Puebla receives 592.3 million pesos in federal health supplies

The federal Ministry of Health and the Government of the Free and Sovereign State of Puebla formalized the Second Modifying Agreement to the Specific Coordination Agreement regarding the transfer of supplies and the provision of federal budgetary resources, whereby the supply of inputs for the Health Services of the State of Puebla is set at 592 million 301 thousand 126.29 pesos. The instrument, with official reference 02-CM-SaNAS-PUE/2026, was published in the Official Gazette of the Federation on November 3, 2026, in Section I (Executive Branch), pages 14 to 41, although it was signed on June 10 of that year.

The agreement is based on articles 9 and 13, section B, of the General Health Law, and within the framework of the MAS-BIENESTAR program. Its immediate precedent is the Specific Agreement signed on January 2, 2026, and the first modifying agreement dated March 25, 2026. The Fifteenth clause of the main agreement allows for modifications by mutual agreement, which are mandatory from the date of signing and subject to publication in the Official Gazette of the Federation and in the state dissemination organ.

A total of 645 million, with 592 in supplies

The Second clause sets the federal resources to be provided by the Federation at 645 million 307 thousand 32 pesos, of which:

• 53 million 005 thousand 905.72 pesos are budgetary resources that will be allocated to the Ministry of Planning, Finance, and Administration of Puebla.
• 592 million 301 thousand 126.29 pesos correspond to federal supplies, delivered directly to the Health Services of the State of Puebla.

The modification adjusts the table of the First clause, the first, second, and fourteenth paragraphs of the Second, declarations 3, 4, 6, 7, 8, 9, and 10 of the entity, as well as Annexes 1, 2, 3, and 5, and adds an Annex 6.

Vaccines account for almost all supplies

Of the supply amount, the majority is destined for a single program. By responsible unit:

• National Center for Child and Adolescent Health: 539 million 429 thousand 371.07 pesos, of which 538 million 899 thousand 145.67 pesos are for Universal Vaccination (program E036).
• National Center for Gender Equity, Sexual and Reproductive Health: 31 million 807 thousand 042.03 pesos, for sexual, maternal, and perinatal health and cancer prevention.
• National Center for the Prevention and Control of HIV/AIDS and Hepatitis: 11 million 841 thousand 110.41 pesos.
• National Center for Disease Prevention and Control: 9 million 066 thousand 563.79 pesos, with an emphasis on dengue (7 million 736 thousand 078.40 pesos).
• General Directorate of Epidemiology: 157 thousand 039 pesos.

The new Annex 6 incorporates, for exclusively informative purposes, a list of assets derived from donations, additional supplier benefits, and the Health Fund for Well-being totaling 288 million 478 thousand 761.84 pesos, including antiretrovirals. The instrument itself clarifies that these assets do not constitute administered federal resources and that their control and verification correspond to the source of financing.

Expenditure control and verification

The agreement requires the registration of the receipt of resources in the SIAFFASPE tool and the notification to the Secretariat, within five business days, of the corresponding digital tax receipt via internet. The supporting documentation must be in the name of the Health Services of the State of Puebla, comply with articles 29 and 29-A of the Federal Tax Code, and be canceled with the legend “Operated.”

In case of non-compliance with the verification criteria, the Secretariat of Health may inform federal and state auditing bodies. The instrument also provides that the information in Annex 6 be used solely to evaluate the efficiency and effectiveness of the programs.

Validity and signatories

The agreement takes effect upon its signing and will remain in force until December 31, 2026. On behalf of the Federation, Ramiro López Elizalde, Undersecretary of Health Policies and Population Well-being, and Daniel Aceves Villagrán, Director General of Public Health Policies, signed along with the heads of the national centers. For Puebla, Daniela Stephanie Pérez Calderón, Secretary of Planning, Finance and Administration, and María del Rocío Rodríguez Juárez, Secretary of Health and Director General of the Health Services of the State of Puebla, signed, in addition to Alejandro Villa Rivas and Crisbel Akeena Domínguez Estrada.

The adjustment is important because it defines the volume of vaccines, medicines, and assets that the state health system will receive in the final stretch of the year and because it establishes the rules by which Puebla must prove to the Federation the expenditure of federalized health spending, a category noted as one of the most audited in the Public Account.

Source: Official Gazette of the Federation, November 3, 2026, Section I (Executive Branch), pp. 14-41 (official reference: 02-CM-SaNAS-PUE/2026).