Cuba has launched a fresh diplomatic offensive, accusing the United States of employing economic extortion to dismantle one of its most vital and longstanding international programmes: the deployment of thousands of doctors across Latin America and the Caribbean.
Foreign Minister Bruno Rodríguez took to social media to declare that the US government was “persecuting, pressuring, and extorting other governments to end the presence of Cuban Medical Brigades in various countries, under false pretenses.” He asserted that the ultimate goal was to “strangle” the economy of the communist island, which relies heavily on the billions earned from these missions.
US Pressure and the Unravelling of Deals
This accusation comes amid a visible unravelling of agreements that have been a cornerstone of Cuban foreign policy for over six decades. The US campaign, a key pillar of the Trump administration’s “maximum pressure” strategy against Havana, frames the medical programme not as humanitarian aid but as a system of state-sponsored “forced labour” and “human trafficking.”
The pressure appears to be yielding results. Guatemala, Honduras, Jamaica, and Guyana have all terminated their medical partnerships with Cuba in recent times. Other regional governments, including the Bahamas and Dominica, are reportedly reviewing or restructuring their arrangements, conscious of the need to maintain strong ties with Washington.
For Cuba, the stakes are critically high. The medical missions are a financial lifeline, projected to generate $7bn in earnings last year for the cash-strapped nation. The US government estimates the annual revenue for Havana at over $4.9bn. This income is especially crucial as Cuba teeters on the edge of economic collapse, grappling with a comprehensive US embargo and an energy crisis exacerbated by US sanctions.
Human Rights Report Alleges “Forced Labour”
The political and economic clash has been sharply refocused by a damning new report from the Inter-American Commission on Human Rights (IACHR), which details allegations of systematic exploitation within the programme.
The IACHR’s investigation denounces serious human rights violations, accusing the Cuban state of withholding the vast majority of doctors’ wages, confiscating their passports, and exerting control over their private lives. The report states that medics face threats of up to eight years in prison if they defect from their posts abroad.
In an interview, the IACHR president, Edgar Stuardo Ralón, a constitutional lawyer from Guatemala, stated that some of these practices could be legally classified as “forced labour” and “human trafficking.” The report cites official Cuban statistics showing that the deployed professionals receive only between 2.5% and 25% of the fee that host countries pay the Cuban government for their services. Independent analyses suggest the state retains between 70% and 90% of the salaries.
This programme, which began in 1963, has seen over 600,000 healthcare professionals deployed globally. As of 2025, approximately 24,000 Cuban doctors and nurses were working in 56 countries, with many serving in remote and underserved areas. Half were stationed in Venezuela, Cuba’s top ally until the US-led abduction of President Nicolás Maduro in January.
Cuba has consistently defended the missions as an act of “solidarity,” designed to bring essential health services to “hard-to-reach places” where local systems are weak. It portrays the US criticism as a cynical ploy to destabilise its government and deprive vulnerable populations of care.
The Trump administration’s approach has included not only diplomatic pressure but also tangible measures such as imposing visa restrictions on officials from countries that engage with the medical programmes, tightening sanctions, and previously operating a specific scheme to encourage Cuban medical professionals to defect.
