The legal proceedings, initiated by a private aviation company, allege a failure to pay for aviation services rendered during the electoral period. The development also coincides with a separate ongoing investigation by the national electoral authority regarding campaign finance.

Legal and Financial Allegations

According to court documents from two civil courts in Bogotá, both Roa and Jaramillo face demands for unpaid debts totaling over $2.253 billion COP (approximately $575,000 USD) owed to Sociedad Aérea de Ibagué (Sadi). The company claims that the debt stems from air transport services provided to the Pacto Histórico’s presidential and Senate campaigns during February and March 2022.

Case Against Roa: The lawsuit against Roa, who served as the manager of the presidential campaign, alleges a debt of $1.109 billion COP. A Bogotá civil court admitted the claim in December 2024. Following Roa’s failure to respond, a judge ordered the embargo of his assets in January 2025. The measure applies to four properties registered in his name, including a $1.8 billion COP apartment purchased in late 2022. The court has authorized the auctioning of the properties to settle the debt.

Case Against Jaramillo: The second lawsuit is against Jaramillo, the Pacto Histórico’s senate campaign manager, for an alleged debt of $1.154 billion COP. In May 2025, a Bogotá judge ordered the embargo of Jaramillo’s salary as minister of health and a property co-owned with family members.

These legal actions are separate from a broader investigation by the Procuraduría General de la Nación, which has opened a preliminary inquiry into Roa regarding a potential conflict of interest related to purchasing the $1.8 billion COP apartment. The property was reportedly acquired from a company linked to the mining and hydrocarbon sectors, which fall under the purview of Ecopetrol, the state-controlled energy company Roa now leads.

Regulatory Scrutiny and Campaign Finance

The lawsuits add a new dimension to existing regulatory scrutiny of the campaign’s financial management. The Consejo Nacional Electoral (CNE), Colombia’s electoral authority, is currently reviewing a report that recommends sanctions against the Petro campaign for alleged violations of campaign spending limits.

The CNE’s investigation has also examined the Pacto Histórico’s transactions with Sadi. The report cites evidence of potential manipulation in the documentation of payments for air transport services. According to the investigation, the campaign submitted invoices from Sadi to the Dirección de Impuestos y Aduanas Nacionales (Dian) that were subsequently voided. The report suggests that these actions, which included a reduction in flight hours and the removal of initially billed concepts, may have been intended to avoid exceeding campaign finance limits.

Ricardo Roa, president of Ecopetrol. Photo credit: Ricardo Roa Barragan/X.

Health authorities are urgently calling on everyone in Colombia to get vaccinated against yellow fever starting at nine months of age, including individuals over 59 years old. Between September 2024 and now, 75 confirmed cases and 34 deaths have been reported nationwide, representing a cumulative fatality rate of 45.3%.

Confirmed cases are distributed across nine departments: Tolima (59 cases), Putumayo (7), Nariño (2), Caquetá (2), Huila (1), Vaupés (1), Cauca (1), Meta (1), and Caldas (1). Fatalities associated with the disease have been recorded in eight departments: Tolima (23 deaths), Putumayo (5), Caquetá (1), Nariño (1), Caldas (1), Cauca (1), Huila (1), and Meta (1).

Yellow fever is a viral illness transmitted through the bite of infected mosquitoes. Initial symptoms within the first 24 hours can include fever, headache, and general malaise. In the subsequent 72 hours, symptoms often intensify with gastrointestinal manifestations such as vomiting, diarrhea, and abdominal pain. From the fifth day onwards, signs like jaundice (yellowing of the skin and eyes) and bleeding may occur, which can be fatal in unvaccinated individuals. The disease is highly preventable through vaccination, with a reported fatality rate ranging between 40% and 50%.

Colombia is implementing an urgent, free, door-to-door vaccine program to prevent the gruesome disease from spreading via mosquitos.

