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Millennium Development Goals in Cuba

School in Cuba © Flora Bertizzolo

Cuba has an international reputation for delivering human development results which punch way above the country’s modest economic weight. Supported by relatively high spending priorities for education, health and social welfare, Cuba has already attained three of the Millennium Development Goals (MDGs) and is considered likely to achieve the others before 2015. Universal primary education was reached in the 1990s for both boys and girls and, according to government statistics, child mortality is the lowest in Latin America. Women play a full role in society, holding 66% of professional and technical jobs, 36% of seats in parliament - and 49% of judges are women.

There are however faultlines in the generally positive picture for social welfare in Cuba. MDG 8 (global partnership for development) places an obligation on richer countries to create an international environment which addresses world poverty, including a “non-discriminatory trading and financial system”. The US embargo which denies Cuba access to international trade and credit is diametrically opposed to this goal. Although agribusiness lobbies in Congress have led to concessions for some single states to export limited amounts of food to Cuba, the embargo creates a shortage of affordable protein which, together with domestic inefficiencies in food production and lack of water, renders food security somewhat uneven on the island. The World Food Programme assists as many as 770,000 beneficiaries, mostly vulnerable schoolchildren and women in the poorer eastern provinces.

Health and HIV/AIDS in Cuba

Cuban school children © Flora Bertizzolo

Thanks to its free and widespread national health system, Cuba enjoys much better indicators than neighbouring countries, the US included. Community participation in public health is at the foundation of the system. All strata of society are involved when health emergencies occur, as in the last outbreak of dengue fever in 2006, to an extent virtually impossible elsewhere.

Similar resolve was invested to combat the surging epidemic of HIV/AIDS in the 1980s when Cuba implemented the much debated sanatorium policy. All HIV+ individuals were compelled to reside in sanatoriums where good living conditions were provided in exchange of being “quarantined”. HIV prevalence is still less than 0.1%, mostly concentrated in the stigmatized group of men having sex with men. Despite this prevalence being much lower than in the rest of the Caribbean, the Global Fund has been financing a widespread prevention and support programme (entitling all people living with HIV/AIDS to free antiretroviral therapy), in order to prevent any revival in incidence as occurred in the newly independent countries of Eastern Europe and the Soviet Union.

Hugo Chávez and Fidel Castro © Radio Netherlands Wereldomroep

Cuba also provides medical assistance to other developing countries, by sending as many as 30,000 national staff to the field and by granting scholarships to foreign medical and nursing students who make a commitment to future work in disadvantaged communities – this scheme even attracts US students. These specialised health services have an economic as well as social mission being provided typically in exchange for commercial goods, especially oil from Venezuela.

Whilst the number of trained medical staff per capita in Cuba is unquestionably high, this strategic allocation of doctors and their expertise to the country's import/export requirements is far from neutral in its consequences. Extravagant and prioritised treatment for rich foreign patients exposes divides which contradict Cuban values. The quality of local health services suffers from a chronic shortage of drugs and medical equipment, especially in the provinces, as well as staff fatigue due to low salaries which compel even doctors to engage in secondary jobs. These problems need to be addressed if Cuba is to retain its hard-earned reputation for health provision.
Conflict between Cuba and United States

Since 1959 when Fidel Castro overthrew the US-backed leadership in Cuba and replaced it with a communist government, the US has single-mindedly endeavoured to bring about the downfall of the Castro regime. None of their methods has yet proved successful; not the economic sanctions, nor the expensive production of Radio and TV Marti, nor even the CIA’s bungled assassination attempts.

Another method is enabled by the US Cuban Adjustment Act which provides favourable treatment to illegal Cuban immigrants. They become entitled to permanent residency if they touch US soil and if they declare themselves to be political refugees. This has fostered the balseros boat people who cross the Straits of Florida in defiance of tough Cuban laws to discourage them. This tug-of-war between the two countries has created many tragic family circumstances which raise human rights concerns.

Since the 1960s in varying degrees the US has enforced an economic, commercial and financial embargo against Cuba and in addition taken unpopular steps through the Helms-Burton Law to impose similar restrictions on non-US businesses. The “blockade”, as the Cubans call it, has fundamental consequences for the national economy and is responsible, according to the Cuban government, for all the problems on the island.

The international community views the US persecution of Cuba as outdated anti-communism and inconsistent with its toadying to other unsavoury regimes. Every year the overwhelming majority of the UN General Assembly approves a resolution condemning the embargo.
Politics in Cuba

Fidel Castro © Radio Netherlands Wereldomroep

Such sympathy for Cuba is not intended as an endorsement of its political structure. The country is a one-party system governed by the dominant personality of Fidel Castro, unopposed since 1959. He is the President of the Council of State and President of the Council of Ministers, the Commander in Chief of the armed forces, as well as first secretary of the Cuban Communist Party, the only party allowed and whose last congress was held in 1997.

Downtown Trinidad, Cuba © Flora Bertizzolo

Political institutions in Cuba share many characteristics with the communist model. Participation in public life is more or less compelled for all through a combination of grassroot organisations, such as workers’ councils or Committees for Defence of the Revolution (CDRs), and vast national membership bodies such as the Cuban Women’s Federation. The CDRs administer or, more pragmatically, control small local districts, from civil defence to social activities. They lie at the bottom of a capillary political structure, selecting candidates for municipal councils from which it is possible to rise through the political hierarchy by a combination of supervised selection and popular vote. The process is extremely complex, with no explicit role for the Communist Party, and its adherents claim democratic credentials not always present in more familiar western models.

