Report on the Impact of Organized Crime on Healthcare and Sustainable Development Goals in Mexico

Executive Summary

Organized crime activities in various regions of Mexico are severely undermining the nation’s progress towards key United Nations Sustainable Development Goals (SDGs). The systematic infiltration and takeover of medical facilities by criminal cartels directly contravene SDG 3 (Good Health and Well-being) by compromising the safety of healthcare workers and the accessibility of medical services. Furthermore, these actions represent a profound failure of SDG 16 (Peace, Justice and Strong Institutions), as they demonstrate a loss of state control, an erosion of the rule of law, and a climate of impunity. The creation of unsafe working environments for medical professionals also challenges SDG 8 (Decent Work and Economic Growth), while the overall impact on public safety obstructs the realization of SDG 11 (Sustainable Cities and Communities).

Compromised Health and Well-being (SDG 3)

The integrity of Mexico’s healthcare system is under direct assault, impeding the goal of ensuring healthy lives and promoting well-being for all. This is evidenced by the coercion of medical staff, the seizure of facilities, and the resulting psychological trauma.

Coercion and Abduction of Medical Personnel

• Medical professionals, such as a doctor in Guanajuato, report being forcibly compelled under threat of violence to treat wounded cartel members.
• Criminal groups, including the Jalisco New Generation Cartel, utilize threatening phone calls and intimidation to kidnap personnel from their homes and workplaces.
• These actions violate the fundamental right to safety for healthcare workers and disrupt the provision of care to the general public, directly undermining SDG 3’s target for universal health coverage.

Seizure of Medical Facilities and Violent Incidents

Organized crime groups have taken control of emergency rooms, operating theaters, and entire clinics to serve their own needs. This pattern of violence obstructs access to essential health services.

1. Guanajuato: The San Fermín Clinic in Celaya was reportedly used by the Santa Rosa de Lima Cartel until it was attacked and burned by the rival Jalisco New Generation Cartel in November 2022.
2. Cuernavaca: In April 2024, an armed group entered a private medical center and executed a patient in intensive care.
3. Mazatlán: In September 2024, gunmen threatened staff at a public hospital, stating, “If they die, you die,” to force the treatment of their wounded.
4. Culiacán: Two separate attacks were reported at the Culiacán General Hospital in late 2024.

A 2022 report by the Safeguarding Health in Conflict Coalition identified Mexico as having the most violent incidents against healthcare workers in Latin America, with 14 recorded incidents including deaths, kidnappings, and destruction of facilities.

Erosion of Peace, Justice, and Strong Institutions (SDG 16)

The ability of criminal organizations to operate with impunity and challenge the state highlights a critical deficit in peace, justice, and institutional strength, which are foundational pillars of SDG 16.

Failure of State Control and Security Protocols

• Experts like Guadalupe Correa-Cabrera of George Mason University note that criminal groups have forced the Mexican state to lose control of certain territories.
• Security protocols such as the “Code Silver,” which mandates reporting violent incidents or gunshot wounds to authorities, are often circumvented. Cartels confiscate communication devices and threaten staff to prevent them from alerting law enforcement.
• State police in Guanajuato have implemented security operations in hospitals, but the pervasive fear and threats from cartels demonstrate the limitations of these measures.

Discrepancies in Violence Metrics

Official data presents a conflicting picture of public security, challenging the goal of promoting peaceful and inclusive societies.

• While official data from September 2024 to April 2025 indicated a 32.9% decrease in intentional homicides, disappearances have risen sharply.
• During the first 100 days of the current administration, 4,010 disappearances were recorded, an average of 40 per day.
• Security analyst David Saucedo suggests this discrepancy is due to cartels hiding bodies in “narco-graves,” thus reducing the official homicide count without an actual reduction in lethal violence.

Establishment of Parallel Healthcare Systems

As a response to risks within the public system, cartels are establishing their own medical infrastructure, further undermining state authority and the rule of law.

• Examples include a hospital allegedly built by Nemesio Oseguera Cervantes (“El Mencho”) of the Jalisco New Generation Cartel.
• A mobile clinic was reportedly set up by Ismael “El Mayo” Zambada of the Sinaloa Cartel.

Impact on Sustainable Communities and Decent Work (SDG 11 & SDG 8)

The crisis extends beyond healthcare, affecting the safety of communities and the fundamental rights of workers.

Undermining Community Safety (SDG 11)

The violence makes communities unsafe and unsustainable. In Guanajuato, the state with the highest number of homicides from January to April 2025, a public safety survey revealed that 87.5% of the population considers insecurity to be the most serious problem. When essential services like hospitals become sites of conflict, the goal of creating safe and resilient human settlements is severely compromised.

Violation of Decent Work Principles (SDG 8)

The conditions faced by medical staff are a direct violation of the principles of decent work. The constant fear, anxiety, and trauma have led colleagues to request psychological support and take leave. This unsafe and insecure working environment is antithetical to SDG 8, which promotes productive employment and decent work for all.

