October 3, 2025

The first report of the Observatory for Cuban Labor Export Programs (OCLEP) documents a dual humanitarian crisis: the collapse of Cuba’s domestic health system and the trafficking of tens of thousands of Cuban doctors abroad under conditions that meet international definitions of forced labor.

Based on 28 grassroots reports and more than 60 individual testimonies collected between July and August 2025, the findings describe a country where hospitals and clinics stand empty while the government is proudly claiming that over 22,000 Cuban doctors are currently active in more than 50 countries. Independent estimates, however, suggest that the actual figure is considerably higher — potentially reaching 40,000 to 50,000 or more, depending on how missions and personnel are counted. Arriving at a precise number remains difficult due to the lack of transparency from all parties involved — both the Cuban government and the host countries that contract these missions.”exports dozens of thousands of medical professionals to more than 50 countries of Latin America, Asia, Africa and Europe.

Health System in Ruins

Inside Cuba, healthcare has collapsed:

• Over 12,000 doctors and 7,000 nurses left the system in 2023 alone, either emigrating or reassigned abroad.

• Public health receives just 1.8–2% of the national budget, while tourism and real estate enjoy 20 times more investment.

• More than 30% of field reports described child victims denied surgery, left untreated for tumors, or dependent on donations for survival.

• Ambulances often take days to arrive, resulting in preventable deaths; consultations are carried out by medical students instead of trained doctors.

• Families must bring their own syringes, antibiotics, anesthesia, and even bed sheets; over half of all reports mention reliance on black-market or donated supplies.

Extrapolating from official statistics and the exodus of medical personnel, experts estimate that millions of Cubans—potentially more than half the population—lack reliable access to healthcare today. Children and the elderly are disproportionately affected, with testimonies of untreated brain tumors, hip deformities, and malnutrition.

Doctors as Export Commodities

Abroad, Cuban medical brigades generate billions of dollars annually for Havana but under coercive conditions:

• Host countries pay $3,000–$10,000 per doctor per month, but Cuban professionals receive only 3–30% of this income.

• Testimonies confirm at least 8 of the 11 ILO forced labor indicators, including passport confiscation, surveillance, wage retention, threats, and curfews.

• The Palermo Protocol definition of trafficking applies: doctors are recruited under deception, transported abroad, and exploited in conditions they cannot escape.

• In Venezuela, doctors report being forced to treat armed groups at gunpoint; in Mexico, contracts until 2028 remain secret, with state institutions admitting they cannot verify how much money reaches the doctors themselves.

• In one documented case in the Bahamas, 92% of salaries were withheld.

A State-Sponsored Crisis

The OCLEP report concludes that Cuba’s regime operates a “trafficking-for-labor economy”, prioritizing foreign currency inflows over the health of its citizens. International donations, from NGOs or diaspora groups, are frequently diverted to elite hospitals for foreigners while ordinary Cubans are left with nothing.

The human toll is staggering: if 50–60% of Cuba’s 11 million citizens now face inadequate healthcare, between 5–6 million Cubans may be suffering directly from the collapse of the public health system.

Call for Accountability

The report urges urgent international action, including:

• Independent scrutiny of Cuban medical contracts by host governments.

• Conditioning of foreign aid on transparency and non-diversion.

• Use of U.S. Magnitsky-style and EU anti-trafficking sanctions to hold perpetrators accountable.

• Amplification of Cuban victims’ testimonies before the ILO, UN, and Inter-American human rights bodies.

“Cuba exports doctors as commodities, while children die at home waiting for gauze and antibiotics,” one testimony summarized. The Observatory warns that without decisive action, the regime’s model will continue to violate basic rights and fuel a humanitarian emergency in one of the world’s most celebrated yet hollowed-out health systems