Cuban Health Cooperation Continues Under Attack

By Silvana Solano – Mar 27, 2026

Cuban doctors have transformed public health systems from Algeria to Brazil.

The internationalism of Cuban medicine has become a cornerstone of global health debates, particularly in the Global South.

For more than six decades, the island has sent hundreds of thousands of health professionals to nearly every region of the world.

This in-depth article explores the historical origins, expansion, and current geopolitical challenges of these medical missions in 2026.

Health as a Human Right, Not a Commodity
The Cuban medical model is predicated on a fundamental belief that healthcare is a human right rather than a commodity. This notion is the guiding principle behind the efforts of the Cuban Medical Brigades, formally designated the International Contingent of Doctors Specialized in Disaster Situations and Serious Epidemics.

In the contemporary era of heightened ideological polarization, these groups have evolved into a component of a more extensive ideological struggle. International organizations frequently laud their reach and effectiveness in underserved communities.

Nevertheless, renewed regional tensions, most notably the resurgence of a contemporary ‘Monroe Doctrine’ approach, have placed their missions under political and media scrutiny.

The establishment of one of the world’s largest medical cooperation networks by a small Caribbean nation provides a valuable case study in the challenges to the commercialization of healthcare.

From the Sierra Maestra to Algeria: Origins (1960–1963)
Cuba’s medical internationalism emerged from the social and moral transformations that followed the 1959 Revolution. The concept of the “revolutionary doctor,” rooted in Che Guevara’s vision, defined medicine as a vocation of service, not wealth.

After 1959, Cuba faced a severe “brain drain.” Nearly half of its 6,000 doctors emigrated to the United States. Instead of retreating, the new government accelerated training programs for young professionals, prioritizing rural medicine and solidarity abroad.

In 1963, Cuba launched its first long-term medical mission in newly independent Algeria, a nation left without a functioning health system after French colonization.

A group of 54 Cuban healthcare workers, 28 doctors, 25 nurses, and one technician, volunteered to serve. This was not a transaction but an act of what Havana called “true internationalism.” The message was clear: Cuba would share what it had, not merely what was left over.

It was during this period that Fidel Castro coined the term “Army of White Coats.” The goal was to build a mobile, professional force capable of responding to humanitarian crises without the constraints of military or corporate aid.

By the late 1970s, Cuban doctors were already active in sub-Saharan Africa and the Caribbean, laying the foundation for the massive cooperative health programs of the 21st century.

Flagship Programs That Challenged the Global Health Market
In the 21st century, Cuban medical cooperation evolved from emergency relief to comprehensive, long-term health initiatives.

These programs aimed to provide specialized care to populations excluded from mainstream medical markets.

Operation Miracle (Operación Milagro)
Launched in 2004 in partnership with Venezuela, Operation Miracle became one of the largest ophthalmology programs in the world. It has restored eyesight to more than 4 million people in 35 countries by offering free surgeries for cataracts, pterygium, and other curable causes of blindness. Equal parts humanitarian and political, the program disrupted the business model of private eye clinics across Latin America by proving that sight could be restored without profit motives.

Cuba and Venezuela Strengthen Support for Mexico in Response to Floods

The Henry Reeve Contingent
Created in 2005 and named after an American who fought for Cuban independence, the Henry Reeve Contingent specializes in disaster and epidemic response. It gained international recognition during the 2014 Ebola outbreak in West Africa and later during the COVID-19 pandemic, when Cuban teams were dispatched even to Europe, including Italy and Andorra. Over 50 brigades served in nearly 40 countries, showcasing a health model that operates outside the private insurance system.

ELAM: The Latin American School of Medicine
Located in Havana, ELAM has become the educational core of Cuba’s health diplomacy. With more than 30,000 graduates from over 100 countries, the school trains young people from poor communities on the condition that they return to serve in underserved areas. This approach transforms the problem of “brain drain” into “brain gain” for the Global South.

The Geography of Hope: Medicine for the Margins
Cuba’s “Geography of Solidarity” is defined by its doctors’ presence in regions where local and private physicians often refuse to work. Their missions adapt to the social, political, and environmental conditions of each country.

In Guatemala, Haiti, and other impoverished nations, Cuban doctors have maintained a continuous presence since the late 1990s. After Hurricane Mitch in 1998, Cuba launched the Comprehensive Health Program (PIS), which evolved from disaster response into permanent public health coverage in remote mountain and forest regions.

In Haiti, teams have remained through political upheavals, the 2010 earthquake, and the cholera epidemic that followed.

In South America, Cuban health diplomacy moved into urban communities historically excluded from public services.

In Venezuela, Barrio Adentro created thousands of small clinics in hillside neighborhoods and rural villages, bringing doctors directly to marginalized populations.

In Brazil, Mais Médicos (2013–2018) placed over 11,000 Cuban physicians across 3,600 municipalities — many of which had never had a resident doctor before.

In wealthier countries such as Algeria, South Africa, and Qatar, Cuba’s cooperation takes a more technical form.

These nations pay for Cuban medical services, allowing Havana to finance both its domestic healthcare system and free programs in poorer regions. This “solidarity economy” sustains Cuba’s medical diplomacy even amid economic sanctions.

The Right-Wing Offensive: Political Shifts and Expulsions (2018–2026)
Over the past decade, Cuban medical cooperation has faced a wave of political backlash. The rise of conservative governments across Latin America, aligned with Washington’s “Monroe Doctrine 2.0,” has reversed years of expansion.

These governments have followed a familiar pattern when removing Cuban brigades. They accuse Havana of “modern slavery,” focusing on the Cuban state’s retention of part of doctors’ salaries, a mechanism used to fund Cuba’s universal healthcare.

Others allege espionage or political interference, though without public evidence. This campaign has intensified since 2024. In early 2026, Ecuador’s President Daniel Noboa expelled all remaining Cuban medical and diplomatic personnel.

Around the same time, Honduras ended its contracts following the close of Xiomara Castro’s term and the election of Nasry Asfura.

These decisions reflect an ideological rather than practical realignment, and their impact has been felt most by vulnerable populations.

In Brazil, the 2018 withdrawal of Cuban doctors left more than 700 municipalities without any resident physicians.

Reports from 2025 show that regions like the Amazon and rural Honduras have seen rising infant mortality and untreated chronic illnesses, as private health providers failed to replace the capacity Cuba once supplied.

The Lasting Legacy of the White Coats
The story of Cuba’s medical brigades remains one of the most influential experiments in South-South cooperation. Against a backdrop of sanctions and diplomatic isolation, Havana’s “Army of White Coats” continues to challenge the logic of healthcare as a marketplace.

By deploying doctors to places others would not go, from mountain villages to conflict zones, Cuba demonstrated that medical care can be universal when political will supports it.

Through ELAM, it built a generation of doctors who serve, rather than profit from, their communities. Even when right-wing governments expel the brigades, the demand for their services persists among ordinary people who witnessed their impact.

As 2026 unfolds, Cuba’s health diplomacy stands at a crossroads. While geopolitical pressure seeks to dismantle it, the results, millions of lives saved and countless patients treated at no cost, continue to speak for themselves.

In an age of privatized healthcare, the Cuban model remains a powerful reminder that medicine can be guided by solidarity, not markets.

(Telesur)