Cuba Policies to Confront the COVID-19 Pandemic

Cuba’s Policies to Confront the COVID-19 Pandemic

By Ph.D. Ailynn Torres Santana, Postdoctoral Fellow, Rosa-Luxemburg-Stiftung, FLACSO & María José Espinosa Carrillo, Director of Programs, Center for Democracy in the Americas Introduction Like every country in the world, Cuba is combating the spread of COVID-19. On March 11, four initial cases were announced, three Italian tourists and one Cuban, and cases have continued to increase. As of April 6, there were 350 cases, 18 recovered patients, and 9 deaths. According to the country’s health authorities, Cuba is still in the pre-epidemic phase of the pandemic, in which confirmed cases are returned travelers from abroad, or locals who have been in contact with them.

Cuba’s universal healthcare system—well-regarded worldwide in terms of its scope and the training of its doctors—is completely focused on COVID-19 diagnosis, prevention and treatment. In order to alleviate the socioeconomic effects of the crisis, the country has also adopted several protective policies, but women and some social groups face unique challenges. Cuba’s capacity to respond to the global pandemic is also hampered by U.S. sanctions; the comprehensive U.S. embargo deters international humanitarian efforts.

Cuba’s Policies to Confront the COVID-19 Pandemic On March 23, Cuba’s government officials publicly announced an initial set of forty measures to combat the virus’s spread, and have continued to update them since. The government has intensified and increased rapid testing, and has reportedly created isolation centers nationwide. As of April 6, Cuban authorities confirmed that 5,998 tests have been carried out. Since the first cases were confirmed, nearly 30,000 medical workers and students have been going door-to-door to check on people in their homes and explaining the steps they should take.

Among other relevant measures Cuba halted tourism to the island, which initially did not extend to permanent residents or citizens of Cuba, but was later extended to all commercial passenger flights into the island; cancelled sports and artistic events; closed discotecas, pools, gyms and other public venues; suspended schools for three weeks (until April 20); shut down all inter-provincial public transportation; restricted citizen mobility in neighborhoods with the highest number of cases; and called for religious institutions to follow social distancing.

Many of the measures are focused on vulnerable populations, especially the elderly. Monitoring and prevention measures in geriatric facilities have increased. Residential and community spaces commonly used by elderly people have also ramped up their sanitation efforts.

Economic Impact The pandemic reaches Cuba at a time when the country is already facing an economic crisis, characterized by recent shortages of fuel, food, medicines, and necessary hygienic products. Now, with the halt of foreign tourism and commercial passenger flights—tourism is one of Cuba’s top sources of revenue—and a temporary dip in foreign investment, the Cuban economy will face what some experts

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predict to be a crisis with no parallels, more precarious than the one faced in the 1990s following the fall of the Soviet Union.

The U.S. embargo against Cuba is particularly affecting the nation’s capacity to combat the pandemic.

The ratcheting up of sanctions under the Trump administration has heavily limited travel and trade to the island and significantly impacted the economy, weakening it in the face of the crisis. Moreover, despite supposed humanitarian allowances under U.S. sanctions framework, limitations and obstacles to the island’s financial transactions with the U.S. and with third countries remain. U.S. sanctions also affect Cuba’s capacity to import and export and frustrate efforts to deliver humanitarian assistance to the country. The Center for Democracy in the Americas, along with several U.S.-based organizations have called on the U.S. government to issue a suspension of sanctions on Cuba to facilitate the flow of needed humanitarian and medical supplies to the Cuban people as they cope with COVID-19.

Socioeconomic Policies The economic impact of the COVID-19 pandemic will have a very negative and differentiated effect on Cuban households' economies. Cuba has adopted several protective policies, especially for those who work in the state sector—which account for almost 70 percent of the island’s workforce. Those who can telework will receive 100 percent of their salary, while others will be relocated to other jobs. If relocation or teleworking is not possible, or if the person must stop working because they are taking care of a school-aged child (a child between 5 and 11 years old) or a child with special needs, they will receive 100 percent of their salary during the first month, and 60 percent of their salary thereafter for the duration of the stoppage. Additionally, the government has established a temporary moratorium on the collection of debt and interest by banks, and prioritized domestic food production in order to cover the population's basic needs.

The government also took steps to offer protections in the self-employed sector, but the measures do not offer the level of protection provided to the state sector .1 If a self-employed worker (owner of the business or not) decides to temporarily suspend operations due to COVID-19, there are rules to expedite procedures for the suspension of licenses. Those businesses with employees who are currently working, are obliged to guarantee their salaries at, at least, the country's minimum wage. However, self-employed, contracted and informal workers will lose their source of income when they stop working.

