Cuba Prioritizes Health and Education Even in Hard Economic Times

Cuba Prioritizes Health and Education Even in Hard Economic Times
Photo of Havana, Cuba by Pedro Szekely via Flickr Creative Commons

By Gerry Bill

Cuba never ceases to amaze me. Here we are in the throes of an international economic crisis affecting every country in the world. Yet, amid that crisis, the Cubans manage to maintain and practice the socialist values that have been at the core of Cuban society for the last 52 years. How do they do that?

It isn’t that Cuba is unaffected by the international economic collapse. The price of some of Cuba’s major export commodities, such as nickel, has dropped precipitously. Meanwhile, the prices of some of the things that Cuba must import have been going up. Perhaps worst of all, tourism, a major source of revenue for the island nation, is down because fewer people have the money to travel. All of those conditions are, of course, worsened by the immoral and illegal U.S. blockade of our southern neighbor—a policy that has effectively kept the island in a state of siege for the last 50 years.

I just returned from a 10-day visit to the island—my sixth in recent years—and, as always, I was inspired by the magnificent achievements of the Cuban people despite the constant persecution by the U.S. government. Both the Cuban government and, more important, the Cuban people, are thoroughly committed to preserving the major achievements of the revolution and to doing so regardless of what is happening in the international economy. Cuba will find its own way through the current economic chaos.

Cuban Priorities in Hard Economic Times

Yes, there is an economic crisis in Cuba these days just as in many other places around the globe. The difference is in the choices Cuba makes as it adapts to the changing economic circumstances brought on by the crisis. It is a matter of priorities. When Cuba prioritizes its budget it puts the health and educational needs of its people first.

When compared to other nations, Cuba devotes a rather large share of its national budget to education and healthcare for its people. The results of that decision are quite visible throughout the island. Cuba is a highly literate, highly educated society. Unlike my experience in many other countries around the globe, in Cuba I have never met an illiterate person. UNESCO has certified Cuba to be essentially free of illiteracy, with a literacy rate of 99.8%, the highest of any Latin American country.

Not only are Cubans literate, the level of education is quite high. Education is free from preschool through graduate school, and an amazingly high percentage of Cubans have graduate degrees. You run into them all the time when traveling around the island. For example, more than half of Cuba’s ordinary school teachers have master’s degrees. The Cubans are a well-educated people, and they are proud of it.

Healthcare and Medical Education in Cuba

The crowning achievement of the Cuban educational system is in medicine. Cuba has 23 medical schools for training its doctors. It trains them first in family practice, a mandatory specialization for all doctors, and then offers training in a wide variety of other specialties. The best known of the medical schools, internationally, is the Latin American School of Medicine in Havana (ELAM). ELAM is now training students from more than 100 countries, all completely free of charge.

Yes, you read that right—Cuba is training students from more than 100 countries to become doctors, all paid for by the
Cuban government. You might ask, “How does a poor country with only 11 million inhabitants afford to provide free medical education for so many people from foreign lands and still have money left to train its own doctors?”

The answer lies in Cuba’s priorities and commitments. Along with education, healthcare is a top priority in Cuban society. The general level of health of the Cuban people has been raised dramatically since the revolution, giving Cuba some of the best health statistics in Latin America, and in many cases surpassing the health statistics in the United States and Canada (e.g., infant mortality rates, vaccination rates, number of doctors per person).

Furthermore, the health benefits of living in Cuba are not really dependent on one’s income level. For example, in stark contrast to most countries in the world, infant mortality rates in Cuba do not vary according to the income level of the parents. Socialism seems to create an equality of outcome that just cannot be duplicated in capitalist countries.

Cuba has the knowhow to keep its own people healthy. It also has a culture that emphasizes generosity, which means Cubans want to share their medical knowhow with the rest of the world, particularly with poor third-world countries. Since the triumph of the revolution in 1959, Cuba has sent more than 500,000 health professionals overseas to help meet the unmet medical needs of millions of people around the world. Currently, Cuba has 30,000 medical personnel abroad in places like Haiti, Africa and Latin America serving otherwise underserved populations. Remember, this is all coming from a society of only 11 million people.

Again you might ask, how can they possibly afford it? Well, they use what resources they have to make it happen. A big share of the national budget goes to healthcare and education because that is what is important to the Cubans.

Cuban Priorities versus U.S. Priorities

It seems that my own country, which is sometimes referred to as the richest country in the world, cannot afford the things that a poor country like Cuba can afford. Why is that? Well, to start with, the United States spends more than 50% of its discretionary budget on the military. With that as a starting point, there is no way the United States can devote what is needed to provide adequately for the nation’s health and education. As President Dwight Eisenhower rightly stated nearly 60 years ago, every dollar spent on the military represents a theft from the resources needed for society to look after the health and educational needs of its own people.

Stated another way, it is a matter of priorities. In Cuba, 69% of the budget is devoted to human needs: health, education, culture, sports, social security and social assistance. Unfortunately, in the United States, the needs of the people are not the first priority. Try to imagine what the United States would look like if we spent 50% of our budget on education and health instead of on warfare. It boggles the mind.

Arts Education in Cuba

Look at what is happening in the United States during these times of so-called austerity budgets. Education and healthcare are facing large cuts. Consider what has happened to arts education in our public schools. When I went to school in the 1950s, classes in music and the arts not only were available in the public schools but also, in many cases, were required subjects. The goal was not to make artists or musicians of all of us but rather to give us the background to be able to recognize and appreciate good art and good music. Much of that has now gone by the wayside. It seems that when budgets are tight, education in the arts is the first thing to go.

