Volume 5, No. 1, January 2023
Editor: Rashed Rahman
Following increasing COVID-19-related deaths in Italy since mid-February 2020, the Republic of Cuba decided to send a medical team to set up a hospital in northern Italy, the epicentre of the pandemic. This is yet another example of many Cuban medical contingents that are already working in Latin America against natural calamities and contagious diseases, including SARS and Ebola. Earlier, from the 1960s till the beginning of the 1980s, it had dispatched many aid missions to countries in Africa and Latin America. This included military assistance as a collaborative effort with the then Soviet Union to assist in fighting for liberation in Angola and Ethiopia.
Helen Yaffe, a writer on Cuba, in her book, How a Revolutionary People Have Survived in a Post-Soviet World (Yale University Press, 2020) has explained how “a small, Caribbean island, underdeveloped by centuries of colonialism and imperialism, and subject to punitive, extra-territorial sanctions by the United States for 60 years, has so much to offer the world.” Cuba received compliments from the US’s former UN ambassador Samantha Powers in the following words: “That’s an awesome thing for a country of 11 million people to be sending doctors to Africa to fight Ebola. And it’s a similarly awesome thing for Cuba to be sending doctors to Italy as part of a worldwide effort, really, to fight this pandemic.”
Now, for the impending ‘collaboration missions’ due to the pandemic, almost 400 Cuban doctors and specialists are preparing for missions by training at Pedro Kouri National Institute of Tropical Medicine, a Havana-based institute that has been designated for treating confirmed COVID-19 cases.
“Cuban internationalism” has been criticised by many western leaders and scholars, especially the US. For one thing, being a socialist state, Cuba has been an anathema to all US regimes. Secondly, Fidel Castro’s defiance and active involvement in Africa and Latin America raised many eyebrows as it challenged the US Monroe Doctrine in Latin America and western hegemony in Africa. Thirdly, the Cuban social engineering experiment under Fidel Castro has been successful and earned the goodwill of many Third World countries. Fourthly, as a small island nation it has recorded achievements in many walks of life, including education and health, when compared to many Third World developing countries.
Cuban nationals sent abroad to Latin America and Africa have been labelled ‘proxies’, ‘clients’, ‘surrogates’, ‘cat’s paws’ and ‘paladins’ at the behest of the Soviets; the Cuban model of aid was denigrated as ‘Castroitis’. And recently, the litany of criticism includes their ‘low quality’ development, ‘minting money’, ‘filling their pockets’ and ‘creating guerrilla cells and indoctrinating people’ under ‘the cover of socialist internationalism’. Lately the US has warned Cuba’s neighbours not to deal with it, not easily fall for its overtures of ‘help’, and ‘scrutinise’ all its agreements on this score.
Yet along with all this, it is often not realised that Cuba’s ‘tropical communism’ and Third World background were qualitatively different from Soviet and East European Communism. Cubans, as an Afro-Latin people, easily mingled with local people, shared their culture and offered desired technical assistance, had modest expectations of rewards, and shared a common history of colonialism and exploitation. Besides, race and language make them more acceptable to many nations in Latin America and Africa. Incidentally, Portuguese spoken in Brazil, Angola and Mozambique is a cognate language of Spanish.
The COVID-19 affliction in the US has led to rising fatalities. The present death toll has reached thousands and infections are already in the millions, which has upended the US medical system, especially in New York. Ironically, US President Donald Trump’s administration has sought help from the international community to combat the viral disease. State Department officials have reportedly called on foreign aid recipients to provide critical medical supplies and the President himself has appealed to South Korea for provision of ventilators, according to the read out of the South Korean Foreign Ministry. Miffed at the World Health Organisation (WHO) for being overly soft towards China, the US has withdrawn funding from the world body.
The US in the past rejected Havana’s offers to assist during national emergencies such as Hurricane Katrina that devastated the city of New Orleans and surrounding areas in 2005. Cuban officials then told Newsweek: “No official request for help has been received” from the US amid the crisis.
Many observers have called for the end of sanctions well as removal of all international trade barriers and restrictions against Cuba to jointly combat the rapid global spread of COVID-19. The UN Human Rights Commissioner Michelle Bachelet has specifically appealed for lifting sanctions against Cuba, North Korea, Zimbabwe and Venezuela. Some of these states have frail health systems. Obstacles to the import of vital medical supplies, including over-compliance with sanctions by banks, bring long-lasting harm to vulnerable communities. Allied with restrictions against Cuba, Washington has sought regime change in many Latin American countries. Besides Cuba, it is struggling to oust another leftist, US-blacklisted government in Venezuela under President Nicolás Maduro.
Cuba has made notable progress in tropical medicine. In the case of the coronavirus, Cuba’s contribution to bio-technologies is notable. In this connection, the Cuban Centre for Genetic Engineering and Biotechnology (CIGB) was set up in 1986. Among the thirty medicines the Chinese National Health Commission selected to fight the coronavirus is a Cuban anti-viral drug, Interferon Alpha 2b. Produced in China since 2003 by the enterprise ChangHeber, a Cuban-Chinese joint venture, it has proven somewhat effective for viruses with characteristics similar to those of coronavirus.
