Cuba’s Struggle Against the Pandemic

By Andrew Martin

“The ever more sophisticated weapons piling up in the arsenals of the wealthiest and the mightiest can kill the illiterate, the ill, the poor and the hungry, but they cannot kill ignorance, illness, poverty or hunger.”
– Fidel Castro

Cuba, the small island nation in the northern Caribbean is facing a battle on many fronts. Six decades of U.S. blockade have politically and economically cut off the island, hindering its social development. The pandemic is now hitting the small but influential country hard, bringing pressure on Cuba’s socialist revolution.

Heralded as an early success story in dealing with Covid-19, Cuba is now struggling to bring infection rates under control. Covid-19 in Cuba was first reported in March 2020 after three Italian tourists visiting the central town of Trinidad tested positive for the disease. Cuba’s response dealt decisively with the outbreak, focussing on prevention and control. The country led the region in contact testing and tracing and had suspended all international flights. In May, new cases had fallen to less than 20 per day. Restrictions were eased in November when case rates were well below average compared to the rest of the region. Cruise ships and international flights to the island resumed.

Nurse Yosian Diago checks door-to-door for people with symptoms of Covid-19 in Havana, Cuba, in June 2020
Alexandre Meneghini/Reuters/PA Images

The government’s measures relied on the willingness of travellers to self-isolate. As in many other countries, problems with the self-isolation system then led to an exponential rise in the number of cases. The government required travellers to self-isolate for seven days and return a negative test before mingling with the community. The government estimates that 70% of the breaches are from Cubans who live abroad, returning to visit family. In January, with rising infection rates, Cuba decided to implement a program of hotel quarantine.

Now cases are expected to reach 1500 per day by the end of February. This prediction has come from modelling conducted by Havana’s school of Mathematics and Computer Science. Cuba could have 7,000 more active cases by the end of the month. Its daily record peaked at 1044 infections. The national case load peaked at 32,000, but with high recovery rates, has dropped to 11,603 at the time of writing. The death toll is 282.

January was the worst month, with 70 deaths and 15,536 cases. The epicentre is Havana, a city of 2.2 million people. Only one municipality has remained virus-free, with 5,500 people receiving medical treatment and 49 in intensive care.

There are many wealthier countries with similar levels of population that have done much worse. For example, with 10 million people, Sweden pursuing a herd immunity strategy has now lost over 12 500 people to covid-19 with well over 600,000 cases. The Trump administration’s failures to deal with the pandemic in the U.S. has left the country in a dire situation. Almost 500,000 people have died from a total of 27 million cases.

In the US, the virus has also exposed systemic racial disparity, with underlying health conditions, insecure work, lack of access to quality healthcare, and greater exposure to the virus acutely affecting Black and Latino people. A lack of testing sites in more impoverished communities has compounded the problem. The number of deaths for people of colour in the US is 5.8 times higher, and 4.2 times higher for Latino people compared with whites. These disparities further expose the need for a fully-funded socialised healthcare system.

Why Cuba is Suffering from the Pandemic and the Government’s Response

Cuba relies heavily on tourism. In particular, the economy depends on travellers from cruise ships and international flights. There are several reasons why Covid-19 has spread quickly in Cuba since late 2020. The government was unable to enforce self-isolation. The more infectious mutations of the virus have also found their way to Cuba.

Cuba’s lack of financial and material resources contributes to a shortage of housing that makes social distancing difficult. Relying on the tourism industry for income, many Cubans have a high degree of social interactions with travelers. Much of the social and cultural life of Havana is situated in its tight alleyways, paths and busy boulevards. Public transport is often overcrowded, and social distancing is difficult in the many queues for necessities.

For economic reasons, it is much harder for poorer countries to maintain a hard lock-down. Most poorer countries lack the resources to support strict quarantine measures. The user-pays system of hotel quarantine is much more onerous to implement in poorer countries. Nevertheless, Cuba has had to implement similar measures to those used in Australia and New Zealand. The Cuban government has also restricted travel between provinces and mandated the wearing of masks. It has also implemented a curfew. Only essential workers are permitted to travel.

Compared to much of the developing world, Cuba has many advantages that help deal with the pandemic. Cuba prides itself on having the best healthcare system in the region. All healthcare services are government-run. The healthcare system is a product of the Cuban revolution, which regards healthcare as a fundamental human right. Despite its lack of development, it has one of the lowest infant mortality rates (4.2 per thousand) and one of the highest in life expectancy (77 for men and 81 years for women). It’s doctor to patient ratio is one per 150, lower than the advanced capitalist countries. There are almost 100 000 physicians in Cuba.

In Cuba, hospitals are less centralised, with most hospitals having around 150 beds. The most immediate healthcare measure taken to combat the pandemic was to increase the number of hospital beds. 

