US Punishes Cuba for Providing Foreign Medical Assistance

March 15, 2025

Cuba Sends Doctors, the US Sends Sanctions
JACOBIN
March 8, 2025
By Helen Yaffe

The United States calls Cuba’s medical internationalism “human trafficking” – but it’s really an internationalist lifeline for the Global South.

On February 25, US secretary of state Marco Rubio announced restrictions on visas for both government officials in Cuba and any others worldwide who are “complicit” with the island nation’s overseas medical-assistance programs. A US State Department statement clarified that the sanction extends to “current and former” officials and the “immediate family of such persons.” This action, the seventh measure targeting Cuba in one month, has international consequences; for decades tens of thousands of Cuban medical professionals have been posted in around sixty countries, far more than the World Health Organization’s (WHO) workforce, mostly working in under- or unserved populations in the Global South. By threatening to withhold visas from foreign officials, the US government means to sabotage these Cuban medical missions overseas. If it works, millions will suffer.

The predominant global approach, exemplified by the United States, is to regard health care as an expensive resource or commodity to be rationed through the market mechanism. Medical students “invest” in their education, paying high tuition fees and graduating with huge debts. They then seek well-paid jobs to repay those debts and pursue a privileged standard of living. To ensure medics are well remunerated, demand must be kept above supply. The World Economic Forum projects a shortfall of ten million health care workers worldwide by 2030. But the Cuban investment in medical education raises the supply of professionals globally, thus threatening the status of physicians operating under a market system. Critically, the Cuban approach removes financial, class, race, gender, religious, and any other barriers to joining the medical profession.

The key features of the Cuban approach are: the commitment to health care as a human right; the decisive role of state planning and investment to provide a universal public health care system with the absence of a parallel private sector; the speed with which health care provision was improved (by the 1980s Cuba had the health profile of a highly developed country); the focus on prevention over cure; and the system of community-based primary care. By these means, socialist Cuba has achieved comparable health outcomes to developed countries but with lower per capita spending — less than one-tenth the per capita spending in the United States and one-quarter in the UK. By 2005, Cuba had achieved the highest ratio of doctors per capita in the world: 1 to 167. By 2018, it had three times the density of doctors in the US and the UK.

Today Cuba is in the midst of a severe economic crisis, largely resulting from US sanctions. The public health care system is under unprecedented strain, with shortages of resources and of personnel following massive emigration since 2021. Nonetheless, the government continues to dedicate a high proportion of GDP on health care (nearly 14 percent in 2023), maintaining free universal medical provision, and currently has 24,180 medical professionals in fifty-six countries.

Revolutionary Cuba was never solely concerned with meeting its own needs. Between 1999–2015 alone, overseas Cuban medical professionals saved 6 million lives, carried out 1.39 billion medical consultations and 10 million surgical operations, and attended 2.67 million births, while 73,848 foreign students graduated as professionals in Cuba, many of them medics. Add to that the beneficiaries between 1960 and 1998, and those since 2016, and the numbers climb steeply.

The beneficiary nations have been the poorest and least influential globally; few have governments with any leverage on the world stage. Recipient populations are often the most disadvantaged and marginalized within those countries. If Cuban medics leave, they will have no alternative provision. If Rubio and Trump are successful, it is not just Cubans who will suffer. It will also be the global beneficiaries whose lives are being saved and improved by Cuban medical internationalism right now.

 

Comment by: Don McCanne & Jim Kahn

The world community respected the United States for its humanitarian support via USAID which helped to meet the medical needs of countries that lack the resources to do so on their own. One of the first major actions of the Trump administration was to slash the resources and functionality of USAID such that the nations we served were stripped of life-saving medical prevention and care, and further denied food resources to prevent starvation, especially in children. USAID was moved to the State Department wherein Secretary Marco Rubio was set to supervise the degradation of this important agency.

Fortunately, Cuba has made it a national priority to try to fulfill these unmet health needs. Though not as wealthy as the United States, the extent of their success has been phenomenal.  Millions of lives saved; massive suffering and grief averted.

As we abandon the humanitarian mission of USAID, what approach have we taken to honor the work of Cuba in providing these valuable services? None. We don’t honor Cuba for meeting needs that we have abandoned. Instead, we place restrictions on visas for government officials in Cuba and others worldwide who are complicit with Cuba’s overseas medical-assistance.

What? We not only lay waste to our own humanitarian efforts, we try to slow Cuba’s? Hard to fathom, unconscionable.

People of good will in the US have been trying for decades to provide affordable, broad health care for everyone here, while offering meaningful support to poorer nations with even greater needs. President George W. Bush, in his most noble act, founded and fostered the PEPFAR program for foreign health assistance in HIV, and thus super-charged global health assistance. Strong foreign aid in health has been a bipartisan consensus (albeit still just 1% of the US federal budget). Now, in 2025, not only does the new Trump administration want to undo our own programs, it plans to punish a country whose offense is to fulfill the unmet medical needs of poverty-stricken nations.

We ask what kind of government leadership is it that we have elected that would drive us in the direction voiced by Trump, Musk, Miller, and now Rubio? We’re sure that the actions are illegal and impeachable. We also recognize that such outcomes are all but impossible in the foreseeable future.

For now, we ask you to link the ongoing fight for US Health Justice via universal publicly financed health insurance (single payer) to the ongoing fight for global Health Justice via foreign assistance. Write to your representatives and senators, donate to organizations that are advocating for USAID programming and staff, and for Cuba, and participate in public protests. Unified outrage is the only appropriate response.