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192-535: The Cuban government operates a national health system and assumes fiscal and administrative responsibility for the health care of all its citizens. All healthcare in Cuba is free to Cuban residents, although challenges include low salaries for doctors, poor facilities, poor provision of equipment, and the frequent absence of essential drugs. There are no private hospitals or clinics as all health services are government-run. The current public health minister of Cuba
384-568: A milkmaid named Sarah Nelmes with which he infected an eight-year-old boy named James Phipps , and two months later he inoculated the boy with smallpox, and smallpox did not develop. In 1798, Jenner published An Inquiry Into the Causes and Effects of the Variolæ Vaccinæ which created widespread interest. He distinguished 'true' and 'spurious' cowpox (which did not give the desired effect) and developed an "arm-to-arm" method of propagating
576-580: A spontaneous protest in Havana. From the start of the crisis until 1995, Cuba saw its gross domestic product (GDP) shrink by 35%. It took another five years for its GDP to reach pre-crisis levels. Cuba has since found a new source of aid and support in the People's Republic of China. In addition, Hugo Chávez , then president of Venezuela , and Evo Morales , former president of Bolivia , became allies and both countries are major oil and gas exporters. In 2003,
768-541: A 2006 report to the U.N. Secretary-General, Cuba acknowledged the authorization of medicines, though stated that they were subject to severe restrictions and complicated procedures. Cuba is obliged to make payments in cash and in advance, and is precluded from obtaining credit funding, even from private sources. The sale and transportation of the goods require licenses to be obtained for each transaction. Cuba cannot use its own merchant fleet for transporting these goods, but has to make use of vessels from third countries, primarily
960-566: A 90% decrease in exposure rates. Vaccination adoption is reduced among some populations, such as those with low incomes, people with limited access to health care, and members of certain racial and ethnic minorities. Distrust of health-care providers, language barriers, and misleading or false information also contribute to lower adoption, as does anti-vaccine activism . Most government and private health insurance plans cover recommended vaccines at no charge when received by providers in their networks. The federal Vaccines for Children Program and
1152-597: A Somali invasion. On 24 January 1978, Ethiopian and Cuban troops counterattacked, inflicting 3,000 casualties on the Somali forces. In February, Cuban troops launched a major offensive and forced the Somali army back into its own territory. Cuban forces remained in Ethiopia until 9 September 1989. Despite Cuba's small size and the long distance separating it from the Middle East, Castro's Cuba played an active role in
1344-434: A campaign titled the "revolutionary offensive" was initiated to nationalize all remaining private small businesses, which at the time totaled to be about 58,000 small enterprises. The campaign would spur industrialization in Cuba and focus the economy on sugar production, specifically to a deadline for an annual sugar harvest of 10 million tons by 1970. The economic focus on sugar production involved international volunteers and
1536-613: A collapse in the price of sugar, political unrest, and repression. Protesting students, known as the Generation of 1930, turned to violence in opposition to the increasingly unpopular Machado. A general strike (in which the Communist Party sided with Machado), uprisings among sugar workers, and an army revolt forced Machado into exile in August 1933. He was replaced by Carlos Manuel de Céspedes y Quesada . In September 1933,
1728-672: A disease if there is no animal reserve. Other vaccines, including those for COVID-19 , help to (temporarily) lower the chance of severe disease for individuals, without necessarily reducing the probability of becoming infected. Just like any medication or procedure, no vaccine can be 100% safe or effective for everyone because each person's body can react differently. While minor side effects , such as soreness or low grade fever, are relatively common, serious side effects are very rare and occur in about 1 out of every 100,000 vaccinations and typically involve allergic reactions that can cause hives or difficulty breathing. However, vaccines are
1920-452: A disease in spite of being vaccinated against it. Primary vaccine failure occurs when an organism's immune system does not produce antibodies when first vaccinated. Vaccines can fail when several series are given and fail to produce an immune response. The term "vaccine failure" does not necessarily imply that the vaccine is defective. Most vaccine failures are simply due to individual variations in immune response. The term " inoculation "
2112-721: A growing number of Americans also are coming. By 1998, according to the Economic Commission for Latin America and the Caribbean, the Cuban health sector had risen to occupy around 2 percent of total tourism. Some of these revenues are in turn transferred to health care for ordinary Cubans, although the size and importance of these transfers is both unknown and controversial. At one nationally prominent hospital/research institute, hard currency payments by foreigners have financed
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#17327829485752304-446: A growing sex industry. At the same time, Cuba’s prevention of mother-to-child transmission programme remains highly effective. All pregnant women are tested for HIV, and those testing positive receive antiretroviral drugs. In 2015, Cuba became the first country in the world to eliminate mother-to-child transmission of HIV and syphilis, a major public health accomplishment. Following the successful 2022 Family Code referendum , surrogacy
2496-536: A higher level of adverse events than alternative vaccines resulting in legal action. In a response to the narcolepsy reports following immunization with Pandemrix, the CDC carried out a population-based study and found the FDA-approved 2009 H1N1 flu shots were not associated with an increased risk for the neurological disorder. The ingredients of vaccines can vary greatly from one to the next and no two vaccines are
2688-567: A joint U.S.-Latin American assault on Francoist Spain to overthrow its authoritarian regime. Cuba lost six merchant ships during the war, and the Cuban Navy was credited with sinking the German submarine U-176 . Batista adhered to the 1940 constitution's strictures preventing his re-election. Ramon Grau San Martin was the winner of the next election, in 1944. Grau further corroded
