Cubas

A spike in mortality

The tightening restrictions have forced the Cuban government to effectively ration care.

In February, Havana announced a package of emergency energy-saving measures. Among them was the suspension of all non-essential medical services across the island.

But non-essential does not mean unimportant. Fernandez, the paediatric anaesthesiologist, explained that preventive healthcare plays a major role in saving lives.

Under normal conditions, he said, preventive healthcare helps doctors catch potentially fatal conditions like appendicitis sooner.

But in recent months, Fernandez has observed patients arriving at his hospital in a “worsened” condition than they might otherwise have had.

“All the appendicitis cases we treat now present complications,” he said. “They demand more resources and antibiotics – supplies we don’t have.”

Deaths in Cuba have also escalated as years of increasing restrictions take effect.

Just last month, the Cuban Ministry of Public Health (MINSAP) reported that survival rates for childhood cancer dropped from 85 percent to 65 percent amid the oil blockade.

Infant mortality has also steadily climbed. In 2017, at the start of Trump’s first term, Cuba had an infant mortality rate of four for every 1,000 live births. That figure climbed to 7.7 in 2024, just before Trump’s second term, and reached 9.9 in 2025.

The maternal mortality rate similarly rose to 44.1 deaths for every 100,000 live births by the end of 2025, up from 40.6 the previous year.

Lilian Delgado, an obstetrician and gynaecologist at Cuba’s main maternity hospital, explained that the escalating humanitarian crisis has triggered a sharp rise in premature births and severe morbidity among pregnant women.

“Conditions are far from ideal at all the levels of the system,” Delgado noted. “There are shortages everywhere.”

The decision to prioritise emergency care can be deceptive. A wide range of medical procedures are considered “elective”. But just because they do not rise to the level of an emergency does not mean they are optional.

Typically, in Cuba, emergency surgeries are those that need to be urgently completed within 48 hours. Other necessary surgeries often fall into the “elective” category.

Mastectomies – a common breast cancer treatment – are among the surgeries often categorised as elective. So too are some organ transplants.

Healthcare advocates point out that, if certain elective surgeries are postponed too long, they too can result in deadly conditions.

More than 100,000 Cubans are currently on waiting lists for elective or reconstructive surgeries, a backlog MINSAP credited to the US sanctions.

Among those waiting are 5,152 cancer patients and approximately 12,000 children. Delgado said some of her patients have been languishing on such lists for months.

“Our surgical services are severely hampered by a lack of supplies,” she explained. “We have more women suffering from serious complications, and our operating rooms have become tied up with emergency cases, making it impossible to perform elective surgeries.”

Hospitals in Cuba largely have backup generators to weather the increasingly frequent power outages. But accessing even emergency medical care is tough when the fuel blockade is affecting basic services like transportation.

“Ultimately, if you have a cancer patient and cannot operate due to a number of factors – such as a nationwide blackout forcing the suspension of surgeries – then, whether you intend to or not, you are directly condemning that patient to death,” Delgado said.

The oil embargo has cost “human lives, both directly and indirectly”, she added.

Millions lost power as Cuba’s fifth nationwide blackout of 2026 hit amid a US-imposed oil blockade.

Cuba’s national power grid has collapsed, plunging the island into its third nationwide blackout in less than 10 days and leaving approximately 10 million people without electricity.

The outage began around 11am local time (15:00 GMT) on Tuesday, when the country’s entire power grid went offline, according to the state-run electricity company, UNE.

“There has been a total disconnection of the electrical system,” Cuba’s Ministry of Energy and Mines said on social media.

The latest blackout comes as Cuba faces its worst economic crisis in decades, worsened by an oil blockade imposed by the United States that has deepened fuel shortages and pushed the island’s ageing power system to the brink.

US President Donald Trump imposed the blockade in January after the United States removed Venezuelan President Nicolas Maduro from power. Venezuela had long been Cuba’s main supplier of subsidised oil, and under US pressure, Mexico also halted fuel shipments to the island.

As of 2023, according to the International Energy Agency, Cuba was producing only about 40 percent of the oil it consumed, leaving it heavily reliant on imported fuel.

The Trump administration says the measures are intended to pressure Cuba’s communist government to hold democratic elections and release what it calls political prisoners.

The repeated blackouts have fuelled growing frustration across the island. Just a week ago, scattered protests broke out across Havana, with residents banging pots and pans and shouting “turn on the lights” as millions endured another prolonged outage. In both of last week’s blackouts, it took over 24 hours to restore power across the island.

Cuban authorities have struggled for months to keep the lights on as fuel shortages and an ageing electricity grid, much of it dating back to the 1960s and 1980s, leave the system increasingly prone to collapse.

Havana blames the crisis on the US fuel blockade, while Washington says Cuba’s communist government is responsible for the country’s deteriorating power system.

Speaking at a UN General Assembly debate on US sanctions last week, US Ambassador Michael Waltz said Cuba’s leaders were to blame for the electricity shortages.

“Change your ways and turn the lights back on for your people,” he said.

June 19 (UPI) — Cuba’s parliament approved a package of 174 economic reforms in just one week, marking the most significant shift in government policy in at least 15 years. Driven by President Miguel Díaz-Canel in response to the country’s deepening economic crisis and mounting pressure from the United States, the plan approved Thursday opens the door to private capital and reshapes the rules governing the island’s economy.

