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Cuba: How a Tiny Island Defies U.S. Sanctions to Lead in Healthcare

Renée L. Quarterman and Dr. Leonardo González de Dios

In the heart of the Cuban capital, the Dr. Cosme Ordoñez Carceller Teaching Polyclinic stands as a testament to the nation’s unique approach to healthcare: universal, free of charge, accessible, regionalized, community-centered, and deeply rooted in preventive medicine. Unlike the profit-driven models that dominate much of the world, Cuba’s system prioritizes equitable access, public health education, and early intervention.

At the core of this approach is a commitment to health promotion through education, disease prevention through habit management, and the integration of medical care and rehabilitation. By emphasizing proactive healthcare rather than reactive treatment, the system ensures that communities receive continuous, comprehensive support to maintain overall well-being.

During a recent visit to the Dr. Cosme Ordoñez Carceller Teaching Polyclinic in Havana, the staff detailed how the system was developed and how it ensures that no Cuban, regardless of income, is left without medical care.

The Structure of Cuba’s Healthcare System

Cuba’s National Health System operates as a hierarchical, state-run model designed to ensure seamless coordination of care. At the top, the National Assembly oversees the Ministry of Public Health, which sets national policies and directs specialized health institutes that tackle broader public health concerns.

Below the Ministry, provincial governments, answering directly to the Assembly, oversee provincial health departments, which manage larger hospitals and specialized medical facilities. These provincial bodies, in turn, delegate responsibilities to municipal governments, which run the municipal health departments and smaller hospitals that serve local populations. At the community level, municipal health departments manage Cuba’s extensive polyclinic network, the cornerstone of the country’s healthcare system. These polyclinics not only provide specialized care, diagnostics, and emergency services, but they also coordinate closely with family doctor-and-nurse teams, who serve as the first point of contact for Cuban citizens.

These frontline providers play a crucial role beyond immediate treatment, emphasizing preventive care, home visits, and alternative therapies such as nutrition counseling, acupuncture, and plant-based medicine. Despite supply shortages exacerbated by U.S. sanctions, this integrated, top-down approach ensures that resources are distributed efficiently, maintaining consistent healthcare access nationwide.

Founded in 1974, the Dr. Ordoñez Carceller, Polyclinic serves approximately 13,000 residents, offering care in medical specialties such as cardiology, orthopedics, fertility consultations, and genetic testing. The clinic is named after Dr. Cosme Ordoñez Carceller (1927–2019), an epidemiologist and pioneer of Community Medicine, who championed the polyclinic model that emerged in the 1960s and 1970s. He played a key role in training young physicians in comprehensive general medicine and launched innovative programs like the Grandparents’ Circles, a senior care initiative so effective that it was replicated nationwide.

Unlike the profit-driven models that dominate much of the world, Cuba’s system prioritizes equitable access, public health education, and early intervention. The country’s healthcare approach is rooted in promoting health through education, preventing disease by managing habits, and ensuring comprehensive medical care and rehabilitation. Unlike the fragmented, for-profit U.S. healthcare model, Cuba’s integrated, community-based approach ensures better health outcomes and higher patient satisfaction. At polyclinics like Ordoñez Carceller, primary care is not just about treating illness but about education, prevention, and holistic well-being. This commitment to accessible, people-centered medicine reflects Cuba’s broader philosophy: that healthcare is not a privilege, but a fundamental human right.

Cuba’s Healthcare Achievements: A Global Leader in Public Health

Despite enduring over six decades of economic embargo, Cuba has achieved remarkable public health milestones. The following list highlights key accomplishments of both the Ordoñez Carceller Polyclinic and the Cuban healthcare system as a whole:

• AIDS: Cuba identified HIV in 1983 and quickly set up a system to track and treat it. By 2014, it eliminated mother-to-child transmission of HIV and syphilis, a milestone the U.S. has yet to reach.
• COVID: Cuba developed two COVID vaccines, kept infections low, and even sent vaccines abroad.
• Diabetes: The nation has developed an effective medication that treats diabetic ulcers (skin wounds that result from poor blood sugar control)
• Alzheimer’s Research: Cuba developed a drug that may help reverse Alzheimer’s effects.
• Maternal-fetal medicine: 99% of Cuban children are vaccinated, and the country has a lower infant mortality rate than the U.S.
• Nutrition: While obesity is not an issue in Cuba, malnutrition is an increasing concern due to shortages caused by the U.S. embargo
• Home health: Doctors make house calls to care for the elderly and new mothers.