Since September 2024, the National Government has implemented a series of strategic actions to control the spread of yellow fever and protect public health:

• Intensified Vaccination Strategy: The age range for immunization has been expanded to include individuals from 9 months of age and older, with mass mobilization efforts in affected municipalities.
• Strengthened Epidemiological Surveillance: Over 20 rapid response teams have been deployed for active community case finding and field investigations. Entomovirological, pathological, and laboratory surveillance has also been reinforced through the national reference laboratory of the National Health Institute (Instituto Nacional de Salud).
• Expanded Primary Care: More than 100 Basic Health Care Teams (Equipos Básicos de Atención en Salud – EBAS) have been activated in municipalities with confirmed virus presence.
• Coordination with Health Promotion Entities (EPS) and Vaccination Networks: Health Promotion Entities (Entidades Promotoras de Salud – EPS) have been instructed to establish and operate vaccination teams in coordination with the public and private healthcare network in all affected territories.
• Territorial Coordination through Unified Command Posts (PMU): Twenty-two PMU sessions have been held in the department of Tolima, one in Caldas, and one at the national level, involving local, departmental, and national authorities. Additionally, an extraordinary session of the Risk Management Committee was convened in Huila.
• National Communication and Education Campaign: An information and education strategy has been activated to promote vaccination, self-care, and vector control nationwide.
• Clear Technical Guidelines for the Health System: Circulars with precise instructions for all actors in the national and territorial health system have been issued, disseminated, and technically supported.

The outbreak has demonstrated a progressive expansion, particularly in areas of the Amazon basin, the Magdalena River valley, and departments such as Meta, within a short period. Cases have also emerged in territories with no historical records of the disease, such as the municipality of Neira in Caldas, located in the coffee-growing region.

While urban transmission of yellow fever has not been reported in Colombia since 1929, there is a potential risk of re-emergence due to the frequent entry of individuals into enzootic areas—where the virus circulates in its sylvatic cycle through Sabethes and Haemagogus mosquito species—and their subsequent movement to urban zones below 2,200 meters above sea level, inhabited by urban cycle transmitting species such as Aedes aegypti and Aedes albopictus.

Epidemiological monitoring has identified cases in populated centers and urban peripheries of municipalities with low population density, indicating a risk of expansion into larger urban centers. Given this scenario, vaccination remains the most effective tool for controlling yellow fever. Analysis of fatal cases has shown that the deceased individuals were unvaccinated, underscoring the urgency of increasing vaccination coverage. Territorial entities must prioritize immunization of the entire population over 9 months of age in high-risk municipalities and strengthen the intensification strategy in the rest of the country.

The Minister of Health and Social Protection (Ministerio de Salud y Protección Social), Dr. Guillermo Alfonso Jaramillo, stated, “With the declaration of the yellow fever emergency, we are intensifying actions to protect the entire population. Our Basic Health Teams, totaling more than 10,000, continue to travel to vaccinate all people in the most remote areas of the country, especially in high-risk zones. The vaccine is free, safe, and administered in a single dose, at least 10 days before entering risk areas.”

The Minister also added that door-to-door campaigns, vaccination drives in educational institutions, transportation terminals, military and police facilities, and other collective spaces will be strengthened. Furthermore, mosquito control measures will be reinforced, and immediate access to healthcare services without barriers will be guaranteed.

Considering the above, and within the framework of the declared health emergency, the following measures are adopted at the national level to contain the yellow fever outbreak, protect the lives of the population, and ensure a coordinated response from the health system:

