Cuban medical missions, providing doctors, nurses, and healthcare infrastructure, are fundamental to Caribbean healthcare systems.
So, how are Caribbean nations reacting to these threats, and what implications might this hold for healthcare in the region?
Why is the US government targeting Cuba’s medical program?
The US government’s focus on Cuban medical missions is not new, as former President Donald Trump’s administration also imposed visa sanctions on Cuba’s global medical program, claiming these missions were akin to “human trafficking” due to allegedly underpaid Cuban doctors.
This time, US Secretary of State Marco Rubio has announced visa restrictions not only for Cuban government officials but also anyone worldwide deemed by the US to be “complicit” in Cuba’s foreign medical programs, including their immediate family. The State Department reported these restrictions will apply to current and former officials as well as their families.
Rubio characterized the Cuban medical program as a form of “forced labor,” warning that Caribbean nations participating might also face visa restrictions and potential trade consequences.
However, there is a lack of concrete evidence supporting these accusations.
The United States is expanding visa restrictions related to Cuba. @StateDept has taken steps to restrict visas for Cuban and complicit third-party government officials and individuals involved with Cuba’s exploitative labor export program. We aim to promote…
— Secretary Marco Rubio (@SecRubio) February 25, 2025
The US argues that Cuba exploits its medical professionals by keeping much of their wages and curtailing their freedoms. While some Cuban doctors have fled and criticized the program, others voluntarily participate.
Tamarys Bahamonde, an economist at the US-based Center for Latin American and Latino Studies, called this issue “complex” and emphasized the importance of listening to the doctors themselves.
“Although Cuban doctors’ status as forced labor is debatable, it is clear that they do not negotiate their contracts or work conditions on their own,” Bahamonde said.
“Cuba retains a significant part of their salaries, and there are testimonies from doctors about restricted movement, passport confiscation by Cuban authorities in host countries, and limitations on bringing their families along,” she added.
Bahamonde stressed the essential role Cuban medical professionals play, particularly in providing healthcare to underserved areas.
During my time with a foreign embassy in Havana, I saw firsthand how grateful various countries are for Cuban doctors and the benefits they bring to isolated areas – places without prior access to medical services, she said.
Is it legal for Trump’s administration to take this action?
Legally, President Trump has broad authority over visa policy through the State Department. The US government can impose these restrictions without Congress’s approval, citing national security or foreign policy interests.
Impacted nations can object through diplomatic or legal means. However, Bahamonde noted that targeting Cuban medical missions isn’t unique to Trump’s administration.
The proposed visa restriction is actually an expansion of a policy initiated by the Biden administration. In 2024, President Biden signed a spending bill that included sanctions against officials from third countries that hired Cuba’s medical services.
Biden’s administration also accused Cuba of profiting from its medical professionals, Bahamonde told Al Jazeera.
She added that opposition to Cuban medical missions is bipartisan, citing a 2024 resolution led by Republican Congressman Mark Green calling for visa revocations against countries hiring Cuban doctors.
“The sentiment regarding Cuban medical missions is consistent across political lines. Whether or not President Trump has unilateral authority to implement these visa restrictions, I wouldn’t expect significant opposition to them,” Bahamonde said.
This implies that, regardless of who holds power, Caribbean nations will likely continue facing diplomatic pressure regarding their reliance on Cuban medical professionals, she noted.
How have Caribbean leaders responded?
Several Caribbean leaders have declared they might relinquish their US visas if it means keeping Cuban medical missions in their countries.
Barbados Prime Minister Mia Mottley delivered a strong speech to parliament, calling the US stance “unfair and unjustified.”
“We wouldn’t have made it through the pandemic without Cuban nurses and doctors,” she stated.
Trinidad and Tobago’s Prime Minister, Keith Rowley, criticized US interference in Caribbean healthcare decisions, adding he’s willing to forfeit his US visa.
Vincentian Prime Minister Ralph Gonsalves, meanwhile, underlined the critical role Cuban doctors play in patient care, stating he prefers to lose his visa rather than risk the lives of patients reliant on them.
Jamaica’s Foreign Minister Kamina Johnson Smith voiced her government’s view that Cuban medical personnel are essential to their healthcare system.
Bahamian Foreign Minister Fred Mitchell defended the Cuban program, asserting that his government adheres to international best practices in labor recruitment.
Guyana’s Foreign Minister, Hugh Todd, told AP that 15 Caribbean foreign ministers met with the US special envoy in Washington to contest these actions and seekclarity on US policy.
“The US is a strategic partner, but this matter needs to be addressed at the government level,” he said.
Why are Cuban medical missions critical to Caribbean healthcare and what are the implications if they’re cut?
Cuban medical missions are vital, with over 24,000 doctors serving in 56 countries, significantly enhancing healthcare across the Caribbean, especially in impoverished states facing economic hardship and limited medical services.
The impact on Caribbean nations will depend on how essential Cuban doctors are to their healthcare systems and how difficult they are to replace short-term without severely affecting the communities reliant on them, Bahamonde said.
For many Caribbean countries, cutting off Cuban medical missions could lead to dire consequences. Training local doctors takes years, and many qualified professionals migrate, leaving a chronic shortage.
Bahamonde explained that these missions deliver affordable primary care and emergency services that would be out of reach for locals without them.
They were also key in responding to disasters and health crises, such as the 2010 Haiti cholera outbreak and the COVID-19 pandemic in the Caribbean.
Which other countries rely on Cuban medical missions?
Cuban medical missions aren’t confined to the Caribbean; they are global. Significant examples include:
- Venezuela has thousands of Cuban doctors working in community clinics.
- Brazil had a large number of Cuban doctors until 2018 when Cuba withdrew them due to a diplomatic issue.
- Italy welcomed Cuban doctors to assist overwhelmed hospitals in COVID-19 affected regions.
- South Africa hosts Cuban medical professionals in rural areas to address doctor shortages.
