Guatemala announced last week that it would begin phasing out a 30-year-old program in which Cuban doctors worked in the country to fill gaps in the country’s health system.
Communist Cuba, under heavy U.S. sanctions, earns billions of dollars each year by sending thousands of “white coat troops” to countries around the world, particularly in Latin America. Havana has used medical missions around the world as a tool of international diplomacy.
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So why do some countries withdraw from programs that support host countries?
Why is Guatemala phasing out Cuban doctors?
Guatemala’s Ministry of Health said in a statement that it would begin a “phased end” this year.
“The phased withdrawal of the Cuban Medical Brigade arose from the analysis of the completion of the mission cycle,” the statement, originally written in Spanish, said on February 13.
The statement added that the Cuban medical mission was aimed at helping Guatemala through Hurricane Mitch in 1998, which devastated parts of Central America, overwhelmed local hospitals and left rural areas with little access to medical care.
“The Ministry of Health is developing a step-by-step strategic replenishment plan that includes recruitment of state employees, enhanced incentives for hard-to-reach positions, strategic reallocation of human resources, and specialized technical support,” the statement said.
The Cuban delegation in Guatemala is made up of 412 medical personnel, including 333 doctors.
The Central American country’s decision comes amid mounting pressure from the United States, which wants to prevent Cuban doctors from working abroad.
The move is aimed at draining Cuba of much-needed revenue, as a large portion of the income earned by doctors flows into the national treasury. Cuba is facing severe power, food and medical shortages due to the Trump administration’s oil blockade since January.
Guatemala is just one of the countries benefiting from Cuba’s medical mission.
Over the past several decades, Cuba has sent medical missions around the world, from Latin America to Africa and beyond. These missions began immediately after Fidel Castro came to power in the Cuban Revolution in 1959.
Castro’s communist regime reversed many of the pro-business policies of U.S.-backed dictator Fulgencio Batista. The revolution tore relations between the two countries, and the US intelligence agency, the CIA, made several unsuccessful attempts to overthrow the Castro regime.
Since Bernardo Arevalo was elected president in January 2024, Guatemala has moved closer to the United States. He is cooperating with the administration of US President Donald Trump. Last year, Guatemala agreed to increase the number of repatriation flights it receives from the United States. The United States has forcibly returned thousands of immigrants to third countries, including Guatemala and El Salvador, led by pro-Trump leaders, without following due process.
In November 2018, shortly after Brazil elected Jair Bolsonaro as president, Cuba announced its withdrawal from the country’s Mais Médicos program. Bolsonaro, known as Brazil’s Trump, has criticized medical dispatch, viewing it as “slave labor.” Bolsonaro was convicted in September 2025 of plotting a coup to maintain power after losing the 2022 presidential election, and is serving a 27-year prison sentence.
Why is the US targeting Cuba’s global medical mission?
The United States considers Cuba’s overseas medical deployments, without any evidence, a form of “forced labor” and human trafficking, with the goal of restricting the Cuban government’s access to its largest source of foreign revenue.
U.S. efforts to rein in Cuba’s medical mission are not new. Just last year, Washington imposed visa restrictions aimed at preventing foreign governments from signing medical cooperation agreements with Cuba.
Last February, US Secretary of State Marco Rubio announced restrictions on visas for “forced labor associated with Cuba’s labor export program.”
A statement posted on the U.S. State Department website said: “This expansion policy applies to current or former Cuban government officials and other individuals, including foreign government officials, who are responsible for or believed to be involved in Cuba’s labor export program, specifically Cuba’s overseas medical missions.”
Rubio, a native of Cuba, is a vocal critic of Havana and has pushed U.S. policy in Latin America, including the military operation that kidnapped Venezuelan President Nicolás Maduro on January 3. Under the Trump administration, Washington will increase its focus on Latin America as part of its Western Hemisphere pivot, seeking to restore Washington’s prominence in the region.
Since President Maduro’s abduction, the US focus has shifted to Cuba. U.S. officials, particularly Mr. Rubio, have hinted that Havana could be the next target of Washington’s pressure campaign.
The United States has effectively stopped oil shipments from Venezuela to Cuba as part of a new oil blockade. Havana has faced sweeping U.S. sanctions for decades, and since 2000 Cuba has become increasingly reliant on Venezuelan oil provided as part of an agreement with President Maduro’s predecessor Hugo Chávez.
The blockade caused fuel shortages in Cuba and triggered a severe energy crisis. President Miguel Diaz-Canel imposed tough emergency restrictions in response.
This puts renewed pressure on countries to phase out medical missions in Cuba.
How many Cuban doctors are serving missions abroad?
More than 24,000 Cuban doctors work in 56 countries around the world. This includes Latin American countries such as Venezuela, Nicaragua, and Mexico. Africa, including Angola, Mozambique, and Algeria. and the Middle East, including Qatar.
It is also occasionally deployed in other countries. For example, Italy hosted Cuban doctors during the coronavirus pandemic to help overwhelmed hospitals in some of the hardest-hit regions.
Cuban doctors are very important to the Caribbean nation. They are filling a huge gap in healthcare as there is a shortage of trained medical professionals.
Have countries resisted U.S. pressure in the past?
Caribbean countries hit back in March 2025 against a U.S. threat to restrict visas. “We could not have gotten through this pandemic without Cuban nurses and Cuban doctors,” Barbados Prime Minister Mia Mottley said in a speech to parliament.
Trinidad and Tobago Prime Minister Keith Rowley said at the time that he was prepared to lose his US visa.
“If we don’t have Cubans there, we may not be able to operate the services,” said Ralph Gonsalves, then Prime Minister of Saint Vincent and the Grenadines. “I would rather lose my visa than 60 poor workers die.”
In August 2025, the United States announced that it would revoke visas for officials from Brazil, Africa, and the Caribbean due to their involvement in Cuba’s Doctor Overseas Program.
The report named Mozart Julio Tabosa Salles and Alberto Kleiman, Brazilian Ministry of Health employees whose visas were revoked for their work in Brazil’s Mais Médicos (“More Doctors”) program, created in 2013.
Some countries are now looking for ways to circumvent pressure from Washington. For example, Guyana announced this month that it would begin paying doctors directly, rather than through the Cuban government.
