“It Strips the Governorships of Their Powers”: Santa Cruz Rejects the Government’s Health Plan

Santa Cruz’s departmental government has rejected Bolivia’s 2026-2030 health plan, accusing President Rodrigo Paz’s administration of concentrating authority and stripping the country’s departmental governments of their powers.

Germán Antelo, Santa Cruz’s health secretary, said officials in the department were not consulted while the plan was prepared. He said the health minister, Marcela Flores, later sought a meeting that would have allowed Santa Cruz to approve the proposal, but the department refused to appear in a photo or sign a document it had not seen.

“This plan, 2026-2030, concentrates decision-making powers at the central level of the state. Even the MAS did not do that,” Antelo said. He argued that the proposal would centralize not only decisions, but also financial resources and personnel management, leaving the governorships with little authority.

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Even the MAS did not do that.

Antelo also warned that the plan would allow the central government to intervene in departmental governments, condition their budgets and exercise total control over health workers and medical records. He criticized the proposed direct relationship between the Health Ministry and civic committees, saying it failed to recognize the role of the governorships.

Santa Cruz wants to exercise departmental oversight over public and private services, including those operating through agreements. Antelo defended the autonomy process and rejected any measure that would return powers to the central government.

He called on Paz to hold a technical meeting with the minister and representatives from Santa Cruz and the other departments. The dispute, he said, concerns all departmental health services, not only Santa Cruz. He added that the Medical College and sector unions also oppose recentralizing health administration.

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We were not consulted at any time.