On June 25, the streets of Asunción witnessed a force that has been growing in across in hospitals, health centers and clinics: the organized voice of Paraguayan nurses.

Convened by PSI members from the Paraguayan Nursing Association (APE) and other organizations of the Nursing Unity Front, more than 4,000 workers marched from different parts of the country to the capital to demand decent working conditions and reject the privatization of public health services.

Neither the winter cold, nor the veiled threats. Neither the historical dispersion of the Paraguayan trade union movement nor the silencing strategies were able to stop the protagonists of the day. What seemed to be just another cry in the midst of social discontent, ended up being a demonstration of force that led to concrete commitments from the Paraguayan government.

But the mobilization did not come out of nowhere. It was the most recent expression of the grassroots power that APE has managed to build over the years, especially in historically invisible sectors of the public system. A striking example of this is the Law regulating the professional career of nursing staff, won in 2020 thanks to the tenacity of the union, even in a country where nepotism, political favors and co-optation of positions in the State are still commonplace.

The existence of this law not only formally dignified the profession, but also made APE one of the most strategic organizations of Paraguayan trade unionism, capable of disputing structural reforms in a complex and adverse institutional scenario. The demand for the full implementation of this professional career is today one of the main issues of the ongoing struggles.

Concrete advances after the day

During the demonstration, the organizations formally delivered a petition to the Ministry of Public Health and Social Welfare (MSPyBS), in which they expressed their categorical rejection of outsourcing and privatization, denounced the serious lack of supplies and medicines, demanded the proper functioning of intensive therapies and raised the urgent reduction of the workload for nursing staff.

As the "white tide" advanced through the streets of downtown Asunción, the president of the APE and a delegation made up of representatives of the nurses' unions of the Instituto de Previsión Social (IPS) were received by the director of the agency, Jorge Magno Brítez Acosta, and later by the vice-minister of the Ministry of Economy and Finance, Felipe María González Soley, who was forced to respond with a series of concrete commitments that represent significant advances for the sector.

One of the highlights was the announcement that the fifth year of the Professional Career will be incorporated into the preliminary draft of the 2026 national budget, thus benefiting professionals of the Ministry of Public Health and Social Welfare (MSPyBS), the Hospital de Clínicas and the Police Hospital. To this was added the commitment to include the results of the sub-level promotion competition in the same budget, an important step to ensure a fairer and more transparent promotion structure.

Regarding the Instituto de Previsión Social (IPS), an additional budget allocation of 8.2 billion guaraníes, equivalent to approximately US$1.1 million, was announced to strengthen the Professional Career and advance in the recategorization processes of the personnel. In addition, a salary leveling was agreed for 800 contracted workers, who will now have access to a base income of 4 million guaraníes, or approximately US$540 per month, an important relief in a context of historically low salaries and high informality.

Finally, it was agreed to set up a permanent working group between the Nursing Unity Front and the authorities of the Vice-Ministry of Economy, which will make it possible to follow up on the agreements and deepen future reforms. In addition, the Government announced the holding of public competitions for new contracts in the MSPyBS, the IPS and the Hospital de Clínicas, giving priority to young professionals and guaranteeing criteria of merit and transparency in the entry to the public system.

More than a protest: interpellation, visibility and power building

What happened on June 25 was not just a union demonstration. It was a powerful challenge to the management model of the Paraguayan State, where labor and budgetary decisions are usually influenced by clientelistic criteria and political favoritism rather than by the recognition of merit and social need. Nurses have come out to say enough is enough. Enough of precariousness, of junk contracts, of unworthy salaries, of invisibilization. And it did it not from the isolated complaint, but from the collective and proactive mobilization.

The message was clear: there is no health system without nursing, and there is no professional dignity without fair working conditions. The forcefulness of the march also managed to cross the country's borders. An example of this was the presence and active support of Nayareth Quevedo, sub-regional secretary of Public Services International (PSI) for the Southern Cone countries, who marched alongside the workers and said:

"Health is a fundamental human right that must be guaranteed by a present and responsible State. We call on the authorities to assume their responsibility and guarantee sufficient resources, decent contracts and job stability for those who are the heart of public health in Paraguay".

This international support highlighted that the struggle in Paraguay is part of a broader debate in Latin America, where health workers face the consequences of management models that commercialize the public sector and strip the rights of those who sustain it on a daily basis.

The advances achieved in this day are significant, but also fragile if they are not sustained with organization. The struggle is not over: now begins a key stage of follow-up, pressure and articulation to ensure that what has been committed to is materialized in laws, budgets, appointments and real improvements.

The challenge will also be to multiply this experience and turn it into a broader platform for the defense of public employment, care policies and health as a right and not as a business.

What happened on June 25 shows that even in a country with high levels of union fragmentation, with state structures permeated by cronyism and with little tradition of mass mobilization, it is possible to build collective strength from below. Nursing has done it. With courage, patience and conviction. And in the process, it has given back to thousands of workers not only a concrete victory, but also the certainty that organization and struggle are still the most powerful tools to transform reality.

Today, the white coats not only care. They also march, question and win rights.

Concrete commitments achieved by Paraguayan nurses:

• Incorporation of the fifth year of the Professional Career to the preliminary draft of the national budget 2026, benefiting professionals of the Ministry of Health, Hospital de Clínicas and Police Hospital.

• Inclusion of the results of the sub-level promotion competition in the 2026 budget, to guarantee a fairer promotion structure.

• Additional budget allocation of 8.2 billion guaraníes ( approximately US$1.1 million) for the IPS, aimed at strengthening the Professional Career and advancing in the recategorization of personnel.

• Salary leveling for 800 contracted workers, who will have access to a base income of 4 million guaraníes (approximately US$ 540 per month).

• Establishment of a permanent working table between the Nursing Unity Front and the authorities of the Vice-Ministry of Economy.

• Holding of public tenders for new contracts in the MSPyBS, the IPS and the Hospital de Clínicas, prioritizing young professionals and guaranteeing merit and transparency criteria.

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