• Mass Vaccination: A national mass mobilization will commence in high-risk municipalities and extend to the rest of the national territory. The vaccine is free, safe, administered in a single dose, and should be received 10 days before entering risk areas. Strategies will include door-to-door campaigns and vaccination in educational institutions, transportation terminals, military and police facilities, and other collective spaces.
• Integrated Vector (Mosquito) Control: Actions to control mosquitoes in homes, communities, healthcare facilities, and high-traffic areas such as market squares and terminals will be intensified. Mosquito nets will also be distributed in high-risk rural areas.
• Immediate Deployment of Basic Health Teams and Rapid Response Teams: These teams will play a crucial role in case identification, community education, epidemiological monitoring, and vaccine administration, bringing services closer to the most vulnerable and hard-to-reach populations.
• Centralized Management of Health Services: Regional Emergency and Disaster Centers (Centros Reguladores de Urgencias y Emergencias – CRUE) will assume control of the availability of Intensive Care Units (ICU) and patient transfers.
• Obligations of Health Promotion Entities (EPS): EPS are required to allocate all necessary technical and financial resources through their public, private, and mixed networks to guarantee vaccination, prevention, and care for their entire affiliated population. Prior authorization from EPS for the provision of health services is not required.
• National Hospital Alert: A yellow hospital alert is activated throughout the public, private, and mixed healthcare network nationwide. This will be elevated to orange alert in municipalities with human cases and, if justified, to red alert, based on the analysis conducted by the territorial entity with the support of the Ministry of Health and the National Health Institute.
• Mobility Restrictions: Local authorities may implement access restrictions to areas with active virus transmission, following established protocols and in coordination with police forces. The protection of medical personnel during these operations will be guaranteed.
• Requirement of International Vaccination Certificate for Travelers: In compliance with the International Health Regulations, international travelers entering the country may be required to present a yellow fever vaccination certificate. The vaccine must have been administered at least 10 days before entering risk areas. (This measure will be adjusted based on World Health Organization (WHO) recommendations to avoid impacting tourism and trade).
• Culture of Prevention: Citizens are urged to adopt self-care measures, eliminate mosquito breeding sites in their surroundings, and seek timely vaccination. In particular, residents of municipalities located below 2,200 meters above sea level are advised to use insect repellent, mosquito nets, and clothing that covers the skin as personal protection measures against the yellow fever transmitting mosquito.
• Risk Management Committees: Departmental, district, and municipal territorial entities located in high-risk areas will convene risk management committees to adopt comprehensive control and risk management plans.

The director of the National Health Institute, Diana Marcela Pava, reiterated the duty to protect the health and lives of Colombians. “The measure to declare a health emergency was subjected to a rigorous risk assessment exercise, which is an internationally validated process to establish the level of risk the country is facing,” explained the director, adding that “thanks to this exercise, the measures announced by the Ministry of Health were taken.”

The Vice Minister of Public Health, Jaime Urrego, stated, “This emergency has a preventive emphasis. The vaccine saves lives, and this emergency reminds us that we must take extreme precautions. There are two key points: the change in the behavior of the disease and the risk of urbanization, especially in municipalities below 2,200 meters where we must vaccinate the entire population. We are not seeking to generate fear but to act jointly with experts to stop yellow fever.”

The General Secretary of the Ministry of Health, Rodolfo Salas, affirmed, “Colombia is a social state governed by the rule of law, where the right to life and health prevails. According to Article 69 of Law 1753 of 2015, the Ministry of Health and Social Protection is the competent governing body to declare a health emergency in the event of epidemics that endanger the public health of the country. This virus is showing rapid transmission, so we call on the competent authorities to take the necessary measures to prevent its spread.”

The Ministry of Health and Social Protection calls for the shared responsibility of all actors in the health system, territorial authorities, and the community in general to confront this emergency and protect lives.

Information for Travelers and Individuals in Risk Areas:

Yellow fever is transmitted by the bite of infected Aedes and Haemagogus mosquitoes. These mosquitoes typically bite during the day. For travelers and residents in areas below 2,200 meters above sea level, especially those in the departments with reported cases, the following precautions are recommended:

• Vaccination: The yellow fever vaccine is highly effective and provides lifelong protection with a single dose. It is recommended to receive the vaccine at least 10 days before traveling to or residing in risk areas. The vaccine is available free of charge in affected municipalities for individuals over 9 months of age.
• Insect Repellent: Use insect repellent containing DEET.  Follow the instructions on the product label.  
• Protective Clothing: Wear long-sleeved shirts, long pants, socks, and shoes when outdoors, especially during peak mosquito biting times.
• Mosquito Nets: Use mosquito nets (bed nets), especially if sleeping outdoors or in unscreened accommodations. Permethrin-treated nets offer additional protection.
• Eliminate Mosquito Breeding Sites: Regularly empty and clean containers that can hold water, such as flowerpots, tires, buckets, and pet water dishes, around your home to prevent mosquito breeding.
• Seek Medical Attention: If you develop symptoms such as fever, headache, body aches, nausea, vomiting, or jaundice, especially after being in a risk area, seek medical attention immediately. Early diagnosis and supportive care can improve outcomes.
• International Travel Requirements: Travelers entering Colombia from countries with a risk of yellow fever transmission may be required to present an international certificate of vaccination against yellow fever, as per the International Health Regulations. It is advisable to check the latest requirements before traveling. Similarly, travelers departing from Colombia to certain countries may also need proof of vaccination.

