What Dr. Simi tells us about Mexico’s healthcare disaster

ECATEPEC, Mexico — 

He sports activities a bushy white mustache and a little bit of a intestine. He dances to reggaeton in cities and cities throughout Mexico. He has 2 million followers on TikTook and at live shows is routinely handed into the arms of pop stars. His face even adorns a mountainside.

He is Dr. Simi, the cartoon mascot of Farmacias Similares, Mexico’s largest drugstore chain, with greater than 8,500 areas throughout the nation. His ubiquity speaks to the corporate’s round the clock advertising and marketing technique but in addition one thing darker: the failure of the Mexican authorities to ship on its promise of healthcare for all.

Medicines are sometimes in brief provide in public clinics, the place it will possibly take weeks to get an appointment with a main care physician.

Farmacias Similares helps fill the hole with low cost generics and $2 physician visits. The chain says its clinics subsequent to every location supplied 136 million appointments final yr.

Many pharmacies characteristic an worker in a Dr. Simi padded bodysuit waving to passersby and fascinating in antics equivalent to difficult the cow mascot of Mexico’s Alpura milk model to a dance-off.

At the corporate’s headquarters in Mexico City, a mural exhibits Dr. Simi with a raised arm declaring: “To serve God and the people!”

Dozens of staff there reply calls to the “Simitel” hotline that gives free entry to docs, nutritionists and psychologists — and for many who press “1” to Dr. Simi himself.

Operators who’ve perfected the mascot’s cheerful nasal voice reply a number of hundred calls a day by studying a joke from a binder or just providing a pleasant ear. Alberto González, who has performed Dr. Simi for practically 17 years, cherishes callers equivalent to 27-year-old Luis, who dialed in additional than a decade in the past to speak about his dad and mom’ divorce and nonetheless telephones each few weeks.

The operators by no means break character.

“Hello, hello! How are you?” goes the script. “You’re talking to Dr. Simi. Who is calling me?”

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In 1997, Mexico started requiring medicine to be labeled by their energetic ingredient reasonably than a reputation model. The concept was to extend confidence in drugs and open up the market to generic medicine.

The new guidelines have been a enterprise alternative for Victor González Torres, whose household firm had lengthy manufactured medicine for the federal government well being system.

That yr, he based Farmacias Similares. The identify is a reference to generics, which have been marketed with the slogan “The same, but cheaper.”

Promising “up to 75% in savings,” the corporate launched a advertising and marketing marketing campaign that offered the chain as coming to the rescue of poor Mexicans and pushed again in opposition to transnational pharmaceutical firms that disparaged generics.

González wished a mascot with the precise mixture of goofiness and knowledge. After rejecting a number of concepts from an promoting firm, his workforce discovered an artist who designed the winner: a easy black-and-white drawing of a health care provider joyfully holding up his arms. The inspiration got here from a well-known film character from the Forties, Don Susanito Peñafiel y Somellera.

Dr. Simi first appeared in newspaper commercials. He then took form as an animated cartoon and a puppet on tv, fortunately explaining why the general public ought to belief generics.

Before lengthy, Dr. Simis have been dancing on the sidewalks. The firm created a comic book known as “The adventures of Dr. Simi” and a band of “Simichicas,” well-known actresses and fashions who traveled with the founder and promoted new merchandise such because the “Simicondom.” “SimiInsurance” supplied medical remedy for a premium.

One of the chain’s key strikes was to open clinics — that are operated by a sister firm — alongside its pharmacies.

The low cost clinics made healthcare extra accessible to the tens of thousands and thousands of road distributors, taxi drivers and others working within the nation’s casual sector. It was a inhabitants excluded from public medical health insurance techniques — in obvious breach of the Mexican Constitution, which was modified in 1983 to make healthcare a common proper.

Like some political events, the chain additionally handed out free rice and supplied social help in poor neighborhoods.

Its populist technique labored. By 2003, Farmacias Similares had roughly 1,000 areas and was trying overseas.

