The U.S. Department of State has kept Cuba at Level 3 in its 2026 Trafficking in Persons Report, the most severe category, citing that the Cuban government continues to benefit from a system of forced labor through its medical missions and other programs for hiring professionals abroad.
The report published this Thursday indicates that Cuban authorities do not meet the minimum international standards for combating human trafficking and do not make significant efforts to achieve them.
One of the main concerns from Washington is that the Cuban government retains between 50% and 95% of the salaries that recipient countries pay for the services of professionals sent abroad.
According to the document, labor exploitation is not limited to income. The Department of State also identifies practices such as passport retention, surveillance of workers, movement restrictions, curfews, and threats of retaliation against those attempting to leave missions or against their families.
These reports are part of a pattern that the United States has documented for years and which it considers incompatible with the fundamental rights of workers.
Thousands of Cuban doctors under a questioned system
According to the figures collected in the 2026 report, between 15,000 and 18,000 Cuban health professionals remain deployed in more than 50 countries, compared to approximately 24,000 recorded at the beginning of 2025.
According to estimates gathered by the Department of State, healthcare professionals make up approximately 75% of the Cuban personnel sent abroad through these programs.
Medical missions also represent an important source of income for the State. According to the latest official data available cited by Washington, the export of medical services generated 4.9 billion dollars in 2022.
The Central Unit for Medical Cooperation (UCCM), under the Ministry of Public Health, is involved in the selection and coordination of the professionals assigned to these missions.
In July, the United States sanctioned the Cuban Minister of Health, José Ángel Portal Miranda, and the director of the UCCM, Gretza Sánchez Padrón, for their responsibility in the operation of this system.
The report also addresses the allegations regarding Cubans being recruited through deceit to fight alongside Russian forces in the war against Ukraine, as well as concerns about the involvement of minors in activities related to military structures.
International pressure on Cuban medical brigades is increasing
Criticism of the model for hiring Cuban professionals has also reached Europe and Latin America.
On September 12, the Cuban Observatory of Human Rights (OCDH) requested the European Union to investigate the working conditions of Cuban doctors sent to Calabria, Italy, where more than 200 professionals are working.
The organization requested an examination of potential violations of labor rights and control mechanisms exercised over the members of the brigade.
More recently, Uruguay announced that it will pay directly to around 20 Cuban ophthalmologists, instead of transferring their salaries to the Cuban state, a decision that modifies the traditional payment scheme used in these missions.
Cuba has remained at Level 3 since 2019, when it was downgraded to that category due to concerns related to labor exploitation and medical missions.
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