Profit vs. Public Health: How Medical Education and Healthcare Delivery Differ in Cuba and the U.S.

The paths to becoming a doctor in Cuba and the United States could not be more different. In the U.S., medical students take on crippling debt, often exceeding $200,000, before ever treating a patient. The pressure to repay loans steers many toward high-paying specialties, leaving primary care and rural communities underserved. The system is structured around financial incentives rather than public need, reinforcing the idea that medicine is a business first, a service second.

Cuba takes the opposite approach. Medical education is fully state-funded, allowing students to focus on patient care instead of profit. Training begins immediately after secondary school, with students placed in community clinics early in their careers. By the time they specialize, they have already served in primary care settings, ensuring that the system produces physicians committed to public health, not private wealth.

A Focus on Prevention, Not Just Treatment

Cuba’s prevention-first model stands in stark contrast to the reactive nature of U.S. healthcare. While American medicine often prioritizes treatment over lifestyle interventions, Cuban doctors routinely incorporate nutrition, exercise, and disease prevention strategies into care plans. The country’s polyclinic system ensures patients receive consistent, community-based healthcare rather than navigating a fragmented, for-profit system that often leaves them behind.

The U.S. Blockade: An Unjust Barrier to Health

The U.S. embargo continues to hinder Cuba’s healthcare system by restricting access to essential medicines, medical equipment, and scientific research. Pharmaceutical and shipping companies, fearing U.S. penalties, avoid business with Cuba—leading to severe shortages of everything from aspirin to cancer treatments.

Even medical journals and online resources are blocked due to U.S. restrictions, forcing Cuban researchers to work under constraints that most Western physicians never encounter.

Yet, rather than succumbing to these barriers, Cuba has turned to self-sufficiency, investing in biotechnology, vaccine development, and herbal medicine research to compensate for limited imports. If freed from economic sanctions, Cuba’s contributions to global healthcare innovation could expand exponentially.

For decades, Cuba has exported medical expertise worldwide, sending doctors to disaster-stricken and underserved regions. These global medical brigades have provided care to millions, particularly in Latin America, Africa, and the Caribbean. Yet, rather than supporting these humanitarian efforts, Washington has sought to dismantle them. In February 2025, the U.S. expanded sanctions on Cuba’s international medical program, further restricting its ability to send doctors abroad. The move reflects a deeper failure to understand Cuba’s model of solidarity-driven healthcare, a stark contrast to the U.S. system, where medicine is often dictated by profit rather than public service.

It is within this profit-driven framework that Cuba’s medical missions are misunderstood, labeled as “forced labor” by those who cannot imagine doctors choosing service over salary. The very idea of healthcare as a human right, rather than a commodity, challenges the U.S. worldview, leading to efforts to discredit and sanction those who practice it differently.

What Could Be if the Embargo Were Lifted

Cuba’s healthcare system is a model of resilience and innovation, but its full potential remains hindered by decades of U.S. sanctions. If given access to global resources and technology, Cuban researchers could expand medical advancements in infectious diseases, chronic illness treatment, and disaster response. For now, Cuban doctors continue their work—undaunted by external pressures, committed to the principle that healthcare is a right, not a privilege.

[Renée L. Quarterman, MD, FACS, is a surgical breast specialist. She is the director of Delaware Breast Care, a part of US Oncology. Dr. Leonardo González de Dios is a 1st degree specialist in Family Medicine. He is the Vice Director of Medical Assistance at the Dr. Cosme Ordoñez Carceller Teaching Polyclinic. Courtesy: Countercurrents.org, an India-based news, views and analysis website, that describes itself as non-partisan and taking “the Side of the People!” It is edited by Binu Mathew.]

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New Cuban Report Confirms U.S. Blockade is War

W.T. Whitney

Cuba’s foreign ministry on September 17 released the nation’s annual report on adverse effects of the lengthy U.S. economic blockade of Cuba. It does so ahead of the yearly vote in the United Nations General Assembly on a Cuban resolution stating the “necessity of ending the economic, commercial and financial embargo imposed by the United States against Cuba.” Voting takes place on October 28-29.

