To the Editors:

As the Facts & Figures section in your July 2015 issue illustrates, Cuba’s global health collaboration programs between 1959 and 2015 demonstrate foresight and political will in prioritizing health education and disease prevention across geographic borders.[1] Cuba’s public health mission is health professional education with a focus on primary preventive health care, which has impacted the delivery of quality health care services for the Cuban population and for countries enduring conflicts, disease outbreaks and natural disasters.

When WHO’s Director General, Dr. Margaret Chan, visited Cuba in July 2014, she was impressed with the prevention-based model as a foundation of the health care system with links to health research and development. Touted as a model for effective universal health coverage over the past several decades, Cuba was an ideal setting to host Cuba Salud 2015, an international public health convention whose theme, “Health for all: universal coverage,” convened international research exchanges to highlight evidence-based practices for diagnosis, prevention and control of chronic and infectious diseases with effective service delivery models. Social determinants of health were discussed with respect to related barriers to health equity and optimal population health.

Cuba Salud convened over 1500 delegates from more than 70 countries. The conference proceedings provided opportunities to recognize achievements in countries that increase access to health care services that promote healthy behaviors. Cuban delegates described challenges they faced with limited economic resources, but stressed that intersectoral health actions facilitated critical health achievements in low infant mortality and increased life expectancy at birth, close to the rates of high-income countries.[2] Additionally, Cuba practiced solidarity beyond its borders by training Cuban health professionals for international deployment, notably with the Henry Reeve Brigade during the 2014 Ebola outbreak.

Cuba has shown that national policies for inclusion of culture, ethics, leadership and social determinants of health can enhance health promotion programs utilizing universal health coverage. Cuba’s global health collaboration over the past 56 years has resulted in outstanding achievements in universal coverage for preventive health care. This experience provides an example of how ethical and moral commitments can and should be addressed to identify social, economic and health inequalities in vulnerable populations.[3]

Helena J. Chapman MD MPH (hchapman@ufl.edu), Department of Environmental and Global Health, University of Florida College of Public Health and Health Professions, Gainesville, Florida, USA

1. Cuba’s global health cooperation. Facts & figures. MEDICC Rev [Internet]. 2015 Jul [cited 2016 May 25];17(3). Available from: http://www.medicc.org/mediccreview/index.php?issue=35&id=491&a=vahtml
2. Cooper RS, Kennelly JF, Orduñez-Garcia P. Health in Cuba. Int J Epidemiol. 2006 Aug;35(4):817−24.
3. Etienne CF. Achieving universal health coverage is a moral imperative. Lancet. 2015 Apr 4;385(9975):1271−3.