Not just oil: US seeks to dismantle Cuba’s medical missions in America

International Desk, (EFE).- Washington’s pressure on Havana is not limited to oil. Over the past year, a dozen countries, mainly in the Caribbean and Central America, have closed or reduced their contracts with Cuba for medical services due to the United States’ insistence that they will not collaborate in practices that can be labeled as «forced labor.»

The US maneuver has drastic economic consequences because the export of professional services has been one of the island’s three main sources of foreign currency income for years, alongside tourism and remittances, all of which are currently affected by Washington’s pressure.

The medical brigades, which began over six decades ago, have sent 600,000 professionals to 165 countries, according to official data. This mechanism benefits the involved parties, but its methods are questioned.

Host countries gain access to qualified healthcare professionals, allowing them to quickly and efficiently improve their national healthcare systems. Furthermore, the deployed doctors receive a higher salary in dollars than they would in Cuba, and the Cuban government generates foreign currency, which it claims to use for its own healthcare system.

However, according to NGOs such as Prisoners Defenders, the Cuban government keeps an average of 85% of the payment from host countries, withholds doctors’ passports while they are abroad, and penalizes those who leave their mission early.

For this reason, US Secretary of State Marco Rubio has described the system as «forced labor» schemes with «abusive and coercive labor practices,» a claim the Cuban government rejects.

Consequently, Rubio, a proponent of a hard line against the Cuban government since the start of his career, announced in Feb. 2025 that he would revoke the visas of Cuban and foreign officials involved in contracting Cuban personnel.

The State Department’s 2024 Trafficking in Persons report estimates Cuba’s revenue from the export of professional services at between six and eight billion dollars.

According to Cuba’s National Office of Statistics and Information (ONEI), exports of professional services accounted for over 40% of the island’s total foreign sales between 2018 and 2020.

Caribbean under pressure

The US sanctions against the medical brigades have been met with concern and rejection in Latin America, especially the Caribbean.

Antigua and Barbuda, the Bahamas, Grenada, Guyana, and Trinidad and Tobago initially defended these programs, which are vital for their health systems, but subsequently had to readjust their ties with Havana and make changes to the terms of the contracts.

A source from the Organization of Eastern Caribbean States (OECS) explained to EFE that some islands have decided to suspend the program, while others are still lodging complaints with the US.

On Jun. 2025 the Bahamas announced the suspension of hiring Cuban medical personnel and the cancellation of its current agreements with Havana, with the intention of beginning to hire health personnel directly, a step that has not yet materialized.

Grenada reported in Sep. 2025 that it would equalize the conditions for Cuban doctors with those of its nationals, and Antigua and Barbuda announced in January that it had recruited 120 nurses from Ghana, although it did not explicitly end its agreement with Cuba.

Guyana quietly ended the system on February, according to local media.

Trinidad and Tobago, for its part, stated that its priority is now recruiting local professionals. A total of 770 Cuban doctors have worked in the country since 2003.

The Venezuelan incognito

Venezuela was a key country in this system, and its continuity is now in doubt following Washington’s oversight of Caracas after the military intervention that led to the capture of its former president Nicolás Maduro.

According to official figures, in Jun. 2025 there were nearly 13,000 Cuban professionals in the South American country, mostly doctors. Caracas previously paid for these services with oil, which is now restricted.

Neither country has declared the 2000 cooperation agreement that governed the system canceled, and its future remains uncertain.

Guatemala, home to one of the most stable and longest-running missions, announced earlier in February that it would «progressively» close the agreement in 2026. Currently, 412 Cuban professionals are working in the Central American country.

Honduras, with 120 doctors, is maintaining the collaboration for the moment, but in addition to internal pressure, there are denunciations from local NGOs, and the agreement expires in 2026, putting its renewal in jeopardy.

There is also medical personnel from the island in Nicaragua, although the exact number is unknown. Managua, which recently required Cubans to apply for a visa to enter its territory, has not indicated any changes to its health agreement with Cuba so far. EFE

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