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The U.S. Embargo and
Healthcare in Cuba:
Myth Versus Reality
Released by the Bureau of Inter-American Affairs, August 5, 1997.
"Our country has gone from preventive medicine...to
sophisticated medicine, and today we have things that
no one else has." Fidel Castro, March 1997.
Summary
There is substantial misunderstanding and misinformation about the present
state of healthcare in Cuba, including the accusation, which is not true,
that it is U.S. policy to deny medicine or medical supplies and equipment to
the Cuban people.
The healthcare available to the average Cuban has deteriorated because the
Cuban Government has directed its increasingly scarce resources elsewhere.
While not providing basic medical needs to its people, the Cuban Government
has developed a closed, parallel healthcare system for the Communist Party
elite, foreign "health tourists," and others who can pay for services in
hard currency.
The Cuban Democracy Act of 1992 permits the exports of medicine, medical
supplies, and equipment to Cuba by American companies and their
subsidiaries, provided appropriate end-use monitoring arrangements are in
place. Since 1992, the U.S. has approved 36 of 39 license requests for
medical sales. Thirty-one (31) licenses were for the commercial sales of
medicines, medical equipment, and related supplies to Cuba. Five (5)
licenses were for travel to Cuba by representatives of American
pharmaceutical companies to explore possible sales. During the same period,
the U.S. has licensed over $227 million in humanitarian donations of
medicines and medical equipment. This total does not include the millions of
dollars in medicines sent to Cuban nationals in the form of gift packages
from groups and individuals in the U.S.
The Impact of Cuba's Economic Choices
Cuba's economy is in disarray because of the government's continued
adherence to a dysfunctional economic model. This decline has directly
affected the health of ordinary Cubans. Lack of chlorinated water, poor
nutrition, deteriorating housing, and generally unsanitary conditions have
increased the number of cases of infectious diseases, especially in
concentrated urban areas like Havana.
The grave economic problems in Cuba were exacerbated by the demise of the
Soviet Union and the ending of the $5 billion in subsidies that the U.S.S.R.
gave annually to the Cuban Government. Cuba had made significant advances in
the quality of healthcare available to average citizens as a result of these
subsidies. However, it devoted the bulk of its financial windfall to
maintaining an out-sized military machine and a massive internal security
apparatus.
The end of Soviet subsidies forced Cuba to face the real costs of its
healthcare system. Unwilling to adopt the economic changes necessary to
reform its economy, the Cuban Government soon faced a large budget deficit.
In response, the Cuban Government made a deliberate decision to continue to
spend money to maintain its military and internal security apparatus at the
expense of other priorities--including healthcare.
According to the Pan American Health Organization, the Cuban Government
currently devotes a smaller percentage of its budget to healthcare than such
countries as Jamaica, Costa Rica and the Dominican Republic.
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