Will the Trump Administration Face Headwinds as It Tightens the Noose Around Cuba? (Yes.)
The Nation | Thursday, 31 July 2025 | Click here for original article
President Donald Trump and Secretary of State Marco Rubio declared upon taking office that the Americas were the United States’ sphere of influence and they would ratchet up pressure on a symbol of resistance to that view, socialist Cuba, already reeling from harsh sanctions imposed during the president’s previous term, largely maintained by the Biden administration, and aimed at further denying it cash to import vital goods such as fuel, food, medicine, and production and agricultural inputs.
Amid the international and domestic chaos caused by attacks on progressive and liberal causes, the Trump administration has also taken aim at Cuban international medical missions, a key revenue earner, causing consternation among host countries. The long-standing campaign to brand the country’s medical and education programs abroad as human trafficking is being stepped up and, for the first time, third-country nationals are penalized. The US-dominated Organization of American States human rights commission recently requested members submit details of any past or present agreements with Havana. Most countries appeared to have missed the June 30 deadline.
“If Rubio were to succeed in having the Cuban medics withdrawn, he would be signing a death sentence for many patients and would also devastate badly needed funds for the Cuban healthcare services,” John Kirk, who has interviewed 270 Cuban medical mission participants over the last two decades and is a professor emeritus of Latin American Studies at Dalhousie University, said in an interview.
Trump launched a similar campaign, though without sanctions, in his first term. The administration pressured international organizations such as the Pan-American Health Organization and governments not to contract Cuban medical brigades. When his allies came to power in Brazil (Jair Bolsonaro via an election) and Bolivia (Jeanine Áñez in a coup), thousands of Cubans were forced out.
Cuba’s medical missions in the region and around the world are a primary target of the administration, and the Cuban American establishment that Rubio is a product of. They symbolize open defiance of US efforts to demonize the country and accounted for just over 50 percent of $9.5 billion in export earnings last year—desperately needed funds after sanctions in Trump’s previous term went after international finances and investment, tourism, remittances, and other revenue streams.
Trump and Rubio have announced a series of measures this year besides targeting the medical missions. They include: resurrecting USAID and other programs supporting government opponents, and a recent ban on most Cubans traveling to the United States, combined with increased enforcement of prohibitions on most Americans visiting Cuba that threaten flights between the two countries. Trump issued a memorandum on June 30 ordering all branches of government to tighten existing sanctions.
Perhaps nothing has angered the Cuban Revolution’s foes more than its free and universal healthcare and education systems and sharing of those assets with other developing countries. The brigades arrived at no cost beginning in 1963, but after the collapse of the Soviet Union they were on a sliding scale. Rubio has characterized these professionals in the past as spies, military personnel, and political activists. He was a vocal supporter of a US program to entice Cuban health workers to abandon their posts abroad in exchange for parole and support resuming their careers in the United States. The Cuban Medical Professional Parole Program began under the George W. Bush administration in 2006 and was ended by President Barack Obama in 2017. It is estimated that around 7,000 Cubans, plus their immediate families, took advantage, though this number may be high, as no figures are available
Missions of Mercy or Organized Crime?
Since the 1959 Revolution, around 500,000 Cuban healthcare personnel have served abroad on government- organized missions and more than 24,000, in 56 countries, do so today. Most experts agree that Havana contracts these professionals to work abroad often where no other doctors will set foot; the professionals volunteer and sign contracts, earn far more than they do in Cuba (though a pittance by Western standards), and the profits do not go to individuals or corporations but to a government that subsidizes all services.
Cuban President Miguel Diaz-Canel charges that the Trump administration has launched “a perverse campaign” to undermine one of his country’s most important sources of income regardless of the human cost. He called Rubio, who says he is concerned about the doctors and Cuban healthcare on the island, “a cynic who boasts of his Cuban origins and has done nothing but seek ways to harm Cuba.”
Go to a Western diplomatic reception in Havana and the chitchat is all about debt, democracy, and human rights. Go to a diplomatic reception hosted by a developing country and the conversation trends toward South-South cooperation, healthcare, and education, not only because Cuban doctors and teachers may be working in the ambassador’s country or region, but because so many watch over thousands of foreign students studying in Cuba.
