Timeline of healthcare in Cuba

This is a timeline of healthcare in Cuba, focusing on the modern state. Some international campaigns outside of local healthcare are also described.

Big picture

Year/period	Key developments
Prior to 1960	Pre-Revolution era. Health services and facilities are concentrated in the cities.[1] Provision of medical supplies is heavily dependent on imports from other countries, mostly the U.S. Private sector healthcare is primarily for the wealthy. A poorly funded and staffed public sector responds for the rest of the population.[2]
1960s	Soon after the revolution, universal healthcare is adopted and becomes a priority of state planning. U.S. government imposes embargo against Cuba, which would lead to an increase in disease and infant mortality during this decade.[3] Approximately half the physicians in Cuba emigrate.[4]
1970s	The polyclinic model of primary care is reinforced and expanded, focusing on health education, prevention and environmental monitoring. The number of medical graduates increase, thus enlarging the Cuban medical internationalism program.[4]
1980s	Cuban healthcare system consolidates. Primary care is given impetus with the introduction of the Family Doctor-and-Nurse Program. Biotechnology industry takes off.[4]
1990s	Post Soviet era, starts with Cuba's Special Period of socioeconomic collapse, due to loss of funding from the dissolved U.S.S.R. Cuba starts to accept U.S. donations of food, medicines and cash. At the same time, U.S. embargo tightens.[5] Infectious diseases rise while infant mortality continues to decline.[4]
2000s–present	Cuba's health indices rank extraordinarily at a developed country level, considering that Cuba is a country of poor resources and economic underdevelopment. Cuba also boasts one of the highest physician-per-inhabitant ratios in the world, though massive deployment of doctors on foreign missions can leave gaps in the country's domestic primary healthcare programs.[6] Medical tourism is also a thriving and growing industry today in Cuba.[7] So far, it is widely believed that medical workers are Cuba's most important export commodity.[8] Cuba also successfully exports many medical products, such as vaccines.[9]