The authorities healthcare system expanded considerably the subsequent yr below a brand new program generally known as Seguro Popular that supplied medical health insurance to staff within the casual economic system. But that didn’t seem to stall the expansion of Farmacias Similares. Catering to hourly staff who couldn’t afford to take day without work to journey to public well being facilities, the chain positioned its pharmacies on busy streets, usually close to bus stops, and grew quickly by providing franchises.

By working on an enormous scale and manufacturing lots of its personal medicine, the corporate minimize prices additional and handed on the financial savings to prospects.

“Victor González Torres and Farmacias Similares executed a tremendously effective strategy,” mentioned Michael Chu, a Harvard enterprise professor who has studied the chain.

González’s profile was rising too. Long encouraging individuals to name him Dr. Simi, he didn’t conceal his need for status, declaring as soon as that he wished to be remembered as a revolutionary like Che Guevara.

He butted heads with officers within the public well being system after alleging corruption in its drug-purchasing practices and campaigned for president as a write-in candidate within the 2006 election.

“Poor people can have power in a country where there are so many,” he mentioned in an interview on the time. “They can choose a president.”

The firm has additionally waded by a justifiable share of controversy. González’s brother was the founding father of Mexico’s Ecological Green Party, which in 2010 confronted accusations of battle of curiosity after sponsoring laws to offer individuals with vouchers for drugs in personal pharmacies. The media dubbed it the “Simi law.”

The legislation did not move, however Farmacias Similares proceed to develop amid the federal government’s faltering makes an attempt to enhance the general public well being system.

More than 1 / 4 of the inhabitants lacked entry to care in 2020, in accordance with the federal government’s most up-to-date estimate.

That identical yr, President Andrés Manuel López Obrador changed Seguro Popular with a brand new program he promised would cut back corruption. But it has been beset by drugs shortages that consultants attribute to paperwork and the COVID-19 pandemic. The authorities is at the moment transitioning to one more program.

As a consequence, clinics subsequent to non-public drugstores have been booming and at the moment are thought to serve roughly a fifth of the inhabitants. Farmacias Similares opens practically two new areas a day on common.

Carmen Maldonado, who owns a store that sells artisanal honey and cheeses, just lately dropped by Farmacias Similares’ first retailer — situated in Mexico City’s Portales neighborhood — to purchase chilly treatment and antibiotic injections, which a health care provider administered on the clinic subsequent door. An indication outdoors marketed contraception, oxygen and blood sugar readings, stitches and ear cleanings.

Maldonado might decide to make use of the general public system, however the clinic is close to her house and she or he’s been seeing this physician for 20 years.

“He’s like the family doctor,” she mentioned.

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In November 2021, a 19-year-old highschool scholar named Avril Christelle Vega Martinez was on her strategy to a live performance in Mexico City when she stepped right into a Farmacias Similares to choose up some hand sanitizer.

She had additionally been on the lookout for a Dr. Simi doll, so she was comfortable to seek out the shop had one left in inventory. The dolls come in several guises — together with boxer, mariachi and fireman — however the one she purchased was the traditional model: Dr. Simi in his lab coat.

Vega had taken the doll out of her backpack on the live performance — Norwegian electro-pop singer Aurora Aksnes — when an concept popped into her head.

“I suddenly thought of the idea of maybe giving it as a present to Aurora,” she recalled. “Dr. Simi is a symbol of Mexican culture. We grew up seeing Dr. Simis dancing everywhere.”

And so she handed the doll up by the group till somebody flung it onto the stage. Aurora picked up Dr. Simi and hugged him to her chest.

Captured on video, the incident went viral on social media, and it wasn’t lengthy earlier than Dr. Simi dolls have been routinely being thrown onstage at live shows of pop stars together with Dua Lipa and Rosalía. Joining in on the enjoyable, a former chief justice of Mexico’s Supreme Court “ruled” on TikTook that doing so isn’t a criminal offense.

The publicity was excellent news for Farmacias Similares. Dolls have been promoting so quick that the corporate boosted month-to-month manufacturing to 40,000 from 12,000. When one was left at a memorial for Queen Elizabeth II in Edinburgh final yr, Mexican media shops thought it newsworthy sufficient to cowl.

