Cuba

Cuba is the clearest test case in the Americas of what happens when a society organises around different priorities while the most powerful economy on earth works to make that experiment fail. Its constitution guarantees housing, free healthcare, and free education. For decades it produced life expectancy close to that of the United States and one of the highest ratios of doctors to population in the world, under chronic scarcity — while operating under a US embargo that the UN General Assembly has condemned in annual votes since 1992. The same system has also persistently denied Cubans competitive elections, an independent press, and the right to protest, and it is now in its deepest crisis since the 1990s: blackouts, medicine shortages, rising infant mortality, and the departure of roughly a tenth of the population. Both stories are true at once, and neither can be understood without the other.

Power structures

Political power in Cuba is constitutionally concentrated. Article 5 of the 2019 Constitution names the Communist Party of Cuba as "the superior driving force of the society and the State," and Article 4 declares the socialist system "irrevocable."^[1] No other party may compete for power. Freedom House rates Cuba 10 out of 100 in its 2025 assessment — 1 of 40 points for political rights — noting that the party has monopolised government since the mid-1960s and permits no electoral competition.^[2] The generational handover from the Castro brothers to President Miguel Díaz-Canel changed the faces at the top without changing this structure.

The limits of dissent became starkly visible on July 11, 2021, when thousands of Cubans took to the streets in the largest nationwide demonstrations since 1959, driven by food and medicine scarcity, the pandemic, and long-standing restrictions on rights. Human Rights Watch documented systematic arbitrary detention, abuse in custody, and prosecutions that violated basic due process; Cuban rights groups counted more than 1,400 people detained.^[3] By October 2025 the rights group Prisoners Defenders counted nearly 700 political prisoners, and protests over blackouts, shortages, and internet price increases continued through 2025.^[4]

Alongside the party sits the military. GAESA, the business conglomerate of the Revolutionary Armed Forces, controls much of the tourism sector, hard-currency retail, and remittance channels. How much GAESA actually holds is contested: a 2025 Miami Herald investigation based on leaked balance sheets reported roughly $18 billion in assets, while economist Emily Morris of University College London argued that the figures were denominated in Cuban pesos and amount to well under $1 billion.^[5] The dispute itself illustrates the structural problem: the institution with the most economic power on the island is also among the least transparent.

Institutional capture

In most countries on this site, institutional capture means private wealth bending public institutions. In Cuba the direction is reversed: the party-state absorbs institutions that elsewhere act as independent counterweights. Article 55 of the Constitution recognises press freedom but declares that the "fundamental means of social communication" are socialist property that "may not be categorized as any other type of property," and Article 56 conditions assembly and association on "respect to public order" as defined by law.^[1] The practical result is that newspapers, broadcasters, trade unions, and mass organisations operate within the party's orbit rather than outside it.

The same concentration extends to the professions most admired abroad. Cuba's medical missions have deployed more than 400,000 health workers to 164 countries over six decades. Human Rights Watch has documented that the rules governing them require doctors to report romantic relationships, bar friendships with people "hostile" to the revolution, and penalise those who leave a mission with an effective eight-year ban on returning home; "abandoning" a post can carry criminal charges of up to eight years in prison.^[6] Internationalism and coercion coexist in the same institution.

Housing, healthcare, and cost of living

Cuba's housing system rests on an unusual foundation. Under the 1960 Urban Reform Law, tenants who paid rent to the state for twenty years became owners of their homes; by 2019 roughly 85% of Cubans owned the dwelling they lived in, according to economist Carmelo Mesa-Lago.^[7] Article 71 of the Constitution recognises "the right to adequate housing and a safe and healthy home for all people."^[1] This has largely insulated Cubans from the mass eviction, rent extraction, and speculative displacement seen across much of the region.

But ownership is not the same as adequate shelter. The official housing deficit stands at roughly 800,000 units, and about a third of the country's 3.9 million homes are classified as being in fair or poor condition; at recent construction rates, closing the gap would take decades.^[8] Multiple generations routinely share cramped homes — a persistent source of household strain and of delayed independence for young adults. Since 2011, Decree-Law 288 has allowed Cubans to buy and sell homes at freely agreed prices for the first time since the revolution, while limiting ownership to one permanent residence and one vacation home.^[9]

Everyday costs are shaped by a split economy. State salaries are paid in pesos while a growing share of goods is sold only for foreign currency, so access to remittances from relatives abroad increasingly determines who eats well and who does not. Human Rights Watch, citing a mid-2025 survey, reports that seven in ten Cubans skip meals and that only about 30% of essential medicines are available in the country.^[4] Material equality, long a source of social cohesion, is eroding along the line of who has family overseas.

