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Opinion | Addressing North America’s Excess Mortality

Cecilia FarfanThe Mexican government has revised the official death toll caused by Covid-19. The updated data is 60% higher placing the number of deaths at 321,000 compared to the 200,000 originally reported in mid-March. In the United States, more than 550,000 have died due to the pandemic and preliminary data from the Centers for Disease Control and Prevention show drug overdose deaths spiked to 88,000 in the 12-month period ending in August 2020. Last year, in another sad record-breaking year Mexico lost 35,000 lives due to homicide.

Deaths caused by Covid-19, drug overdoses, and homicides may seem unrelated but in fact there are important overlaps between public health and public security that ought to be used in the design of effective life-saving policies. 

In the context of a new administration arriving to the White House and considering the lessons offered by the pandemic, the Center for U.S.-Mexican Studies launched the U.S.-Mexico Forum 2025 aimed at rethinking and redesigning the relationship between Mexico and the United States. Scholars and practitioners have come together and published five whitepapers on key issues of the bilateral relationship including one on security and public health I had the pleasure of co-chairing.

Our starting point may seem obvious, but it needs to be explicit: Too many lives continue to be lost both in Mexico and the United States. Furthermore, the pandemic has brought to the fore the differential impact that insecurity has on different sectors of society based on gender, race, ethnicity, age, and class, on both sides of the border.

We propose, therefore, an approach to security and public health that recognizes the social and economic costs that crime and violence have for societies, the disproportionate negative effects on vulnerable populations, and a joint approach that acknowledges pandemics as a security threat while prioritizing health outcomes and life expectancy.

Contrary to those who oppose the Mérida Initiative would claim, tackling the shared challenges in public health and security not only has the potential for reconfiguring security cooperation but aligns with priorities in the domestic and foreign policy agendas in both countries. As we argue in the whitepaper, President López Obrador’s interest in a victim-centered approach to violence aligns with two pillars of the Mérida Initiative: institutionalizing the rule of law and building strong and resilient communities.

These pillars are also compatible with thinking about security questions from a public health perspective which acknowledges the human costs of crime and violence in terms of life expectancy, mental health, physical harm, and the erosion of community ties. These outcomes are also central to the Biden administration’s drug policy priorities aimed at promoting evidenced-based public health and public safety interventions focused on ensuring racial equity and promoting harm-reduction efforts.

Preliminary evidence shows excess mortality will continue to be a significant, but not insurmountable, challenge for the neighbors in the near future. Unilateral approaches will do little for the security and physical integrity of North America’s citizens. As both administrations seek to protect the most vulnerable in their countries, the next four years offer an important window of opportunity for rethinking security cooperation. We recommend at least the following measures:

  1. Create a bilateral coordinating group to reconcile priorities for both nations with a joint U.S.-Mexico taskforce on fentanyl disruption and bilateral units for monitoring piracy of medical supplies as high priorities.
  2. Incorporate evidence-based and life-saving public health interventions as solutions to some public safety problems. Use WHO guidelines for addressing homicides as a health crisis.
  3. Improve health data collection and sharing capabilities in Mexico, developing recordkeeping systems similar to those used by the CDC including police reports, medical examiner files, and hospital charts that support standardized data exchange with appropriate privacy protections.
* Cecilia Farfán Méndez is head of Security Research Programs at the Center for U.S.-Mexican Studies at the University of California San Diego (UCSD). Twitter: @farfan_cc
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© 2019 Mexico Today.