For 32 years, member states have overwhelmingly approved Cuba’s resolution. At times recently, the U.S. and Israel have been alone in rejecting it.

The 55-page Report – accessible here – is remarkable for its detailed and far-ranging description of disarray and distress caused by the blockade. It exposes the cruelty and lawlessness of U.S. intrusion in the lives of a sovereign people.

This year’s version of the Report is convincing as to the urgency of opposing this U.S. policy. Showing that the blockade kills people, it casts the blockade as war. Struggle against the blockade might gain new strength with a new focus on the issue of peace over war.

The idea of the U.S. as war-maker is not new. Beginning with the Monroe Doctrine of 1823, the U.S. government has relied on military power as well as economic and political pressure to work its way in Latin America and the Caribbean area. Even now the U.S. wages war on Venezuela, Cuba’s close ally and fellow victim of U.S. economic sanctions.

A recent study adds precision to the notion of U.S. war against Cuba. The Lancet medical journal in August 2025 reported that economic sanctions imposed in 152 countries between 1971 and 2021 caused so many deaths annually as to exceed battle-related deaths and, often, to equal the annual toll of battlefield deaths plus civilian casualties.

This information removes any lingering surprise that the blockade might be lethal. Awareness of that reality would be a big step toward recognition of the blockade as war against Cuba. The agenda here is to show the Report as backing these claims. The inquiry offers perspective as to Cuba’s place in the world system of wealth accumulation, conflict, and oppression.

Big picture

The Report records damage affecting various sectors of Cuban society between March 2024 and February 2024. It surveys financial losses, shortages, and consequences. It shows that adverse effects themselves lead to far-ranging difficulties for individual Cubans and Cuban commercial and production entities.

Troubles stacked one upon another undermine strenuous efforts by Cuba’s government and people to encourage production and create living conditions that are sustaining and fulfilling. The Report is a story of institutions, production units, private enterprises, schools, healthcare entities, government agencies, and service organizations having to cope with frustrations and failed improvisations. A section appears on solidarity activities on Cuba’s behalf taking place in the United States and in the world.

The Report outlines two general categories of requirements under the blockade. Measures relating to Cuba’s finances make for low salaries, diminished flow of remittances, obstacles to investments from abroad, and inability to re-finance accumulated debt. Other measures block access to materials and commercial products. These include: food, hospital supplies, medicines, raw materials, new machinery, miscellaneous devices and tools, construction materials, replacement parts, fuel, chemicals, fertilizers, and more.

The categories overlap. According to the Report, “Dozens of banks suspended their operations with Cuba, including transfers for the purchase of food, medicines, fuel, materials, spare parts for the national power system, and other essential goods.”

The Report identifies the U.S. instruments that created regulations governing Cuba’s access to money and goods, among them:

• Designation of Cuba as a state sponsor of terrorism, whereby Cuba loses access to international loans and payments due from abroad.
• Lawsuits filed in US courts under Title III of the Helms-Burton Act. These seek damages from those foreign businesses making use of nationalized properties. The effect is to discourage future investments.
• Hundreds of U.S. measures devised for weakening Cuba’s tourism industry, that until recently was the country’s leading source of income.
• New sanctions aimed at foreign officials who enable Cuban doctors to work in their countries. They block income that formerly supported Cuba’s own healthcare system.
• Threats and sanctions mounted against “shipping companies, carriers, insurers or reinsurers involved in supplying fuel to Cuba.”
• The 1992 U.S. “Torricelli Law” that requires third-country enterprises affiliated with U.S. corporations to never sell goods to Cuba containing more than 10% U.S. components.
• The legacy of 1996 Helms-Burton Act stipulating that the blockade would be altered or ended only by Congress and not by the U.S. president.

Money talks

The Report records monetary data relating to shortages. The term “damages” that crops up. It signifies a combination of costs, loss of income due to the blockade, and potential gains stymied by the blockade.

Damages recorded for various sectors are:

• Biotechnology – $129.3 million
• Energy and mining – $496.1 million
• Information and communication – $78 million
• Industry (goods and services) – $5.1 billion
• Construction – $161.9 million
• Transportation – $353.0 million
• Tourism – $2.5 billion
• Education – $89.9 million
• Sports – $4.1 million
• Culture – $195.1 million
• Healthcare – $288.8 million
• Food supply and processing – $932.3 million
• Agricultural production – $51.9 million

Total damages during the period under study were $7.6 billion. That amount exceeds damages by 49%. The total since the blockade’s onset is $170.7 billion. With inflation, “quantifiable damages” over the years become $2.1 trillion.