The Cuban government says the missions have cared for hundreds of millions of people since the early 1960s, conducted 17 million operations, assisted in 5.5 million births, and saved countless lives. Currently 23 missions are gratis—for example, in Haiti—others at cost, and others bring in revenue to keep Cuba’s economy and universal and free health system afloat. For example, in Saudi Arabia and Qatar, recently visited by Trump and Rubio apparently without a peep over the more than 2,000 Cubans on health missions there caring for mainly immigrant workers.
No Silence in The Americas
Rubio may have kept quiet when he accompanied Trump to the Middle East, but he has been anything but silent on Cuba’s medical presence in the Americas since announcing on February 25 that anyone in the world “involved in Cuban forced labor practices” would be banned from entering the United States along with immediate family members.
A few weeks before his Middle East trip, Rubio met with leaders from seven eastern Caribbean nations and the Bahamas—countries that rely on the US and have long benefited from Cuban medical and educational aid. While the meeting was to review issues such as the Haiti crisis, disaster cooperation, and fighting drug trafficking and corruption, the title of the State Department readout revealed Rubio’s priorities. “US Secretary Of State Rubio Focuses On Cuba During Meeting With Caribbean Heads Of Government,” it declared, later adding that Rubio “reaffirmed our commitment to holding accountable Cuban regime officials, foreign government officials, and those involved in facilitating the regime’s forced labor scheme.” The State Department has failed to mention that for the last two decades hundreds of Cubans have worked in Haiti alongside more than 1,000 local practitioners educated in Cuba.
Caribbean-area headlines soon focused on the most dependent of the countries, the Bahamas, which quickly canceled a mission of 45 healthcare personnel, mainly lab technicians, and not the other six heads of state who so far have stood their ground. They are not alone. Soon after his February announcement that those involved with the missions would be sanctioned, Rubio traveled to Jamaica, where differences over the 400 Cubans working there spilled over into a joint press conference. Rubio lashed into the exploitation. Prime Minister Andrew Michael Holness made clear his differences with the secretary of state. “Let us be clear, the Cuban doctors in Jamaica have been incredibly helpful to us…. We are, however, very careful not to exploit the Cuban doctors who are here,” sentiments echoed by other Caribbean leaders at the time.
Mexico, where close to 3,000 Cuban healthcare professionals, mainly doctors, work, has repeatedly defended its collaboration. “There is a contract for Cuban doctors to assist the Mexican population. We see no issue with that,” Mexican President Claudia Sheinbaum said at one of her daily press conferences. “First, it’s not forced labor. They would need to prove that. In Mexico’s case, there’s a contract with Cuba and other countries because during the neoliberal period, Mexico stopped training enough doctors.”
A Battle Far From Over
But the battle, at least in the region, is far from over and has yet to go public elsewhere, particularly in Africa, where US diplomats have reportedly raised the issue and African governments are discussing a response. It appears to be moving to the Organization of American States, where Cuba, which is not a member, charges that “the Inter-American Commission on Human Rights is being weaponized by the US Secretary of State as part of his immoral campaign against Cuba’s international medical cooperation.”
The United States and a relatively small number of former mission participants claim Cubans are forced to go on the missions, spied on while abroad, and have their passports confiscated, and the state pockets the lion’s share of payments for perverse causes. Cuba, meanwhile, insists that medical cooperation is based on voluntariness and humanism, something I can attest to, having been married for 25 years to a local nurse and through my own experience and reporting. While public health workers often express job-related frustrations in Cuba and abroad, none have reported to me issues of forced labor or funds being misappropriated.
“No one I talked to felt that they were being exploited. Quite the contrary, their primary motive for participating in the mission was a significant increase in income,” Kirk said. “Most saw it as a rite of passage, something that many of their colleagues did. Most saw it as an opportunity to develop their medical education, seeing pathologies they had only read about.”
Kirk said the Trump administration might hinder missions or discourage new host countries, but was unlikely to end them, as developing nations are already frustrated by aid cuts and the US exit from the World Health Organization.
“Remember that in Cuba healthcare is universal and free and considered a human right. Access to a medical education is also universal and free and shared with others, so a battle is surely brewing in the Global South,” he said.
