Code blue for HIV meds in Mexico

Doctors at the Guadalajara Civil Hospital work in precarious conditions. Guadalajara, Mexico. Photo © Ricardo Balderas.

Opinion • Ricardo Balderas • November 21, 2025 • Leer en castellano 

On December 1, 2024, as part of World AIDS Day, Claudia Sheinbaum Pardo's government announced that Mexico, in partnership with the Joint United Nations Programme on HIV/AIDS (UNAIDS), would guarantee universal and free access to medicines to treat, manage, and prevent HIV/AIDS.

Just eight months later, the part of the public health sector that’s run by Petróleos Mexicanos (Pemex) reported a shortage of supplies essential for people with the human immunodeficiency virus (HIV). The medicines in question were Bictegravir, Emtricitabine, Tenofovir, and Alafenamide, a combination of antiretroviral drugs (ARVs) that prevent HIV from replicating in the patient's body. Pemex was down to a single month’s supply.

In September, Alaín Pinzón, founder of VIHve Libre, an organization specializing in antiretroviral treatment (ART) in Mexico City, warned about shortages of drugs commonly used to treat patients who have been exposed to or are living with HIV. In 2022, the National Statistics and Geography Institute (INEGI) reported that there are 341,313 people living with HIV in Mexico.

Reality caught up to the federal government, despite attempts to guarantee the availability of these supplies. 

Pemex, which provides healthcare to 750,000 workers affiliated with its system, published a statement warning people treated at its clinics about the lack of medication to fill prescriptions that should have been in stock, but that had not arrived. 

“There were several months when many institutions had a major problem with shortages,” Pinzón explained to Ojalá. “There’s an ongoing shortage of medication in several public health institutions, but it is less severe.”

Today, almost a year after President Sheinbaum's promise of free and universal access, the supply of medicine remains insufficient and fails to reach local clinics. That means the threat of shortages or errors in the distribution of HIV medicines to those who need them is an ongoing issue.

Dangerous failures 

The AIDS Healthcare Foundation (AHF) is a global nonprofit organization that provides treatment and advocacy to people living with HIV and AIDS in over 45 countries, making it the largest provider of HIV/AIDS care internationally. The organization paints a similar picture of Mexico to that described by Pinzón.

“Pemex reported a shortage of [the ARV] Bictegravir,” said Guillermo Bustamante Vera, head of strategy at AHF, in an interview with Ojalá. “That's a problem because, for example, for Atripla, there is a monthly stock of 588, but consumption is lower. That shows poor planning, because [patients] are most likely not making the transition [from one drug to another] with doctors.”

The news about the drug shortage was reported on Monday, October 12, in a fact sheet sent to Ojalá. Since the beginning of this year, under an agreement with the National Council for the Prevention and Control of AIDS (CONASIDA), public agencies that provide HIV treatment are required to publish figures on the supply of ARVs in the country.

In the fact sheet, AHF explains that the situation at Pemex is part of a larger problem of ARV supply shortages among public health institutions.

The document indicates supplies are dangerously low, particularly of first-choice antiretrovirals with the highest monthly demand nationwide. 

For its part, the National Center for HIV/AIDS Prevention and Control reported having a 3.6-month supply of this combination of ARVs. Today, most key medicines are in stock, but there are exceptions.

Pemex also reported having only a month's supply of several antiretrovirals. Despite that short horizon, the institution continues to provide other ARVs to most of its patients.

Funeral services waiting for a body outside the medical specialties building of the Guadalajara Civil Hospital. Guadalajara, Mexico. Photo © Ricardo Balderas.

For its part, the Mexican Social Security Institute reported shortages or very low supplies of several antiretroviral drugs throughout its system.

The Institute for Social Security and Services for State Workers has yet to publish the information as required. In July, shortages were reported in states including Oaxaca, Jalisco, Veracruz, the State of Mexico, and Mexico City. In addition, there are ongoing reports of shortages at the Social Security Institute of the State of Mexico and Municipalities (a state-level institution).

The Ministry of National Defense and the Ministry of the Navy, which run the armed forces' health system, have also failed to comply with the CONASIDA’s order to make their antiretroviral supply data public.

Calls for accountability 

The shortage of antiretrovirals in Mexico, as reported by Pemex, is part of a global problem of access to vital medication for HIV prevention.

Concern has been heightened by the recent exclusion of virtually all of Latin America by major pharmaceutical companies from a crucial agreement on access to generic versions of Pre-Exposure Prophylaxis (PrEP), a highly effective injectable. PrEP is used to prevent HIV infection and reduce the risk of transmission.

Transnational pharmaceutical companies, such as Gilead, have developed products that can prevent HIV infection with up to 95 percent effectiveness with only two doses per year. But the market price is prohibitive: up to $40,000 per person annually.

The exclusion of middle-income countries, including Mexico, Brazil, Peru, and Argentina, from voluntary licensing or generic agreements has been strongly criticized by organizations like the UNAIDS.

UNAIDS Executive Director Winnie Byanyima has called this exclusion “wrong and unethical,” as these countries have the capacity to produce affordable generic versions of the treatments for as little as $40 a year.

The refusal of pharmaceutical companies to license generic production in countries with high infection burdens limits the regional response to HIV and further exposes vulnerable populations.

It’s a monopoly and a form of exclusion reminiscent of the antiretroviral access crisis that shook Africa decades ago. Byanyima has warned that the tactics used by pharmaceutical companies to delay production of generics are replicating the “same old story” that resulted in the deaths of millions of people while they waited for prices to fall.

The situation is doubly urgent as cases have risen sharply in countries like Venezuela and Peru over the past two years, largely due to the community’s limited access to health services and persistent stigma. 

In Mexico, according to INEGI figures, the number of new HIV infections and deaths has remained consistently high.

The lack of medication to treat and prevent HIV in Mexican institutions is a symptom of the failure to guarantee the universal and timely access promised by the government. 

It highlights the need for the country to strengthen its legal frameworks to challenge patents and declare essential medicines, such as preventive HIV treatments, to be in the public interest.

People living with HIV and rights advocates have spoken out about distribution problems alongside rising cases and deaths. It is in this context that the Mexican government is under fire for cuts to health spending. 

There is no specific budget line for HIV care, and activists say underfunding leads to a decrease in care. According to the organization México Evalúa, last year the health budget was reduced by 51.1 percent compared to the previous year. Activists said this represented largest cut to health spending in the past 20 years.

Access to HIV treatment, be it in the form of ARVs for people living with the virus or newer, long-acting preventative treatment, is a right and a public health necessity that is deserving of efficient action against the obstacles imposed by corporate greed.