’s health care area.²⁶

During the coronavirus pandemic, UNAM and Funsalud spearheaded the development of a tool to “quantify the demand for equipment and supplies of the Federal Government’s priority hospitals for COVID-19 care”²⁷ as part of the Juntos por la Salud (Together for Health) Initiative.

Although the research processes are important and may seem legitimate, “in the collaboration agreements with these research centers, which are not always public, what often exists are the questions about what needs to be researched. So, although they do not interfere in the collection of data, they can interfere in the conduct of research,” said Rocha.

UNAM is not the only research entity with which Funsalud has signed agreements. Empower identified at least 55 agreements between the two signed between 2003-21, 21 of them with the Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán (INCMNSZ), 11 with the Fondo Sectorial de Investigación en Salud y Seguridad Social (Conacyt-FOSISS), and 5 for donations from Funsalud to the Instituto Nacional de Salud para el Bienestar, among others.

With these agreements, Funsalud not only grants money but receives funding for the Foundation. It is financed with public resources through agreements in which it acts as an administrator of funds or donations, from which it obtains a percentage for its work. In 13 of the agreements signed with INCMNSZ, Funsalud operated as administrator. In five of them it obtained a percentage for its management.²⁸

Although donations are used for public entities, such as INCMNSZ, the traceability of resources is difficult to follow once they enter Funsalud’s coffers.

In 2011, Funsalud signed two contracts to manage donations received by the Carlos Slim Institute for Health for the construction of a high security laboratory at INCMNSZ. The amount of the donations is not specified in the contracts, but is set at a maximum of up to 19.4 million Mexican pesos, of which 7.9 million are contemplated for construction.²⁹

In other words, Funsalud could have had a surplus of up to 13 million Mexican pesos in donations received from the Carlos Slim Institute, whose destination is not specified. At the same time, according to Rocha, the Foundation “seeks these agreements many times to take advantage of the legitimacy of these research centers or universities.”

As this article went to publication, Funsalud had not responded to requests for interviews or comments made by voice mail to the number listed on its website. The contact e-mail listed on its website is disenabled.

According to Torres and Rocha, the fact that the narrative about how public health policies are constructed has been co-opted by Funsalud does not benefit the Mexican population. They agree that the Foundation operates through corporate interlock in order to benefit its vision of public health and with little transparency about its private interests, to the detriment of initiatives that truly consider the public interest of everyday Mexicans.

1 Funsalud, accessed January 2023, funsalud.org.mx/funsalud.

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3 “Asamblea General de Asociados,”, Funsalud, accessed January 2023, funsalud.org.mx/funsalud/asociados.

4 “Semblanza del Presidente Julio Frenk,” University of Miami, president.miami.edu/about/bio-spanish/index.html.

5 Fernanda Hopenhaym, “La élite empresarial y la economía en MX: entrecruzamiento corporativo,” PODER, 2014, poderlatam.org/2014/11/la-elite-empresarial-y-la-economia-nacional-en-mexico-un-analisis-de-caso-del-entrecruzamiento-corporativo.

6 “Consejo Promotor y Equipo de Trabajo,” Universalidad y Competitividad en Salud, Funsalud, funsalud.org.mx/areas-estrategicas/universalidad-y-competitividad-en-salud/consejo-promotor-y-equipo-de-trabajo.

7 “Pablo Escandón Cusi, Presidente del Consejo Directivo y del Consejo Promotor de Universalidad y Competitividad en Salud, Fundación Mexicana para la Salud,” OECD, www.oecd.org/espanol/pablo-escandon-cusi-presidente-del-consejo-directivo-y-del-consejo-promotor-de-universalidad-y-competitividad-en-salud-fundacion-mexicana-para-la-salud.htm.

8 “Cofece retoma pesquisa en caso Nadro tras un año de espera por amparos,” Axis Negocios, 7 March 2023, www.axisnegocios.com/breves.phtml?id=45530.

9 “Luis Doporto, multado por el caso Nadro-Marzam, detrás de vacunas CanSino,” PODER, 21 June 2021, poderlatam.org/2021/06/luis-doporto-multado-por-el-caso-nadro-marzam-detras-de-vacunas-cansino.

10 “COFECE multa a empresas y personas físicas por coludirse en el mercado de distribución de medicamentos,” COFECE, 16 August 2021, www.cofece.mx/cofece-multa-a-empresas-y-personas-fisicas-por-coludirse-en-el-mercado-de-distribucion-de-medicamentos.

11 Alejandra Escandón’s LinkedIn account, accessed January 2023, mx.linkedin.com/in/alejandra-escandon-840b7726?original_referer=https%3A%2F%2Fwww.google.com%2F.

