Cubas

Guatemala announced last week that it will begin phasing out its three-decade-old programme, under which Cuban doctors work in its country to fill the gap in the country’s healthcare system.

Communist-ruled Cuba, under heavy United States sanctions, has been earning billions of dollars each year by leasing thousands of members of its “white coat army” to countries around the world, especially in Latin America. Havana has used its medical missions worldwide as a tool for international diplomacy.

So why are some countries withdrawing from the programme that helps the host countries?

Why is Guatemala phasing out Cuban doctors?

Guatemala’s health ministry said in a statement that it would begin a “gradual termination” over this year.

“The phased withdrawal of the Cuban Medical Brigade stems from an analysis of the mission’s completion of its cycles,” the statement, originally in Spanish, said on February 13.

The statement added that the Cuban medical mission was meant to support Guatemala through the 1998 Hurricane Mitch, which devastated parts of Central America, overwhelmed local hospitals and left rural communities with almost no access to medical care.

“The Ministry of Health is developing a phased strategic replacement plan that includes hiring national personnel, strengthening incentives for hard-to-reach positions, strategic redistribution of human resources, and specialized technical support,” the statement said.

The Cuban mission in Guatemala comprises 412 medical workers, including 333 doctors.

The Central American country’s decision comes amid growing pressure from the United States, which wants to stop Cuban doctors from serving abroad.

The move aims to starve Cuba of much-needed revenue as a major share of the incomes earned by doctors goes to government coffers. Cuba has been facing severe power, food and medical shortages amid an oil blockade imposed by the Trump administration since January.

Guatemala is just one country which benefits from Cuban medical missions.

Over the past decades, Cuba has sent medical missions around the world, from Latin America to Africa and beyond. It began sending these missions shortly after the 1959 Cuban revolution brought Fidel Castro to power.

Castro’s communist government reversed many of the pro-business policies of Fulgencio Batista, the dictator backed by the US. The revolution ruptured ties between the two countries, with the US spy agency CIA trying several times unsuccessfully to topple Castro’s government.

Guatemala has moved closer to the US since the election of Bernardo Arevalo as the president in January 2024. He has cooperated with US President Donald Trump’s administration. Last year, Guatemala agreed to ramp up the number of deportation flights it receives from the US. The US has deported thousands of immigrants without following due process to third countries such as Guatemala and El Salvador, which are headed by pro-Trump leaders.

In November 2018, shortly after Brazil elected Jair Bolsonaro as president, Cuba announced its withdrawal from the country’s Cuba “Mais Medicos” (More Doctors) programme. Bolsonaro, who is known as Brazil’s Trump, had criticised the medical mission, deeming it “slave labour”. Bolsonaro is serving a 27-year prison sentence after he was convicted in September 2025 of plotting to stage a coup in order to retain power after his defeat in the 2022 presidential election.

Why is the US targeting Cuba’s global medical missions?

The US has deemed Cuba’s foreign medical missions a form of “forced labour” and human trafficking, without any evidence, and has a goal of restricting the Cuban government’s access to its largest source of foreign income.

US efforts to curb Cuba’s medical missions are not new. Just last year, Washington imposed visa restrictions aimed at discouraging foreign governments from entering into medical cooperation agreements with Cuba.

In February last year, US Secretary of State Marco Rubio announced that the US would restrict visas targeting “forced labor linked to the Cuban labor export program”.

“This expanded policy applies to current or former Cuban government officials, and other individuals, including foreign government officials, who are believed to be responsible for, or involved in, the Cuban labor export program, particularly Cuba’s overseas medical missions,” a statement on the US State Department’s website said.

Rubio, who is of Cuban origin, has been a vocal critic of Havana, and has pushed US policies in Latin America, including the military operation to abduct Venezuelan President Nicolas Maduro on January 3. Under Trump, Washington has pushed its focus on Latin America as part of its Western Hemisphere pivot, which seeks to restore Washington’s preeminence in the region.

Since Maduro’s abduction, the US focus has turned towards Cuba. Senior US officials, particularly Rubio, hinted that Havana could be the next target of Washington’s pressure campaign.

The US, in effect, cut off Venezuelan oil shipments to Cuba as part of a new oil blockade. Havana has faced sweeping US sanctions for decades, and Cuba has since 2000 increasingly relied on Venezuelan oil provided as part of a deal struck with Maduro’s predecessor, Hugo Chavez.

The blockade has caused a fuel shortage and, in turn, a severe energy crisis in Cuba. President Miguel Diaz-Canel has imposed harsh emergency restrictions as a response.

This has renewed US pressure on countries to phase out Cuban medical missions.

