Patient organisations must be treated as essential partners in translating health policy into real-world care, the president of a Mexican patient foundation argues, pointing to the gap between adopting national protocols and reaching people living with chronic kidney disease.
Writing in response to a Health Policy paper by Tonelli and colleagues that emphasised implementation, the president of the Mario Robles Ossio Foundation said the analysis reflects the situation in Mexico, which carries one of the highest burdens of kidney disease in the world.
The correspondence notes that in March 2025, chronic kidney disease was included within Mexico's National Medical Care Protocols. That step marked formal recognition of the condition within the country's health system framework. But the foundation's president stresses that the harder work starts after such a policy is adopted.
«The real challenge begins after policy adoption: translating those commitments into actions that reach people in their daily lives,» the correspondence states, endorsing the implementation focus of the original paper.
The intervention highlights a recurring theme in health policy debates: official adoption of a protocol or treatment guideline is only the first stage. Between a national commitment and a patient receiving timely diagnosis, sustained treatment, or follow-up care lie practical obstacles that patient groups say they see at close range.
Mexico's kidney disease burden gives the issue particular urgency. The country has long ranked among those with the highest rates of the condition worldwide, and the inclusion of chronic kidney disease in the National Medical Care Protocols was intended to strengthen the system's response.
Patient organisations such as the Mario Robles Ossio Foundation position themselves as implementation partners rather than outside advocates. Their argument is that groups representing patients can help ensure that policies designed at the national level are actually felt in clinics, communities, and households.
The correspondence does not detail specific implementation failures or propose a step-by-step plan. Its central claim is structural: policies succeed or fail at the point of delivery, and patient organisations have a role to play in that phase.
The message aligns with the broader Health Policy argument advanced by Tonelli and colleagues, which placed implementation at the centre of health system performance. By extending that logic to the Mexican context, the foundation's president connects a general policy principle to a specific national reality.
For readers following health policy, the exchange underscores a distinction that often shapes outcomes: the difference between a commitment written into official protocols and a commitment that changes what happens to a patient. The correspondence argues that patient organisations are key to closing that distance.
The foundation's intervention also reflects a wider trend in health governance, in which civil society groups seek a formal role not only in designing policy but in carrying it out. In Mexico's case, that role is framed as necessary given the scale of kidney disease and the complexity of delivering care across the health system.
The correspondence stops short of assessing how far implementation has progressed since March 2025. Instead, it uses the Mexican experience to reinforce the paper's central point: adoption is a milestone, not an endpoint, and the work of reaching patients is where the real test lies.