Cuba has been conducting up to 18 000 tests per day and  providing results within three days. Recovery rates in Cuba are better than most countries – 35 000 have recovered, a rate of 86.9% (compared to 65.6% in the U.S., where people remain ill for far longer). Despite an overwhelming situation, fatality rates for those infected have remained relatively low at 0.7% (compared to 1.8% in the U.S.).

Cuba’s Biotech Sector

For over 60 years, the U.S. blockade has crippled Cuba’s economic and social development. In 2002, John Bolton, then U.S. Under-Secretary of State for Arms Control and International Security, accused Cuba (without a shred of evidence) of developing technology for biological warfare. This neo-conservative narrative was similar to the disproven, Bush era, accusations of Weapons of Mass Destruction in Iraq – used to justify the invasion of that country.

Cuba’s response was to open its doors and allow a team of U.S. scientific and security experts to examine its medical laboratories. The U.S. delegation chose the laboratories they wanted to visit. They were permitted to film and document what they saw. According to Phillip Coyle, former Assistant Secretary of Defence: “Our Cuban hosts could not have been more welcoming or open … They showed us proprietary information about the Cuban pharmaceutical industry, information that U.S. companies would likely not have shared had the situation been reversed.”

In their report, the investigating team stated: “In talking with the researchers and production people at the Cuban facilities, we saw that they were truly incredulous at our questions about bioweapons. The idea that they would do such work had not occurred to them, and was an astonishing suggestion to them…” The conclusion of the mission was predictable. General Wilhelm, a former Commander in Chief of U.S Southern Command, declared: “Cuba does not pose a significant military threat to the U.S. or to other countries in the region.” What became clear to them was Cuba did not have the facilities to manufacture biological weapons. They found a highly developed biotechnology sector that worked directly in conjunction with the national healthcare sector and that all its resources supported its health missions.

Cuba’s biotechnology sector has continued to develop. Part of Fidel Castro’s vision for Cuba was for a high level of scientific development. From the outset of the Cuban revolution, the government prioritised training doctors and investing in medical research. In the 1980s, the biotech industry was part of Fidel Castro’s vision of Cuba being more independent from the Soviet Union. Cuba was already at this time, struggling to get access to medical supplies. U.S companies and their global subsidiaries hold nearly 80% of medical patents.

The U.S. blockade has prevented many countries from trading with Cuba and made it difficult for Cuba to attain the hard currency necessary to purchase imports. Not only are US companies banned from doing business with Cuba, but so are many of their subsidiaries. The collapse of the Soviet Union wiped out 80% of Cuba’s foreign trade. The focus on medical research became more important than ever. By the 1990’s – the period in Cuba known as the “special period” owing to the sharp economic crisis following Soviet collapse – the country manufactured its own generic pharmaceuticals, laying the basis for greater inventiveness.

It is difficult for Cuba to source scientific equipment, but the government of Cuba and its people have proven to be resourceful. Cuba’s Finlay Institute, established in the 1990s, has developed various vaccines against life-threatening diseases such as tetanus, diphtheria and meningitis. Cuba was the first to create synthetic antigens, which have successfully inoculated people against multiple flu strains. A process of organochemical synthesis is used in the manufacture of antigens. This process allows for greater control of the vaccine’s quality and enables it to be more easily mass-produced. Cuba has been able to work with some advanced capitalist countries to develop scientific research to learn more about how to combat viruses. It was able to send scientists to Finland to learn to synthesise the virus-fighting protein interferon.

Under Trump, the tightening of the US economic and trade blockade of Cuba and increased political aggression has made this sort of cooperation virtually impossible. China, also facing aggression from the U.S, has become an obvious partner to help deal with the pandemic. A joint Cuban-Chinese project has established a medical lab in central Cienfuegos, which processes 500 test samples a day from Cuba’s total of up to 18,000 tests.

Cuba has developed four Covid-19 vaccines through its Finlay Institute, two of which are in a clinical trial. The WHO is monitoring the tests which are being conducted by Cuba’s Center for Genetic Engineering and Biotechnology. Cuba is also experimenting with the way the vaccines will be applied; either nasally or intramuscularly. Cuba’s Soberna 2 (Sovereign 2) vaccine has so far been the most successful. The vaccine requires three doses with two weeks between each dose.

The government is confident that it will be able to inoculate Cuba’s population and begin exports of the vaccine before the end of 2021. Soberna 2 will enter the final phase of testing next month. The government has also indicated that it will offer the vaccine to those who travel to Cuba and that it will be able to produce 100 million doses by the end of the year. It will send the vaccine to other countries in need, such as Iran, Venezuela and Vietnam.

The vaccine has developed strong immune responses which produce neutralising antibodies blocking the virus from binding to the body’s cellular receptors. The vaccine has stimulated long term memory of immune response. There are 150 000 doses available for clinical trials.