12 Mathieu Tourliere, “Revés de la Cofece al ‘cártel de los fármacos,’” Proceso, 24 August 2021, www.proceso.com.mx/reportajes/2021/8/24/reves-de-la-cofece-al-cartel-de-los-farmacos-270458.html.

13 Managment Teram, XB Ventures, xbventures.com.

14 Dirección general, Dr. Guadalupe Mercedes Lucía Guerrero Avendaño, Hospital General de México, Secretaría de Salud, accessed February 2023, hgm.salud.gob.mx/interna/dirgral/dirgral.html.

15 Adrián Pacheco López, CENETEC, www.gob.mx/salud%7Ccenetec/estructuras/ing-adrian-pacheco-lopez.

16 Luis Calderón, www.linkedin.com/in/luis-calderon-0641456/?originalSubdomain=mx.

17 María Constanza Losada, www.linkedin.com/in/constanza-losada-0085548/?originalSubdomain=mx.

18 “Primera reunión del Consejo Promotor de Nuevas Tecnologías,” Funsalud, 31 March 2022, funsalud.org.mx/2022/03/31/primera-reunion-del-consejo-promotor-de-nuevas-tecnologias.

19 “Informe del Presidente del Consejo Directivo sobre cumplimiento del Programa de Trabajo 2021,” Funsalud, https://funsalud.org.mx/wp-content/uploads/2022/08/Inf-2021.pdf.

20 “Alimentación y Hábitos Saludables,” Funsalud, funsalud.org.mx/areas-estrategicas/alimentacion-y-habitos-saludables.

21 “Asamblea General de Asociados,” Funsalud, accessed January 2023, funsalud.org.mx/funsalud/asociados.

22 “Atzimba Romero Gallegos asume como directora general ejecutiva del CCE,” El Economista, 9 September 2022, www.eleconomista.com.mx/empresas/Atzimba-Romero-Gallegos-asume-como-directora-general-ejecutiva-del-CCE-20220909-0045.html.

23 “Biogen presenta a Mauricio Guizar, su nuevo Director General en México”, PMFarma México, 10 February 2022, www.pmfarma.com.mx/noticias/19124-biogen-presenta-a-mauricio-guizar-su-nuevo-director-general-en-mexico.html.

24 “Convenio de colaboración que celebran, por una parte, la Universidad Nacional Autónoma de México, a la que en lo sucesivo se le denominará La UNAM, representada en este acto por el Dr. Leonardo Lomelí Vanegas, en su carácter de secretario general, asistido por el director de la Facultad de Medicina, el Dr. Germán Enrique Fajardo Dolci; y por la otra parte, Fundación Mexicana para la Salud, Asociación civil, al que en lo sucesivo se le denominará La Fundación, representado en este acto por el Lic. Héctor Valle Mesto, en su carácter de presidente ejecutivo, a quienes de manera conjunta se les denominará Las Partes, conforme a las declaraciones y cláusulas siguientes,” UNAM, 8 June 2020, www.plataformatransparencia.unam.mx/archivos/repositorio/AGEN/2021/veconv2021_1t01/58043-0074-04-ii-21rev.pdf.

25 “Dr. Germán Fajardo, director de la Facultad de Medicina para el periodo 2020-2024,” Gaceta Facultad de Medicina, 21 January 2020, gaceta.facmed.unam.mx/index.php/2020/01/21/dr-german-fajardo-director-de-la-facultad-de-medicina-para-el-periodo-2020-2024.

26 “Calidad en la atención en salud,” Funsalud, funsalud.org.mx/areas-estrategicas/atencion-medica.

27 “Iniciativa Juntos por la Salud,” Funsalud, April 2020, https://funsalud.org.mx/wp-content/uploads/2020/04/200429-Juntos-por-la-Salud_V2-2-1.pdf.

28 “Convenio para la realización de estudios clínicos que celebran por una parte el Instituto Nacional de Ciencias Médicas y Nutrición ‘Salvador Zubirán’, que en lo sucesivo se le denominara ‘INCMNSZ’, representado por su director general Dr. Fernando Gabilondo Navarro y como investigador principal el Dr. Guillermo M. Ruiz-Palacios Santos, y por la otra parte Glaxosmithkline México, S.A. de C.V., en lo sucesivo denominara ‘GSK’, representado por la Dra. María Yolanda Cervantes Apolinar, de manera conjunta se les denominara ‘las partes’; de conformidad con las siguientes cláusulas,” INCMNSZ, 2 October 2010, share.mayfirst.org/s/p9pi84C25LBrbgp. Accessed 11 January 2022.

29 Contracts between Funsalud and INCMNSZ, share.mayfirst.org/s/DsXgs5d6cPptacw, share.mayfirst.org/s/DJZBTKicrQYreMi.