Full timeline

Year/period	Type of event	Event	Location
1881	Discovery	Cuban epidemiologist Carlos Finlay provides evidence that mosquito Aedes aegypti transmits disease to and from humans.[10]
1898–1902	Achievement	Yellow fever is virtually eradicated due to the efforts of Clara Maass and surgeon Jesse William Lazear during this period of U.S. presence.[11]
1950–1955	Report	Infant mortality rate levels at 80.69 deaths per 1,000 live births, a figure higher than those of Paraguay and Surinam.[12]
1959	Political change	End of Cuban revolution and establishment of the socialist state and communist government. Fidel Castro takes office.
1960	Publication	Revolutionary and physician Ernesto "Che" Guevara writes crucial essay entitled On Revolutionary Medicine, outlining the future of Cuban healthcare.[13]
1960	Policy	The Ministry of Public Health begins a program of nationalization and regionalization of medical services.[14] First U.S. embargo against Cuba.[15]
1961	Organization (campaign)	Cuba starts to deploy physicians to work in poor countries around the world, starting with medical brigades to assist during the Algerian War.[16][17]
1962	Policy	"Vaccination days" are established with the goal of reaching the entire population. Proving later to be effective in eliminating polio, it is subsequently adopted in other countries as a primary strategy.[18]
1963	Policy (Campaign)	The Cuban medical internationalism program is initiated.
1963	Foreign policy	U.S. embargo against Cuba prohibits trade in food, medicines, and medical supplies.[16]
1963	Achievement	Cuba declares free of polio.[19]
1965	Policy	Cuban government creates a system of community-based polyclinics, with aims at providing primary-care, specialty services, and laboratory and diagnostic testing to a catchment area of 25,000 to 30,000 people.[16]
1969	Organization (research institute)	Cuban Neuroscience Center (CNEURO) founded.[20]	Havana
1970	Development	First Kidney transplant is performed in Cuba.[21]	Havana (Nephrology Institute)
1970	Policy	The Maternal–Child Programme (Programa Nacional de Atencion Materno-Infantil—PAMI) is launched with the purpose of assuring the health of women of child-bearing age and their children.[18]
1972	Organization (alliance)	Cuba becomes a full member of the Soviet-based Council for Mutual Economic Assistance (COMECON).[22]
1972	Achievement	Cuba declares free of neonatal tetanus.[18]
1976	Policy	Fidel Castro elected president. Cuban constitution revision. Article 50: Everyone has the right to health protection and care. The state guarantees this right by providing free medical and hospital care by means of the installations of the rural medical service network, polyclinics, hospitals, preventative and specialized treatment centers; by providing free dental care; by promoting the health publicity campaigns, health education, regular medical examinations, general vaccinations and other measures to prevent the outbreak of disease. All the population cooperates in these activities and plans through the social and mass organizations.[23]
1979	Achievement	Cuba declares free of diphteria.[18]
1979	Organization (medical school)	University of Medical Sciences, Cienfuegos is founded.[24]	Cienfuegos
1982	Organization (hospital)	Hermanos Ameijeiras Hospital (HDCQHA) is founded.[25]	Havana
1984	Policy	A Family Doctor-and-Nurse Program is launched, by which neighborhood/home clinic model is adopted. The physician and the nurse must live in the neighborhood they're serving. They're also expected to conduct research and present their findings at congresses or in journals.[4][26]
1985	Development	First heart transplant is performed in Cuba.[21]	Havana (HDCQHA)
1985–1990	Report	Infant mortality rate levels at 13.01 deaths per 1,000 live births, the lowest in Latin America.[12]
1986	Development	First heart-lung transplant is performed in Cuba.[21]	Havana (HDCQHA)
1986	Development	First liver transplant is performed in Cuba.[21]	Havana (HDCQHA)
1986	Development	First pancreas-kidney transplant is performed in Cuba.[21]	Havana (Nephrology Institute)
1989	Development	First lung transplant is performed in Cuba.[21]	Havana
1990	Development	First heart-lung transplant is performed in Cuba.[21]	Havana (HDCQHA)
1991	Crisis	Collapse of Soviet Union and beginning of the so-called Special Period. Soviet funding halts, depriving Cuba from almost all foreign commodities, including pharmaceuticals. An epidemic of optical and peripheral neuropathy, subsequently traced to a sharp decline in protein, vitamins, and some other micronutrients, afflicts at least 50 000 Cubans. Also a modest increase in mortality from infectious diseases, particularly tuberculosis, is observed.[18]
1992	Foreign policy/crisis	U.S. “Torricelli Bill” tightens embargo against Cuba, thus deepening the severe material shortages and affecting medical care. The number of foreign-based subsidiaries of U.S. companies granted licenses to sell medicines to Cuba start to decline dramatically.[16][27]
1993	Achievement	Cuba declares free of measles.[18]
1994	Achievement	Cuba declares free of pertussis.[18]
1994	Organization (medical school)	Facultad de Ciencias Medicas Sancti Spiritus is founded.[28]	Sancti Spiritus
1994	Organization (Research institute)	Center of Molecular Immunology (Centro de Inmunología Molecular) or CIM is founded.[29]	Havana
1995	Achievement	Cuba declares free of rubella and mumps.[18]
1999	Organization (medical school)	ELAM (Latin American School of Medicine) is founded.[30]	Havana
2000		Kofi Annan: "Cuba's achievements in social development are impressive given the size of its gross domestic product per capita. As the human development index of the United Nations makes clear year after year, Cuba should be the envy of many other nations, ostensibly far richer. Cuba demonstrates how much nations can do with the resources they have if they focus on the right priorities - health, education, and literacy."[31]
2002	Report	Cuba attains the second lowest infant mortality in the Americas, 20% below the U.S. rate for all ethnic groups and also below the rate for white Americans.[18]
2004	Organization (program launch)	Operation Miracle is initiated by Cuba jointly with Venezuela, in which medical workers from both countries would perform surgeries for cataracts, glaucoma, and other eye ailments, with the goal of reaching six million operations across the Americas by 2015.[32]
2005	Development	First pediatric liver transplant is performed in Cuba.[21]	Havana (HDCQHA)
2005	Organization (campaign)	Cuba offers to send 1500 medics to New Orleans in response to Hurricane Katrina. Such aid is rejected by the U.S. government.[33][34]
2006	Policy	The Cuban government spends about $355 per capita on health, 7.1% of total Gross Domestic Product (GDP).[16]
2011	Achievement	Cuba announces release of the world's first lung cancer vaccine.[35]
2012	Development	First Latin American catheter ablation registry established.[36]
2015	Achievement	Cuba becomes the first country to eradicate mother-to-child transmission of HIV and syphilis.[37]