Not so in Cuba. The Cubans place a high value on art and music education, and education in those subjects is given a prominent place in the schools. The results in society are pretty visible—the artistic and musical communities in Cuba are thriving, and Cuban citizens have become discerning consumers of those arts.

Again, it is worth asking, how can the poor Cubans afford to include the arts in their curriculum, whereas we in the United States cannot find the resources to do it? The answer, once more, is priorities. In the United States, military spending takes priority over spending on education, including arts education.

Science Education and Medical Research in Cuba

Another priority in the Cuban educational system is science education. The sciences are given strong emphasis in Cuban schools, and a relatively high percentage of university graduates in Cuba get their degrees in the sciences. Somehow, this tiny, impoverished and besieged nation turns out significant numbers of world-class scientists.

Nowhere is this more evident than in medical research. During my trip to Cuba in July, our group visited the Center for Genetic Engineering and Biotechnology in Havana. It is one of several such research centers operating in Cuba. The discoveries and resulting medicines that have come out of these research centers are becoming well known in medical communities around the world—except, of course, in the United States, where there is an effective information blackout of any good news coming out of Cuba.

Here are a few examples. Cuba has developed a highly effective therapeutic hepatitis B vaccine that has the potential to completely wipe out the disease. Indeed, Cuba is on track to be the first country in the world to completely eliminate hepatitis B from its territory. Currently, there are only 11 active cases in the country, and by 2020 it is anticipated that there will be zero cases. Cuba is also working on a therapeutic hepatitis C vaccine that is expected to come on line in about five years—the first such vaccine in the world.

Cuba has developed a highly effective treatment for the foot ulcers that occur among diabetics. The new treatment makes it possible to avoid the amputations that were so common in the past. Cuba is expecting to fully eliminate therapeutic amputations among its diabetics through the use of this new medication. The medication will be exported to other countries to reduce or eliminate the amputations in those countries as well, but the United States will miss out on that advance. Why? Because the U.S. blockade prohibits importing things made in Cuba, even if those things are imported through a third country. This is one of the ways that the U.S. blockade backfires and hurts the United States just as much as it hurts the Cubans. What a stupid policy—aren’t we just shooting ourselves in that not-yet-amputated foot?

The Cuban medical research centers are working on vaccines for diseases that do not even exist in Cuba. Cuba is a tropical country, but it is completely free of tropical diseases. Despite not having a domestic need, the Cubans care about their neighbors and about other poor countries plagued by the diseases not found at home. Therefore, they are working on a vaccine for things like dengue fever and cholera. Those are the sorts of vaccines not likely to be developed in capitalist societies because there is not much money to be made in preventing those diseases. In fact, there is more money to be made in treating those diseases than in preventing them.

For the Cubans, however, it is not primarily about money—it is about reducing human suffering. I specifically asked the researchers if the point of developing these vaccines was to bring money into Cuba by selling the product to other countries. They said not really. The vaccines will be sold to countries that can afford to pay for them, if those countries have the need for them. But for the really poor countries that need the vaccines the most, the vaccines will be provided to them by Cuba at little or no charge. That is the socialist way—from each according to his or her ability to pay, to each according to his or her need. Cuba is not really pursuing a capitalist path as it develops these new medicines. If it brings money into Cuba, fine; if not, Cuba will still have been of service to people in need.

The Cuban Example: Putting the Needs of People First

The pattern in all of the above is pretty clear. A capitalist economy is driven by the need to protect corporate profits. In Cuban-style socialism, that is not the driving force. Instead, the general welfare of the entire population is the driving force. Once that priority is established, ways are found to make it happen.

Cuba is not a perfect society. They face some serious economic problems. The standard of living there is low by U.S. standards, if measured by the production and consumption of consumer goods. Because of the tourist trade, some inequalities in income have crept into the society that are much greater than the Cubans would like to see.

The Cubans are working on these issues, and they will find uniquely Cuban solutions to their economic woes. But what they won’t do is give up their core values. They are quite proud of their accomplishments in education and healthcare, and those are likely to be the last things Cubans will give up as they adapt to changing economic realities.

It is a matter of priorities. Cubans run their society as though the needs of people mattered above all else. That is why Cuba is such a threat to the United States. It has made the socialist model work to the benefit of its people, and the United States fears other countries might want to follow suit. Who knows, maybe someday even the U.S. population will rise up and demand a system that provides parity with the Cubans in the realms of healthcare and education. Wow—that’ll be the day! No wonder our leaders hate the Cubans so much—they make us look really bad because we don’t seem able to do what they are doing.

Don’t believe me? Go see for yourself. Join the Pastors for Peace Caravan to Cuba in July 2012. For more information, visit


Gerry Bill is emeritus professor of sociology and American studies at Fresno City College. He traveled to Cuba in July of this year with the 22nd Pastors for Peace aid caravan to Cuba. This was his sixth trip to Cuba with Pastors for Peace. He is one of the founders of the Fresno Center for Nonviolence and is on the boards of the Fresno Free College Foundation, Peace Fresno and the Central California Criminal Justice Committee.



  • Mike Rhodes

    Mike Rhodes is the executive director of theCommunity Alliance newspaper and author of the book Dispatches from the War Zone, about homelessness in Fresno. is his website. Contact him at

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