Article 72 of the Constitution makes healthcare a right "free of charge," and the system built around that commitment is organised around neighbourhood family-doctor-and-nurse offices linked to community polyclinics.^[1] The World Health Organization's Bulletin described this primary-care model in 2008 as having "produced enviable results," with each polyclinic serving a catchment of 30,000–60,000 people and acting as a teaching hub.^[10]

The outcomes have been substantial by any standard. WHO estimates Cuban life expectancy at 77.2 years in 2023, compared with 78.5 in the United States.^[11] Cuba has around 85 medical doctors per 10,000 people — more than three times the US ratio of about 27.^[12] These results were achieved under chronic material scarcity, which suggests that health outcomes are reliably driven as much by access, prevention, and continuity of care as by national wealth.

A well-known anecdote illustrates how these comparisons have been received in the United States. Filmmaker Michael Moore has said that his 1994 NBC series TV Nation sent camera crews to emergency rooms in Fort Lauderdale, Toronto, and Havana, and that Havana provided the fastest and cheapest care — but that the network would not allow the segment to say Cuba won, so it declared Canada the winner instead.^[13] This is Moore's account, not an independent finding, and it is offered here only as an illustration; the case for Cuba's health record rests on the WHO data above, not on a television segment.

That record is now under severe strain. Infant mortality, which the government reported at 4.0 per 1,000 live births in 2018, was officially announced at 9.8 for 2025 — the highest in more than two decades.^[14] WHO and UN inter-agency estimates, which use different methods, also show a rise, from about 6.2 in 2022 to 6.8 in 2024.^[15] Shortages of medicines, power, and staff — many doctors among the emigrants — mean that the constitutional guarantee persists on paper while its material basis erodes.

Environmental pressures

The collapse of the Soviet bloc forced Cuba into an accidental experiment in low-input living. In 1989 the socialist bloc supplied 84.6% of Cuba's merchandise imports. Between 1989 and 1993, petroleum imports fell 53%, fertiliser imports 77%, and pesticide imports 62.5%.^[16] The "Special Period" that followed brought real hunger, but it also pushed the country toward organic urban agriculture and agroecology out of necessity rather than ideology.

Cuba has since built one of the most ambitious long-range climate adaptation plans of any small island state. Tarea Vida (Project Life), adopted in 2017, bans new home construction in threatened coastal zones, mandates relocation of communities at risk from sea-level rise, and shifts agriculture away from salt-contaminated land over a century-long horizon.^[17]

The energy system is the most acute vulnerability. Cuba produces only around 40% of the oil it needs, and its thermoelectric plants date largely from 1960–1980.^[18] After Venezuelan supplies stopped in January 2026, the national grid collapsed island-wide at least six times by September 2026, with outages commonly lasting more than 30 hours, cutting water supply, refrigeration, and communications.^[19]

Cooperative and mutual aid traditions

Urban agriculture is the most visible product of collective improvisation under constraint. During the Special Period, residents began farming vacant lots, and a 1993 agrarian reform allowed urban residents to cultivate state land. Raised-bed gardens called organopónicos spread across Havana; officials estimated that more than half of the fruit and vegetables consumed in the capital were grown within the city.^[20] By the 2010s, according to FAO data compiled by economist Mario González-Corzo, some 35,500 hectares nationwide were in urban agriculture, including 4,000 organopónicos, employing between 300,000 and 400,000 people.^[16]

In the countryside, the National Association of Small Farmers (ANAP) built the Campesino a Campesino (farmer to farmer) movement, in which peasants teach agroecological methods to one another rather than receiving instruction from extension agents. A study produced with ANAP and La Vía Campesina found that agroecology spread rapidly largely because of this peer-to-peer social method, contributing to significantly increased food production by the peasant sector without imported agrochemicals.^[21]

Cuba's best-known form of solidarity faces outward. The Henry Reeve medical brigade sent 165 health workers to Sierra Leone at the peak of the 2014 Ebola outbreak — at the time the largest single-country foreign medical team there — under a special agreement with WHO and the government of Sierra Leone.^[22] At home, informal networks of neighbours and kin — sharing food, medicine, and electricity when one house has a generator — remain the real safety net when state provision falters.