Apart from vaccines, highly skilled Cuban biomedical and other workers have been inventive in other ways. The country has developed its own air passageway ventilator, diagnostic tools and methods of DNA and RNA extraction. It has also, through its recent trials, been able to create better ways to evaluate vaccines.

International Solidarity – an Expression of the Cuban Revolution

Cuba’s vaccine programs are best understood as part of its international solidarity. Cuba expressed international solidarity from the outset of the revolution sending health professionals to Chile in 1960 after an earthquake killed 5000 people. Whereas medical achievement in the US is driven by profit and controlled by large corporations. In contrast, Cuba’s solidarity through its health missions makes Cuban medicine genuinely revolutionary. 

Doctors and nurses from Cuba’s Henry Reeve International Medical Brigade bid farewell before travelling to Italy to help fight the Covid-19 pandemic on March 21, 2020 in Havana. Yamil Lage/AFP

Cuba has sent 3,700 doctors around the world to help combat Covid-19. It has done this through its Henry Reeve medical brigade. Founded in 2005, the brigade of doctors has specialised in dealing with disasters and epidemics. Fidel Castro offered to send 1,500 doctors to the U.S. after Hurricane Katrina ravaged New Orleans in 2005, killing close to 2,000 people. President George W. Bush rejected the offer.

Despite Cuba’s suffering, it has not deserted its Caribbean neighbours. Cuba has sent 100 medical practitioners to Barbados to help combat and contain the spread of Covid-19, while China has also sent medical equipment and supplies. The prime minister of Saint Vincent and the Grenadines, Ralph Gonsalves, referred to them as “lifesavers” and said that “in some countries, they constitute the backbone of the response to the pandemic.” There are almost 500 Cuban health professionals in Jamaica. Dr Christopher Tufton, Jamaica’s health minister, described the doctors as “health heroes”. Cuban doctors often find that they are treating people with no access to an established health system.

Since 2005, the Henry Reeve brigade has sent 8,000 doctors around the world. They are currently deployed in over 39 different countries to fight Covid-19. The brigade often establishes field hospitals, surgical and intensive care units and advanced diagnostic services.

Emergency contingent of Cuban doctors and nurses arrives at Italy’s Malpensa airport after travelling from Cuba to help Italy fight the spread of coronavirus disease. REUTERS/DANIELE MASCOLO

Cuban doctors are well prepared to deal with the pandemic. Cuba was foremost in the struggle against the Ebola virus in West Africa. When the U.N. and aid groups such as Doctors Without Borders and Red Cross appealed for assistance, Cuba was the first to respond, sending three teams, 460 health professionals in total to deal with the outbreak. There were high risks in dealing with such a deadly disease, but the Cuban government saw it as a duty to respond in a humanitarian way. The other motive was to contain the Ebola virus – it is with great foresight that the Cuban government has acted to contain such outbreaks.

Sanctions Biting Hard

Although Cuba has been well prepared for the pandemic, it is struggling. Six decades of U.S. blockade has impacted every aspect of life in Cuba. Every year the U.N. General Assembly (UNGA) votes to end the U.S. embargo on Cuba. Only the U.S. and a handful of its imperialist allies oppose these motions. However the resolutions of the UNGA are unenforceable. While Cuba’s socialist government has been able to prevent significant losses of life, the blockade’s intent is genocidal. A 1960s US State Department report spells out the aim of the blockade at its inception: “Every means should be undertaken to weaken the economic life of Cuba to bring about hunger, desperation and overthrow the government”.

In 2017, Donald Trump introduced new sanctions against Cuba, rolling back the Obama administration’s easing of certain measures, including revoking freedoms to travel to Cuba and preventing Cubans living in the US from sending money (remittances” to their family living on the island. He also allowed U.S. firms and Cuban Americans to file claims in U.S. courts for compensation for property expropriated during the Cuban revolution.

The Trump administration prohibited cruise ships and air travel to Cuba and the US state department restricted remittances to US$1000 per quarter. Bizarrely, they also imposed visa restrictions on Raul Castro for human rights violations in Cuba and Venezuela. Trump also re-added Cuba to its designation of the axis of evil, listing Cuba as a state sponsor of international terrorism.

The sanctions hit hard. When the pandemic struck, it was a one-two punch to Cuba’s economy. The Cuban economy has also been damaged by Venezuela’s economic crisis. Venezuela has also faced crippling US sanctions. US interference effectively cut off Cuba from Venezuelan oil as Trump imposed sanctions on several shipping companies that traded between the two nations.

Similar to much of the world, Cuba is experiencing the worst economic decline in 27 years –  the economy shrank by 11% in 2020. Foreign exchange received for Cuban exports was half of the 2019 amount. The combined impact of sanctions and the pandemic has meant an almost total loss of tourism. Most restaurants are closed, the classic American cars are left idle, and many resorts and hotels are empty. Imports and exports have slumped.

