The challenge presented by the COVID-19 pandemic has thrust Cuba and its medical internationalism into the spotlight. Australia should take note if it wants to make significant inroads with its South Pacific neighbours and enhance its presence in the region.
Internationalism has been a significant feature of Cuban foreign policy since the 1959 socialist revolution. Cuba provides generous assistance to fellow nations of the Global South, chiefly in the education and healthcare sectors. This phenomenon has historically had a strong ideological dimension, with the Cuban leadership considering the island’s humanitarian efforts an expression of the revolution’s humanistic worldview. In line with this outlook, Cuba has offered assistance to many Global South nations irrespective of their financial situation, including some of the poorest and most remote countries on Earth – examples include Guinea-Bissau, Kiribati, and Haiti.
Cuban aid projects focus chiefly on healthcare and education in a bid to universalise access to these rights, which are deemed inalienable by the Cuban government. Cuban assistance has also cemented mutually beneficial relationships with a number of resource-rich nations, such as Venezuela and Angola. Since 2005, collaboration with wealthier countries has added a pragmatic dimension to the island’s internationalism. Indeed, a lack of natural resources and trade potential, coupled with Cuba’s significant investment in human capital, has made medical internationalism both viable and logical as a means of establishing and strengthening bilateral relationships.
Cuba’s so-called “doctor diplomacy” draws its strength from the island’s domestic public healthcare system, which has received international acclaim for decades, including from the World Health Organization. Cuba operates centrally funded and coordinated services, has an excellent medical education program, and boasts the world’s best patient-to-doctor ratio at 155:1. This allows the island to dedicate some 30,000 medical personnel to international projects without significantly burdening the domestic health system. Moreover, Cuba’s emphasis on a preventative medicine in its healthcare system is a relatively cheap and resource-light approach to medical care. This strategy is easily adapted to other Global South nations receiving Cuban assistance.
Cuban medical internationalism has been particularly notable in the context of the COVID-19 pandemic. One of the first foreign states to receive Cuban medical teams in the fight against coronavirus was Italy, a far wealthier state that should have been better prepared to confront the threat posed by COVID-19. However, when Italy’s privatised health system proved unable to adequately protect the nation’s citizens, a request for aid by the Lombardy regional government was promptly answered with 52 medics provided by Cuba. So vital was this Cuban assistance in mitigating both the spread of COVID-19 and its associated casualties that the Piedmont Regional Council granted all Cuban medics operating in Lombardy awards for civil merit.
Italy is just one of many countries to benefit from Cuban medical assistance during the pandemic. Over 30 countries across Africa, Latin America, and Eurasia have received Cuban medical teams and other forms of assistance to confront COVID-19. This is in addition to the doctors and nurses from Cuba already engaged in medical projects around the world. Cuba’s initial robust domestic handling of the COVID-19 pandemic, coupled with the wide availability of medical professionals, enhanced the island’s capacity to respond to international calls for assistance. While cases have increased dramatically in 2021, Cuba’s case load and death rate still sit below the world average, and that of Latin America. There has been little indication that Cuba’s domestic COVID-19 surge has hampered the island’s medical missions abroad – many are now in the process of concluding, given that they began last year, and those Cuban medical teams still operating abroad against COVID-19 haven’t had their programs cut short.
Decades of investment in medical science and the pharmaceutical industry by the Cuban government have permitted an effective response to COVID-19, and simultaneously given the island the capacity to assist other nations in vaccinating their populations. Five domestic vaccine candidates have been developed in Cuba. Two, Abdala and Soberana 02, have been approved for international use and are being offered to those nations unable to afford other, more expensive doses. To date, Venezuela, Iran, Mexico, Vietnam, and Nicaragua have approved the Cuban vaccines for use. Meanwhile, Cuba’s domestic vaccination campaign has become one of the quickest in the world. As of late September, almost 80 percent of the population had received at least one dose, including children as young as two years. The inclusion of children this young in the vaccination campaign is a world first.
Cuba, a small, poor, and isolated nation, has had a disproportionately positive impact on the global fight against the COVID-19 pandemic, made possible because of its well-funded universal public healthcare system and highly trained personnel. Australia’s healthcare system shares many of these characteristics, with the added advantage of far greater financial resources compared to Cuba. Yet at the regional level, Australia has been an inconsistent and often inadequate source of support for its Pacific neighbours during the pandemic. Pacific Island nations have suffered acute economic hardship over the past two years, and while Australia has continued to render assistance within the framework of its existing foreign aid mechanisms, little else is being offered to the Pacific Islands. For example, the initial $100 million of “quick financial support” set aside to address pandemic-related issues in the Pacific was taken out of Australia’s already meagre aid budget for the region. While this was later supplemented with an additional $305 million, a total decrease of $188 million in the aid budget between 2020-2022 has made this contribution far less generous than it first appeared.
Cuba demonstrates that there is little to lose and much to gain for Australia in pursuing strong foreign aid policy. Enhanced Australian medical outreach in the Pacific would build goodwill with the region, particularly given recent tensions with Pacific Island states over issues such as climate change. Greater engagement in the Pacific would enhance existing relationships and potentially lead to new political and business opportunities for Australia, as it has for Cuba. In doing so, Australia would be assisting neighbours where it is needed most right now.
Sasha Gillies-Lekakis is an Honours Student in Spanish and Latin American Studies at the University of Melbourne, focussing on Cuban development assistance in the Global South. Sasha is passionate about Cuban history and politics and has lived and studied in Havana as a part of the Consortium for Advanced Studies Abroad (CASA) scholarship program.
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