Healthcare in Cuba
[8] Cuba has had many world-class doctors, including Carlos Finlay, whose mosquito-based theory of yellow fever transmission was given its final proof under the direction of Walter Reed, James Carroll, and Aristides Agramonte.
Most of Cuba's doctors were based in the relatively prosperous cities and regional towns, and conditions in rural areas, notably Oriente, were significantly worse.
In 1960 revolutionary and physician Che Guevara outlined his aims for the future of Cuban healthcare in an essay entitled On Revolutionary Medicine, stating: "The work that today is entrusted to the Ministry of Health and similar organizations is to provide public health services for the greatest possible number of persons, institute a program of preventive medicine, and orient the public to the performance of hygienic practices.
"[16] These aims were hampered almost immediately by an exodus of almost half of Cuba's physicians to the United States, leaving the country with only 3,000 doctors and 16 professors in the University of Havana’s medical college.
[23] Tassie Katherine Hirschfeld, an associate professor at the department of anthropology of the University of Oklahoma,[24] said that doctors have incentives to falsify statistics, as a spike in infant mortality may cost them their jobs.
[25] Epidemiologist Manuel Franco describes the Special Period as "the first, and probably the only, natural experiment, born of unfortunate circumstances, where large effects on diabetes, cardiovascular disease and all-cause mortality have been related to sustained population-wide weight loss as a result of increased physical activity and reduced caloric intake".
[27] In 1995 the Inter-American Commission on Human Rights of the Organization of American States informed the U.S. Government that such activities violate international law and has requested that the U.S. take immediate steps to exempt medicine from the embargo.
[30] The embargo forced Cuba to use more of its limited resources on medical imports, both because equipment and drugs from foreign subsidiaries of U.S. firms or from non-U.S.sources tend to be higher priced and because shipping costs are greater.
In addition, the collapse of the Soviet Union caused the loss of several billions of dollars in yearly subsidies and overnight required hard currency for all imports.
[37][non-primary source needed][dead link] One effect of the embargo has been to make it necessary for Cuba to create its own biotech industry to produce drugs which it is unable to access.
At one nationally prominent hospital/research institute, hard currency payments by foreigners have financed the construction of a new bathroom in the splenic surgery wing; anecdotal evidence suggests that this pattern is common in Cuban hospitals.
[79] Sánchez wrote that nearly 7,000–8,000 doctors since 2006 have gone into hiding or failed to return to Cuba after having gone on abroad as part of the Cuban government's "volunteering" them to provide healthcare to foreign nationals without remuneration.
While Cuban doctors are sent abroad to assist in medical missions, domestically, although wages in the health sector have increased in recent years, they are still considered low compared to the prices of basic goods in Cuba.
[7] Furthermore, there is a notable disparity between the medical service offered to Cuban citizens and the "health tourism" targeted at foreigners, with the latter being of higher quality and enjoying a better international reputation.
Despite the revenues generated by the medical missions, only 0.8% of the national budget was allocated to public health in the first half of 2021, compared to 45.5% focused on international tourism and other business activities.
[80] Because the U.S. government restricts investments in Cuba by U.S. companies and their affiliates, Cuban institutions have been limited in their ability to enter into research and development partnerships, although exceptions have been made for significant drugs.
After outbreaks of meningitis B in the United States, the U.S. Treasury Department granted a license in 1999 to an American subsidiary of the pharmaceutical company SmithKline Beecham to enter into a deal to develop the vaccine for use in the U.S. and elsewhere.
[85] In 2006, BBC flagship news programme Newsnight featured Cuba's healthcare system as part of a series identifying "the world's best public services".
The report alleged that "Thanks chiefly to the American economic blockade, but partly also to the web of strange rules and regulations that constrict Cuban life, the economy is in a terrible mess: national income per head is minuscule, and resources are amazingly tight.
[86] A 2006 poll carried out by the Gallup Organization's Costa Rican affiliate — Consultoría Interdisciplinaria en Desarrollo (CID) — found that about three-quarters of urban Cubans responded positively to the question "do you have confidence to your country's health care system".
Wayne Smith, former head of the US Interests Section in Havana identified "the incredible dedication" of Cubans to healthcare, adding that "Doctors in Cuba can make more driving cabs and working in hotels, but they don't.
[90] Robert N. Butler, who was president of the International Longevity Center in New York and a Pulitzer Prize-winning author on aging, traveled to Cuba to see firsthand how doctors were trained.
[92] In 2001, members of the UK House of Commons Health Select committee travelled to Cuba and issued a report that paid tribute to "the success of the Cuban healthcare system", based on its "strong emphasis on disease prevention" and "commitment to the practice of medicine in a community".
[86] The Parliament of the United Kingdom also drew up an analysis of the key features of Cuba's healthcare system, drawing comparisons with the state funded National Health Service (NHS).
Complaints have also arisen that foreign "health tourists" paying with dollars and senior Communist party officials receive a higher quality of care than Cuban citizens.
Former leading Cuban neurosurgeon and dissident Hilda Molina said that the central revolutionary objective of free, quality medical care for all has been eroded by Cuba's need for foreign currency.
Molina said that following the economic collapse known in Cuba as the Special Period, the Cuban Government established mechanisms designed to turn the medical system into a profit-making enterprise.
makes similar claims, also stating that senior Communist party and military officials can access this higher quality system free of charge.
[102] The San Francisco Chronicle, the Washington Post, and National Public Radio have all reported on Cuban doctors defecting to other countries when on international missions.
[104] The difficulty in gaining access to certain medicines and treatments has led to healthcare playing an increasing role in Cuba's burgeoning black market economy, sometimes termed "sociolismo".
