An internal audit by the Social Security Institute (IPS), Paraguay’s institution that administers mandatory social security and health services, identified a difference of G. 625,159,218,225 in medication and supply records between 2020 and 2024. The amount represents a discrepancy between the inventory reported by the systems and the physical movement of goods, but by itself does not prove that products disappeared or that an equivalent shortfall occurred.
Medicines delivered to patients, transferred between units or returned continued to appear in certain records as available. Most of the accumulated differences over the five years occurred in 2023, at about G. 271.394 billion. The review also identified approximately G. 13.875 billion in 2020, G. 133.511 billion in 2021, G. 163.532 billion in 2022 and G. 32.075 billion in 2024. Together, those years total about G. 614.390 billion; another G. 10.768 billion was associated with virtual logistics centers.
The problem involves communication between the Integrated Hospital System (SIH), used to record deliveries and other movements, and the SAP MM logistics module, which controls inventories and values. The audit had already recommended in 2021 that procedures be reviewed and integration between the platforms improved. IPS implemented SAP in 2017, with an investment of approximately G. 184.452 billion.
In practice, an adjustment recorded in one system was not necessarily reflected in the other. This created a “virtual inventory” that could have affected replenishment and purchasing decisions: a unit might appear digitally stocked even though the medicine had already been delivered or moved to another facility.
One of the most significant cases was identified at the IPS Regional Hospital in Encarnación, where an overvaluation of medicines amounting to G. 36,195,904,875 appeared without sufficient documentation to reconstruct all the movements. Between July 2023 and December 2025, printer problems, shortages of paper or ribbon, and equipment undergoing maintenance also made it difficult to issue delivery receipts.
IPS Development and Technology Manager Juan Carlos Frutos attributed some of the inconsistencies to a tool introduced during the Covid-19 pandemic and to exceptional procedures that continued after the health emergency. He said that at some units medicines were recorded in the system, but there were no physical slips or patient signatures for later verification. “We do not consider it a shortfall, but a procedural matter that we must review in detail,” he said.
Frutos also said that technical adjustments began in 2023 and that the discrepancy had already been corrected in the operational systems. IPS President Derlis León ordered information to be collected from the Technology and Internal Control departments. The institution intends to compare the electronic records with the available documentation and submit the results for the investigation of possible administrative or criminal responsibility.
Authorities also linked the system’s frequent interruptions to cooling failures at the data center, fiber-optic outages and power problems in the country’s interior. IPS says it maintains paper protocols for contingencies, but the absence of receipts for some deliveries shows that reconstructing traceability still depends on incomplete documents.