Editor—In her news item Carillo de Albornoz gives the stage to two Cuban doctors who “defected.”1 Both are critical of Cuba's national health system and international cooperation, in sharp contrast to the representatives of academia, the World Health Organization, and non-governmental organisations interviewed.
Longstanding collaboration with Cuban research institutes makes us privileged witnesses to the country's successes and hardships. Since the collapse of the Soviet Union and the tightening of the US blockade, Cuba has been in dire straits but overall health outcomes have remained excellent and continue to improve.2,3 International solidarity has always been at the centre of the Cuban societal project, lately from structural health cooperation with Haiti and Venezuela to massive emergency relief to Pakistan after the earthquake last year.4
The Venezuelan government is developing comprehensive health programmes, aiming at universal coverage (F Armada, speech, Continental Social Forum, Caracas, January 2006). Many middle and upper class Venezuelan doctors elect not to work in poor neighbourhoods for limited salaries. It is not surprising that some Cuban doctors who were posted in these areas left for the United States. What is surprising—and admirable—is the commitment of the Cuban government and most of the more than 20 000 Cuban doctors who continue to serve all over Venezuela and in other Latin American, African, and Asian countries.
Today, Cuba is one of the few important players in international health that actively opposes the dominant discourse of privatisation and neo-liberal health services. Inevitably, the debate on the performance of the Cuban health system and—even more—on its international (health) cooperation is not based on public health concerns alone.
Competing interests: None declared.
References
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- 3.World Bank. World development report 2001. New York: World Bank, 2001.
- 4.Balan-Neyra J. Firman Cuba y Paquistán Memorando de Entendimiento. Diario Granma 10(81), 22 March 2006. www.granma.cubaweb.cu/2006/03/22/nacional/artic01.html (accessed 8 Sep 2006).