For the latest article in the World of Genomics series, we head over to the home of tacos, tortillas and tequila! Mexico not only has incredible food, but it also boasts one of the world’s most vibrant and rich ancient histories. Aside from its rich culture, Mexico has also made great strides in ensuring that genomic medicine will improve healthcare in the Mexican population. Despite only a limited number of specialists in Mexico devoted to human genetics, Mexican researchers and clinicians have made, and hope to continue to make, important contributions to the field.
The population of Mexico
Mexico is a country in the southern region of North America, bordered to the North by the United States and to the South and West by the Pacific Ocean. First populated more than 13,000 years ago, Mexico is now the 10th most populous country in the world.
Various political turning points throughout the history of Mexico have had a significant impact on the population demography. The origins of pre-Columbian (before Columbus) Mexico trace back to 8,000 BC. It was home to many Mesoamerican civilisations, most notably the Maya and Aztecs. Then, in 1521, the Spanish Empire conquered and colonised the region of Mexico City, establishing the colony of New Spain.
In 1821, Mexico finally gained independence from Spain in the Mexican War of Independence. Mexico has a fascinating demographic history making it an important population to study genetic diversity. That’s not all – Mexico is also filled with ancient remains that have enabled researchers to understand ancient populations and civilisations.
Geographic and demographic information
Summary statistics:
- Land area: 1,972,550 km2
- Gross domestic product (GDP):
- Total: $2.715 trillion
- Per capita: $21,362
Population statistics:
- Population size: In the 2020 census, the population of Mexico was estimated to be 126,014,024.
- Birth rate: In 2019, the crude birth rate was 17.297 per 1,000 people.
- Death rate: In 2019, the crude death rate was 6.082 per 1,000 people.
- Infant mortality rate: In 2019, the infant mortality rate was around 12.2 deaths per 1,000 live births
- Average life expectancy: The average life expectancy in 2018 was 74.99 years.
- Ethnicity: Mexico is the product of advanced pre-Columbian civilisations e.g., the Aztec and the Maya, as well as immigration. The population is composed of many ethnic groups. The largest segment of the population today is the Mestizos who make up about 62% of the total population. Mestizo identity is mixed, mainly including European and American Indian descent. Indigenous American Indians are the second largest ethnic group in the population. The rest of the population largely come from European descent.
Healthcare system
After the Mexican Revolution in 1917, the state of Mexico adopted a constitution with a deep social orientation toward policies of education, work and health. As a result of reasons rooted within Mexico’s history, an effective healthcare system was not adopted. Mexico currently has a fragmented healthcare system. It consists of three main components: employment-based social insurance scheme, public assistance services for the uninsured supported by a financial protection scheme and a private sector.
In 1943, the Mexican Social Security Institute (Instituto Mexicano del Seguro Social, or IMSS) was created to provide healthcare coverage to private-sector, formal and salaried workers and their families. Then, in 1959, the Institute of Social Services and Security for Civil Servants (Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, or ISSSTE) was established to provide coverage for government employees and their families. In 2003, the government looked to offer subsidised, publicly provided health insurance by launching the System for Social Protection in Health (Sistema de Protección Social en Salud or SPSS and commonly referred to as “Seguro Popular”). The state oil company (PEMEX), the armed forces (SEDENA), and the navy (SEMAR) also have their own smaller healthcare institutions. The quality and approach of healthcare varies across these six institutions.
Although Mexico delivers a wide range of healthcare services, nearly 14% of the population lacks financial protection. Private sector services are also in high demand due to insufficient resources within most public institutions. Investment in the Mexican healthcare system is lower than other OECD (Organisation for Economic Co-operation and Development) countries, although this is increasing. The system also faces challenges with obesity, diabetes, violence and health inequity.
Health priorities
While in some health areas there are problems of underdevelopment, Mexico is also faced with the emerging challenges of chronic and degenerative diseases commonly found in industrialised nations.
In 2020, heart conditions were the most common cause of death in Mexico. That year almost 172,000 people died due to these diseases. Other leading causes of death include diabetes and stroke.
Despite the President launching a National Strategy on the Prevention and Control of Overweight, Obesity and Diabetes in 2013, Mexico in 2020 was reported as still having one of the largest overweight and/or obese populations in Latin America. This is not just a matter of food intake. In fact, a 2019 survey found that only 42% of the Mexican population practiced sports and physical activities in their spare time.
Although Mexico has introduced policies to tackle underlying risk factors for non-communicable diseases, such as alcohol use and smoking, there still remains a challenge in the availability of drinking water. This is particularly true for populations at the highest risk of disease.
Injuries are also a burden on society, specifically challenges regarding road-traffic deaths and those related to violence. This issue, however, extends beyond the health sector to a need for stronger legislation.
Key areas of continued focus are the strengthening of access to, and quality of, healthcare, developing programs for health promotion, disease prevention and control, and promoting international collaboration.
Genomic medicine capabilities
The scientific funding environment in Mexico is complicated. Public spending on research and development is lower than that of developed countries such as the United States, the United Kingdom and Canada. Nonetheless, Mexico’s government has been strengthening its commitment to improve competitiveness and innovation through science and technology.
The first research into human population genetics in Mexico began in 1949. Over the past few decades, important ground-breaking efforts within genomics have taken place in Mexico, including its participation in the Escherichia coli genome project, as well as the establishment of scientific societies. The first large-scale sequencing project in Mexico was performed at the Computational Genomics Program of the Nitrogen Fixation Research Center (now known as the Center for Genomic Sciences). This project involved determining the 370-kb nucleotide sequence of the symbiotic plasmid of Rhizobium etli.