Political language

El bloqueo / the embargo

The Cuban government calls US sanctions a "blockade"; Washington calls them an "embargo." The choice of word signals political alignment. Since the Helms-Burton Act (1996), lifting the measures requires an act of the US Congress.

Resolver

"To solve" — the everyday verb for obtaining what the formal economy cannot supply, through barter, informal markets, favours, or ingenuity. It names a whole survival culture.

La libreta

The ration book introduced in the early 1960s that entitles each household to a basic monthly quota of subsidised food. Once a symbol of guaranteed subsistence, its shrinking contents now mark the depth of the crisis.

Período Especial

The "Special Period in Time of Peace" — the official euphemism for the economic collapse of the 1990s after Soviet support ended. Many Cubans now describe the current crisis as worse.

Patria o Muerte / Patria y Vida

"Homeland or Death" is the revolution's founding slogan. "Homeland and Life," the title of a 2021 song by Cuban musicians, inverted it and became the rallying cry of the July 2021 protests.

Internacionalismo

The state doctrine of sending doctors, teachers, and (historically) soldiers abroad in solidarity — a source of genuine pride, international prestige, and hard-currency revenue all at once.

Unique structural features

The embargo is the defining external structure of Cuban life. On October 29, 2025, the UN General Assembly voted 165 to 7, with 12 abstentions, to demand its end — the 33rd consecutive year it has done so. Only the US Congress can lift it.^[23] In its submission to the UN Secretary-General's 2025 report, the Cuban government estimated damages of $7.56 billion between March 2024 and February 2025, and cumulative losses of $170.7 billion at current prices over six decades. The same submission acknowledges that "the shortages and problems faced by the Cuban people are not exclusively due to" the embargo.^[24] These are Cuba's own estimates; they have not been independently audited.

Independent observations confirm part of the mechanism. In the same UN report, WHO and the Pan American Health Organization state that although the US says humanitarian goods are permitted, "United States companies have in certain cases declined to supply vaccines and life-saving medications to WHO when they are procured for Cuba." UNICEF estimates its freight costs to Cuba would fall by an average of 40% if it could procure from the US market.^[24] Sanctions intensified sharply in 2026: a January 29 executive order authorised tariffs on any country supplying oil to Cuba.^[25] UN High Commissioner for Human Rights Volker Türk warned that children were dying because doctors could not access essential medicines.^[18]

Constraint has also produced remarkable scientific creativity. Cuba's state biotechnology sector developed CIMAvax-EGF, a lung cancer immunotherapy given to more than 5,000 patients worldwide and approved in several countries; Roswell Park Comprehensive Cancer Center became the first US institution cleared to trial it, though it remains experimental in the United States.^[26] During the pandemic, Cuba developed and mass-produced its own COVID-19 vaccines. A peer-reviewed cohort study in The Lancet Regional Health – Americas found the Abdala vaccine 98.2% effective against severe illness in fully-vaccinated adults in Havana.^[27]

The most consequential structural fact of the present may be demographic. Official figures show the population falling by roughly 1.4 million, nearly 13%, between 2020 and 2024, driven by emigration and a collapsing birth rate; independent demographers estimate the loss is larger.^[28] Those leaving are disproportionately young and skilled. Sociologists describe this as a slow-motion loss of social fabric: ageing parents left behind, families divided across borders, and the professionals the free education system trained now serving other countries.

Legal and constitutional context

The 2019 Constitution, approved by referendum, simultaneously entrenches one-party rule and expands social and economic rights. It guarantees free healthcare (Article 72), free education from preschool through postgraduate study (Article 73), and the right to adequate housing (Article 71), while formally recognising private property alongside socialist and cooperative property.^[1] Rights of expression, press, and assembly are recognised in principle but subordinated to "public order" and to state ownership of the media.

This dual character is the central lesson of the Cuban case. Social guarantees written into law and backed by trained personnel can deliver health and education outcomes that rival wealthy nations on modest resources. But rights that depend on a single party's discretion, without independent courts, press, or elections to hold power accountable, persistently leave citizens without recourse when the system fails them — and external economic pressure designed to force political change has, over six decades, reliably deepened material hardship without producing that change.