In 2025, 33 governments from Latin America and the Caribbean (LAC) met in Tlatelolco, Mexico, and committed to a decade of action on care, months after the Inter-American Court of Human Rights recognized care as a stand-alone right. A year later, Ecuador's Ministry of Women was dissolved with its national care system still unfunded, and Colombia's Ministry of Equality is under dissolution over a legal technicality the Congress has not repaired. Two of the strongest care frameworks in the region lost their institutional anchor in the same period the region announced its decade.
But this is not a story about governments failing, it is about the wrong outcome being measured. While the care agenda counts progress in laws passed, ministries created, and commitments signed, the evidence shows us something far less exciting: recognition is the easy part. What decides whether a care policy is still standing after an election is technical and unexciting — legislation rather than decrees, money coming from statute rather than annual negotiation, or time-use surveys being conducted regularly rather than sporadically.
LAC is the only region that can show us that evidence with cases instead of predictions. Across two comparative studies covering six countries and 168 legal and policy documents, the pattern repeats itself: legal recognition consistently outruns financing and delivery. Countries adopted their laws at different moments, and many have already been tested by a change of government. While governments elsewhere are designing their new care systems now, they should look at LAC for evidence on policies that endure, and those that do not.
Ecuador wrote the right to care into its constitution and two organic laws, and it remains one of the most advanced legal frameworks anywhere. What it never did was fund the National Care System. Not coincidentally, long-term care does not provide enough services — e.g., day centers, care services —in a country where projections estimate long-term care should account for 57.8% of care policy spending. A right without a financial plan is a promise, and promises are the first thing a finance ministry reconsiders.
Colombia built the best care measurement infrastructure in the region — a time-use law dating to 2010, and Bogotá's Manzanas de Cuidado, cited worldwide. Fifteen years of evidence, however, never translated into budget reallocation. Investment modelling shows that Colombia should prioritise spending in Early Childhood Care and Education (ECCE), which accounts for 71.6% of care policy recommended expenditure, but coverage for children under 3 is only 9.4%, for instance. Data does not move money unless budget authorities are required to act.
Brazil did allocate the money. Its 2024 national care policy carries a $5 billion budget, and coordination across 20 ministries, which is more than most countries manage. Delivery, however, depends on voluntary municipal adhesion — so municipalities with the weakest services are the most likely to opt out. A national policy delivered locally needs obligations, not invitations.
The Dominican Republic took the opposite route, and got the most durable agenda in the group. By framing care as economic development, it built cross-partisan support that survived a change of government — a genuine achievement, and the clearest evidence in the region that framing could determine political survival. The trade-off is that there is still no binding care law, which leaves the gains resting on programmes rather than obligations. Framing buys entry, but legislation buys permanence.
Even Uruguay, the only consolidated system in the region, is unfinished. Labor reform raised contributory coverage among domestic workers from roughly a third in 2006 to almost three-quarters by 2021. Yet its financing still depends on annual budget negotiation rather than a statutory fund, which leaves years of institution-building exposed to a bad fiscal year.
None of this would matter if care was merely a public good to be regulated. It is not. Full implementation of childcare, long-term care and leave policies would cost 5.98% of GDP a year in Brazil, and 2.85% in the Dominican Republic, and return between $1.41 and $2.33 per dollar invested, generating over 11 million direct jobs in Brazil alone, and narrowing the gender employment gap by more than 8 percentage points. Those returns are modelled rather than observed, and should be read as such. But the direction is consistent with what the purple economy literature has argued for a decade: care spending behaves like infrastructure investment, not like welfare. Every ministry dissolved overthrows a return someone already calculated.
For policymakers, four design choices decide durability, and none of them requires new political consensus. Legislate instead of governing by decree. Ring-fence care budget lines in law rather than in planning documents. Require time-use data on a fixed cycle, disaggregated by gender, race, ethnicity and migration status. Anchor coordination in at least two ministries, one of which controls money. For funders deciding where care investment holds its value, the design conditions above are the difference between a program that lasts and one that is reversed at the next election.
The decade of action will not be judged by what was signed in Tlatelolco. It will be judged by what is still standing when the signatures are ten years old.
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