See also

• Timeline of healthcare in India
• Timeline of healthcare in China
• Timeline of healthcare in Japan

References

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2. Primary Health Care in Cuba, The Other Revolution, by Linda M. Whiteford and Laurence G. Branch
3. Dominguez, Jorge (1993), "Cuba since 1959", in Bethell, Leslie (ed., 1993), Cuba: a short history, Cambridge: Cambridge University Press
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9. Cuba sells its medical expertise BBC News
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11. The Philip S. Hench Walter Reed Yellow Fever On-line Collection [02954005]&query=james+carroll Online Archived 2012-12-11 at Archive.today
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13. On Revolutionary Medicine by Che Guevara Monthly review
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17. Gleijeses, Piero (1996). "Cuba's First Venture in Africa: Algeria, 1961-1965". Journal of Latin American Studies. 28 (1): 159–195. doi:10.1017/s0022216x00012670. JSTOR 157991. The Minister of Public Health, Jose Ramón Machado Ventura, led the group, which included 29 doctors, three dentists, 15 nurses and eight medical technicians. (There were 45 men and ten women.) . . . With the arrival of this medical mission in Algeria on 24 May 1963, Cuba's technical assistance abroad began. (Quote is from p. 165).
18. Richard S Cooper1, Joan F Kennell, and Pedro Orduñez-Garcia (2006). "Health in Cuba". International Journal of Epidemiology. 35 (4): 817–824. doi:10.1093/ije/dyl175. PMID 16931525.CS1 maint: multiple names: authors list (link)
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22. "Cuba profile - Timeline".
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24. Universidad de Ciencias Médicas de Cienfuegos
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27. Whiteford, Linda M.; Manderson, Lenore, eds. (2000). Global Health Policy, Local Realities: The Fallacy of the Level Playing Field. Boulder, Col.: Lynne Rienner Publishers. p. 69. ISBN 978-1-55587-874-0. Retrieved September 14, 2009.
28. Cuban Ministry, Higher Education. "Facultad ciencias Medicas in Cuba". Cuban Education Ministry. Government of Cuba. Archived from the original on 28 November 2011. Retrieved 29 November 2011.
29. "Cuba Announces Release of the World's First Lung Cancer Vaccine". PopSci. 2011-08-09. Retrieved 2011-12-11.
30. "Cuba-trained doctors making difference around the world".
31. https://www.pbs.org/wgbh/amex/castro/sfeature/sf_views_uriarte.html "The Right Priorities: Health, Education, and Literacy. Views on Cuba.
32. "Cuba's Health-Care Diplomacy: The Business of Humanitarianism".
33. "Venezuela and Cuba offer US aid ." Al Jazeera, September 7, 2005. Retrieved on 2010-04-14.
34. "Venezuela and Cuba offer aid to Katrina victims." The Free Press, Volume 1, Issue 4. Retrieved on 2010-04-14.
35. "Cuba Announces Release of the World's First Lung Cancer Vaccine".
36. Keegan R, Aguinaga L, Fenelon G, Uribe W, Rodriguez Diez G, Scanavacca M, Patete M, Carhuaz RZ, Labadet C, De Zuloaga C, Pozzer D, Scazzuso F; SOLAECE registry investigators (2015). "The first Latin American Catheter Ablation Registry". Europace. 17 (5): 794–800. doi:10.1093/europace/euu322. PMID 25616407.CS1 maint: multiple names: authors list (link)
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