Cuba's doctors-abroad programme comes under fire

Cuba y seguridad sanitaria mundial: Cuba’s role in global health security

“…There is some suggestion, for example, that these doctors may not have autonomous decision-making regarding whether they want to deploy on these international missions, but rather are forced to do so by the government. 24 Recent legal proceedings in Brazil, moreover, have sought to show that the Cuban model of exporting physicians for economic gain violates the International Labour Organization's agreement on the protection of wages. 24 This is based on the findings from the Mais Medicos programme that suggest that Cuban medics received significantly less in wages than their international counterparts, with the majority of the wages paid directly by Brazil to Cuba for its doctors being retained by the Cuban state.…”

“…24 Recent legal proceedings in Brazil, moreover, have sought to show that the Cuban model of exporting physicians for economic gain violates the International Labour Organization's agreement on the protection of wages. 24 This is based on the findings from the Mais Medicos programme that suggest that Cuban medics received significantly less in wages than their international counterparts, with the majority of the wages paid directly by Brazil to Cuba for its doctors being retained by the Cuban state. 23 24 Discussions about the profit-making nature of these overseas medical missions suggest that Cuba's medical internationalism may be less about a notion of international solidarity or global health security, but rather functions as a form of income generation for the government within a failing economic system.…”

“…Moreover, the focus of Cuba's medical internationalism in strengthening the provision of routine health services in resourceconstrained settings speaks to a broader vision of health security than disease containment and response alone-a focus of current debates concerning how global health security activities can be integrated in a more sustained way into broader health system strengthening and UHC aims. Yet, this deployment of Cuban teams has also raised concerns of taking jobs away from locally qualified physicians and healthcare workers, which raises further questions of sustainability within health systems 24 as a cornerstone of UHC.…”

Cuba's Response to COVID‐19: What Underlies its Apparent Success?

“…Concerns have been raised around, on the one hand, Cuban doctors taking jobs away from locals -less relevant for the COVID-19 experience -and, on the other hand, accounts of doctors' salaries largely funding the Cuban state enterprise and leaving doctors with little control over decisions around their working lives (e.g. Alves, 2018Alves, , 2019. Similarly, the extent to which Cuban doctors have any role in decisions on where they are posted to assist COVID-19 affected countries is arguably hidden by rhetoric and idealist views that this is their role and duty and they are giving back to the state who trained them.…”