The firm fastidiously guards Dr. Simi’s picture. The greater than 1,000 staffers who put on Dr. Simi bodysuits are forbidden to talk to the general public whereas in costume as a way to protect the character’s id. One advantage of the job: classes in dancing salsa, cumbia and the Simi pasito.

A communications workforce works an evening shift to supply seven tv exhibits per week, bringing in specialists to debate anxiousness and stress, in addition to staffers from completely different areas to clarify their jobs. Employees maintain an in depth eye on social media, monitoring down for an interview members of the general public who’ve helped Dr. Simi go viral.

The firm additionally promotes its model by what Victor González Herrera, the son of the founder, known as “conscious capitalism” — funding pure catastrophe reduction, tree planting and meals help for the hungry.

In December, the corporate raffled 25 automobiles to prospects to mark its twenty fifth anniversary. Before the winners collected their new automotive keys, pharmacy staff launched into the company anthem:

We have the braveness
Dr. Simi has the center
What we provide
We do with love

With pharmacies in all of Mexico’s 32 states and greater than 400 in Chile, the corporate goals to attain its goal of 10,000 pharmacies within the subsequent 5 years and finally grow to be the most important chain on the planet.

“Simi has simply become necessary,” mentioned Victor González Herrera, who just lately took over as head of an umbrella group that features the pharmacies and the clinics.

Health consultants have warned that whereas the pharmacy clinics can deal with instant sickness, they aren’t splendid for power circumstances.

“Can it be a business that does good? Without a doubt,” mentioned Dr. Andrés Castañeda, who coordinates well being points for Nosotrxs, a Mexican group that promotes citizen participation in public insurance policies. “But the health system can’t leave things 100% in the hands of clinics adjacent to pharmacies.”

One drawback is that the care will not be constant, as a result of the docs have a tendency to return and go.

But Cori Hayden, an anthropologist at UC Berkeley who just lately printed a e-book on Farmacias Similares known as “The Spectacular Generic,” mentioned that many individuals have resigned themselves to “something is better than nothing” when the state fails to offer healthcare.

“It’s a force. It’s wild,” she mentioned of the chain. “It’s totally wild.”

But its true energy stays one thing of a thriller, as a result of Farmacias Similares retains its gross sales figures personal.

“It’s a gray area,” mentioned Jorge Perichart, director of the National Assn. of Sales Executives of the Pharmaceutical Industry. “We don’t know what we’re competing against.”

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About 30 miles north of the middle of Mexico City, in a mountainside neighborhood within the municipality of Ecatepec, the properties have naked concrete flooring and tin roofs. Access to operating water is a luxurious.

For Farmacias Similares, the Lomas de San Carlos neighborhood was not only a image of neglect: It was a canvas.

Last yr, the corporate despatched in representatives providing residents meals help and free home portray. Then painters started working on 305 homes.

The consequence was an commercial for Farmacias Similares seen from the close by freeway.

White homes make up a person’s bushy mustache, pink homes his tongue, and black-striped homes the three wiry hairs on both sides of his head.

It was, in fact, Dr. Simi.

The firm — which additionally reworked the neighborhood middle, constructed a vegetable backyard and opened two new pharmacies close by — dubbed Lomas de San Carlos “Simi Neighborhood.” Reporters rushed to cowl the story.

“No one has ever paid this much attention to us,” mentioned Hortencia Olivares Ramos, whose house was painted blue — the background of the mural.

At the mountain’s peak, Eva Ojeda López lives together with her husband and 4 kids in a home painted to match the hairs on Dr. Simi’s balding head.

The stay-at-home mom buys her hypertension drugs at Farmacias Similares when the general public pharmacies run out and frequents the corporate’s clinics for primary illnesses equivalent to colds.

Ojeda swore that the arugula from the brand new neighborhood backyard lowered her levels of cholesterol. One of her daughters learn the e-book that Farmacias Similares gifted the household: the founder’s autobiography, “My Life Is a Struggle.”

Another daughter Johana, 18, joked about how a few of her neighbors lived by Simi’s tongue or his eyes.

“We consider ourselves a part of Dr. Simi,” she mentioned.