Caribbean leaders have hit back at a threat issued by the United States government to cancel visas for anyone working with or supporting Cuban medical facilities, citing allegations of forced labour and claiming these missions “enrich the Cuban regime”.
Cuban medical missions, which provide doctors, nurses and other medical staff as well as medical facilities, are critical to healthcare systems in the Caribbean.
So how have Caribbean nations responded to this threat and what would it mean for healthcare there?
Why is the US government taking aim at Cuba’s medical programme?
The targeting of Cuban medical missions is not new for US President Donald Trump’s administration. During his first term as president of the US from 2017 to 2021, his administration imposed visa sanctions on Cuba’s global medical programme. His government claimed these missions amounted to “human trafficking” because, it said, Cuban doctors are reportedly underpaid.
This time around, US Secretary of State Marco Rubio has announced restrictions on visas for government officials in Cuba and anyone else, globally, that the US deems to be “complicit” with Cuba’s foreign medical programmes. The State Department said the restrictions would extend to “current and former officials” as well as the “immediate family of such persons”.
Rubio called the Cuban medical programme a form of “forced labour” and the government has warned that Caribbean nations participating in these programmes could face visa restrictions as well as 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 US alleges that Cuba’s government exploits its medical professionals by keeping a large portion of their wages and restricting their freedoms. While some Cuban doctors have defected and criticised the conditions of the programme, many others say they willingly participate.
Tamarys Bahamonde, an economist at the US-based Center for Latin American and Latino Studies, said this issue is “complex” and should centre the voices of the doctors themselves.
“Regardless of whether Cuban doctors qualify as forced labour, 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 reiterated the crucial role that Cuban medical professionals play, especially when it comes to 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 US government can impose restrictions without needing approval from Congress by citing national security or foreign policy concerns.
Affected nations can push back through diplomatic or legal channels, but Bahamonde pointed out that the US 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,” Bahamonde told Al Jazeera.
“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, calling for visa revocations against countries hiring Cuban doctors.
“The sentiment regarding Cuban medical missions is fairly consistent across party lines. Whether or not President Trump has unilateral authority to impose these visa restrictions, I wouldn’t expect significant resistance to them,” she said.
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, she said.
How have Caribbean leaders responded?
Some Caribbean leaders have declared they will give up their right to US visas if it means keeping Cuban medical missions.
This week, Barbados’s Prime Minister Mia Mottley gave a fiery address to parliament, calling the US stance “unfair and unjustified”.
“We could not get through the pandemic without the Cuban nurses and the Cuban doctors,” she said.
Trinidad and Tobago’s prime minister, Keith Rowley, warned that US interference in Caribbean healthcare decisions was unacceptable.
“Out of the blue now, we have been called human traffickers because we hire technical people who we pay top dollar,” Rowley said, adding that he was prepared to lose his US visa.
Similarly, Saint Vincent and the Grenadines Prime Minister Ralph Gonsalves highlighted the direct effect Cuban doctors have on patient care.
“If the Cubans are not there, we may not be able to run the service,” he said. “I will prefer to lose my visa than to have 60 poor and working people die.”
And last week, Jamaican Foreign Minister Kamina Johnson Smith told reporters her government views Cuban medics as vital.
“Their presence here is of importance to our healthcare system,” she said. There are 400 Cuban doctors, nurses and medical technicians currently working in the country.
In a post on X, Bahamian Foreign Minister Fred Mitchell vouched for the Cuban programme, saying his government “follows all international best practices in the recruitment of labour”.
Hugh Todd, Guyana’s foreign minister, told the AP news service on Tuesday that 15 foreign ministers from the Caribbean Community (CARICOM) had met with Mauricio Claver-Carone, US special envoy for Latin America, in Washington, DC, to voice their opposition and demand clarity on US 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 the missions particularly boosting healthcare across the Caribbean, especially in impoverished nations facing deep economic crises and with limited medical services.
“The impact on Caribbean nations will depend on how essential Cuban doctors are to their healthcare systems and how difficult they would be to replace in the short term without significantly affecting the communities that rely on them,” Bahamonde said.
For many Caribbean nations, the short-term consequences could be devastating. 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 that are much more affordable to locals than private healthcare options, Bahamonde explained. These missions provide primary care, emergency response teams and specialists in fields that are often underrepresented in Caribbean hospitals.
They have also played a prominent role when it comes to responding to regional disasters, such as hurricanes, earthquakes and public health emergencies. Cuban doctors were instrumental in combating the cholera outbreak in Haiti following a devastating earthquake in 2010, and in assisting Caribbean nations during the COVID-19 pandemic.
Which other countries rely on Cuban medical missions?
Cuba doesn’t just send doctors to the Caribbean; it has medical missions all over the world. Some key examples include:
- Venezuela is 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 help overwhelmed hospitals in some of its hardest-hit regions.
- South Africa hosts Cuban medical professionals in rural areas where there are doctor shortages.