All of those who, as a result of the crisis, are left with insufficient income to pay for basic services, may elect for temporary social assistance payments. Despite the importance of this protective social policy, these temporary monetary benefits are insufficient to cover an individual’s necessities. According to the Economic Commission for Latin America and the Caribbean, the monetary benefits of social assistance programs in Cuba were between $217 and $260 Cuban pesos per month in 2018. 2 In 2016, the average monthly consumption expenditure of a three-person household in Cuba was $2,245 Cuban pesos.

Actors from Cuba’s private sector and civil society have also launched initiatives to support those affected by the pandemic. Individuals and community and religious organizations have begun to make masks for distribution. Youth groups and social collectives are organizing to deliver food and assist the elderly who live alone, those in poor economic conditions, and those who are highly vulnerable to the spread of COVID-19. Artists are offering online concerts and are recording educational videos for those families staying at home. Independent media outlets are offering daily coverage of COVID-19-related issues.

1 Cuba’s non-state sector now comprises almost 30 percent of the workforce from which 13 percent is the private sector, composed of self-employed workers (owners or salaried employees), known in Cuba as “cuentapropistas” and small local businesses. In order to become “cuentapropista”, individuals must receive a permission or license to operate from the Ministry of Labor and Social Security.

2 25 Cuban pesos (CUP) are equivalent to approximately 1 USD.

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Despite the challenges posed by the health crisis, this response from civil society actors continues to expand with the passing of days.

Impacts on Women and Children Since the novel coronavirus began to install itself as a global drama, different organizations such as UNWomen, UNICEF, and the UNFPA have warned that the crisis has specific effects for these groups: 1) due to the mandatory quarantines (or stay-at home measures), an increase in domestic violence against women and children has been verified worldwide; 2) women are more exposed to contagion because they are the main caregivers both within the health systems and in homes; 3) as a result of the closure of schools, and with the entire family staying at the home, the burden of care and domestic work increases for women, who are typically the main caregivers and those who do most of the domestic work in a household; 4) women have more presence in the informal economy (including paid domestic work) and are seriously affected by mobility restrictions and absence of labor rights; 5) the health crisis can limit women's sexual and reproductive rights, as a result of the redirection of medical resources, restrictions on mobility, and the fears associated with the pandemic, which make women hesitate to request health services for fear of contagion.

These challenges need to be considered by institutional policies and civil society. If unaddressed, gender inequalities and their deleterious effects will persist and may grow more pronounced during and after the COVID-19 crisis.

Since school was suspended, government measures were taken to take care of children without family protection. State-run foster care facilities have continued to ensure their physical and psychological wellbeing and extraordinary measures have been taken to deal with the pandemic. For example, family visits were restricted, educational activities were designed in accordance with mobility restrictions, and specific spaces were created for the isolation of children with respiratory symptoms or any viral disease. On the other hand, in order to avoid limits to women's sexual and reproductive rights, prenatal national programs run by the Ministry of Health continue to operate, as well as all maternal and childcare consultations services. However, it is necessary to increase medical consultations at home, have alternatives for the transportation of pregnant women to health centers, prioritize them in the distribution of hygiene and food products to prevent them from having to wait long lines, and especially protect pregnant paid workers.

As mentioned before, among the measures taken is the possibility of paid leave for those taking care of school-aged children—caregivers who, as in the rest of the world, are mostly women. There are two important biases in this policy. First, it only applies to state sector workers; second, mothers of preschoolers or those who are taking care of older adults are not included. The basic reason for this decision is that, so far, public nurseries continue to offer service. However, the capacity of these institutions is very limited (they only serve 22.66 percent of the country's minors at that age), and many children of working mothers receive care at home, or in private day-care centers that have closed due to the health emergency. Under these conditions, these types of measures are not inclusive and are not consistent with the rest of the protective policies that are being implemented.

In a similar vein, it is necessary to implement specific measures that consider the protection of women working in the informal sector, and that provide those women workers in the private sector —who are the most vulnerable in terms of labor rights and economic dispossession —with stronger social and economic protections. At the same time, it is vital to place the debate about caregiving at the center of the current institutional and popular discourse, something that has not happened so far. The work overload of women in these conditions needs to be redistributed among all family members and different social actors.

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In relation to the increase in gender violence in domestic spaces during this period of isolation and/or mandatory quarantine, there are no wide-ranging institutional measures to tackle it, nor has it been a topic present in the political discourse. Although the rates of gender violence are comparable to global averages, in a country where the health system is universal, there are no specific official telephone lines to make complaints or inquiries about these issues. During the crisis associated with COVID-19, actions in this regard have come fundamentally from civil society (two channels - telephone and virtual - that provide advice and support to victims of domestic violence) but these alone are not enough. There is still much to be done in that regard.

