Read the Conversation
Conversation highlights:
- From Crisis Response to Permanent Infrastructure. Direct Relief has evolved from disaster-driven support to a structured, on-the-ground platform ensuring safe, traceable, and compliant medical donations in Mexico.
- A Bridge Across Sectors. The organization connects pharmaceutical companies, government, and civil society through transparent, one-to-many donation systems that simplify compliance and maximize impact.
- Preparedness as a Daily Discipline. Humanitarian response depends on professional warehousing, logistics, regulatory compliance, and traceability systems built long before a crisis emerges.
- Balancing Reactive and Proactive Models. While emergency response remains core, Direct Relief increasingly anticipates needs, maps gaps with partners, and secures resources before shortages escalate.
- Strengthening the Third Sector. A more professionalized civil society, equipped with governance, permits, and medical oversight, is essential to closing healthcare gaps and improving national resilience.
EF: Could you take us through Direct Relief's role in the Mexican healthcare ecosystem?
CT: Direct Relief is a humanitarian organization founded in 1948 to support reconstruction after World War II. We began by sending packages of food, clothing, and medical supplies to help rebuild people’s lives after the war. Over time, we realized that a more direct, dignified approach was needed and established ourselves in California with a mission to support vulnerable populations, particularly by addressing gaps in healthcare access. In 1962, we became a licensed wholesale pharmaceutical distributor and developed strict protocols for safe handling and distribution. Today, we provide medical resources to communities worldwide, including the US and 90 additional countries, serving all in need regardless of politics, religion, or ability to pay.
After the H1N1 pandemic, which began in Mexico, we realized there was no organization in the Mexican ecosystem distributing medication freely and openly to everyone. At that point, we saw a critical gap and recognized that, as an organization, we could expand into Mexico. That was the first idea to bring Direct Relief to Mexico. It was not until 2014 that Eduardo Mendoza established the organization in the region.
The Mexican ecosystem is highly complex, so operating here the same way we do in other countries, or shipping from the US into Mexico, did not work. In 2014, when the H1N1 pandemic brought attention to the gap, we realized we needed to be on the ground to understand local health systems, build capability, ensure proper import of medications from the start, develop alliances with the private, public, and third sectors in Mexico, and establish rigorous local operations. Since then, we have served as a bridge, facilitating transparent, traceable, and efficient medical donations.
EF: What is at the top of your agenda right now?
CT: I need to go back briefly to explain where we are today. In 2017, when the earthquake struck Mexico, Direct Relief provided $8 million in donations, which we distributed to help organizations rebuild. One example is Casa de la Amistad, a key partner treating pediatric oncology patients.
In Mexico, people naturally come together to help one another, but effective aid requires structure. After the earthquake, many brought medicines and supplies to the collection centers. Without systems to catalog medications, store them correctly, and maintain proper conditions, those donations can deteriorate and even cause harm.
From that experience, we strengthened our organization, building shared knowledge and the capacity to manage medicines and humanitarian assistance. We realized humanitarian work must be professionalized. Today, we use best-in-class systems to track every donation.
The pandemic then accelerated our growth. We were already operating with systems that allowed us to adapt quickly. During COVID-19, we supported the transfer of 17 million vaccine doses donated by the U.S. government to the Mexican government, marking a turning point in collaboration among the public, private, and humanitarian sectors. We contributed logistics, traceability tools, and technical expertise, deepening our relationship with the pharmaceutical industry.
All of this relies on trust. During the vaccine shipments, FedEx and Direct Relief covered the costs as a charitable effort in a global crisis. By then, we had the systems, infrastructure, relationships, and trust needed to sustain Mexico's first large-scale humanitarian response of this kind.
We now act as a platform to channel aid in a transparent, efficient way, giving international donors a reliable way to contribute during disasters and emergencies. Our daily work creates the conditions to scale when a crisis hits.
One of the most complex parts of an emergency is dealing with bureaucracy and due diligence across multiple agencies. Government entities and 501 (c) (3)- equivalent institutions must be able to receive products and issue tax deductions, so operational readiness is essential.
We will continue supporting the Mexican people and government, aware of the country’s complex challenges. As an apolitical organization, our mission is to get medication to those who need it, regardless of affiliation.
We are now focusing on more specialized medications for specialized hospitals. Today, we work with 50 partner institutions and aim to collaborate with more, so that in times of crisis, they can rely on us and focus on broader, systemic change.
EF: To what extent does Direct Relief go from a reactive approach to a macroeconomic or external problem to a proactive approach?
CT: We must play a reactive role in emergencies. That is part of our core institutional mandate. Now that the organization is established, we also have the trust of the pharmaceutical industry and partner organizations. We have built an ecosystem that goes beyond crisis response.
Today, we store products in our warehouse and distribute them regularly. Each year, we send more than 100 shipments to organizations and partners across Mexico.
Sometimes companies approach us with products they want to donate. We check with our partners to see what their needs are and then decide how to allocate those donations. To be more proactive, we also ask partners to map out their needs in advance. With that information, we can approach the pharmaceutical industry or the public for financial support and begin closing those gaps.
We act as a trusted channel that simplifies complexity. Companies can partner once instead of negotiating with dozens of organizations, while we manage the due diligence, compliance, and distribution at scale. That one-to-many model delivers both efficiency and impact. In the end, it is a balance. You need enough product for emergencies, but you also need a steady flow of supplies so institutions can rely on you and keep collaborating, knowing you deliver consistently.
EF: Could you identify one or two key challenges and opportunities in the humanitarian landscape in Mexico?
CT: One of the biggest challenges organizations face today is fundraising. It is not appealing to raise money for a warehouse or for systems, but that infrastructure is critical to the supply chain. We need warehousing that is large-scale and professional.
We partner with a major warehousing provider and rely on strong systems. We work with SAP and need full traceability across everything we handle, along with support in transportation, logistics, and regulatory compliance. Fundraising for this core capacity is very challenging. In Mexico, many donors prefer to give cash directly to a visible cause, which often leaves the underlying systems unfunded. Many people react during emergencies, but you cannot do in an emergency what you do not do every day. Infrastructure, trust, and systems must be built in advance.
Logistics is another major challenge. Moving medicine is far more complex than moving other goods, especially when a cold chain is involved and must be maintained across the country. You need proper storage, full traceability, and safe distribution. Mexico is large and diverse, and that requires high standards.
The third challenge is regulation. Few people see the level of compliance, quality controls, documentation, and due diligence required under Mexican law. We meet every regulatory standard, but the process is complex, and we need support. No organization can do this alone; it has to involve every sector. We can help by providing aid and stepping in where government or private industry cannot fully cover the gap, but it only works as a team effort.
EF: What is a conversation we are not having that we need to have in the industry for the next four years as we approach 2030?
CT: We need to help local organizations operate more professionally. In Mexico, finding a donation recipient that meets all requirements is difficult. They need solid due diligence processes, the ability to receive products and issue tax write-offs, specialization in health, all required COFEPRIS permits, and a medical director. When you add it up, very few organizations qualify.
As a country, and across civil society, the private sector, and the public sector, we need to strengthen and recognize the role of the third sector. It can support day-to-day operations and respond during crises. In the long term, the goal is for these organizations to no longer be needed once systems work as they should. Until then, we help fill the gaps.
We are not the ones who will drive systemic change, but we can close gaps and give governments and the private sector the bandwidth to do so. Preparedness is built together through alliances, systems, and trust. Empowering civil society is part of the global infrastructure. Ultimately, we are part of the health ecosystem, and there is a great deal we can do to support one another.
