How many people have died in Cuba, have seen their diseases aggravated, or suffered intense pain, due to the lack of essential medicines? What is behind the health disaster? What is the government doing to deal with it?
These are three questions that UN Secretary General Antonio Guterres and WHO Director-General Tedros Adhanom should ask Miguel Díaz-Canel and José Ángel Portal, Cuba's Public Health Minister.
In a survey conducted on the island by Cubadata and cited a few days ago by DIARIO DE CUBA, 55.8% of those interviewed describe access to medicines as "impossible", and 80.3% describe it as "very difficult." This is happening in the "medical powerhouse" praised by the Left, particularly the United States'.
Right now one can read an online article in The New York Times entitled "What we can learn from the Cuban health system," signed by Nicholas Kristof, who, among other things states that medical care in Cuba "is able to ensure that no one is left unattended (...) everything is free (...) an American baby is almost 50% more likely to die than a Cuban one (...) Cuba has developed its own pharmaceutical industry, in part to circumvent the US embargo."
On another U.S. website, MEDICC, Dr. William Keck claims that "many high-income countries could learn a lot from Cuba's model (...) the country's health system is universally accessible and fully integrated."
The National Institutes of Health, meanwhile, an entity of the US Government itself, states that "in Cuba, universal health access and coverage hinge on three key principles: health as a human right, equity and solidarity (...) with coverage and access without exclusions."
In addition, the journal Science has published the conclusion of a study by scientists at Stanford University School of Medicine in California. Quoted by BBC News in London, it contends that "(US) sanctions have not prevented Cubans from enjoying better health standards than many countries in Latin America, with levels that can be compared to those in developed countries (...) their health-related success is due to excellent prevention and health promotion programs."
Many more pages could be filled with the propaganda that continues to be read worldwide about a health system that, in fact, has imploded because it was left without a foreign benefactor to bankroll it.
Officially, 251 essential medicines are lacking, but there are more
Leaving the country's disastrous medical care in general, aside, let us focus only on its lack of medication, arguably the worst scourge of all. It is not known how many Cubans have died, will die, or will see their maladies aggravated because they do not receive the necessary medication, or because the medical instruments to care for them are lacking and to perform urgent surgical interventions and apply pressing hospital treatments.
However, with the little that the regime has acknowledged, one can get an idea. The BioCubaFarma monopoly, producer and distributor of medicines in the country, recently recognized that 251 of the 369 basic medicines are missing; that is, 40% of them.
Of course, if the government says it is 251, the actual shortfall is greater. In addition, BioCubaFarma released this news mainly to blame the US "blockade," with the president of the monopoly, Eduardo Martínez, "forgetting" to mention that the world's largest suppliers of products used to produce medicines are, in fact, China and India, close friends of Castroism. The US buys 80% of the raw materials to produce drugs from them.
A year earlier, in June 2022, Martínez himself said that Cuba was lacking 151 drugs, 88 classified as "Priority 1" (life or death), 19 to treat "serious patients," and another 63 rationed with the "control card." It revealed that 30 more medications were missing than at the end of 2021. Now, more than 100 more medications are lacking. How many will be missing in December, or a year from now?
When the pandemic struck, thousands of Cubans died of Covid-19, but the Government reported that they died of other causes. As I stated here, a cousin of mine and her husband died of Covid-19 in the same week (July 2021) in Ciego de Ávila, where they were being housed at a former Physical Education school (EIDE) converted into a makeshift hospital, with a single doctor for 100 patients, and without oxygen, antibiotics, or the necessary medications. Their death certificates indicate that they died from "breathing problems," not mentioning Covid-19). Neither Nieves nor Alejo were asthmatic, nor did they have any chronic conditions.
There is no way to know how many Cubans today are alive, or more or less in control of their chronic ailments, thanks to medicines, equipment and money they receive from their relatives abroad (basically, from Miami); those conveyed by "mules," or those stolen from ports, warehouses, pharmacies and hospitals, which supply the black market.
Indignant, Minister Portal told the National Assembly: "We are witnessing the theft of medicines and the illicit sale of imported drugs." But, why is there so much medication theft?
1958: No theft, no resellers, no handouts, no empty shelves
I can bear personal witness to the fact that before 1959 there were no robberies or clandestine resellers of medicines in Cuba. There were pharmacies everywhere. An uncle of mine, and two cousins of my father, had one each. My sister, with a PharmD degree, ran another one. I never saw a line, or cards, to get a medicine; or customers told "there is none here, or anywhere else," or pharmacies with their shelves empty. Today, even in Burundi or Sierra Leone, pharmacies are much better stocked.
As a result of Communism, resellers of anything and everything are a matter of life and death in Cuba. They are an effect, not the cause of scarcity.
Thanks to the "black market" many Cubans are cured, or relieved of their suffering. They go less hungry, dress themselves and wear shoes, buy dollars to survive, and obtain other fundamental goods.
There are fewer tragedies and seriously ill people in Cuba is because of the medicines that are received from abroad, those personally sent or carried by Cuban emigrants, travelers who return to the Island, and "mules."
For this the Castroist dynasty is solely and criminally responsible, as it killed the market economy, the lever that moves the world (to parody Archimedes). With capitalism outlawed, pharmacies became "nobody's property," as Mikhail Gorbachev acknowledged while still the Soviet leader.
The network of drug resellers does not entirely make up for the absence of private pharmacies, but, to some extent, covers some empty niches and prevents the death and suffering of many Cubans. This underground pharmaceutical market has two suppliers: 1) Cuban emigrants 2) Theft from pharmacies, ports, warehouses, hospitals and clinics.
There will only be a solution when the market economy is restored
The first source appears to have contracted slightly, due to inflation and other factors, and theft has dropped precisely because there are fewer drugs to steal.
Oh, and those who steal medicines in Cuba do so without any remorse, because they see how political leaders, generals, colonels, and the entire dictatorial caste steal more medicines than they do, and receive excellent medical treatment at hospitals reserved for these patricians, as military officials prohibit access by "commoners" and the press.
As for the high prices on the black market, the explanation is simple: those who receive medicines directly from abroad, or from travelers, or "mules," after supplying themselves, sell the rest at the prices set by the 'law' of supply and demand: the greater the shortage, the higher the prices. Those covert suppliers are hungry, and have a thousand unmet needs. The average salary is 3,500 pesos, and basic groceries cost at least 12,000 pesos.
The conclusion is obvious: this dramatic situation will not be turned around until a market economy is restored in Cuba, something that Raúl Castro refuses to do. He remains determined to go down in history as Raúl "the Cruel."