Paraguay has set itself ambitious development goals for 2030. To achieve them, it will have to tackle two major challenges: buttressing sources of sustainable economic prosperity and putting the country on a more inclusive development path. Progressing towards a more inclusive society will require a broad and vigorous reform agenda. First, the country’s healthcare system requires systemic reform to widen its coverage, reduce Paraguayans’ vulnerability in the face of health risks and increase the efficiency of health service provision. Second, the social protection system needs to overcome its fragmentation and become more effective in delivering the right services and risk management tools to citizens according to their needs. In particular, the pension system requires reforms to increase its coverage and become more equitable and more sustainable.