General Health Council mandates the application of cardio-renal-metabolic protocols

The General Health Council established the mandatory implementation of the National Medical Care Protocols (PRONAM) related to cardio-renal-metabolic syndrome in all public institutions providing health services. The measure was published in the Official Gazette of the Federation on Monday, August 24, 2026, on page 87, and will enter into force the day following its publication.

The agreement was approved during the First Extraordinary Session 2026 of the Council, held on July 30, 2026, and is signed by the Secretary of Health and President of the Council, Dr. David Kershenobich Stalnikowitz, and by the Secretary of the Council, Dr. Patricia Elena Clark Peralta.

A Growing Public Health Problem

The Council justifies the decision by pointing out that cardio-renal-metabolic syndrome constitutes a public health problem in Mexico, resulting from the exponential increase in recent decades; therefore, clear and standardized guidelines are required to improve people’s quality of life through health services.

The measure is supported by Article 4, fourth paragraph, and 73, fraction XVI, bases 1a and 3a of the Political Constitution of the United Mexican States, as well as Articles 4, fraction II, 17, fractions V and XII, 24, fraction I, 32, and 33 of the General Health Law and the Internal Regulations of the General Health Council.

Regulatory Background

The new agreement is part of a line of previous regulation by the Council itself:

• The Agreement of June 30, 2023, which mandated the harmonization of Clinical Practice Guidelines with Medical Care Protocols, and its modification published on April 10, 2024.
• The Sectoral Health Program 2025-2030, published on September 4, 2025, whose action line 2.2.2 provides for the mandatory implementation of PRONAMs in the first level of care.

Protocols to be Implemented

According to the SECOND article of the agreement, the protocols that must be applied upon its entry into force are:

• Chronic kidney disease.
• Systemic arterial hypertension.
• Type 2 diabetes and metabolic syndrome.
• Overweight and obesity.
• PRONAM Integration Route for cardio-renal-metabolic syndrome.

Public institutions must provide medical care in compliance with these protocols, unless there is a documented medical contraindication. Additionally, they will have a maximum period of ninety calendar days to develop their implementation plan, which must be presented to the plenary of the Council no later than November 2026.

Impact for Readers

With this provision, the Mexican public health system standardizes the care of cardiovascular, renal, and metabolic diseases, which are among the leading causes of morbidity and mortality in the country. The mandatory nature seeks to guarantee a minimum and homogeneous quality in the first level of care, and the agreement may be expanded to other protocols as determined by the Council itself.

Source: Official Gazette of the Federation, Publication No. 230/2026, August 24, 2026, p. 87 (Agreement of the General Health Council).