Abhishek Mohanty is a Fellow at the ERA Institute. He is currently pursuing M.A. degree at the Russian Academy of National Economy and Public Administration.
Cuba and the US are big players in the field of health diplomacy as they have been at the front in numerous global health crises and natural disasters. Since the COVID-19 pandemic began, Cuba has sent more than fifty medical teams to twenty countries across the world. While there is currently 28,000 Cuban medical staff deployed in more than 60 countries without facing any major shortage at home, US State Department was seeking foreign medical staff to handle the increasing number of coronavirus cases in the country, despite funding $20.5 billion to counter the impacts of COVID-19 in more than 120 countries. Taking this into account, it would be significant to analyze whether the US can take lessons from Cuba on how to improve its own medical diplomacy.
First, to understand the modern success of Cuban medical diplomacy, it’s necessary to study its history. During the Cold War, Cuba was using its health professionals as a diplomatic instrument to counteract political isolation. In 1963, Cuba sent its first international medical mission to Algeria. A team of 56 Cuban doctors replaced the French health officials who had left the North African country after it got decolonized in 1962. Other major Cuban medical missions were during the 1986 Chernobyl Explosion, 2004 Indonesia Tsunami, and the 2014 Ebola outbreak in West African countries.
With the beginning of the COVID-19 outbreak in Europe, Cuba launched its first humanitarian mission to the continent in March 2020. The first medical team landed in Andorra, a small principality lying between France and Spain, and then two of Italy’s severely-hit regions – Piedmont and Lombardy. In Italy, the first Cuban group has been working at a field hospital in Crema since late March. The second group landed in Turin on April 12 to substitute the exhausted Italian health professionals.
Health diplomacy has facilitated Cuba to build an image of goodwill in the international arena and in return acquired significant investments from the countries which it assisted, particularly the oil-for-doctors agreement with Venezuela. Today, Cuban doctors are globally renowned for their humanitarian services, especially in the developing countries of Latin America, Africa, and Asia. These doctors have single-handedly assisted in developing friendly bilateral cooperation.
Nevertheless, the United States leads in the global war against contagious diseases through Global Fund to Fight AIDS, Tuberculosis and Malaria. The most recent Global Fund financial report lists donors, showing that the U.S. pledged $4.68 billion for the 2020-2022 biennium. The U.S.-led Global Health Security Agenda (GHSA) is a partnership of 67 nations, international organizations and NGOs that helps countries develop capacity to prevent, detect and respond to disease outbreaks. In spite of all such initiatives, the US also has also numerous problems in its medical sector.
According to David J. Skorton, MD, CEO and President of Association of American Medical Colleges, “The increasing physician shortage over the last two decades, and now the COVID-19 pandemic, has demonstrated that we need to increase the number of physicians to ensure we can care for patients in the near-term and in the future.” Michael Dill, the AAMC’s director of workforce studies speaks that “in addition to training more physicians, there should also be better use of technology, including training doctors and staff on how to use it to improve care and reach underserved populations”.
As seen from above, when there is a shortage of doctors at home, it’s not feasible to send native doctors to foreign medical missions for a long time. Here, Cuba triumphs without difficulty because there is no shortage of doctors at home, as the medical education in the country is state-subsidised and the profession is viewed as a lucrative opportunity in a socialistic society. It can be argued that the US is one of the largest donors for global aid against severe diseases, however, when we speak of diplomacy, people-to-people contact also plays a major role, and leaves a long-lasting impression.
In the midst of pandemic, the US refused to take part in a global vaccine conference, and terminated its relationship with the World Health Organization. According to Devi Sridhar, a global health professor at the University of Edinburgh, “’Trump needs to find an easy target to deflect blame from the abysmal US response to the pandemic and the George Floyd outrage, and WHO is an easy target”. Tim Evans, Director of the School of Population and Global Health at McGill University, and former Director of Health, Nutrition and Population at the World Bank said in light of Trump’s decision that “in times of crisis, real leadership is characterized by constructive engagement not destructive disengagement”.
Cuba has engaged in health diplomacy with countries without considering their form of government or global outlook. Take for example Italy, currently being ruled by a right-wing government, which also took medical support from communist China. In times of pandemic, there is a need for cooperation, instead of competition and criticism. The latest actions by Donald Trump just to gain some petty political gains before the US elections are against the interests of common American citizens. The US should reconsider its role in health diplomacy, as it’s not the right time to pull out from global health engagement, rather it’s time to lean in.