How many Cuban doctors are on missions abroad?

More than 24,000 Cuban doctors are working in 56 countries worldwide. This includes Latin American countries such as Venezuela, Nicaragua and Mexico; Africa, including Angola, Mozambique, Algeria; and the Middle East, including Qatar.

There have been occasional deployments in other countries. For instance, Italy received Cuban doctors during the COVID-19 pandemic to help overwhelmed hospitals in some of its hardest-hit regions.

Cuban doctors are crucial for Caribbean countries. They fill a significant gap in medical care amid a lack of trained medical professionals.

Have countries resisted US pressure in the past?

Caribbean countries hit back in March 2025 against the US threats to restrict visas. “We could not get through the pandemic without the Cuban nurses and the Cuban doctors,” Barbados’s Prime Minister Mia Mottley said in a speech to the parliament.

“Out of the blue now, we have been called human traffickers because we hire technical people who we pay top dollar,” Trinidad and Tobago’s Prime Minister Keith Rowley said back then, adding that he was prepared to lose his US visa.

“If the Cubans are not there, we may not be able to run the service,” Saint Vincent and the Grenadines then-Prime Minister Ralph Gonsalves said. “I will prefer to lose my visa than to have 60 poor and working people die.”

In August 2025, the US announced that it was revoking the visas of Brazilian, African and Caribbean officials over their ties to Cuba’s programme that sends doctors abroad.

It named Brazilian Ministry of Health officials, Mozart Julio Tabosa Sales and Alberto Kleiman, who had their visas revoked for working on Brazil’s Mais Medicos, or “More Doctors” programme, which was created in 2013.

Some countries are now finding ways around the pressure from Washington. For instance, this month Guyana announced that it would start paying doctors directly, rather than through the Cuban government.

A fire at a key fuel refinery in the capital comes amid Cuba’s mounting fuel emergency due to US-imposed restrictions.

A fire broke out at a key fuel processing plant in the Cuban capital Havana, threatening to exacerbate an energy crisis as the country struggles under an oil blockade imposed by the United States.

A large plume of smoke was seen rising above Havana Bay from the Nico Lopez refinery on Friday, drawing the attention of the capital’s residents before fading as fire crews fought to bring the situation under control.

Cuba’s Ministry of Energy and Mines said the fire, which erupted in a warehouse at the refinery, was eventually extinguished and that “the cause is under investigation”. There were no injuries and the fire did not spread to nearby areas, the ministry said in a post on social media.

“The workday at the Nico Lopez Refinery continues with complete normalcy,” the ministry said.

The location of the fire was close to where two oil tankers were moored in Havana’s harbour.

Cuba, which has been in a severe economic crisis for years, relied heavily on oil imports from Venezuela, which have been cut off since the abduction of the country’s leader Nicolas Maduro by United States forces last month.

US President Donald Trump has also threatened Cuba’s government and passed a recent executive order allowing for trade tariffs on any country that supplies oil to the island.

The country has seen widespread power outages due to the lack of fuel. Bus and train services have been cut, some hotels have closed, schools and universities have been restricted, and public sector workers are on a four-day work week. Staffing at hospitals was also cut back.

United Nations Secretary-General Antonio Guterres warned last week of a humanitarian “collapse” in Cuba if its energy needs go unmet.

On Thursday, two Mexican navy vessels carrying more than 800 tonnes of humanitarian aid arrived in Havana, underscoring the nation’s growing need for humanitarian assistance amid the tightening US stranglehold on fuel.

Experts in maritime transport tracking told the AFP news agency that no foreign fuel or oil tankers have arrived in Cuba in weeks.

Cuba can only produce about one-third of its total fuel requirements.

Cuba’s Deputy Foreign Minister Carlos de Cossio accused the US of carrying out “massive punishment” against the Cuban people in a post on social media Friday.

Cuba requires imports of fuel and “the US is applying threats [and] coercive measures against any country that provides it”, the deputy minister said.

“Lack of fuel harms transportation, medical services, schooling, energy, production of food, the standard of living,” he said.

“Massive punishment is a crime,” he added.

Mexico’s President Claudia Sheinbaum has said her government seeks to “open the doors for dialogue to develop” between Cuba and the US and has criticised Washington’s oil restrictions as “unfair”.

Cuba’s President Miguel Diaz-Canel has denounced what he called an attempt by his United States counterpart, Donald Trump, to “suffocate” the sanctions-hit country’s economy.

Trump signed an executive order on Thursday threatening additional tariffs on countries that sell oil to Cuba, the latest move in Washington’s campaign of pressure on Havana. The order alleged that the government of communist-run Cuba was an “unusual and extraordinary threat” to US national security.

