The U.S. State Department announced on Thursday a program of 61.5 million dollars to help Caribbean governments hire healthcare professionals directly and transparently, ensuring that salaries go entirely to the workers and not to state intermediaries.
The announcement was made during the U.S.-Caribbean Dialogue held in Washington, chaired by Under Secretary of State Christopher Landau on Wednesday, October 15, with high-level delegations from 15 countries in the region, including Jamaica, Belize, Barbados, Trinidad and Tobago, and Haiti.
The program is called ASPIRE (Strategic Alliance of the Americas for Independent Regional Health Excellence) and, according to the State Department, aims for Caribbean governments to develop self-sufficient health workforces through ethical hiring and fair compensation paid directly to each professional.
The funding still requires approval from the U.S. Congress, so the announcement represents a political commitment, not funds that have already been disbursed.
ASPIRE is part of a broader diplomatic offensive against the model of Cuban medical missions, which Washington, the Inter-American Commission on Human Rights (IACHR), and various human rights organizations classify as forced labor and human trafficking.
According to documented reports, the Cuban regime retains between 60% and 97.5% of the payments made by recipient countries for each professional, generating an annual revenue of between $5 billion and $6 billion, according to estimates from the organization Prisoners Defenders.
In April 2026, the IACHR published a 199-page report based on testimonies from 71 professionals in 109 countries, recommending that American states withdraw from the Cuban medical missions program.
Throughout 2026, at least ten countries in the region canceled or did not renew their agreements with Cuba: Jamaica, Guatemala, Honduras, Guyana, Antigua and Barbuda, the Bahamas, Dominica, and Grenada, among others.
The most emblematic case was that of Jamaica, which terminated an agreement that had been in force since 1976 in March, prompting Cuba to withdraw 277 professionals from the island.
Jamaica subsequently enabled the direct and individual hiring of Cuban doctors under its local labor legislation, a model that ASPIRE aims to finance and replicate throughout the region.
In July, the U.S. sanctioned the Cuban Minister of Health, José Ángel Portal Miranda, and the Central Unit for Medical Cooperation, describing the program as "forced labor" and "human trafficking."
Meanwhile, Belize continues to postpone its decision regarding the future of the 92 Cuban professionals who make up its medical brigade.
ASPIRE is part of a total package of U.S. commitments to the Caribbean that exceeds 340 million dollars, according to the State Department.
The package also includes 175.8 million for submarine cables for digital connectivity, 37 million for critical infrastructure and the fight against illegal fishing, and 66 million for security cooperation and combating drug trafficking.
The dialogue fulfills the commitment that Secretary of State Marco Rubio made to the heads of government of CARICOM during their meeting in February 2026 in Saint Kitts and Nevis, and Washington has already announced that it will host a Caribbean Investment Summit in early 2027 to connect U.S. businesses and investors with partners in the region.
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