Analysis of Sustainable Development Goals (SDGs) in the Article

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being

  The article directly addresses the disruption of healthcare services, the safety of medical personnel, and the takeover of medical facilities by organized crime. These issues fundamentally undermine the goal of ensuring healthy lives and promoting well-being for all.

• SDG 16: Peace, Justice and Strong Institutions

  The core of the article discusses the breakdown of peace and justice due to organized crime. It highlights violence, impunity, corruption, and the failure of state institutions to maintain control and protect citizens and essential services, which are central themes of SDG 16.

• SDG 8: Decent Work and Economic Growth

  The article details the hazardous and coercive working conditions forced upon medical professionals. Doctors and nurses are kidnapped, threatened, and forced to work under duress, which is a direct violation of the principles of decent and safe work environments.

2. What specific targets under those SDGs can be identified based on the article’s content?

1. SDG 3: Good Health and Well-being

   • Target 3.d: Strengthen the capacity of all countries, in particular developing countries, for early warning, risk reduction and management of national and global health risks.

     The article shows this target is being undermined. The “Silver Code” protocol, designed to manage the risk of violence in health centers, is often not followed because criminals threaten staff and force them “not to activate Code Silver and that we not notify the authorities.” The takeover of hospitals by cartels represents a severe failure in managing national health security risks.

2. SDG 16: Peace, Justice and Strong Institutions

   • Target 16.1: Significantly reduce all forms of violence and related death rates everywhere.

     The article is filled with examples of violence, including threats, kidnappings, and armed takeovers of hospitals. It provides data on homicides (“a 32.9% decrease in the daily average of intentional homicide victims”) and disappearances (“4,010 disappearances were recorded, an average of 40 per day”), directly relating to this target.

   • Target 16.3: Promote the rule of law at the national and international levels and ensure equal access to justice for all.

     The article illustrates a breakdown in the rule of law, where “some criminal groups have managed to force the Mexican state to lose control of certain territories.” The impunity with which cartels operate, taking over hospitals and coercing doctors, shows a failure to promote the rule of law.

   • Target 16.4: By 2030, significantly reduce illicit financial and arms flows, strengthen the recovery and return of stolen assets and combat all forms of organized crime.

     The entire narrative centers on the power and actions of organized crime groups like the Jalisco New Generation Cartel and the Santa Rosa de Lima Cartel. Their ability to operate with “long guns” and take control of infrastructure points to the challenge of combating organized crime.

3. SDG 8: Decent Work and Economic Growth

   • Target 8.8: Protect labour rights and promote safe and secure working environments for all workers, including migrant workers, and in particular women migrants, and those in precarious employment.

     The working environment for medical staff described in the article is the opposite of safe and secure. The doctor’s testimony reveals constant fear and threats: “They force us to come in through threatening phone calls… If you don’t treat this person, we’re going to pick you up right here.” The psychological trauma is so severe that “there were colleagues who asked for their leave,” indicating an unsafe working environment.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

1. For Target 16.1 (Reduce violence and death rates)

   • Intentional Homicide Rate:

     The article explicitly provides data that can be used as an indicator: “from September 2024 to April 2025, there was a 32.9% decrease in the daily average of intentional homicide victims, falling from 86.9 victims per day to 58.3.” It also notes that Guanajuato is the state with the most homicides, with “980 from January to April 2025.”

   • Number of Enforced Disappearances:

     The article provides a direct indicator of violence by stating that “disappearances increased significantly: In the first 100 days of Claudia Sheinbaum’s administration, 4,010 disappearances were recorded, an average of 40 per day.”

2. For Target 3.d (Manage health risks)

   • Number of Attacks on Health Facilities and Personnel:

     The article cites a 2022 report that serves as a direct indicator: “Mexico had documented the most violent incidents against health care workers in Latin America: at that time, 14 recorded incidents, including three deaths, five kidnappings, two destroyed or damaged medical facilities and a damaged or looted medical unit.” The burning of the San Fermín Clinic is another specific example.

3. For Target 16.3 (Promote rule of law)

   • Perception of Public Safety:

     The article mentions the “National Survey of Victimization and Perception of Public Safety,” which “revealed that 87.5% of the population considered public safety to be the state’s most serious problem.” This serves as a powerful indicator of the population’s confidence in the rule of law and security.

4. For Target 8.8 (Promote safe working environments)

   • Reports of Workplace Violence and Psychological Distress:

     While not a formal statistic, the doctor’s testimony provides a qualitative indicator of an unsafe work environment. Statements like “One lives with anxiety, and this shouldn’t be normal for us” and “it can cause trauma. In fact, there were colleagues who asked for their leave” can be used to measure the impact on worker well-being.

4. Table of SDGs, Targets, and Indicators

Source: nbcnews.com