Under the threat of forgoing the payment of its financial contribution, the United States, the main contributor to the PAHO budget, has forced the Secretariat of that organization to accept what is called “an external audit of PAHO’s role in Brazil’s ‘More Doctors’ Program”, which involved the participation of thousands of Cuban professionals, at the express request of the Workers’ Party’s popular government. Said Program has been the target of to the most gross disparagement campaign launched by the United States and the current Brazilian government.
The alleged concerns of the United States regarding Cuba’s cooperation, particularly about the ‘More Doctors’ Program, are neither legitimate nor relevant so as to deserve further consideration at PAHO. The ‘More Doctors’ Program, which has been audited several times before with positive results, was established by virtue of a tripartite agreement achieved between the Cuban government, the then Brazilian government and PAHO. Thanks to this program, from August 2013 to November 2018, Cuban doctors in Brazil assisted 113 000 359 patients in more than 3 600 municipalities and provided permanent health coverage to 60 million Brazilians. Thanks to this program, primary health care was expanded; health services access and offers were increased; health indicators improved and hospital admissions decreased due to the preventive work carried out by Cuban doctors.
The level of satisfaction and acceptance among patients, doctors and the Program’s managers was high. According to a survey made by the Federal University of Minas Gerais (UFMG), 95 per cent of patients said to be pleased or very pleased with the Program.
If Cuba had not been forced to withdraw its doctors from Brazil, they could have contributed to tackle and control the COVID-19 pandemic in that country, which is currently the second most affected by this disease in the world.
As was stated in the Declaration issued by the Cuban Ministry of Public Health on November 14, 2018, Cuba decided to discontinue its participation in the ‘More Doctors’ Program, in the face of the servile behavior of the Brazilian President Jair Bolsonaro, who adopted a contemptuous and threatening attitude towards our cooperation workers and, in open disregard for PAHO and the agreement reached by this organization with Cuba, imposed modifications on the terms of the Program, which led to non-compliance with originally agreed guarantees and the imposition of new conditions to the permanence of our professionals in that country, which were unacceptable.
The US government’s attempt to manipulate international and regional bodies to its will is disgusting. It is well known that the executive organs of PAHO have not adopted any single document mandating or legitimatizing the implementation of this audit or the drafting of its so-called “Terms of Reference”.
Such document was drafted by a group made up by the United States, Brazil, PAHO’s own Secretariat and Canada, where the latter acted as mediator among the parties. The height of all these arbitrary actions is that the entire auditing process is being financed from PAHO’s regular budget.
Without any mandate whatsoever, a US law firm was hired to issue an adjusted and pre-determined evaluation within a term of 180 days, in conformity with the “Terms of Reference” that the select group headed by the United States had already defined.
No one with an elemental sense of honesty, knowing the intentions and behavior of the government of the United States, or with a modicum of common sense, would ever doubt that this is a head-on attack against multilateralism; a gross politically-motivated manipulation of PAHO and an extension of the aggression against Cuba.
After the denunciation of this maneuver by Dr. Jose Ángel Portal Miranda, Minister of Public Health of Cuba, at the Fifty Eighth meeting of the Directing Council of PAHO on September 28, the statements made by the representatives of the State Department showed that the government of the United States is behind the pressures that are exerted on the Organization, against Cuba’s cooperative programs with member States of the region and the so-called “external audit” of the ‘More Doctors’ Program for Brazil. The United States went far beyond that and opposed the election of Cuba as member of the Executive Committee of PAHO, an action that failed to succeed thanks to the unanimous support that Cuba’s candidature received. During the sessions of the Council, several countries recognized and expressed their gratitude for the solidarity and cooperation offered by the Cuban medical staff to cope with the COVID-19 pandemic.
The Ministry of Foreign Affairs of Cuba denounces that a spurious and mendacious evaluation is currently in the making, promoted by and to serve the aggressive purposes of the United States, in its effort to discredit Cuba’s international cooperation.
It is unfortunate that, through this new maneuver, the US government is trying to damage Cuba’s relations with PAHO, which has historically been based on cooperation, respect, common identification of humanist goals and values and a determination to guarantee health quality services to the people. This has been the basis of a relation Cuba feels proud of.
The Ministry of Foreign Affairs of Cuba reiterates Cuba’s firm commitment to the development and sustainability of its health system for the benefit of the Cuban people and the cooperation with the peoples in the region and elsewhere in the world.
Cuba has the capacity to do it, which has been created with its own efforts. This is a reality that no one can change.
Access to health care is a human right and the United States is committing a crime when it tries to deprive millions of persons of that inalienable right.
As was expressed in the Declaration issued by the Ministry of Foreign Affairs on December 5, 2019, it is both immoral and unacceptable that the dignity, professionalism and altruism of the more than 400 000 Cuban health cooperation workers, having accomplished missions in 164 countries during 56 years, are called into question.
The tightened economic, commercial and financial blockade imposed by the United States against Cuba, whose effects are being particularly devastating in the context of the COVID-19 pandemic has not, nor will it prevent our country from sharing its scarce resources with other peoples in need in the world.
In addition to coping with the pandemic en within its borders, and guided by the humanist and fraternal vocation of our people, Cuba has reinforced its international medical cooperation by sending more than 3 800 cooperation workers, organized in 52 medical brigades, to 39 countries and territories affected by the disease. These specialists have been joined by those who were already offering their services in 59 States, prior to the outbreak of the pandemic.
As was expressed by the historical leader of the Cuban Revolution, Fidel Castro Ruz, in his Reflection of October 20, 2014 entitled “The Time of Duty”, “the medical staff that is ready to go to any region to save lives, even at the risk of losing their own, is the best example of solidarity that human beings can offer.”
Havana, September 30, 2020.