The major challenges facing Gustavo Petro's government in health and education

The last three years have been turbulent for the health system, and much of that instability, according to analysts and experts consulted by EL TIEMPO, has been a consequence of the different measures, positions, and policies adopted by the government of President Gustavo Petro, led by his Minister of Health, Guillermo Alfonso Jaramillo.

Hence, in his final year in office, the challenges are enormous, especially in terms of system financing, but also in improving care. These are long-standing problems that, according to figures such as former Health Superintendent Conrado Gómez, "are deep-rooted and don't originate with this administration, but they are issues that are not being resolved either," and are even worsening.

Since its arrival, the current government has promoted a complete restructuring of the sector. Proof of this are the two reform initiatives filed before Congress, in addition to the intervention measures by the Health Superintendency in seven EPSs , including some of the largest, such as Nueva EPS, Famisanar, and Sanitas (the latter now out of executive control following a court ruling).

But beyond the executive branch's vision of the system or the intervention measures, according to experts and analysts, the system is experiencing an alarming financial crisis, motivated, among other things, by the inadequacy of the Capita Payment Unit (UPC), as well as the non-payment of the maximum 2022 budgets, which has left the main health players in a difficult situation.

Hence, a recent report by the Así Vamos en Salud observatory shows that the equity deficit of the intervened EPSs reached 10.03 trillion pesos in the first quarter of 2025, almost double what it was in 2024. This must be added to the constant complaints from IPS associations about payment delays, as well as the crises presented in the dispensing of medications.

Experts such as Augusto Galán, former minister and director of Así Vamos en Salud, insist that all of this has resulted in disruptions to health care. This is evidenced by the increase in PQRs (Related Accident and Compensation Claims) recorded by Supersalud in recent years (see appendix).

"The general population feels that their health system has deteriorated, that they are not receiving the services they needed before," said Galán, who asserted that the profound deterioration of the Colombian health system has been driven by ideological decisions, structural underfunding, and failures in the management of the intervened health care providers.

And while the sector's demands focus on these issues, the government's efforts continue to focus on reforming the system, as it did this week with the decree implementing a large part of the health reform currently being discussed in Congress. Specifically, the future of this initiative is uncertain given a legislature that already defeated a first attempt at reform. Furthermore, the following questions arise: Will the government insist on pushing the bill forward after issuing the aforementioned decree? What will happen with the legal actions already announced against it?

Even before taking office, President Gustavo Petro announced that his top priority would be education, a commitment he maintains three years later. To demonstrate this, he outlined several goals, primarily for higher education, in the National Development Plan and the Multi-Year Investment Plan.

The most notable was the creation of 500,000 new places in higher education, including not only universities but also technical and technological institutions, which resulted in the creation of the "I Can Study" program.

This week, Education Minister Daniel Rojas presented the progress made on this strategy: 190,000 new places created, with a target date of 2024.

However, the figure has been controversial, not only among opposition political sectors but also among analysts and industry experts. The reason: despite the announcement, figures from the National Higher Education Information System (SNIES) show that between 2022 and 2024, total enrollment in the sector grew by 87,000 (or 62,000 if only undergraduate data are included), a figure well below that presented by the Ministry of Education.

And although the debate regarding the calculation remains open, the truth is that, even following the Ministry of Education's methodology, 310,000 new places would still need to be created, which must be reached by the end of 2026.

Experts such as former finance minister and rector of EIA University, José Manuel Restrepo, already believe this is impossible to achieve: "The real data shows that the Ministry of Education will not reach the goal of 500,000 new places."

Although this goal was always considered very ambitious, analysts agree that the lack of awareness of the role that private educational institutions can play (with measures such as the elimination of the Generation E program, or the 80 percent reduction in educational loans granted by Icetex - also intended for vulnerable populations) further complicates the outlook, in addition to causing enormous pressure on these educational centers, which depend on tuition fees to survive.

The economic problems also apply to public universities, which are saddled with a multi-trillion-dollar budget deficit and whose possible solution (the reform of Law 30) remains stalled in Congress.

But financial and university enrollment issues aren't the only ones the government faces in its final year. For example, it remains to be seen whether it will be able to meet the goal of 100 higher education campuses (for which it has begun using school infrastructure to serve the university population).

And when it comes to basic and secondary education (schools), the situation will not be easy. In 2022 and 2023 (the latest data available), the highest dropout rates were recorded, while net enrollment fell to 90 percent, meaning 926,000 children and adolescents are no longer in the school system. All this without taking into account that the grade repetition rate in the last two years has also been the highest in decades.

On the other hand, the PISA tests are being administered this year, the results of which will be revealed at the end of 2026 and will show how much progress the country has made in educational quality. It's worth remembering that the results of the 2022 tests were not positive, and when President Gustavo Petro presented them, he stated that the ones that would truly measure his performance would be those administered in 2025.

Finally, the School Feeding Program (PAE) continues to increase its coverage and now exceeds 80 percent. However, the PND's goal is to reach 86 percent of the school population.