Natural disasters and the fragility of the right to health in Mexico

Gustavo Adolfo Santillana Meneses
Santillana Hintze, Mexico City
gsantillana@santillana-abogados.net

In recent weeks, severe rainfall across Veracruz, Puebla and other regions of the country has left behind not only landslides and isolated communities but also a profound social wound: the impossibility of accessing basic health services. Rural medical centres were flooded or left without electricity; roads leading to the nearest hospitals were destroyed; and thousands of people, particularly those living in conditions of vulnerability, faced days without medical attention, medicines or even drinking water.

These tragedies are neither isolated incidents nor inevitable acts of nature: they reflect a state which, despite constitutionally recognising the right to the protection of health, has failed to guarantee it effectively for all. When rivers overflow and hillsides collapse, the most vulnerable sectors of the population are invariably the most exposed. Their vulnerability is not only economic but structural: they live far from hospitals, depend on roads that vanish during storms, and rely on clinics operating with minimal resources.

In such contexts, the human right to health becomes an unattainable aspiration. Climate emergencies demonstrate that poverty and inequality in access to medical services and medicines are not separate problems but two sides of the same reality. Each natural disaster follows a predictable pattern: collapsed infrastructure, insufficient medical personnel and families forced to face illness without assistance. In the rural areas of states such as Puebla and Veracruz, this situation is particularly severe: a single climatic event can completely interrupt the provision of medical services and leave communities without care for days or even weeks.

The National Institute of Statistics and Geography (INEGI) has reported a significant reduction in poverty levels in recent years, resulting from increases in minimum wages and the expansion of social programmes. According to official data, between 2022 and 2024 the population living in multidimensional poverty fell from 46.8 to 38.5 million people – a decrease of 8.3 million individuals. Likewise, the population in extreme poverty decreased from 9.1 to 7 million. These figures, derived from the official Measurement of Multidimensional Poverty, reflect a notable social achievement that must be acknowledged as the outcome of combined public and private efforts, including wage adjustments implemented by the business sector and the social transfer programmes promoted by the federal government.

At first glance, these results represent an important step forward in social welfare and could be interpreted as evidence of sustained progress. However, the recent natural disasters that have struck raise serious doubts about the real scope of those numbers. Torrential rains, landslides and floods have shown that, beyond statistics, millions of people continue to live in conditions of high vulnerability, without stable access to basic services or timely medical care.

This vulnerability becomes even more apparent when examining access to health services. INEGI’s 2024 report indicates that 34.2 per cent of Mexico’s population – equivalent to 44.5 million people – lacked access to public health services. From 2016 to 2022, this deficiency grew alarmingly, from 15.6 to 39.1 per cent of the population. These figures reveal that, despite reductions in income poverty, the structural barriers to exercising the right to health have intensified, aggravating the overall vulnerability of the population. Economic growth and social transfers, though necessary, have proven insufficient to guarantee effective access to health protection or to build a system resilient enough to withstand crises such as the ones recently experienced.

This lack of resilience becomes evident in every emergency. During such events, the health system faces a dual fracture. On one hand, there is the physical infrastructure: damaged hospitals and clinics, shortages of medicines, lack of ambulances, and insufficient personnel to reach the affected areas. On the other hand, there is the institutional fracture: the lack of coordination between federal, state and municipal authorities, which delays assistance and amplifies suffering. Institutions created to expand coverage, such as IMSS Bienestar, face logistical and budgetary limitations that prevent a timely response to emergencies. Both in rural areas and in cities, shortages of supplies and medical staff reveal the magnitude of the national health challenge.

The fragility of Mexico’s health system also stems from a deeper cause: the absence of sufficient, sustained public investment aligned with international standards. This budgetary constraint results in hospitals without maintenance, obsolete equipment and a structure incapable of withstanding recurring crises. When a natural disaster strikes, these deficiencies become visible and, in many cases, deadly.

The human right to health is not suspended in times of disaster; on the contrary, its enforceability is strengthened. Under Article 4 of the Mexican Constitution and the international treaties on economic, social, and cultural rights, the Mexican state has an obligation to always ensure effective access to medical services, even under extreme conditions. Yet the gap between the law and reality remains vast. Improvised shelters and flooded clinics demonstrate that millions of people in Mexico live outside the reach of that constitutional guarantee, owing to the absence of effective public policy.

Considering this reality, it is essential to redesign health policy through the lens of resilience. Post-disaster reconstruction cannot be limited to repairing roads or homes; it must include the strengthening of the health system as a national priority. Mexico requires medical infrastructure capable of withstanding extreme climatic events, secure supply chains for medicines, and protocols that guarantee continuous care even in the most remote areas.

Natural disasters are inevitable, but institutional neglect is not. Every storm or landslide that destroys a health centre or prevents an ambulance from arriving serves as a reminder that the country has yet to build a truly equitable system. Ensuring effective access to medical services, particularly for individuals and communities in conditions of greater vulnerability is not a concession of the state, but an unavoidable responsibility arising from its duty to guarantee fundamental rights.

The reconstruction of Mexico, both physical and social, must begin with health. As long as the rain continues to expose the country’s deepest fractures, effective access to medical services will remain not a deferred promise, but the persistent reflection of a fundamental right left unfulfilled.