Fuelingla Rev.Brotherton

Nueva Sociedad, 2008

Le Monde Diplomatique (English), 2020

Just weeks ago, in late February 2020, US Democratic Senator Bernie Sanders was vilified by the US establishment for acknowledging education and healthcare achievements in revolutionary Cuba. Now, as the SARS-CoV-2 pandemic sweeps the globe, the island’s medical prowess is back in the spotlight, first because the Chinese National Health Commission listed the Cuban anti-viral drug Interferon alfa-2b among the treatments it is using for Covid-19 patients. Effective and and safe in the therapy of viral diseases including Hepatitis B and C, shingles, HIV-Aids and dengue, the Cuban anti-viral drug has shown some promise in China and the island has now received requests for the product from 45 countries. Then, on 21 March a 53-strong Cuban medical brigade arrived in Lombardy, Italy, at that time the epicentre of the pandemic, to assist local healthcare authorities. While images spilled out over social media, little was said in mainstream outlets. The medics were members of Cuba’s Henry Reeve Contingent, which received a World Health Organisation (WHO) Public Health Prize in 2017 in recognition for providing free emergency medical aid. In addition to Italy, Cuba sent medical specialists to 37 of the 59 countries in which their healthcare workers were already operating, to treat Covid-19 cases.

Cuban Studies, 2011

Medical diplomacy, the collaboration between countries to simultaneously produce health benefits and improve relations, has been a cornerstone of Cuban foreign policy since the outset of the revolution fifty years ago. It has helped Cuba garner symbolic capital (goodwill, influence, and prestige) well beyond what would have been possible for a small, developing country, and it has contributed to making Cuba a player on the world stage. In recent years, medical diplomacy has been instrumental in providing considerable material capital (aid, credit, and trade), as the oil-for-doctors deals with Venezuela demonstrates. This has helped keep the revolution afloat in trying economic times. What began as the implementation of the one of the core values of the revolution, namely health as a basic human right for all peoples, has continued as both an idealistic and a pragmatic pursuit. This article examines the factors that enabled Cuba to conduct medical diplomacy over the past fifty years, the rationale behind the conduct of this type of soft power politics, the results of that effort, and the mix of idealism and pragmatism that has characterized the experience. Moreover, it presents a typology of medical diplomacy that Cuba has used over the past fifty years.

Revolutionary Medicine is a richly textured examination of the ways that Cuba's public health care system has changed during the past two decades and of the meaning of those changes for ordinary Cubans. Until the Soviet bloc collapsed in 1989, socialist Cuba encouraged citizens to view access to health care as a human right and the state's responsibility to provide it as a moral imperative. Since the loss of Soviet subsidies and the tightening of the U.S. economic embargo, Cuba's government has found it hard to provide the high-quality universal medical care that was so central to the revolutionary socialist project. In Revolutionary Medicine, P. Sean Brotherton deftly integrates theory and history with ethnographic research in Havana, including interviews with family physicians, public health officials, research scientists, and citizens seeking medical care. He describes how the deterioration of health and social welfare programs has led Cubans to seek health care through informal arrangements, as well as state-sponsored programs. Their creative, resourceful pursuit of health and well-being provides insight into how they navigate, adapt to, and pragmatically cope with the rapid social, economic, and political changes in post-Soviet Cuba.

Healthcare Policy | Politiques de Santé, 2008

About 40 years ago, Thomas McKeown demonstrated that the historic decline in the great killer diseases owed little or nothing to progress in medicine. A generation of research on population health followed, highlighting the large social gradients in health within populations. These vary greatly across societies, but appear largely unrelated to medical care. Medicine was acknowledged as "powerful, but within limits"; the major determinants of health lie elsewhere. We may have missed something. Cuba has achieved "first world" population health status despite a minimal economic base. Far from marginalizing medicine, Cuba has by far the world' s largest physician workforce. But doctors' roles are significantly expanded. The system seems to work.

Since 2003, Cuba has dramatically expanded its decades-long program of international humanitarian missions. This article explores the political, economic, gender and racial equality dimensions of Cuba's international missions at various scales of analysis. At the macro-level, medical export services have in recent years replaced tourism as a source of hard currency in Cuba, with positive political and economic results. Their impacts on the domestic front are complex. In Cuba, health workers' devalued salaries in a dual economy are a substantive incentive to volunteer for missions abroad. The expansion of international medical missions is thus a means for health professionals-a large part of whom are female, black or mulato-who are otherwise disadvantaged in the dual economy, to improve their livelihoods. It is also re-structuring the delivery of health care in Cuban neighborhoods.

This paper investigates the formation of a public health system in modern Cuban during the years from 1959 to 1970. The goal is to identify some of the specific programs and methods that constituted the state’s public health system and to understand how those policies were related to the revolutionary ideology that inspired and defined Fidel Castro’s government. This was done by studying state discourse, including state newspapers, speeches by government officials, Ministry of Public Health publications, and doctors’ memoirs. This study showed that construction of hospitals and clinics, effective distribution of medical personnel, targetted programs against specific disease, and widespread sanitary education brought about significant gains in health outcomes for many Cubans. The study further showed that a consistent and pervasive state ideology both shaped these programs and employed them to legitimize the new revolutionary state. This case shows that public health in revolutionary Cuba is a result of both effective and innovative policies and of an ideological system that brought health entirely into the realm of state power.

The Lancet, 1980

This paper depicts Cuba as a relic of the Cold War. Its coverage of healthcare demonstrates steadfastness and success in surmounting hurdles of complacency and disregard to socialized medicine -an extension of Soviet patronage and third world alliances. The literature relays a mission of inclusivity underpinned by political ideology and a conviction to humanity. With the aid of endorsements, it speaks to contrasts and critiques in service and results by reflecting on the delivery of free healthcare for all Cuban citizens and its impression on the eradication of numerous diseases, reduced mortality rate and increased life expectancy. Punished by the longest trade embargo in modern history, the regime is in possession of limited resources to expedite remedy to its subjects. Such, much to the dislike of the authorities, elevates elements of distinction in association with the dispensation of service and drugs demonstrated by an evolving two-tier system for the disenfranchised and privileged clientele while simultaneously impacting the maintenance of facilities and equipment. Consequently, it recognizes harsh ramifications attributed to compliance with ideology and subtle adjustments to withstand external exertion. The Cuban replica is currently a tale of sorts awaiting a comprehensible definition for future generations.

Cuba in Transition, Vol. XX, 2010