President Santiago Peña announced on Sunday, September 13, 2026, a change in the leadership of Paraguay’s public health system: Isaías Fretes was replaced as president of the Social Security Institute (IPS), a social security and public health institution, and took over from María Teresa Barán at the Ministry of Public Health and Social Welfare. Derlis León, until then the IPS health manager, became president of the institution.
The change comes during a crisis with the National Medical Association (Sinamed), which has maintained a nationwide strike call for September 21 and 22. The union is demanding a salary increase and rejected the government’s proposal to prioritize the healthcare career structure. The Paraguayan Society of Pediatric Emergency Medicine (Sopep) expressed support for the mobilization and said professional commitment cannot be used to justify the deterioration of working conditions.
In his first intervention, Fretes promised to negotiate directly with doctors and said he had the backing and “tools” to seek a solution. “Improving doctors’ pay was a postponed right. This government will take that into consideration,” he said. The new minister said he expected to reach an agreement later this week, but he did not publicly present the terms of any possible proposal.
Fretes also defended a salary floor compatible with the profession, citing the costs of continuing education and the legal risks of practicing medicine. Sinamed Secretary-General Rossana González wished the new minister success but reiterated that the salary demand remained in place. The organization has not yet announced that the strike has been called off.
Derlis León said he would continue the work Fretes began at the IPS, prioritizing access to consultations, services and medicines. A pediatrician and institution employee for 22 years, he also promised transparency and integration between the IPS and the Ministry of Health.
The leadership change coincides with questions about the IPS’s financial management. An audit by the Office of the Comptroller General of the Republic recommended preventive monitoring and investment diversification after Ueno Bank’s share reached 19.7% of savings deposit certificates in guaraníes and 19.95% in dollars at the end of 2025. The body pointed to significant exposure of social security funds to a single private institution and noted that the IPS has no specific internal protocols for cases of bank insolvency.
A court request for access to information about the IPS’s operating accounts, deposits, balances, interest and bank documents in 2026 is also pending. Economist and retiree Sergio Lovera Cañete says the institution did not respond within the deadline established by Law No. 5,282/2014. The allegation is part of the lawsuit he filed and has yet to be considered by the courts.
Peña also announced that the 2027 budget would set aside US$760 million for medicines and supplies, nearly 200% more than in 2023, as well as US$195 million for the National Cancer Institute. The government says it has invested more than US$500 million in health infrastructure over the past three years. As she left office, María Teresa Barán highlighted hospitals, family health units and the expansion of the intensive care network, but acknowledged that “we surely made mistakes” and that tasks were still outstanding.