China has become one of Cuba’s largest trading partners, but it is not the same lifeline that the Soviet Union once was. Cuba exports nickel and sugar to China. China is also investing in renewable energy, light industry and communications in Cuba. But Cuba’s imports from China have fallen. In 2020 they fell by 40% to US$483 million compared to $791 million in 2019. Imports from China declined from nearly 1.9b in 2015. Imports from Spain dropped by 37% in 2020. Exports to Spain (mostly sugar and rum) are down 12%. 

The Cuban economy faces a crisis of stagnation caused by a lack of liquidity. In 2017 foreign debt stood at $18.3 billion. Cuba has struggled to repay this debt and the sanctions have cut off from new sources of funding. These difficulties have forced the government to impose drastic economic measures. Cuba has ended a long-standing tax on the U.S. dollar and established 100 state-owned stores accepting payment only in US dollars using Visa or Mastercards.

The balsa negra (the black market), a daily reality in Cuba, has become more prominent covering economic areas that the state cannot control. Under reforms initiated by Raul Castro, more Cubans have been able to work for themselves and do so legally. The government has issued 300,000 licences under 200 categories to allow for this. In this way, the government has some control over previously informal sectors.

Cuba will also devalue its peso and scrap its system of dual currency. In a public address, President Miguel Diaz-Canel stated the peso would be set to 24 per dollar. For nearly 30 years, two currencies have been used in Cuba, the Peso and the Cuban Convertible Peso (CUC) which was established in 2004 to replace the role of the US dollar inside Cuba. The CUC will now be scrapped. The government has acknowledged the measure is likely to trigger inflation, but it will enable the Government to collect more of the US dollars it needs to pay for vital imports.

Cuba relies heavily on imports for what it consumes. Reuters estimated in 2017 that 60-70% of Cuban food was imported. The actual amount is difficult to calculate as Cubans, especially in regional areas, often grow their food. Around 80% of the food rations that the government distributes is imported, this includes grains and cooking oil. Most, if not all, Cubans also buy food from street vendors. There are thriving urban farms that provide vegetables, fruit, herbs and fresh eggs – these are often overlooked by foreign commentators.

The embargo against Cuba has hindered the development of its agricultural sector and rural infrastructure. The embargo exacerbates the dependence on imports. The coming period will be a struggle for food security and sovereignty. While indicating it may reverse some of Trump’s restrictions on Cuba, the Biden administration still presents challenges.

The goal of regime change remains the same. It will more likely take softer forms, with the U.S. continuing to engage in subversive acts through the CIA and other agencies. Its latest subversion attempts are through online media – social networks of discontented artists and intellectuals who have become the sharp edge of counter-revolution. The intent is to form a narrative of regime change and undermine support for Cuba from liberal sections of U.S. society.

Through funding such actions, the U.S hopes to form a movement based on the cult of individualism, uprooted from any attachment to Cuba’s social solidarity. Propaganda fed into Cuba through online portals associates freedom with consumer-driven society and the accumulation of individual wealth.

The U.S. openly admits to funding projects for regime change. On 27 November and 27 January, demonstrations took place outside the Ministry of Culture demanding dialogue with the government. The activists surrounded the building for several hours and presented no specific demands. Some in attendance admitted that they were being paid small sums of money from organisations linked to USAID.

The Cuba Money Project Portal (CMPP) received $410,710 in 2020 from USAID. The organisation reports on money sent to and from Cuba helping the U.S to tighten its sanctions. According to Tracy Eaton in an article that appeared on the CMPP, The Democracy Business in Cuba is Bustling, at least 54 groups have operated projects in Cuba with funding from USAID since 2017. The U.S. has spent $261 million in subversion projects since 1990 – $124m for “civic matters”, $38m for “human rights” and $25m to support media projects.

None of these efforts has been enough for the U.S. empire to subjugate the Cuban people. The Cuban revolution continues to endure. Its steps forward in biomedicine, is international solidarity in the face of the pandemic and its own sophisticated Covid-19 response are evidence of that.

5 comments

  1. This is a fascinating article, and I’m glad to gain a greater appreciation in perspective for a nation that hasn’t received too much attention during the pandemic. I’m managed more attention hasn’t been given to Cuba developing four potential vaccines. Cuba has suffered historically at the hands of the US, and it sounds like, as ever, the additional pandemic challenges have further exposed those difficulties, and the disparities between wealthy nations and others. Thanks for sharing this great read!

    • The United Nations estimates that the U.S blockade has cost Cuba $134 billion. The real cost is much greater as there is an exponential factor on investment…the real cost is many hundreds of billions and a fetter on social development. Cuba’s government would be much more effective if it had those resources.

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