The current health emergency underscores the importance of vaccination and preventive measures to mitigate the risk of yellow fever transmission in Colombia. Residents and travelers in affected areas should adhere to the recommendations of health authorities to protect themselves and prevent further spread of the virus.

Photos © Loren Moss

Photo: Colombian Inspector General Margarita Cabello has summoned the involved parties to a technical meeting in hopes of resolving the conflict. (Photo credit: Office of the Inspector General of Colombia)

Colombian Inspector General Margarita Cabello indicated that resolving this issue will require a series of meetings “for the purposes of achieving points where the best interest, which is the benefit of citizens, especially those affiliated with Sanitas, can be resolved quickly.”The first meeting was planned for November 9, but it was canceled after Health Minister Alfonso Jaramillo questioned the representative assigned for that meeting by the inspector general. 

While the dispute between the firms has been simmering longer, the crisis came to a head when Cruz Verde claimed on October 30 that Sanitas, which in total serves more than five million people, owes the pharmacy around $100 million USD that has been accumulating gradually over several years, month by month, for certain medications and supplies. For this reason, beginning November 15, the pharmacy has said it will stop supplying Sanitas members with these medications that are included in the nation’s Health Basic Plan.

Regarding the deadline, Sanitas said in a statement that it has reached an agreement with Audifarma, pharmaceutical management firm, to distribute these medicines and avert the feared crisis.

The Health Basic Plan (PBS) generally dictates which medications are covered and paid for by the public system and therefore mandated to be distributed by the private administrators. By contrast, non-PBS medications and supplies are those that are not included in the plan. 

Although the list is updated regularly, broadly speaking, the non-PBS medicines, supplies, or technologies fall outside of the core mission of prevention, diagnosis, treatment, rehabilitation or palliation of disease. Since they are not covered by the government, these items must be first authorized by the health providers before pharmacies distribute them to the patients.

The list is extensive, but some non-PBS items include diapers, vitamins, supplements, contact lenses, wheelchairs, orthopedic insoles, sunscreen, and certain skin remedy creams.

According to Sanitas, the reason for the debt is because the Colombian government  has had a payment delay of $619,000 USD in the maximum budgets, which are the payments that the state makes in advance to companies for medications not included in the Basic Health Plan.

“Unfortunately,” wrote Sanitas in a statement, “the issue of maximum budgets with which this decision is related is one of the reasons why we have been alerting the government for months about the importance of finding solutions to the current situation without, until now, having had a response in this regard.”

Colombian Health Minister Downplayed the Financial Struggles of EPS Providers

In August, Colombia’s health minister downplayed the claims from the nation’s largest public EPS health coverage providers — including Sanitas, along with Sura and Compensar — that they are suffering a financial crisis that could affect the provision of services to patients if the government does not increase the budget they are allocated to fulfill their mission.

“They want to make a storm in a glass of water, and we cannot accept that either,” said Guillermo Alfonso Jaramillo, head of the Ministry of Health (MinSalud), during an August press conference. “Except for some debts from the former government related to COVID issues, we can say that we do not have financial obligations to them. Now, they tell us about losses, but they never told us about the profits they had in 2020 and 2021.”

Despite the comments, Jaramillo did commit in August to set up technical tables with the EPS providers and other industry stakeholders. As a result of the discussion, Jaramillo announced that his ministry will transfer another $2.4 million USD to the Sanitas, Sura and Compensar, the three organizations that sent him the missive, until the end of the year. 

