June 18, 2025 — Belly of the Beast
The Inter-American Commission on Human Rights (IACHR), part of the D.C.-based Organization of American States (OAS), has sent a letter to member states requesting they submit information within 30 days about Cuba’s medical cooperation missions in their countries.
The move is unprecedented, according to Francesca Emanuele, senior international policy associate at the Center for Economic and Policy Research (CEPR), a Washington think tank. It also comes at a time when the Trump administration is ratcheting up its campaign against Cuban health cooperation abroad, including threats to restrict the visas of officials from other governments who have received the Cuban medical teams.
“The IACHR may be acting as an enforcer for the United States, a kind of policing arm advancing Washington’s agenda of tightening the 60-year-old blockade to try to overthrow the Cuban government,” said Emanuele, whose research is focused on the OAS. “The timing is highly suspicious especially given the context, which puts at risk public officials who are working to expand access to healthcare in their countries.”
The letter was sent on May 20 by Javier Palummo Lantes, the IACHR’s special rapporteur on Economic, Social, Cultural and Environmental Rights.
In the letter, Palummo submits a laundry list of requests for information about past and present Cuban medical missions, including details of the contracts, documentation of legal complaints and information about medical personnel who have abandoned the missions.
“To issue such a sweeping request to all countries and announce that the information will be made public seems either malicious, externally driven or dangerously naive,” said Emanuele.
U.S. Pressure On Medical Missions Bears Fruit
The IACHR letter was sent amid a U.S. government campaign to pressure other governments to stop receiving assistance from Cuban health professionals, under the guise of concern for human rights, claiming Cuban doctors are victims of “forced labor.”
However, extensive research and interviews with the doctors themselves tell a different story. While available information indicates the Cuban state takes the lion’s share of payments for the missions in most cases, the Cuban doctors and nurses volunteer for missions abroad and are paid many times more than their salaries back on the island.
The Cuban medical teams most often are posted in urban neighborhoods and remote rural areas home to the poorest of the poor. The teams have also been dispatched in response to international health emergencies such as Ebola and Covid, and natural disasters including earthquakes in Pakistan and Haiti.
Cuba has long championed health internationalism, whereby Cuban medical personnel serve on missions in other countries while thousands of students, mostly from Global South countries, study medicine for free at the Latin American School of Medicine (ELAM) in Havana.
In recent years, the missions have generated billions of dollars in revenue through agreements with host countries, making the export of medical services the government’s primary source of foreign currency. The Cuban government says the revenue is key to help fund free universal healthcare on the island.
The Trump administration’s propaganda and diplomatic arm-twisting aimed at Cuban medical cooperation, coupled with harsher sanctions, is a part of its “maximum pressure” strategy to bring about regime change via economic strangulation.
The Cuban people bear the brunt of these policies, but government officials in other countries are now feeling the pinch.
In February, Secretary of State Marco Rubio announced visa restrictions for foreign government officials – and their families – who have welcomed the Cuban medical teams. And earlier this month, Rubio announced that unnamed Central American officials had had their visas restricted.
The threats to restrict visas initially sparked outrage across the Caribbean, with several heads of government openly defying the U.S.
But some governments appear to be caving.
The Bahamas on Monday announced it would cancel contracts with Cuban doctors after its talks with Washington.
The Bahamas Health and Wellness Minister Michael Darville said his government would try to “enter into direct employment contracts” with the Cuban health personnel in the country, but indicated that such a new arrangement would need approval from the Trump administration.
“The services they provide in the country are needed, and so the [Bahamas] Ministry of Foreign Affairs is presently in discussions with their counterparts in the United States,” said Darville.
Meanwhile, Guyana is reconsidering its agreement with Cuba in response to U.S. demands.
“We are working to ensure that the people who come here from Cuba meet the definition because of what the U.S. secretary of state mentioned, that the conditions of work here don’t run afoul of the requirements set by the United States of America,” said Guyana’s Vice President Bharrat Jagdeo at a news conference.
A Tool of U.S. Policy
The OAS has long served as a tool of U.S. foreign policy, supporting U.S.-backed dictators the likes of Chile’s Augusto Pinochet and U.S.-backed armed interventions, including the 1954 coup that toppled Jacobo Arbenz, Guatemala’s democratically elected president. At the insistence of the United States, Cuba was suspended from the OAS three years after its 1959 revolution.
The U.S. lost some control over the organization during the Pink Tide of the 2000s, when South American presidents like Hugo Chavez, Evo Morales, Luiz Inácio Lula da Silva, and the Kirchners pushed back against U.S. hegemony in the region.
But in 2015, the OAS took a sharp turn to the right under the leadership of Luis Almagro, who wielded the organization to back far-right politicians worldwide, from Spain’s Vox Party to Argentina’s President Javier Milei, and to vocally support Israel even as it committed genocide in Gaza. During Trump’s first term, Almagro said a U.S. military intervention in Venezuela should not be ruled out, a position that contradicted the OAS Charter’s principles of non-intervention and respect for national sovereignty.
Almagro, who counted on strong support from the Trump administration and Cuban-American hardliners like Marco Rubio, also opened the OAS’s doors to prominent Cuban opposition figures.
One of them, Rosa María Payá, was recently nominated by Trump to join the IACHR. Payá’s organization Cuba Decide is backed by numerous groups bankrolled by the U.S. government. She has also been a vocal supporter of U.S. sanctions against Cuba, which have contributed to shortages in food, medicine and electricity.
Almagro stepped down three weeks ago, replaced by Albert Ramdin, a Surinamese diplomat who was voted in with strong support from Caribbean nations.
Even if Ramdin wants to change the course of the organization, his options may be limited given that its budget is largely subsidized by the U.S. government. The U.S. hosts the OAS headquarters and is its largest financial contributor at more than $60 million in 2024.
