Originally published in Granma, 11/14/2018
“Jair Bolsonaro, president elect of Brazil, who has made direct, contemptuous and threatening comments against the presence of our doctors, has declared and reiterated that he will modify the terms and conditions of the More Doctors program , disregarding the Pan-American Health Organization.”
The Ministry of Public Health of the Republic of Cuba, committed to the solidarity and humanist principles that have guided Cuba’s medical cooperation for 55 years, has been participating in Brazil’s “More Doctors” program since its inception in August of 2013. This initiative launched by Dilma Rousseff, who was at that time the president of the Federal Republic of Brazil, pursued the noble purpose of guaranteeing medical assistance to the majority of the Brazilian people, following the principle of universal health coverage promoted by the World Health Organization.
The program had planned the inclusion of Brazilian and foreign doctors who would work in poor and remote areas of the country.
Cuba’s participation in this program was arranged through the Pan-American Health Organization with one distinctive feature: it was intended to fill the vacancies left by doctors from Brazil and other foreign nations.
During these five years of work, some 20 000 Cuban collaborators have assisted 113,359,000 patients in more than 3,600 municipalities. They were able to provide health coverage to a vast 60 million Brazilians, when they accounted for 80% of all the doctors who were taking part in the program. More than 700 municipalities were able to have a doctor for the first time ever.
The work of Cuban doctors in areas of extreme poverty, in the favelas of Rio de Janeiro, Sao Paulo, Salvador de Bahia, and the 34 Special Indigenous Districts, particularly in Amazonia, was widely recognized by federal, state, and municipal governments of that country and its population, 95% of which expressed their acceptance, according to a survey carried out by the Federal University of Minas Gerais at the request of the Ministry of Health of Brazil.
On September 27, 2016, the Ministry of Public Health, in an official statement issued on a day close to the expiration date of the agreement and amidst the events associated to the legislative and judicial coup d’ etat against president Dilma Rousseff, announced that Cuba “would continue to honor its agreement with the Pan-American Health Organization for the implementation of the Program More Doctors, providedthat the guarantees offered by local authorities were maintained”, something that has been so far respected.
Jair Bolsonaro, president elect of Brazil, who has made direct, contemptuous and threatening comments against the presence of our doctors, has declared and reiterated that he will modify the terms and conditions of the Program More Doctors, in full disregard of the Pan-American Health Organization and the agreement reached by this organization with Cuba, since he has questioned the qualification of our doctors and has conditioned their permanence in the program to a process of validation of their titles and established that contracts will only be signed on an individual basis.
The announced modifications impose conditions that are unacceptable and fail to ensure the guarantees that had been previously agreed upon since the beginning of the Program, which were ratified in 2016 with the re-negotiation of the Terms of Cooperation between The Pan-American Health Organization and the Ministry of Health of Brazil and the Cooperation Agreement between the Pan-American Health Organization and the Ministry of Public Health of Cuba. These unacceptable conditions make it impossible to maintain the presence of Cuban professionals in the Program.
Consequently, in the light of this unfortunate reality, the Ministry of Public Health of Cuba has decided to discontinue its participation in the Program More Doctors and has informed so to the Director of the Pan-American Health Organization and the political leaders of Brazil who founded and defended this initiative.
The decision to bring into question the dignity, professionalism and altruism of Cuban cooperation workers who, with the support of their families, are currently offering their services in 67 countries is unacceptable. During the last 55 years, a total of 600 000 internationalist missions have been accomplished in 164 nations, with the participation of 400 000 health workers who, in quite a few cases, have fulfilled this honorable task more than once. Their feats in the struggle against the Ebola virus in Africa, blindness in Latin America and the Caribbean and cholera in Haiti as well as the participation of 26 brigades of the International Contingent of Doctors Specialized in Disaster Situations and Great Epidemics “Henry Reeve” in Pakistan, Indonesia, Mexico, Ecuador, Peru, Chile and Venezuela, among other countries, are worthy of praise.
In the overwhelming majority of the missions that have been accomplished, all expenses have been covered by the Cuban government.
Likewise, 35 613 health professionals from 138 countries have been trained in Cuba at absolutely no cost as an expression of our solidarity and internationalist vocation.
All Cuban cooperation workers have preserved their posts and their full salary in Cuba, together with all due labor and social benefits, just as the rest of the workers of the National Health System.
The experience of the Program More Doctors for Brazil and Cuba’s participation in it show that it is indeed possible to structure a South-South Cooperation Program under the auspices of the Pan-American Health Organization in order to promote the achievement of its goals in our region. The United Nations Development Program and the World Health Organization have described it as the main example of good practices in triangular cooperation and the implementation of the 2030 Agenda and its Sustainable Development Goals.
The peoples from Our America and from all over the world know that they will always be able to count on the solidarity and humanistic vocation of our professionals.
The Brazilian people, who turned the Program More Doctors into a social achievement and, from the very beginning,has trusted Cuban doctors, recognized their virtues and appreciated the respect, sensitivity and professionalism with which they have assisted them, will understand who are to be held responsible for our doctors’not being able to continue offering their fraternal contribution in that country.
Havana, November 14, 2018.