A particular concern are rapidly rising rates of obesity, bringing in their wake potentially devastating and costly diseases such as diabetes. In addition, a large proportion of the population continue to be informally employed, where social safety nets are less well developed. To meet this challenging constellation of circumstances, Mexico needs a health system that is responsive to people’s changing needs, capable of offering continuous, personalised care, proactive and preventive in orientation as well as being cost-effective and sustainable. Sizeable investment in the publicly funded part of the health system has not always translated into better health outcomes.