Several prime ministers have expressed their willingness to sacrifice access to the US rather than compromise healthcare for their citizens.

“I will prefer to lose my US visa than to have 60 poor and working people die,” declared St. Vincent and the Grenadines Prime Minister Ralph Gonsalves, emphasizing the vital dialysis treatments provided by Cuban doctors in his country.

This sentiment was echoed by Trinidad and Tobago’s Prime Minister Dr. Keith Rowley, who, at a recent public event, declared to resounding applause: “I just came back from California, and if I never go back there again in my life, I will ensure that the sovereignty of Trinidad and Tobago is known to its people and respected by all.”

The diplomatic tension escalated last month when Rubio announced a new policy targeting what he described as Cuban “forced” labor, particularly in relation to the island’s overseas medical missions. The policy aims to impose visa restrictions on current or former Cuban officials “believed to be responsible for or involved in the Cuban labor export program,” which Rubio has labeled as “exploitation of Cuban workers.”

For Caribbean nations, the partnership with Cuba in healthcare is crucial. Roughly 24,180 Cuban doctors serve in 56 countries globally, significantly enhancing healthcare systems in regions with limited medical infrastructure.

Jamaica’s Foreign Minister Kamina Johnson Smith highlighted this at a recent press briefing, noting that her nation hosts over 400 Cuban medical professionals, including doctors, nurses, biomedical engineers, and technicians, whose contributions are “of importance to our health care system.”

Grenada’s Prime Minister Dickon Mitchell emphasized the historical significance of this support, stating, “We have a legitimate partnership with the government and people of Cuba who have over several decades provided support to the people of Grenada in the medical field.”

He acknowledged the challenges his nation faces in securing specialist doctors, affirming, “We will continue to support and defend the partnership.”

The controversy has led to high-level diplomatic discussions, with foreign ministers from the 15-member Caribbean Community (CARICOM) recently meeting with US Special Envoy for Latin America Mauricio Claver-Carone in Washington, DC.

Guyana’s Foreign Minister Hugh Todd recognized the importance of the US as “a strategic partner to CARICOM” but emphasized that “this very important issue has to be dealt with at the level of heads of government.”

Prime Minister Rowley of Trinidad and Tobago pointed out the inconsistency in the US stance, recalling the difficulties encountered during the COVID-19 pandemic: “Remember what happened during Covid when vaccines were required, and we couldn’t buy one even though we had the money? And even where we paid the money, those we paid put us at the back of the line?”

He defended his country’s medical staffing practices, clarifying that specialists from India, the Philippines, and primarily Cuba are compensated “top dollar -equal to local rates,” yet his government is “now being accused of taking part in a program where people are being exploited.”

Barbados’s Ambassador David Commissiong, speaking on the “Mornin Barbados” television program, placed the current dispute in a historical context, recalling how Caribbean prime ministers Errol Barrow, Michael Manley, Forbes Burnham, and Dr. Eric Williams faced similar pressures 53 years ago when the US and the Organization of American States (OAS) demanded that new Caribbean nations refrain from recognizing Cuba.

According to Commissiong, these leaders asserted their sovereignty: “We are sovereign independent nations, and we will decide for ourselves what nations we will have relations with.”

Commissiong characterized Rubio’s current policy as “part of this continuing US vendetta against Cuba,” aimed at “regime change,” and referenced a 1960 State Department memo that allegedly acknowledged the popularity of Castro’s revolution and suggested making “life uncomfortable for the people in Cuba” by undermining the government.

He also pointed out that the US has withdrawn its traditional support for the Pan American Health Organization (PAHO), which Caribbean nations rely on for health policy.

“The United States, having withdrawn itself from PAHO, will have a tremendous implication for all of us in the Caribbean, and you now turn around and say we must reject the much needed and critical health assistance being given to us by Cuba!” he remarked incredulously.

Cuba’s Foreign Minister Bruno Rodríguez has criticized Rubio, accusing him of prioritizing his “personal agenda” over US interests and describing the policy as an “unjustified aggressive measure.” As this diplomatic situation develops, Caribbean leaders remain focused on their healthcare needs and sovereign decision-making, demonstrating that regional solidarity and public health priorities outweigh the threat of US visa restrictions.