Timeline of healthcare in Cuba

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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

References

  1. C. William Keck, Gail A. Reed (2012). "The Curious Case of Cuba". Am J Public Health. 102: e13–22. PMC 3464859Freely accessible. PMID 22698011. doi:10.2105/AJPH.2012.300822. 
  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
  4. 4.0 4.1 4.2 4.3 4.4 "Cuban healthcare in the nineties" (PDF). 
  5. "Health consequences of Cuba's Special Period". Canadian Medical Association Journal. 
  6. "Health and Health Care: Revolutionary Period (Cuba)". 
  7. Commentary: A Novel Tourism Concept Caribbean Net News
  8. Foreign Affairs July/August 2010. page 69
  9. Cuba sells its medical expertise BBC News
  10. Finlay CJ. (1881). "El mosquito hipotéticamente considerado como agente de transmision de la fiebre amarilla". Anales de la Real Academia de Ciencias Médicas Físicas y Naturales de la Habana (18): 147–169. 
  11. The Philip S. Hench Walter Reed Yellow Fever On-line Collection [02954005]&query=james+carroll Online
  12. 12.0 12.1 United Nations World Population Prospects: the 2015 Revision - an XLS file
  13. On Revolutionary Medicine by Che Guevara Monthly review
  14. Cuban Healthcare: An analysis of a Community-based model Essam Farag online
  15. The impact of the economic crisis and the US embargo on health in Cuba. American journal of public health. 1997 January. Accessed 6 October 2006.
  16. 16.0 16.1 16.2 16.3 16.4 Paul K. Drain, Michele Barry (2010). "50 Years of U.S. Embargo: Cuba's Health Consequences and Lessons". Science. 328: 572–3. PMC 3990013Freely accessible. PMID 20430999. doi:10.1126/science.1189680. 
  17. Gleijeses, Piero (1996). "Cuba's First Venture in Africa: Algeria, 1961-1965". Journal of Latin American Studies. 28 (1): 159–195. JSTOR 157991. doi:10.1017/s0022216x00012670. 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. 18.0 18.1 18.2 18.3 18.4 18.5 18.6 18.7 18.8 Richard S Cooper1, Joan F Kennell, and Pedro Orduñez-Garcia. "Health in Cuba". Oxford Journals. 
  19. "Randomized, Placebo-Controlled Trial of Inactivated Poliovirus Vaccine in Cuba". 
  20. "Cuba, Russia and Neurosciences". 
  21. 21.0 21.1 21.2 21.3 21.4 21.5 21.6 21.7 "Organ Donation & Transplants in Cuba: Promising Results, Challenges Ahead". 
  22. "Cuba profile - Timeline". 
  23. ° English translation of the 1976 Constitution of Cuba Wikisource. 1976 Constitution of Cuba 1976 (in Spanish)
  24. Universidad de Ciencias Médicas de Cienfuegos
  25. "Hospital Hermanos Almejeiras", EcuRed (Cuban state wiki)
  26. Swanson KA, Swanson JM, Gill AE, Walter C. (1995). "Primary care in Cuba: a public health approach.". Health Care Women Int. PubMed. 16: 299–308. PMID 7649887. doi:10.1080/07399339509516183. 
  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 1-55587-874-1. Retrieved September 14, 2009. 
  28. Cuban Ministry, Higher Education. "Facultad ciencias Medicas in Cuba". Cuban Education Ministry. Government of Cuba. 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. http://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. PubMed. 17: 794–800. PMID 25616407. doi:10.1093/europace/euu322. 
  37. "WHO validates elimination of mother-to-child transmission of HIV and syphilis in Cuba". WHO. June 30, 2015. Retrieved August 30, 2015. 

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