He agreed to this compromise despite, as he pointed out, the fact that the government had already distributed more than $3.3 million USD to the companies.

EPS Providers Claim Claimed that Funding Was Insufficient

The companies expressed their concerns in a formal letter to Jaramillo on July 27 that was signed by top executives of the three largest EPS providers: Pablo Otero, general manager of EPS Sura; Andrés Barragán, health director of EPS Compensar; and Juan Pablo Rueda, president of EPS Sanitas. They stated that their companies are suffering major losses because the public funding they rely on is insufficient to attend to the 13 million combined patients they have, a total that represents more than half of the patients affiliated to the Health Contributory Regime (22 million in total). 

This regime covers the people who work and make their payments for health care. This is the opposite of the Health Subsidized Regime, in which the state is the one that assumes this obligation (they are 24 million Colombians).

The text attracted the attention of three main topics. The first critical request is that the value of the Capitation Payment Unit (UPC) is insufficient to meet the real demands of sick people. This value corresponds to a calculation that purportedly responds to what it costs each EPS to care for each patient. Once this figure is defined, the government gives them money that corresponds to the number of people the EPS have under its responsibility.

Regarding this subject, the health companies have pointed out that the cost for taking care of a patient with cancer is not equal to a patient who has temporary food poisoning, for example, in terms of medical staff, equipment, laboratory tests, bed occupation, etc.

The second element is the equitable redistribution of resources given that some EPS have to attend to a greater number of cases of serious illnesses and others present better financial results because their patients do not suffer from such catastrophic ailments, so the expenses are lower. As an example, the letter senders assured that they spend $102 USD for every $100 USD that they receive for this concept.

And the last one is the payment of maximum budget debts, recoveries, COVID related conditions, licenses and disabilities and pending compensation processes. Concerning this point, the Health and Social Protection Ministry office promised that the money is on its way in the next few weeks.

Petro’s Quest for Health Reform and Potential Changes to the Public Healthcare System

President Gustavo Petro campaigned on a promise of reform. The health system was one of his most important areas to change, and he has been attempting to make progress in this area for the whole year since he took office. So far, however, things have been moving slowly and he has lost a lot of political support to enact any changes due to a series of controversies and a major defeat for his party all across the country in local and regional elections.

Nevertheless, the president has put forth a reform package, and some of the ideas have gained some support. The one thing many people — even his political opponents — agree on is that the system is in need of improvements.

While it’s hard to know what the final form of any reform may be, at this moment, in what has been discussed in Congress, it is known the health provider companies would change their names to Health and Life Managers. If the health reform were to be approved, according to the text, the proposal is that the money for the patients would be transferred directly to the Health Care Institutions (known by Colombians as IPS), such as clinics, hospitals and health care facilities.

This name change responds to the fact that, per arguments from the Petro administration, the EPS unnecessarily delays the payments of the funds they receive from the government and this affects the users’ attention. Under the reform, the System of Social Security in Health (ADRES), the state entity that is currently in charge of transferring the budget, would instead transfer funds without intermediaries and, supposedly, this adjustment in the procedure would end the pending debts the EPS providers have with the IPS.

If the reform were to pass, the current EPS would have two years to become Health and Life Managers, and the Superintendence of Health (SuperSalud) would have the power to authorize which Health and Life Managers comply with the government’s requirements and would have the green light to operate.

The Current State of Colombia’s Healthcare System

Despite a desire for improvement from most stakeholders in Colombia, the national healthcare system is generally regarded well compared to its regional peers and many critics have campaigned against the president’s reform proposals, saying that they could push the country toward economic instability due to its anti-private practice measures.

According to a survey conducted by Cifras y Conceptos early this year, 80% of the Colombians indicated that they do not agree with the elimination of the current health providers, and more than half (51%) do not agree that the national government should manage the entities that provide healthcare.

Finally, the Colombian health users differ with Gustavo Petro’s argument that assures that the state would manage health services more efficiently than private firms. In this matter, 85% of those consulted disagree with governors or mayors at the national level having any type of interference in the territorial health funds, as it could exacerbate the menace of corruption among politicians.