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The Cuban Foreign Minister Bruno Rodríguez Parrilla published a statement on Tuesday condemning the United States government, accusing it of exerting fierce pressure and blackmail on Latin American countries to expel Cuban medical brigades, openly acknowledging that Washington's goal is to "continue cutting off sources of income for our economy".
The message from the Minister of Foreign Affairs, published on his social media, comes after a wave of contract cancellations with Cuban medical brigades in the region during the early months of 2026.
Honduras did not renew its agreement upon its expiration on February 25, resulting in the departure of about 172 professionals. Guatemala ended an agreement in February that had been in place since 1998, withdrawing 412 workers, including 333 doctors.
Jamaica notified on March 4th of the unilateral termination of its agreement —in effect since 1976— and Cuba withdrew its brigade of 277 professionals on March 6th. Guyana also withdrew more than 200 Cuban doctors after 50 years of cooperation.
"No only do they aim to undermine the humanistic and solidarity program established by Cuba and Fidel, and continue cutting off sources of income for our economy. They punish the most disadvantaged peoples and communities in the region, which for decades have received Cuban medical assistance. In return, they promise resources that we know will never arrive nor benefit those populations," wrote Rodríguez Parrilla.
The chancellor's statement is revealing: by invoking the regime's "sources of income," it implicitly acknowledges what Havana has always tried to disguise as humanitarian solidarity.
Medical missions are, in practice, the main export business of the Cuban dictatorship. According to the National Office of Statistics and Information (ONEI), they generated 4.882 billion dollars in 2022, and the U.S. Department of State estimates that they contribute between 6 billion and 8 billion dollars annually to the regime's coffers.
The business model is what has fueled the international accusations: the Cuban government collects the full contracts and retains between 70% and 85% of doctors' salaries.
This is compounded by the confiscation of passports, constant surveillance, and the threat of an eight-year ban on returning to Cuba for those who leave the mission.
The European Parliament has described these conditions as "modern slavery." The U.S. official Jeremy Lewin was even more direct this month by labeling them "one of the worst examples of modern slavery."
The diplomatic offensive from Washington against the brigades intensified with the arrival of Marco Rubio as Secretary of State in January 2025. Rubio pushed for visa restrictions on officials from countries that had contracts with Cuba and progressively extended the sanctions to Brazil, African countries, Grenada, Honduras, and Guatemala.
In August 2025, the measures also targeted former executives of the Pan American Health Organization due to their ties to the Brazilian program Mais Médicos.
Cancellations occur at the worst time for the Cuban economy: the GDP has contracted by 11% in five years, with widespread blackouts and a general shortage of fuel, food, and medicine.
In 2025, Cuba had more than 24,000 health workers deployed in 56 countries, a scheme that the regime desperately needs to sustain its finances as the internal crisis worsens uncontrollably.
The business framework behind the Cuban medical enterprise
Far from the official narrative of "solidarity," the export of medical services operates as a highly centralized business system, where state-owned companies act as intermediaries and channel billions of dollars into the power structures of the regime.
One of the key players is the Comercializadora de Servicios Médicos Cubanos (CSMC S.A.), responsible for signing contracts with foreign governments and formalizing the dispatch of medical personnel.
However, in countries like Angola, the role of Antillana Exportadora S.A. (ANTEX) emerges more clearly, as it is directly linked to the military conglomerate GAESA.
Investigations and testimonies published by independent media reveal that ANTEX not only manages the logistics of missions but also controls payments, withholds salaries, and manages the accounts where the money generated by the doctors is deposited.
In this scheme, recipient countries can pay up to 5,000 dollars per month for a professional, but the workers receive only a fraction — between 100 and 200 dollars in cash — while the rest remains under state control.
Leaked documents have also revealed a control system that includes the retention of passports, movement restrictions, and demands for political loyalty, conditions that international organizations and experts have equated with forced labor.
The link with GAESA is crucial: this military corporation, which controls large sectors of the Cuban economy, has received hundreds of millions of dollars from these contracts, consolidating its role as the financial backbone of the regime.
In recent months, however, this model has begun to show signs of strain. Reports from doctors in Africa, payment cuts, and even lawsuits against ANTEX for "theft" of salaries reflect an increasing level of internal conflict.
At the same time, some countries have chosen to hire Cuban professionals directly, bypassing state mediation and weakening the regime's control over these revenues.
This context helps to understand why Havana considers medical missions a strategic “source of income”: it is not just about health cooperation, but one of the economic pillars supporting the system amid its worst crisis in decades.
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