ANTIGUA | Gaston Browne Proposes Direct Payment to Cuban Doctors Despite Contract with Havana

ST. JOHN,  Antigua, March 23, 2025 - The Gaston Browne administration of Antigua and Barbuda has proposed a controversial solution to U.S. authorities: paying Cuban medical professionals directly, despite an existing contractual arrangement with the Cuban government that deployed them.

This unprecedented diplomatic maneuver represents a fracture in the unified stance previously maintained by CARICOM nations, as Antigua navigates mounting pressure from Washington.

This pivotal policy proposal comes as the Trump administration intensifies its characterization of Cuba's medical missions as potential "human trafficking" – a claim that has sent shockwaves through Caribbean capitals heavily dependent on Cuban healthcare support.

For Cuba, these medical brigades represent not merely humanitarian outreach but a critical economic lifeline. The overseas program reportedly generated over $11 billion between 2011 and 2025, providing essential revenue for an island nation gasping under the weight of six decades of crushing U.S. economic sanctions – precisely the financial artery the Trump administration appears determined to sever in its renewed campaign to strangle the Cuban economy.

While other Caribbean leaders have forcefully rejected Marco Rubio's characterization of the Cuban Medical Brigades as "forced labor," Antigua's unilateral proposal signals potential regional fragmentation in response to American pressure.

Under the suggested arrangement, Cuban doctors and nurses would receive 100% of their contractual amounts directly from the Antiguan government, eliminating the payment structure that channeled funds through Havana.

In a move designed to further legitimize the arrangement, Antigua proposes implementing statutory deductions from each medical worker's pay package, mirroring standard employment practices for all other workers in the country – a clear attempt to deflect accusations of exploitation while reinforcing commitments to fair labor practices.

Antiguan officials have communicated this dramatic payment restructuring proposal to U.S. authorities and now find themselves in diplomatic limbo, awaiting Washington's response.

The diplomatic tensions escalated significantly last month when Rubio unveiled a hardline policy aimed at imposing visa restrictions on current or former Cuban officials allegedly involved in what Washington characterizes as the "exploitation of Cuban workers" through overseas medical missions.

This move represents the latest salvo in the decades-long economic warfare against the island nation, now with Caribbean healthcare systems caught in the crossfire.

For Caribbean nations wrestling with chronic healthcare shortages, however, the Cuban partnership represents a vital lifeline rather than exploitation. Approximately 24,180 Cuban medical professionals currently serve across 56 countries worldwide, significantly bolstering medical infrastructure in regions where resources hang by a thread. Their presence fills critical gaps that would otherwise leave vulnerable populations without access to essential care.

The Cuban medical mission stands as one of the Revolution's most enduring and far-reaching international initiatives. Since its inception, an estimated 600,000 Cuban professionals have served in more than 160 countries worldwide, with current programs operating across nearly 60 nations—creating a global healthcare safety net that stretches from Latin America to Africa and across the Caribbean.

Throughout CARICOM nations, Cuba's eye care program has emerged as a signature healthcare achievement, restoring sight to thousands of Caribbean citizens who would otherwise navigate blindness without access to specialized ophthalmological care. The initiative exemplifies Cuba's approach to medical diplomacy—combining humanitarian assistance with strategic international relationships.

More recently, during the COVID-19 pandemic's darkest hours, Cuban doctors and nurses formed the backbone of the regional health response in many member states. They arrived when other nations sealed their borders and global healthcare systems buckled under unprecedented strain—a stark contrast to the accusations now leveled against the program.

Against this backdrop of escalating regional tensions, U.S. Secretary of State Marco Rubio is preparing for a high-stakes diplomatic tour across three Caribbean nations this week. The mission comes at a critical juncture, with meetings scheduled amid growing concerns over Haiti's security crisis and the potential fallout from new U.S. policies threatening Caribbean economic stability.

The high-profile diplomatic offensive will begin in Jamaica, where Rubio will meet with Prime Minister Andrew Holness on Wednesday. From there, he'll continue to Guyana and Suriname for strategic talks with Presidents Mohamed Irfaan Ali and Chandrikapersad "Chan" Santokhi, respectively—conversations that will undoubtedly touch on the Cuban medical brigade controversy now reverberating throughout the region  and his use of the "forced labour" epithet to describe the programme.

For Antigua and Barbuda, the decision to propose direct payments to Cuban medical staff represents a delicate balancing act—attempting to preserve crucial healthcare support while avoiding potential American sanctions.

The outcome of this diplomatic gambit could set a precedent for other Caribbean nations facing similar pressure, potentially reshaping regional healthcare delivery for years to come.

As Caribbean leaders await Washington's response to Antigua's proposal, the future of Cuba's medical missions hangs in the balance—along with the health and wellbeing of thousands who depend on their care.

The unfolding situation highlights the complex intersection of healthcare, diplomacy, and geopolitics in a region where medical resources remain scarce and political pressures increasingly intense.

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