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The response of governments to the health crisis caused by COVID-19 has been different in each country. This chapter analyzes the reaction that the Mexican government had to the health crisis. At first, the context in which the pandemic occurs is described, characterized by high social and political polarization, a process of centralization of authority, a precarious health sector with limited institutional capacities, and government communication characterized by ambiguous and confusing messages. Subsequently, we discuss the tensions and limitations of state autonomy and the coordination mechanisms, such as the National Health Council. We also present the policies portfolio developed and implemented to address the health crisis, like the national healthy distance program, hospital reconversion, and the national vaccination program. Finally, we identify a series of challenges and learnings offered by the Mexican case to improve health crisis management in the future.