Millions of Colombians will vote Sunday in a presidential election expected to force a runoff between far-left Senator Iván Cepeda and far-right lawyer Abelardo de la Espriella, with security and healthcare topping voter concerns.

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Violence has marred the campaign, including the assassination of a candidate, bombings, and the killing of dozens of local leaders. Human rights groups report over 50 massacres this year, fueling demand for change.

De la Espriella, a Trump-styled outsider, proposes bombing trafficker camps and building private megaprisons. Cepeda, heir to President Gustavo Petro, continues advocating negotiations with armed groups. Moderate Paloma Valencia offers a center-right alternative, calling for increased troops and drone surveillance.

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The election outcome will impact U.S. relations. The Trump administration, which has waged aggressive anti-drug operations and sanctioned Petro, could see a strong ally or a combative foe take power in Bogotá.