Mexico initiated newborn screening in 1977 with testing for a few inborn errors of metabolism, including phenylketonuria, galactosemia, congenital hypothyroidism, sickle cell anaemia and cystic fibrosis. Since then, Mexico has expanded its newborn screening programme, which is now available in most states. Two of Mexico’s genetic screening programmes have become models for other developing nations: the Program of Early Detection of Inborn Errors of Metabolism and the Registry and Epidemiological Surveillance of External Congenital Malformations.
Access to genetic testing in Mexico, particularly in relation to cancer, is limited. This is mainly due to its high cost. In addition, while genetic counselling has expanded globally, Mexico has yet to adopt it as a separate profession. As a result, there is limited access to genetic counselling in Mexico. In addition, the distribution of medical geneticists and the genetics infrastructure in Mexico is highly concentrated in the capital, Mexico City.
Notable projects
- The Mexican Genome Diversity Project: The Mexican Genome Diversity Project led to the first catalogue of genomic variation in the Mexican population to be published in 2009. This project has contributed to the development of genomic medicine in Mexico and also the rest of Latin America. (Silva-Zolezzi et al, 2009)
- MX BioBank Project: The MX BioBank Project will build one of the largest genetic resources in Latin American and support big data science in medical genomics in admixed populations. The project will generate data on 10,000 Mexican individuals with linked demographics and medical data.
- Naia (skeleton): As part of a 2007 discovery of animal bones in an underwater chamber in the Yucatán Peninsula, researchers discovered bones of a 12,000 to 13,000-year-old human skeleton of a teenage female. Naia is among the most complete of the handful of New World skeletons. (Abbott, 2014)
Due to Mexico’s unique demographic history, several research studies have also explored the genomic variation and ancestry of Mexicans, with a focus on indigenous populations.
Notable organisations and companies
- Genomica Medica (Medical Genomics): Genomica Medica is a leading company in human genomics in Mexico. It is focussed on translating complex scientific challenges into simple solutions.
- National Institute of Genomic Medicine (INMEGEN): Founded in 2004, INMEGEN is dedicated to the development of genomic medicine for the Mexican population.
- The National Laboratory of Genomics for Biodiversity of Mexico (LANGEBIO): The CINVESTAV launched the National Laboratory of Genomics for Biodiversity of Mexico in 2005. It has state-of-the-art facilities and internationally recognised researchers.
- The Centre for Genome Sciences (CCG in Spanish): The CCG is composed of a relatively small group of researchers with laboratories focussed on microbial and plant genomics, ecological research and human genomics. The CGS is committed to the education and teaching of genome sciences.
Notable individuals
- Gerardo Jiménez Sánchez (1965-): Sánchez is a paediatrician, scientist and businessman. He was one of the first to complete medical analysis of the human genome. Sánchez was the founder and director of the IMMEGEN. He was also the leader of the team that developed the Genomic Map of the Mexican Population.
- Francisco Xavier Soberón Mainero (1955-): Mainero is a Mexican scientist and academic. His research focusses on DNA synthesis, biopharmaceutical and vaccine development, and biocatalysis.
- Valeria Souza: Souza is a Mexican scientist who specialises in evolutionary and microbial ecology, specifically processes involved in adaptation, speciation and biodiversity.
- Nancy Carrasco: Carrasco has conducted research in the fields of biochemistry, biophysics, molecular physiology, molecular endocrinology and cancer. She cloned the sodium/iodide symporter (NIS). The Carrasco group’s NIS knockout mouse has made it possible to generate an animal model of hypothyroidism.
Next steps
While the scientist training pipeline in Mexico has solid foundations, it still requires support at the more advanced levels. For example, current governmental support for postdocs is limited. Not just this, there are approximately just 315 researchers per million people in Mexico. As a result, it is critical to inspire future generations to pursue careers in STEM and to implement programs to stimulate innovation.
Most importantly, as genomic medicine develops in Mexico, modern legislation in relation to the ethical and social implications that will arise must be considered. Issues such as equity, discrimination and confidentiality will require new regulations. At the forefront of this will be INMEGEN. As it is the official reference centre in genomic medicine, it must work alongside Mexican Congress for matters relating to the field.
Despite the several challenges that lie ahead, Mexico’s efforts have successfully contributed to key developments within the genomics field. Now, Mexico has a great opportunity to strengthen local research networks, employ new science communication strategies to further educate the workforce and public, and promote public and private investment in science. This in turn will allow Mexico to be among the leading countries developing genomic medicine around the world, which will ultimately benefit the health of their population.
References
- Jimenez-Sanchez G, Silva-Zolezzi I, Hidalgo A, March S. Genomic medicine in Mexico: Initial steps and the road ahead. Genome Research. 2008 Aug 1;18(8):1191-8.
- Robles-Espinoza CD. Going home: the challenges and rewards of genetics research in Mexico. Nature Genetics. 2021 Jun 7:1-3.
- Salamanca-Gómez F. The development of human genetics in Mexico. Nature Reviews Genetics. 2006 Mar;7(3):852-.
- Gutiérrez JP, García-Saisó S. No easy answer for how to tackle Mexico’s health challenges. The Lancet Global Health. 2016 Oct 1;4(10):e668-9.
- Palacios R, Collado-Vides J. Development of genomic sciences in Mexico: a good start and a long way to go. PLoS computational biology. 2007 Sep;3(9):e143.
