Quality of medical care and treatment of cancer patients in Cuba; the effect of the US embargo on the quality and quantity of medical drugs available (1998 to June 2001) [CUB37194.E]

In July 1998, the US+Cuba Medical Project, a New York-based humanitarian organization dedicated to sending medical supplies to Cuba, published the following on the impact of the US embargo on the treatment of breast cancer patients in Cuba:

Breast cancer, a primary cause of death for women worldwide, is often preventable with early detection and treatment. In Cuba it is also the most prevalent form of cancer for women and the principal cause of death by cancer. More than 1,000 women in Cuba die of breast cancer each year and many of these deaths can be ascribed to the United States economic embargo. Before the early 1990's every Cuban woman over 35 received regular mammograms and comprehensive early detection programs were in place throughout the country. Today, as a result of the [embargo], spare parts for the best mammography equipment, produced only by U.S. companies or subsidiaries, are not available and equipment is in disrepair. Shortages in medicines and supplies are having an equally devastating effect. Cuba has developed national programs for the prevention and early detection of breast and cervical cancer. These community-based programs supported by the media, local organizations and the neighborhood doctor-nurse teams, have been in place in one form or another since the 1960's and are based on the World Health Organization guidelines. Yet, as a result of the decline in early detection programs for breast cancer, more cancers are going undetected, and most Cuban women who are found to have cancer are beginning treatment late, if at all. The American Association for World Health cited breast cancer as a prime example of the disastrous and pervasive nature of the embargo.
As a result of the Cuban Democracy Act, the oil supply for the island has been cut in half from 1989 levels, and only 12 to 15 of the worlds tankers now travel to Cuba. The lack of fuel directly effects the ability to utilize mobile mammogram units. Each unit functions with a generator which can run the equipment for some four to six hours a day, yet fuel is often simply not available. The embargo also prevents the purchase of Kodak Mini-R Film-the film which exposes women to the least radiation and makes the purchase of any other mammogram film very difficult. While functioning each mobile unit can carry out some 400 mammograms per week yet the entire programs has shut down on various occasions due to the lack of Mammograms are only available in highrisk situations.
During the 1980's an average of 15 surgical interventions were performed daily. Now due to the lack of surgical supplies that number has dropped to two or three with up to 100 women on a two-month waiting list. The U.S. dominance of the cancer drug market, combined with the 17-year patent for drug manufacture, make breast cancer therapies developed as far back as 1980 inaccessible to Cuban women. Some 48% of the 215 new medications will not be fully accessible to Cuban women as long as the embargo remains in place.
Drugs used in Cuba's chemotherapy protocol are not always in sufficient stock, and supplies often arrive at erratic intervals. Shortages of anti-cancer agents force physicians to postpone treatment.
The U.S. embargo also directly interferes with Cuba's ability to produce some of these drugs domestically. Companies cannot sell Cuba the active ingredients needed for trial runs of anti-cancer drugs.
Overall, the U.S. embargo prevents comprehensive screening for breast cancer, contributes to the serious limitations on surgery, effectively bans the use of U.S.-developed and manufactured drugs to treat breast cancer, and frustrates domestic production of chemotherapy and other anti-cancer agents in Cuba.
The embargo directly effects the health of Cuban Women. We, in the U.S., have special responsibility. Just as there are many ways to wage war, there are many ways to build bridges of friendship. Please help us send breast cancer therapies and materials for prevention. Let's send a message of solidarity to Cuban women (20 July 1998).

Several other sources state that the US embargo on Cuba has resulted in a shortage of medical drugs and other health care supplies available in Cuba (CWR 11 Oct. 2000; Global Exchange 2 Apr. 2001; MSNBC 10 Apr. 2001; The Washington Post 29 Mar. 1999). The embargo bars the export to Cuba of 50 per cent of new medicines available on the US market (ibid.; Global Exchange 2 Apr. 2001). Cuba is barred from purchasing the latest US-manufactured medical drugs and it is in the US where over half of the world's medical drugs are produced (MSNBC 10 Apr. 2001). While Cuba had access to over 1,300 medicines in 1991, it now has only access to 890; some of the medical drugs for cancer, diabetes, heart disease and asthma are only available on an irregular basis (Global Exchange 2 Apr. 2001). Most pharmacies in Cuba are stocked with herbal and alternative medicines because of the lack of access to modern drugs (The Washington Post 29 Mar. 1999; CWR 11 Oct. 2000).

