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Cuba is facing one of the worst healthcare crises in its recent history. As hospitals collapse, pharmacies are empty, and outbreaks of dengue, chikungunya, and oropouche spread across nearly the entire country, the Minister of Public Health, José Ángel Portal Miranda, remains silent.
There are no press conferences, no public appearances, no clear explanations. The man responsible for ensuring the health of eleven million Cubans has vanished from the news radar just when the country needs answers the most.
The absent minister
In any democratic nation, an official with such responsibility would be stepping forward daily, providing figures, measures, and evaluations. In Cuba, however, the head of MINSAP seems to be holed up behind the epidemiological reports that barely inform the essentials.
Portal Miranda, which in July acknowledged before the National Assembly that the healthcare system is facing an “unprecedented structural crisis”, has chosen to remain administratively silent, as if omission were a strategy.
In recent weeks, it has been the deputy ministers and provincial directors of MINSAP who have come forward to make statements regarding the spread of dengue, chikungunya, and oropouche.
Carilda Peña García, Deputy Minister of the sector, provided partial reports acknowledging active transmission in almost all provinces; Dr. Francisco Durán, National Director of Epidemiology, has taken on the role of almost permanent spokesperson for the crisis.
But from Portal Miranda, nothing: no appearances, no interviews, no public explanations. His silence is already, in itself, a response — and a symptom — of the political and moral paralysis that dominates the country's health management.
His last public appearance was in mid-October, when he downplayed the dengue outbreak and stated that “the situation was under control”.
During a meeting held in Matanzas, Portal Miranda claimed that there had been no reported deaths from dengue or chikungunya, despite citizen reports mentioning deaths, healthcare system collapse, and an increase in fever cases in the province.
The head of MINSAP described the reports of deaths as “rumors” and clarified that the circulating illnesses “are neither new, nor rare, nor unknown”.
Since then, infections have increased, hospitals are overwhelmed, and citizen complaints are multiplying. Doctors without supplies, children hospitalized in hallways, endless lines to obtain painkillers or injections: that is the reality of the country today.
Meanwhile, the MINSAP publishes ambiguous statements and incomplete statistics. It is unclear how many patients there really are, how many have died, or which areas are the most affected.
The lack of transparency is so evident that every week different versions emerge about the magnitude of the crisis, while the authorities urge calm and patience from an exhausted population.
The crisis of combined arbovirus diseases
The current health emergency has a name and a vector: the mosquito. What were once isolated outbreaks of dengue has transformed into an explosive cocktail of combined arboviral diseases —dengue, chikungunya, and oropouche— which are overwhelming hospitals and putting health services at risk.
Experts warn that the co-infection of multiple viruses in the same patient worsens the clinical picture and increases the risk of fatal complications, especially among children and the elderly.
However, the official response remains the same: empty speeches about “focus control” and calls for “individual responsibility.” The state that boasted for decades of having a “medical power” now delegates the elimination of breeding sites to the neighbors, while trash accumulates and fumigation brigades operate without fuel or insecticides.
The minister himself acknowledged in July that only 30% of the essential medicine list is available. This means that the majority of treatments for fighting fever, pain, dehydration, or secondary infections simply do not exist in the state pharmaceutical network.
The sick must turn to the black market or rely on packages from relatives abroad. The result: inequality, desperation, and an alarming increase in preventable deaths.
A system without answers
The silence of Portal Miranda is not only political; it is morally unacceptable. In a country where health authorities control all data and resources, their absence amounts to a denial of the citizens' right to know.
Where is the public report with the actual number of infected individuals? What budget has been allocated for fumigation, epidemiological surveillance, and the purchase of medications? What measures are being taken in the most affected areas? No one knows.
The minister should be explaining to the Cubans why there are no medications in pharmacies, supplies for fumigation, mosquito nets in hospitals, repellents in homes, why diagnoses are delayed for weeks, or why doctors are working without basic materials. But he doesn't.
Instead, the regime repeats the same old script: blaming the "U.S. blockade", talking about "adverse weather conditions," and appealing to the "resilience of the people."
Díaz-Canel, the continuity of impunity
The question many are asking goes beyond the minister: why does Miguel Díaz-Canel keep him in office?
The response is political. Portal Miranda represents obedience, not competition. Its existence confirms that the Cuban healthcare system is not managed as a citizen's right, but rather as a resource for generating foreign currency, propaganda, and control.
Public health has become an empty showcase for Cubans and a lucrative business for the regime's elites: while doctors and vaccines are exported, the people suffer from lack of care.
Díaz-Canel recently called to "face arboviruses as we faced COVID-19." However, during the pandemic, his government concealed statistics, persecuted critical doctors, and manipulated data to project an image of success.
The same tactic is being repeated now: downplaying the severity, censoring the independent press, and maintaining a narrative of "controlled situation" that no one believes anymore.
Transparency, accountability, and responsibility
Cuba urgently needs transparency. The MINSAP must publish detailed epidemiological reports, province by province, with actual figures of cases, deaths, and resources. It must be accountable to the public and the medical community, not to the Communist Party. Opacity kills. And with each passing day without information, the number of victims increases.
A public audit on the use of the healthcare budget is also essential. How much is spent on vector control? How much on medical tourism? How much on propaganda? Accountability cannot be a privilege of free countries; it is a moral obligation of any government, especially one that prides itself on humanism.
José Ángel Portal Miranda and Miguel Díaz-Canel must be held accountable for this catastrophe. They can no longer hide behind the rhetoric of the embargo while children die due to lack of reagents and medications, the elderly suffer without treatment, and the Cuban public health system collapses.
Towards a humanitarian intervention?
The magnitude of the disaster raises an uncomfortable question: Has the time come to request international humanitarian intervention?
When a country cannot guarantee minimum health conditions, when epidemics spread uncontrollably, and the state lacks the capacity—or the will—to respond, the international community has a duty to act. This is not about politics; it is about human lives.
Organizations such as the Pan American Health Organization, the Red Cross, or the WHO must urgently assess the epidemiological situation in Cuba. If the regime does not allow for an independent inspection, its silence will be evidence of guilt.
Cuba can no longer continue dying in the dark.
Cubans deserve to know the truth, they deserve to be taken care of, they deserve to live.
And if their authorities are unable to protect them, the world has a moral obligation to do so.
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