The Cuban bio-tech specialist Dr Luis Herrera Martinez explains: “Its use prevents aggravation and complications in patients, reaching that stage that ultimately can result in death.” Interferons were first developed and used to arrest a deadly outbreak of the dengue virus in 1981. This catalysed the development of now Cuba’s world-leading biotech industry. In 1981, the Biological Front, a professional inter-disciplinary forum, was set up to develop the industry in Cuba. While most developing countries had little access to new technologies (recombinant DNA, human gene therapy, bio-safety), Cuban biotechnology expanded and took on an increasingly strategic role in the public health sector and national economic development despite the US blockade obstructing access to technologies, equipment, materials, finance and even knowledge-exchanges to fast track research and innovation to trials and application.
Although the final vaccine is still at an experimental stage, the Interferons are a positive development as ‘signalling’ proteins produced and released by cells in response to infections that alert nearby cells to heighten anti-viral defences. As of now, Interferon Alpha 2B has been requested by more than 10 countries. Cynics remain dismissive of these efforts, but the work continues nevertheless.
This is hardly a eulogy but a factual account of how a small developing island, a nation of only 11 million, is trying to extend global humanitarian assistance to many countries. This effort is not recent but goes back as far as the 1960s when it assisted nearly 40 countries in Africa and Latin America. This encompassed the fields of education, public health, public administration, construction and agriculture. Many Cubanologists at that time rhapsodised that Cuba was a “small country but had a global policy”.
How Cuba has been able to attain the phenomenal progress in education, sports, bio-technology and health systems despite debilitating sanctions and embargoes is a matter for introspection and admiration for many observers. Also, it has survived many threats of regime-change and attempted assassinations by the US. No wonder Fidel Castro was both admired and detested at the same time.
While it has been conveniently labelled as a ‘proxy’, ‘paladin’, ‘surrogate’ and ‘cat’s paw’ of the then Soviet Union, it has been grudgingly praised for its contribution and ideological commitment to “socialist humanitarianism” and reconstruction work in many Third World states.
To be sure, the economy being hard-hit by sanctions has resulted in the loss of tourism, the mainstay of the Cuban economy; the epidemic is going to be a harder challenge to overcome. Cuba has so far faced far fewer cases of the novel coronavirus, which according to the government are mostly ‘imported’ through tourists. Accordingly, as a precautionary measure like the rest of the world, it has closed its borders to tourists for a month and is now implementing stringent isolation measures in hotels and other public places.
Presently Russia is supporting Cuba, but hardly in material terms as it did during the Cold War. While Cuba is eagerly watching the US presidential elections in November 2020, its economy has been hit hard like other developing countries. Although Trump has offered aid to Vietnam to combat the pandemic, Cuba is unlikely to be a candidate for any such assistance given the history of US animosity.
Many observers believe that for a concerted global effort against the prevailing global pandemic, the US needs to relieve sanctions against countries such as Iran, Cuba and Venezuela. But the Trump administration is believed to have taken a tough and unrelenting posture against Cuba as it hopes to garner votes from the exiled Cuban community in Florida. Disaster relief, risk management, rescue missions, preventive medicine, agricultural farming, bio-tech research and humanitarian assistance have been the forte of the Cuban state since the successful 1959 Revolution. Its socialized medical system is better than many other nations, is readily available and less costly than Europe and the US, though the quality can be disputed.
Hectic research on a corona cure in the form of a vaccine is ongoing in many countries. The anti-virus medicines, as of today, are at best palliatives, till a durable cure is found. As for the vaccine, many countries like China, the US, Israel, Cuba and others are actively working on it.
In sum, despite medical difficulties caused by serious shortages and prolonged US sanctions, Cuba has done well in primary health care, preventive medicine and research in tropical diseases. The quality may not be at par with the west but it is less costly, easily available and more suited to developing countries than the western countries dominated by Big Pharma. Moreover, the ratio of doctors in the population as compared to many other countries is laudable and this fact is equally acknowledged by WHO and other international bodies.
During the October 2005 earthquake in northern Pakistan, the Cuban medical mission of doctors, nurses and relief workers arrived soon after and stayed for months while rendering the much-needed assistance. Today, many Pakistani students are studying in Cuban medical universities and, when asked, enthusiastically narrate the successes of the Cuban system despite national limitations.
The writer is former President, Islamabad Policy Research Institute; Ex-Adviser, COMSATS Institute of Information Technology, Islamabad; Former Chairman, Department of International Relations, National University of Modern Languages, Islamabad, and, until recently, Visiting Faculty, Department of Defence and Strategic Studies, Quaid-e-Azam University, Islamabad.
His PhD dissertation was on Cuba in Africa: The Limitations of the Proxy Model (University of South Carolina, Columbia, USA, 1992)