In personal testimony, Dr. Anthony F. Kirkpatrick of the University of South Florida's College of Medicine related a situation in which a Cuban child died because he did not receive pegaspargase, a drug only manufactured in the US and banned because of the embargo (The Tampa Tribune 26 Apr. 2000). The shortage of appropriate medicines and medical equipment for cancer patients is documented in the case of Carmen Cardenas, a Cuban woman, who was diagnosed with adult leukemia, in the attached 10 April 2001 MSNBC article.

In July 2000, a Canadian company, York Medical, secured the funds necessary to begin trials of Cuban cancer vaccines and antibodies in London, England (The Guardian 27 July 2000). Despite the US embargo and its consequences on the shortage of medicines in Cuba, the Cuban biotechnology industry has "made startling strides in developing revolutionary vaccines and antibodies against meningitis, hepatitis, and lung, breast, head and neck cancers" (ibid.). Please consult the attached article for additional information on the advances related to cancer treatment in Cuba.

The Canadian Child Welfare Research Unit at the University of Toronto reported that over 5,000 foreigners travel to Cuba each year for the quality of health care in Cuba, such as laser surgery and organ transplants for persons suffering from cancer and chronic neurological disorders (11 Oct. 2000).

Both the US House of Representatives and the US Senate voted in favour of legislation easing the sanctions against Cuba, North Korea, Sudan, Libya and Iran by allowing the export of food and medicines (FCLN 26 Apr. 2001; The Times of India 20 Oct. 2000). However, there was an exception in the legislation with regards to Cuba by prohibiting the financing of these exports by the US government or banks (ibid.). This exception is considered "restrictive" and it is unlikely that Cubans will benefit from the legislation (FCLN 26 Apr. 2001). The Cuban government has stated that it will not purchase food or medicine under the new US legislation (ibid.).

Please consult the attached document which provides an executive summary of a report by the American Association for World Health entitled Denial of Food and Medicine: The Impact of the US Embargo on the Health and Nutrition in Cuba for additional information on the impact of the US embargo in Cuba.

This Response was prepared after researching publicly accessible information currently available to the Research Directorate within time constraints. This Response is not, and does not purport to be, conclusive as to the merit of any particular claim to refugee status or asylum.


Canadian Child Welfare Research Unit (CRW). 11 October 2000. "Cuba-Looking at Health Care." http://cwr.utoronto.ca/cultural/english/cuba/health.html [Accessed 6 June 2001]

Friends Committee on National Legislation (FCNL). 26 April 2001. "Cuba Sanctions Policy Update." http://www.fcnl.org/issues/int/sup/cuba_sanctionsupdate_42601.htm [Accessed 6 June 2001]

Global Exchange. 2 April 2001. "Cuba Fact Sheet -- A Few Important Points." http://www.globalexchange.org/campaigns/cuba/background/factsheet.html [Accessed 6 June 2001]

The Guardian [London]. 27 July 2000. Julian Borger. "Cuba Winning Cancer Race." http://www.guardian.co.uk/Distribution/Redirect_Artifact/0,4678,0-347399,00.html [Accessed 6 June 2001]

MSNBC. 10 April 2001. Mary Murray. "Embargo Hits Hard at Cuban Hospitals." http://stacks.msnbc.com/news/556944.asp?cp1=1#BODY [Accessed 6 June 2001]

The Tampa Tribune. 26 April 2000. Anthony F. Kirkpatrick. "U.S. Commits Child Abuse in Cuba." (NEXIS)

The Times of India 20 October 2000. "Senate Clears Legislation Easting Cuba Embargo." http://www.timesofindia.com/201000/20amrc3.htm [Accessed 6 June 2001]

US+CUBA Medical Project. 20 July 1998. Breast Cancer: The Impact of the Embargo. http://www.cubasolidarity.net/uscumedi.html#brcancer [Accessed 6 June 2001]

The Washington Post. 29 March 1999. Serge F. Kovaleski. "With Drugs Scarce, Cuba Tries Natural Cures." http://www.rose-hulman.edu/~delacova/cuba/cures.htm [Accessed 6 June 2001]


The American Association for World Health. March 1997. Denial of Food and Medicine: The Impact of the US Embargo on the Health and Nutrition in Cuba. http://www.cubasolidarity.net/aawh.html [Accessed 6 June 2001]

The Guardian [London]. 27 July 2000. Julian Borger. "Cuba Winning Cancer Race." http://www.guardian.co.uk/Distribution/Redirect_Artifact/0,4678,0-347399,00.html [Accessed 6 June 2001]

MSNBC. 10 April 2001. Mary Murray. "Embargo Hits Hard at Cuban Hospitals." http://stacks.msnbc.com/news/556944.asp?cp1=1#BODY [Accessed 6 June 2001]