In a social media post on Friday, Diaz-Canel said that under “a false and baseless pretext”, Trump plans “to suffocate” Cuba’s economy by slapping tariffs “on countries that sovereignly trade oil” with it.

“This new measure reveals the fascist, criminal and genocidal nature of a clique that has hijacked the interests of the American people for purely personal ends,” he said, in an apparent allusion to Secretary of State Marco Rubio, a Cuban American and a known anti-Cuban government hawk.

Cuba, which is suffering rolling electricity blackouts blamed on fuel shortages, was cut off from critical supplies of Venezuelan oil after the US abducted Venezuela’s President Nicolas Maduro and his wife in a bloody military night raid on the capital, Caracas, earlier this month. At least 32 members of Cuba’s armed forces and intelligence agencies were killed in the January 3 attack.

The US has since taken effective control of Venezuela’s oil sector, and Trump, a Republican, has issued threats against other left-wing governments in the region, promising to stop oil shipments previously sent to Cuba.

Cuba’s Foreign Minister Bruno Rodriguez on Friday declared an “international emergency” in response to Trump’s move, which he said constitutes “an unusual and extraordinary threat”.

Venezuela’s government also condemned the measure in a statement on Friday, saying it violates international law and the principles of global commerce.

Reporting from Cuba’s capital, Al Jazeera’s Ed Augustin said Trump’s announcement “is a massive psychological blow”, noting that analysts describe it as the “most powerful economic blow the United States has ever dealt the island”.

Days after Maduro’s abduction and transfer to the US, Trump urged Cuba to make a deal “before it is too late,” without specifying what kind of agreement he was referring to.

In a post on social media, Trump suggested Rubio could become the president of Cuba. “Sounds good to me!” he wrote on his Truth Social platform.

‘There’s no solution’

In Havana, residents expressed anger at Trump’s tariff threat, which will only make life harder for Cubans already struggling with an increase in US sanctions.

“My food is going bad. We haven’t had electricity since 6am,” Yenia Leon told Al Jazeera. “You can’t sleep. You have to buy food every day. There’s no solution to the power situation,” she said.

“This is a war,” Lazaro Alfonso, an 89-year-old retired graphic designer, told The Associated Press news agency, describing Trump as the “sheriff of the world” and saying he feels like he is living in the Wild West, where anything goes.

Alfonso, who lived through the severe economic depression in the 1990s known as the “Special Period” following cuts in Soviet aid, said the current situation in Cuba is worse, given the severe blackouts, a lack of basic goods and a scarcity of fuel.

“The only thing that’s missing here in Cuba … is for bombs to start falling,” he said.

Meanwhile, Mexican President Claudia Sheinbaum said she would seek alternatives to continue helping Cuba after Trump’s announcement following a decision this week to temporarily halt oil shipments to the island amid heightened rhetoric from Trump.

Mexico became a key supplier of fuel to Cuba, along with Russia, after the US sanctions on Venezuela paralysed the delivery of crude oil to the island.

Sheinbaum said cutting off oil shipments to Cuba could trigger a “far-reaching humanitarian crisis” on the island, affecting transportation, hospitals and access to food. She did not say whether Mexico would cut shipments of oil or refined products to Cuba, which ‌she said accounted for 1 percent of Mexico’s production.

“Our interest is that the Cuban people don’t suffer,” Sheinbaum said, adding that she had instructed her foreign minister to contact the US ‌State Department to better understand the scope of the executive order.

Mexico supplied 44 percent of Cuban oil imports and Venezuela exported 33 percent until last month, while some 10 percent of Cuban oil is sourced from Russia. Some oil is also sourced from Algeria, according to The Financial Times figures.

In November last year, a senior United Nations expert said the long-running US sanctions on Cuba must be lifted as they are “causing significant effects across all aspects of life”.

The US imposed a near-total trade embargo on Cuba in 1962, with the goal of toppling the government put in place by Fidel Castro after he took power in a 1959 revolution. Castro himself was the target of numerous assassination attempts by the US’s Central Intelligence Agency, or CIA.

Alena Douhan, special rapporteur on the negative impact of unilateral coercive measures on human rights, said the “extensive regime of economic, trade and financial restrictions” against Cuba marks the longest-running unilateral sanctions policy in US history.

She noted that there are shortages of food, medicine, electricity, water, essential machinery and spare parts in Cuba, while a growing emigration of skilled workers, including medical staff, engineers and teachers, is further straining the country.

The accumulative effect has “severe consequences for the enjoyment of human rights, including the rights to life, food, health and development”, Douhan said.