What is it with Marco Rubio and Cuba’s medical internationalism?

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This article was published 27/03/2025 (226 days ago), so information in it may no longer be current.

There is no disputing the fact that the Caribbean island of Cuba is well known in the Global South for assisting disaster-ravaged, and desperately-sick, peoples in their time of need. It is often referred to as Cuba’s unique brand of “medical internationalism,” “medical diplomacy” or sometimes even an “army of white coats.”

Since the early 1960s, the Cuban government has allocated substantial humanitarian and medical resources to virtually every region of the world. No natural calamity or health-care crisis is too small for Cuban professionals — from cancer-stricken children from Ukraine’s 1986 nuclear meltdown in Chornobyl to treating impoverished Haitians and Jamaicans with severe ophthalmological problems.

It is very important to note from the outset that José Martí, the country’s national hero in the struggle for Cuban independence (and oft-referred to as the “Apostle of the Cuban Revolution”) wrote extensively about the need for the Cuban people to have a strong moral compass. Many Cubans today follow the example of Martí and practise religiously the entrenched ideas of a duty to serve or a responsibility to help others.

Moreover, its Herculean efforts on the disaster response front correspond nicely with Cuba’s fundamental belief that access to health care is, above all else, a fundamental human right for everyone — and not just Cubans. Underlying this core ideal is a desire to showcase to the rest of the world that there is a different model or another way than simply turning to, as if there are no other options, a privatized or corporatized health-care delivery system.

It goes without saying that Cuba’s commitment to sending health professionals overseas to treat the sick has generated a fair amount of international goodwill, prestige and influence. And for a struggling country that needs all the friends that it can find at the moment, Cuba’s commitment to solidarity has strengthened its diplomatic relations with a host of developing countries — all wielding votes in international institutions such as the United Nations and the Organization of American States.

But in late February, Florida’s Marco Rubio — the U.S. Secretary of State on a very short Donald Trump-held leash — sought to once again undermine Cuba’s medical missions abroad. We really shouldn’t be surprised, though, since he has been targeting Cuba’s doctor diplomacy for almost a decade now.

According to the U.S. State Department press release, this new policy of expanding punishing sanctions against Havana’s medical internationalism is, in effect, good for the developing world. It goes on to say that this new measure “applies to current or former Cuban government officials, and other individuals, including foreign government officials, who are believed to be responsible for, or involved in, the Cuban labour export program, particularly Cuba’s overseas medical missions.”

Moreover, it castigates the Cuban government for the “forced labour of its workers” and its “abusive and coercive labour practices.” The crux of the new sanctions involve visa restrictions on Cuban officials, doctors and nurses associated with the country’s vaunted medical internationalism — while extending those same visa restrictions to recipient countries’ government officials (and even their families).

Understandably, this has sent minor tremors through those countries currently accessing, or working alongside of, Cuba’s white-coat diplomacy.

It is also worth pointing out that it was Trump, Rubio and Elon Musk who actually orchestrated the dismantling of the U.S. Agency for International Development (USAID) and the freezing/slashing of its development assistance budget. As a result, desperately needed medical aid programs, life-saving treatment and even the sending of Ebola vaccines to the Global South have all been shut down. One is reminded of Cuba’s heroic efforts — when it sent almost 500 medical specialists to West Africa — to tackle the deadly Ebola viral outbreak of 2014-2015.

It does need to be said that Cuban medical internationalism has provided the country with much-needed material benefits, diversified trade markets and critical foreign exchange (somewhere between US$6-8 billion annually). To be sure, the “oil-for-doctors” agreement with Venezuela (which is now under severe stress) once displayed what Cuba’s doctor diplomacy was capable of accomplishing.

It is also true that Cuba in the post-Fidel/Raúl era has been less generous with its assistance and sometimes more focused on cost-recovery. As Cuban President Miguel Diaz-Canel explained to then-Bahamian prime minister Hubert A. Minnis after Hurricane Dorian had hit the area in 2019: “I express the willingness (of Cuba) to co-operate, within our means, in the mitigation of damages.” And you can be sure that that emphasis on recovering health care costs is even more pronounced today given Cuba’s dire economic straits.

Still, medical diplomacy has become a key source of desperately-needed revenue and an important foreign policy instrument for Cuba (i.e., soft power). In some ways, it has turned Cuba into a major player on the world stage and enabled it to punch well above its international weight class.

Perhaps that goes some way toward explaining why Rubio and other U.S. government officials are so fixated on mortally wounding it.

Peter McKenna is professor of political science at the University of Prince Edward Island in Charlottetown.