Economists and analysts, however, warned that the real impact of the measures will depend on their implementation and on broader institutional changes that remain absent from the government’s plans.

Cuban economist Alfie Ulloa, a professor at the University of Chile’s Law School, told UPI the reforms represent a significant change in official rhetoric but questioned whether they will translate into meaningful change.

“They are a profound adjustment in discourse and, if implemented, would represent an important adjustment to the model. But for now they are nothing more than another declaration like many made in the past. I do not believe they will be implemented, nor that they will truly free the private sector,” Ulloa said.

The package includes 23 areas of transformation and more than 170 measures aimed at loosening state control over the economy. Among the most significant are allowing direct foreign investment in small and medium-sized private businesses, reviewing activities currently prohibited to the private sector, authorizing direct imports and exports by both state and non-state actors, granting greater autonomy to enterprises and gradually replacing broad subsidies with targeted assistance for vulnerable populations.

The reforms also eliminate broad price controls, a policy Díaz-Canel acknowledged had failed after years of inflation, shortages and expansion of the informal market.

While presenting the plan, the president admitted that part of the country’s current crisis stems from longstanding internal problems.

“There are obstacles that do not come from abroad or from the embargo. There is bureaucracy, delays, regulations that prevent people from producing and decisions that we have postponed,” Díaz-Canel said.

The proposal amounts to an implicit acknowledgment of economic policy failures that Cuban authorities had largely attributed to the U.S. embargo for decades. Analysts noted that several of the measures had been debated previously and rejected by the country’s communist leadership.

Many of the initiatives mirror reforms introduced decades ago in China and Vietnam, although they arrive as Cuba faces one of its worst economic crises since the collapse of the Soviet Union.

Cuban economist Mauricio de Miranda, a professor at the Pontifical Xavierian University in Cali, Colombia, argued in social media posts that the program points toward a transition from bureaucratic socialism to a form of capitalism controlled by political elites.

“It will become the fast track for relatives and close associates of those in power to become shareholders without anyone knowing where their capital came from,” he warned.

De Miranda said Cuba will inevitably need to privatize part of its state-owned assets to attract investment and rebuild its struggling economy. However, he argued that the process lacks the institutional safeguards needed to prevent wealth from being concentrated among groups close to the government.

“Something like this would require a capital market with clear rules, transparency and equal opportunity,” he said.

Questions about legal protections for investors have also emerged as a central criticism.

“None. Cuba is not a state governed by the rule of law. Citizens are completely defenseless before the state,” Ulloa said when asked about protections for potential investors.

He added that investing in Cuba remains highly risky because government power faces few constraints and judicial institutions lack independence.

Cuban economist Pedro Monreal also criticized the process, questioning the secrecy surrounding the package in a lengthy post on X.

“It should not be surprising that the first act of the ‘transformation proposals’ show has reaffirmed public frustration over the secrecy of those proposals,” Monreal wrote.

Monreal also pointed to the failure of the so-called “Monetary Reorganization Task,” a 2021 reform that eliminated the country’s dual-currency system but became associated with surging inflation and declining purchasing power. He argued that experience severely undermines the credibility of the new package.

Despite the skepticism, several specialists acknowledged that some measures could help address urgent problems if fully implemented.

Ulloa said a genuine opening to private investment, particularly from Cubans living abroad, could help revive agriculture, services and food production. He cautioned, however, that critical sectors such as energy, infrastructure, transportation and banking require investment levels that are unlikely to materialize in the near term.

The Cuban government said Thursday that former President Raúl Castro explicitly endorsed the reforms and expressed full support for the package, describing it as what “best serves the Revolution today.”

For critics, that endorsement highlights one of the process’ central contradictions.

The measures acknowledge problems that independent economists have identified for years, yet leave intact the political structure that many blame for creating the crisis.

“The most important point from my perspective is that we are not talking about deep reforms within a new globalized economy. We are simply talking about removing obstacles,” Manuel Cuesta Morúa, vice president of the Council for Democratic Transition in Cuba, told Radio Martí.

He said the reforms arrive too late because Cuba’s economy now operates under extensive U.S. sanctions.

According to Cuesta Morúa, progress will require political and diplomatic negotiations to make the measures viable. He argued that the package merely liberalizes some restrictions but does not yet constitute a genuine economic reform program.

He added that authorities must first address citizens’ immediate needs, create confidence through legal certainty and open Cuban society in broader ways.

Analysts agree that the central question is whether this latest reform effort will produce tangible change or join a long list of initiatives that were announced and later postponed.

Regarding the matter, Vice President JD Vance said, “Right now, we are talking with the Cuban government about how they might change their behavior to achieve that. We’ll see what they do and, obviously, if they do one thing, we’ll do another. If they make smart decisions, we’re going to have a much better relationship with that island.”

Just hours later, details of the measures emerged. For now, however, the White House has remained silent.

Former Cuban president Raul Castro made his first public appearance in Havana since being indicted by the United States on murder charges linked to the 1996 downing of two civilian aircraft. He was cheered at an event commemorating the Interior Ministry, attended by military officials and Cuba’s Olympic wrestling champion.

As Cuba heads into another month of blackouts due to the near-total fuel blockade imposed by the US, many say their lives now revolve around these power outages.

For Ana Rosa Romero, a 70-year-old widow living in a high-rise building, the constant power cuts have transformed her daily life.

BBC’s Will Grant spoke to her about the impact of the blackouts.

Video edited by Blanca Estrada