Caribbean leaders have responded strongly to a threat from the United States government to cancel visas for individuals working with or supporting Cuban medical facilities. The U.S. has accused these missions of involving “forced labor” and claimed they “enrich the Cuban regime.”
Cuban medical missions, which provide doctors, nurses, medical staff, and facilities, are vital to healthcare systems across the Caribbean. So, how have Caribbean nations reacted to this threat, and what would it mean for their healthcare systems?
Why is the US government targeting Cuba’s medical programme?
This is not the first time the U.S. has targeted Cuba’s medical missions. During his first term (2017–2021), former President Donald Trump imposed visa sanctions on Cuba’s global medical programme, alleging it amounted to “human trafficking” due to claims that Cuban doctors are underpaid.
Recently, U.S. Secretary of State Marco Rubio announced visa restrictions for Cuban government officials and anyone globally deemed “complicit” with Cuba’s foreign medical programmes. These restrictions also apply to “current and former officials” and their immediate families.
Rubio labelled the Cuban medical programme a form of “forced labor” and warned that Caribbean nations participating in these programmes could face visa restrictions and potential trade repercussions. However, no concrete evidence has been provided to support these claims.
The United States is expanding its Cuba-related visa restriction policy. @StateDept has taken steps to restrict visa issuance to Cuban and complicit third-country government officials and individuals responsible for Cuba’s exploitative labor export program. We will promote…
— Secretary Marco Rubio (@SecRubio) February 25, 2025
The U.S. alleges that Cuba’s government exploits its medical professionals by withholding a significant portion of their wages and restricting their freedoms. While some Cuban doctors have defected and criticised the programme, many others say they participate willingly.
Tamarys Bahamonde, an economist at the U.S.-based Center for Latin American and Latino Studies, described the issue as “complex” and emphasized the importance of centering the voices of the doctors themselves.
“Regardless of whether Cuban doctors qualify as forced labor, we do know that they do not negotiate their own contracts or working conditions,” she said. “Cuba retains a significant portion of their salaries, and there are testimonies from doctors confirming restrictions on movement, confiscation of passports by Cuban authorities in host countries, and limitations on bringing their families along.”
At the same time, Bahamonde highlighted the critical role Cuban medical professionals play in providing healthcare services to underserved communities. “During my time working for a foreign embassy in Havana, I saw firsthand how grateful many countries are for Cuban doctors and the benefits they bring to isolated areas – places that previously had little to no medical access,” she said.
Can Trump’s administration legally do this?
Legally, Trump has broad authority over visa policy through the State Department. The U.S. government can impose restrictions without congressional approval by citing national security or foreign policy concerns.
Affected nations can push back through diplomatic or legal means, but Bahamonde noted that the targeting of Cuban medical missions is not exclusive to the Trump administration. “The proposed visa restriction is actually an expansion of a policy initiated by the Biden administration. In 2024, President Biden signed a spending bill that included sanctions against officials from third countries that contracted Cuba’s medical services,” she explained. “That same year, his administration also accused Cuba of profiting from its medical professionals.”
She added that opposition to Cuban medical missions is “bipartisan,” citing a 2024 resolution led by Republican Congressman Mark Green, which called for visa revocations against countries hiring Cuban doctors. “The sentiment regarding Cuban medical missions is fairly consistent across party lines,” Bahamonde said. “Whether or not President Trump has unilateral authority to impose these visa restrictions, I wouldn’t expect significant resistance to them.”
This suggests that, regardless of who is in power, Caribbean nations will likely continue to face diplomatic pressure over their reliance on Cuban medical professionals.
How have Caribbean leaders responded?
Several Caribbean leaders have stated that they are willing to give up their U.S. visas to keep Cuban medical missions operational.
Barbados Prime Minister Mia Mottley recently delivered a passionate speech in parliament, calling the U.S. stance “unfair and unjustified.” She emphasized, “We could not get through the pandemic without the Cuban nurses and the Cuban doctors.”
Trinidad and Tobago Prime Minister Keith Rowley condemned U.S. interference in Caribbean healthcare decisions, stating, “Out of the blue now, we have been called human traffickers because we hire technical people who we pay top dollar.” He added that he was prepared to lose his U.S. visa over the issue.
Saint Vincent and the Grenadines Prime Minister Ralph Gonsalves highlighted the direct impact Cuban doctors have on patient care, saying, “If the Cubans are not there, we may not be able to run the service. I will prefer to lose my visa than to have 60 poor and working people die.”
Jamaican Foreign Minister Kamina Johnson Smith also defended the presence of Cuban medics, stating, “Their presence here is of importance to our healthcare system.” Currently, there are 400 Cuban doctors, nurses, and medical technicians working in Jamaica.
Bahamian Foreign Minister Fred Mitchell affirmed his government’s support for the Cuban programme, stating that it “follows all international best practices in the recruitment of labour.” Guyana’s Foreign Minister Hugh Todd revealed that 15 CARICOM foreign ministers met with U.S. Special Envoy for Latin America Mauricio Claver-Carone in Washington, D.C., to voice their opposition and seek clarity on U.S. policy. “The US is a strategic partner to CARICOM, but this very important issue has to be dealt with at the level of heads of government,” he said.
Why are Cuban medical missions critical to Caribbean healthcare, and what happens if they are cut?
Cuba has more than 24,000 doctors working in 56 countries worldwide, with medical missions particularly bolstering healthcare in the Caribbean. These missions are especially vital in impoverished nations facing economic crises and limited medical services.
Bahamonde explained that the impact on Caribbean nations would depend on how essential Cuban doctors are to their healthcare systems and how difficult they would be to replace in the short term. “For many Caribbean nations, the short-term consequences could be devastating,” she said. “Training local doctors takes years, and trained professionals often migrate to other countries, leaving behind a persistent shortage.”
Cuba helps fill this gap by sending thousands of medical personnel who are more affordable than private healthcare options. These missions provide primary care, emergency response teams, and specialists in underrepresented fields. They have also played a critical role in responding to regional disasters, such as hurricanes, earthquakes, and public health emergencies. Cuban doctors were instrumental in combating the cholera outbreak in Haiti after the 2010 earthquake and in assisting Caribbean nations during the COVID-19 pandemic.
Which other countries rely on Cuban medical missions?
Cuba’s medical missions extend beyond the Caribbean. Some key examples include:
- Venezuela: One of the largest recipients of Cuban doctors, with thousands working in community clinics.
- Brazil: Had a major Cuban medical programme until 2018, when Cuba recalled 8,000 doctors due to a diplomatic dispute.
- Italy: Received Cuban doctors during the COVID-19 pandemic to assist overwhelmed hospitals in hard-hit regions.
- South Africa: Hosts Cuban medical professionals in rural areas with doctor shortages.
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