Cuba’s International Response Although there are not yet vaccines for COVID-19, Cuba has a drug that may help limit complications from the virus. The antiviral drug Interferon Alpha 2B was developed in the 1980s and has been used to treat HIV and dengue among other viral illnesses. Since 2003, it has been manufactured through the joint Cuban Chinese venture “ChangHeber.” Reportedly, the drug was successfully used in China near the beginning of the virus outbreak along with a slew of other drugs. Cuba's Genetic Engineering and Biotechnology Center is also working on a new drug to combat the virus. They hope to work on the vaccine with a Chinese research and development center with experience with the disease.

As it did in the aftermath of Haiti’s earthquake in 2010, and during the Ebola crisis in 2014 in West Africa, Cuba has sent medical brigades abroad to assist nations in the combating of the pandemic. There are currently Cuban medical teams in Italy, Andorra, Venezuela, Nicaragua, Suriname, Jamaica, Grenada, Haiti, Saint Christopher, Nevis, and Barbados. The U.S. has not reached any cooperation agreement with Cuba, and, on the contrary, has asked countries suffering from the effects of the pandemic to reconsider asking Cuba for support. The U.S. has characterized Cuba’s medical missions abroad as human trafficking and urges countries to end their participation in the program. Cuba also recently stepped up to help Great Britain when it allowed a British ship to dock and evacuate its passengers after other countries turned the boat away out of fear that the handful of COVID-19 cases onboard would become a domestic threat.

Conclusion All in all, Cuban policies to deal with COVID-19 are systematic and of broad-spectrum. From an epidemiological point of view, the virus has touched much fewer people in Cuba than in other parts of Latin America and the world. Cuba’s measures address the social effects of the crisis and seek to protect vulnerable groups. At the same time, pre-existing gender inequalities pose challenges and will define the ways in which women entered, remain, and will leave this crisis. If not considered, women in Cuba and around the world will unequally shoulder the brunt of the crisis. Finally, U.S. policy is, without question, hurting the Cuban people at this sensitive time. The U.S. government should suspend the sanctions that hurt the Cuban people the most as they cope with the global COVID-19 pandemic.

About the authors Ailynn Torres Santana finished her Ph.D. in Social Sciences with a Major in History at the Latinoamerican Faculty of Social Sciences (FLACSO) in 2017. Her research topics are feminism, gender studies, inequalities and citizenship in Latin America. She is currently part of the post-doctoral program of the Rosa Luxemburg Foundation on “Authoritarian capitalism, reactionary populism, and emancipatory counter-strategies: global perspectives from the South” and has a journalistic column in OnCuba-News.

Ailynn has published articles in a variety of journals and contributed chapters to several books. She originally studied Psychology and Communications in Havana, Cuba, and was a researcher at the Cuban

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Institute of Cultural Research "Juan Marinello" from 2006 to 2019. Ailynn has worked as an invited professor at the University of Havana, FLACSO Ecuador, the University of Barcelona, and the University of Massachusetts. She was a visiting scholar at Harvard University in 2019.

Ailynn is a member of the Editorial Board of the Cuban Studies Magazine at Harvard University. She is a member of the Friedrich Ebert Foundation’s regional project “The future is feminist” and the global project "Feminist visions of the future of work”. She also works with academic working groups of the Latin American Council of Social Sciences (CLACSO) and FLACSO, among other professional networks.

María José Espinosa Carrillo is an economist, foreign policy expert, and human rights advocate with over ten years of international experience in policy research, advocacy, and global affairs. She is currently the Director of Programs at the Center for Democracy in the Americas, a leading non-profit, non-partisan advocacy organization based in Washington, D.C. In her role, María José provides strategic and operational leadership to strengthen CDA’s policy research, public messaging, fundraising efforts, and advocacy initiatives. María José has led dozens of high-level U.S. delegations on fact-finding trips to Cuba, Central America, and the U.S.-Mexico border to inform Members of Congress, policy leaders, philanthropists and others seeking to drive transformative action in foreign policy toward Latin America and the Caribbean, migration, and other issues.

Prior to joining CDA, María José organized exchange programs between the U.S. and Cuba. Earlier in her career, María José worked as an International Affairs Analyst at the Centre for the Study of Asia and Oceania (currently the International Policy Research Center) as the head of the Southeast Asia team where she researched and published articles and reports on economic, political, and social implications of U.S. relations with Asia and Oceania. She began her career as a professor in the School of Economics at the University of Havana.

María José holds an M.Sc. in Tourism and Environmental Economics from the Universitat de les Illes Balears in Spain, an M.Sc. in Economics from the University of Havana in Cuba, and a B.A. (honors) in Economics from the University of Havana. She is the recipient of multiple awards, including a scholarship from the Government of Spain’s Agency for International Development Cooperation and a Ph.D. fellowship at the Universitat de les Illes Balears. Fluent in English and Spanish, María José has lived and worked in Latin America, Europe, and the United States.

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