There are these additional realities:

Cuba’s GDP was down 1.1% in 2024. “The economy …has recorded an 11 per cent downfall since 2018.”

Exports of goods and services achieved 92.5% and 101.6%, respectively, of anticipated goals. Export income was $770 million less than expected. Domestic revenues were down $900 million from 2023.

Food production was so reduced during the year that 100% of the food provided under the rationing system was imported food.

The term “geographic relocation of trade” refers to trade displaced because of the blockade. That necessity leads to elevated transportation costs and inflated prices. Added costs are $1.2 billion.

The year’s inflation rate of 24.9% stems from shortages of supplies, diminished access to hard currency, and state spending to finance its budget deficit.

Overall spending on tourism was $2.5 billion in 2024; tourism was down 9.6%.

Sanctions as war

Presenting the Report to the press on September 17, Cuban chancellor Bruno Rodríguez observed that, “It is impossible to quantify the emotional damage, anguish, suffering, and deprivation that the blockade causes Cuban families. This has been the case for several generations, with more than 80% of Cubans on the island born after the blockade began.”

According to the Report, “The unprecedented tightening of the blockade in recent years has had a particular impact on the public health sector. The tense situation created in our economy, the financial persecution of Cuba and the denial of access to the US market … have hampered the ability of our health system to obtain … supplies when needed and provide quality service to the population. This has, in turn, led to the deterioration of several health indicators, including those related to mortality.”

Indeed, the “blockade imposed by the US government against Cuba is an act of genocide.”

Hospitals and doctors have trouble finding, or may not find, “first line medicines,” cancer drugs, specialized drugs, key surgical supplies, respiratory therapy equipment, imaging equipment, diagnostic agents and test kits, dialysis machines, anesthesia gear, endoscopy equipment, insulin pumps, pacemakers, defibrillators, and pediatric ventilators. According to the Report, 94,729 people are on surgery waiting lists, including 4507 cancer patients and 9913 children.

A benign treatment device for aortic stenosis is available elsewhere but not in Cuba for 158,800 unstable patients. Survival rates for childhood cancer have fallen.

In a recent interview, Paul Jonas, a physician associated with the University of Leiden and admirer of Cuban healthcare, stated that, “In recent years, the Cuban healthcare system has deteriorated significantly…. This leads to untreated illnesses, unnecessary suffering, and sometimes even death … [T]he quality of nutrition in Cuba is currently very poor … there are also shortages of medicines and other medical supplies.”

Cuba’s infant mortality rate (IMR), the number of babies dying in their first year of life per 1,000 births, was 4.2 in 2014 and presently is 8.2.

Cuban economist and demographer Juan Carlos Albizu-Campos, writing in 2023, notes that Cubans’ life expectancy registered a “decrease of 5.39 years” from 2012, also that the “decline … would not only have continued, but would also have accelerated even if the [Covid-19] pandemic had not occurred.”

Food scarcity, mentioned in 2024 by Granma, the Cuban Communist Party’s newspaper, contributes to excess deaths. Blockade effects extend to food production. New machinery, livestock feed, credit, fuel, spare parts, fertilizer, veterinary supplies, and means of transportation are often lacking

War characteristically disrupts societies and kills troops and/or civilians. Doing both, the U.S. blockade of Cuba is a weapon of war and manifestation of war.

What accounts for U.S. warmaking against Cuba? The U.S. has little choice. As chief honcho of the world capitalist order, the U.S. government must stick with capitalist rules. A big one requires that production always increase and expand.

For that to happen, poorer and under-developed nations must cooperate and be subservient. Their job is to provide cheap labor and access to natural resources – and allow their wealth to be transferred to the centers. An outlier like Cuba is surely due for punishment.

[W.T. Whitney Jr. is a retired pediatrician and political journalist living in Maine. Courtesy: CounterPunch, an online magazine based in the United States that covers politics in a manner its editors describe as “muckraking with a radical attitude”. It is edited by Jeffrey St. Clair and Joshua Frank.]