Nevertheless at the highest level of The National Assembly (the parliament) opposition voices are conspicuous by their absence. Members of the Assembly elect the Council of State which carries executive power and chooses Ministers and the Head of State. As the National Assembly meets only twice a year, the true legislative power is held by the Executive which exercises it through decrees.

Until July 2006 politics in Cuba had been epitomised by the unique figure of Fidel Castro, one of a handful of instantly recognisable world leaders and whose endless, eloquent, figurative speeches regulated all aspects of Cuban society, from international relations to the way of cooking rice and beans. With the onset of Castro’s declining health, his younger brother Raul is currently acting as interim President, in parallel to much international speculation as to whether the time is near for major change for Cuba. However, Fidel Castro has been nominated as a candidate for National Assembly elections due in early 2008, in theory opening the way to his re-election to the Council of State and President.
Human Rights in Cuba

The Nobel laureate writer Gabriel Garcia Marquez, a long term supporter of the Cuban revolution, once said that human rights are respected in Cuba concerning health, education and social security; on the other hand, civil rights – freedom of expression, assembly and travel - are not respected. This statement may well summarise the government’s attitude. Political opposition is stifled and eventually sanctioned by imprisonment, there being no independent judiciary. More than 300 dissidents are currently in jail and access to them is denied to the International Committee of the Red Cross. Local human rights groups are refused any status and Amnesty International has not been allowed into Cuba since 1988.

In May 2006 a total of 135 countries out of 191 voted for Cuba to be a member of the newly established UN Human Rights Council, despite vociferous protests of several international human rights groups. Pouring oil on troubled waters, the new Council in June 2007 ordered an end to special UN investigations into human rights violations in Cuba. The decision was presented by Cuba as international recognition of its leadership as current president of the Non-aligned movement and as an alternative to US-led politics. By contrast Cuba did allow a visit during 2007 from the UN Special Rapporteur on the Right to Food.

The US has created its own bed of nails on human rights in Cuba. It assiduously promotes annual UN resolutions condemning human rights violations by the Cuban government, seemingly unaware of the irony of its own notoriety for abuses conducted within an area of Cuban territory held on a disputed long lease – Guantánamo Bay.
Information and Media in Cuba

Cuban journalist Guillermo Farinas on hunger strike © Cubanacán Press / Committee to Protect Journalists

Ranking 165/169 in the 2007 Press Freedom Index, Cuba is the world’s second largest prison for journalists, with 24 incarcerations. Freedom of expression is constitutionally forbidden in Cuba. All media is state-controlled, cultural magazines included. Access to the internet is restricted to selected users such as medical doctors who are allowed a few hours per month. Only private enterprises and Cuban institutions linked to international partners for cultural or professional reasons are connected to the World Wide Web. In order to get in touch with relatives abroad, mainly in Miami and Spain, private homes illicitly seek out a “black market” providing internet access.
The Economy in Cuba

Cuban agriculture

Cuba is one of the last socialist command and control economies in the world. The inefficient and heavily centralised infrastructure suffered a crisis when longstanding Soviet economic assistance abruptly ended after the fall of the Berlin Wall. From 1989 to 1993 Cuban GDP fell 38%, with agricultural outputs decreasing 52%.

Street in Youth Island, Cuba © Flora Bertizzolo

The collapse led to years known as the “special period in peacetime” which brought structural change and the creation of limited market reforms: the free circulation of the dollar (until 1994 dollar holders were incarcerated), the first joint ventures in the tourism and nickel sector and very limited and controlled forms of private entrepreneurship, including more recently the sale of surplus farm produce. Cuba progressed from an economy based on agricultural exports (mainly sugar) to a service economy with tourism as the main provider of hard currency, alongside overseas remittances.

For their everyday needs Cubans must employ a variety of resources of which conventional wages are of least value. Basic subsistence is underpinned by the state through a ration book which provides a mix of free or subsidised provisions, mainly food. Workers are paid in Cuban pesos to a value of no more than $10-$20 per month; even professionals are paid within this range. Furthermore, only limited consumer items are available in this currency and all imported goods (food, toiletries, clothes, etc.) have to be bought in hard currency. This dual economy has greatly exacerbated social differences and fostered illicit ways to obtain hard currency such as prostitution. Raul Castro's term as interim president has been notable for his public acknowledgement that Cuba's wages are insufficient to meet essential living requirements.
The Environment in Cuba

Vinales view, Cuba © Flora Bertizzolo

Ironically the 1990s crisis had a positive impact on the environment. Imported chemicals and oil were drastically reduced, or eliminated. This boosted organic agriculture and made industry less polluting. On the other hand, the lack of maintenance (due to lack of imported spare parts) made sewage treatment plants inoperative. Nowadays the water and sewer networks are in shambles and forests are logged for firewood. Despite government commitment to reforestation and environmental sustainability, desertification is becoming evident in some eastern regions.

In 2006 Cuba launched the “year of the energy revolution”, an awareness campaign to limit energy consumption in a country where black-outs are so common as to be included in jokes. The initiative featured distribution of energy-saving light bulbs and subsidised sales of new-generation electronic devices.



Flora Bertizzolo MA, MPH spent two years in Cuba working with an NGO in the field of public health and child protection. She now works in Algeria in nutritional support and gender issues.

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