The Cuban Healthcare Model: Structure, Resistance, and the Politics of Care

The Cuban system was never designed to be reactive. Its core is built around proactive care—intervening before illness takes hold, addressing root causes rather than symptoms. It aims to keep people healthy and reduce dependence on expensive, high-tech interventions. Its biggest success isn’t a single medical breakthrough, but the elimination of health disparities across geography and class. In Cuba, someone in a rural area receives the same systematic attention as someone living in Havana. That is not an aspiration—it’s the design.

Healthcare is deeply embedded in the community. This is how Cuba addresses the social determinants of health—issues like sanitation, diet, housing, and stress—without which no health system can claim real success. It’s not just about access to medicine; it’s about reshaping the material conditions that produce illness in the first place.

The foundation of this system is the understanding that healthcare is a human right, not a market commodity. The system is entirely state-run and state-funded. There are no private clinics, no medical insurance markets, no profit incentives. Services are free and universal. The system is tiered, but every layer is rooted in accessibility and long-term care, not triage or extraction.

Tier 1: The Consultorio – Family Doctor and Nurse Program

This is the base of the pyramid and the most critical component. The country is divided into small health zones, each served by a consultorio—a neighborhood clinic staffed by a family doctor and a nurse. Most often, the healthcare workers live directly above or next to the clinic. Their presence in the community is constant, not episodic.

Each consultorio team is responsible for 120–170 families, roughly 600–800 individuals. They don’t just wait for patients to show up—they conduct routine home visits (visitas de terreno), including to people who are not currently sick. Their role is comprehensive: they monitor physical and mental health, educate families, track risks, and intervene before conditions become acute.

This model generates deep and continuous health data. Medical and social histories are documented in detail, allowing doctors to understand not just individual bodies but community-level patterns. Prevention isn’t a slogan—it’s a structured, daily practice.

Tier 2: The Polyclinic (Policlínico)

If a case is beyond the consultorio’s scope, it moves to the polyclinic—a more resource-intensive community center that hosts specialists and diagnostic tools. These facilities offer services like gynecology, pediatrics, dentistry, internal medicine, labs, and imaging. They bridge the gap between primary care and hospitals, managing more complex conditions while still aiming to prevent hospitalizations when possible.

Tier 3: Hospitals

Hospitals in Cuba are not the front line. They are reserved for complex surgeries, high-risk interventions, and medical research. Located in larger towns and cities, hospitals receive referrals from the polyclinics and form the top of a very intentional pyramid. Tertiary care is not overloaded because the system below it is designed to absorb and prevent.

Outcomes and Achievements

Despite decades of sanctions and resource scarcity, Cuba’s health indicators rival or outperform much wealthier nations. The country eradicated diseases like polio and measles. It was the first in the world to eliminate mother-to-child transmission of HIV and syphilis, and its infant mortality rate is on par with or better than that of the United States.

In biotechnology, Cuba has produced globally significant innovations. CIMAvax-EGF, a therapeutic vaccine for lung cancer. Heberprot-P, which reduces amputations in diabetic patients. The first effective vaccine against meningitis B. These aren’t isolated wins; they’re evidence of a sustained commitment to research even under embargo.

Internationalism as Practice

Cuba does not hoard its medical expertise. Its international medical brigades have provided care in over 60 countries. During the Ebola crisis in West Africa and the COVID-19 pandemic, Cuban doctors were among the first to arrive. This is not charity or soft power—it is a political stance: healthcare as international solidarity, not a weapon or a commodity.

The Embargo: Health Under Siege

None of this can be separated from the blockade imposed by the United States. The embargo doesn’t just restrict access to goods—it systematically targets Cuba’s ability to care for its population.

Cuba cannot import equipment or medicines that contain even 10% U.S.-origin components. This extends beyond direct American products to any item with embedded U.S. technology—chips, software, spare parts. This means that even when Cuba has the money to purchase a medical device, it’s often legally blocked from doing so.

A significant issue is the inability to maintain older equipment. Much of Cuba’s medical infrastructure relies on durable American-made machines purchased before the embargo. When these machines break, replacements are unavailable. This renders otherwise functional systems inoperative.

On top of that, Cuba must navigate inflated costs. Forced to use third-party intermediaries, it pays premiums on goods it could otherwise buy directly. Shipping costs skyrocket because direct trade routes are closed. Financial institutions, fearing U.S. penalties, avoid processing Cuban transactions altogether. Even non-U.S. banks refuse to facilitate basic exchanges. This is compounded by Cuba’s designation as a “State Sponsor of Terrorism,” effectively freezing it out of the global financial system.

Cuba has built one of the most effective health systems in the world not because it is wealthy, but because it is structurally committed to care. It has redefined what is possible when healthcare is understood as a public good and not a market transaction. The embargo, by contrast, is a form of economic warfare that deliberately targets the sick, the elderly, and the vulnerable. It turns medical care into a battlefield and weaponizes scarcity. And yet, despite that siege, Cuba continues to train doctors, send medical aid abroad, and develop life-saving treatments. It has done more with less than any other country—not because it is exceptional, but because it is intentional. Healthcare in Cuba is not just policy—it is resistance.