2880-629: A key part of the Cuban healthcare system, followed by the science and technology. One of the largest medical universities in the world exists in Cuba, the Latin American School of Medicine . Cuba provides more medical personnel to the developing world than all the G8 countries combined. In the 1970s, the Cuban state initiated bilateral service contracts and various money-making strategies. Cuba has entered into agreements with United Nations agencies specializing in health: PAHO / WHO , UNICEF ,
3072-506: A large-scale plan by the Cuban state to provide free medical aid and services to the international community (especially third world countries) following natural disasters. Currently dozens of American medical students are trained to assist in these donations at the Escuela Latino Americana de Medicina (ELAM). Cuba's missions in 68 countries are staffed by 25,000 Cuban doctors. Medical teams have worked in crisis such as
3264-481: A list of vaccines and their possible side effects. The risk of side effects varies between vaccines. In 1976 in the United States, a mass swine flu vaccination programme was discontinued after 362 cases of Guillain–Barré syndrome among 45 million vaccinated people. William Foege of the CDC estimated that the incidence of Guillain-Barré was four times higher in vaccinated people than in those not receiving
3456-683: A method of "nasal insufflation " administered by blowing powdered smallpox material, usually scabs, up the nostrils. Various insufflation techniques have been recorded throughout the sixteenth and seventeenth centuries within China. Two reports on the Chinese practice of inoculation were received by the Royal Society in London in 1700; one by Martin Lister who received a report by an employee of
3648-484: A middle class in most urban areas. After finishing his term in 1944 Batista lived in Florida, returning to Cuba to run for president in 1952. Facing certain electoral defeat, he led a military coup that preempted the election. Back in power, and receiving financial, military, and logistical support from the United States government, Batista suspended the 1940 Constitution and revoked most political liberties, including
3840-816: A mixture of Spanish, African, and Taíno heritages. Cuba developed slowly and, unlike the plantation islands of the Caribbean, had a diversified agriculture. Most importantly, the colony developed as an urbanized society that primarily supported the Spanish colonial empire. By the mid-18th century, there were 50,000 slaves on the island, compared to 60,000 in Barbados and 300,000 in Virginia ; as well as 450,000 in Saint-Domingue , all of which had large-scale sugarcane plantations. The Seven Years' War , which erupted in 1754 across three continents, eventually arrived in
4032-529: A new ophthalmology center in Venezuela, and later expanded its program to 30 Venezuelan hospitals. Cuba continued to grow the program and by 2017 had established 69 Operación Milagro clinics in 15 different countries. By 2019, over 4 million people in 34 countries had received free surgery through the program. Cuba also exports many medical products, such as vaccines . Cuba attracts about 20,000 paying health tourists , generating revenues of around $ 40 million
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#17327829485754224-426: A patient has contracted a disease to help increase future protection. However, some vaccines are administered after the patient already has contracted a disease. Vaccines given after exposure to smallpox are reported to offer some protection from disease or may reduce the severity of disease. The first rabies immunization was given by Louis Pasteur to a child after he was bitten by a rabid dog. Since its discovery,
4416-650: A primary role in the Mission Barrio Adentro (Spanish: "Mission Into the Neighborhood") social welfare program established in Venezuela under former Venezuelan president Hugo Chávez . Through Operación Milagro (in English, “Operation Miracle”), Cuba began in 2004 to pay for Venezuelans with reversible blindness to travel to Cuba for free operations to restore their sight. Over 200,000 Venezuelans received this free surgery. In 2005, Cuba established
4608-464: A recurring issue, despite Cuba's efforts to develop its own COVID-19 vaccines. Furthermore, there is a notable disparity between the medical service offered to Cuban citizens and the "health tourism" targeted at foreigners, with the latter being of higher quality and enjoying a better international reputation. Cuba Cuba , officially the Republic of Cuba , is an island country , comprising
4800-499: A separate black republic in Oriente Province, but was suppressed by General Monteagudo with considerable bloodshed. In 1924, Gerardo Machado was elected president. During his administration, tourism increased markedly, and American-owned hotels and restaurants were built to accommodate the influx of tourists. The tourist boom led to increases in gambling and prostitution in Cuba . The Wall Street Crash of 1929 led to
4992-490: A severe outbreak of smallpox in 1851 and 1852. It provided that the poor law authorities would continue to dispense vaccination to all free of charge, but that records were to be kept on vaccinated children by the network of births registrars. It was accepted at the time, that voluntary vaccination had not reduced smallpox mortality, but the Vaccination Act 1853 was so badly implemented that it had little impact on
5184-513: A small risk of contracting smallpox that the U.S. Public Health Service recommended for routine smallpox vaccination to be ended. By 1974 the WHO smallpox vaccination program had confined smallpox to parts of Pakistan , India, Bangladesh , Ethiopia and Somalia . In 1977 the WHO recorded the last case of smallpox infection acquired outside a laboratory in Somalia. In 1980 the WHO officially declared
5376-467: A strategic point in the middle of the country, fell into the rebels hands on December 31, in a conflict known as the Battle of Santa Clara ). In the 1950s, various organizations, including some advocating armed uprising, competed for public support in bringing about political change. In 1956, Fidel Castro and about 80 supporters landed from the yacht Granma in an attempt to start a rebellion against
5568-483: A substantial impact on global health. Cuban doctors, accustomed to working under resource-constrained conditions, have been requested to assist in the pandemic response abroad. Yoani Sánchez of 14ymedio wrote in 2020 that there are concerns regarding the working conditions and the distribution of their salaries when they work abroad, as a significant portion is retained by the Cuban government. According to Reason in early 2022, doctors that travel abroad on behalf of
5760-419: A sufficiently large percentage of a population has been vaccinated, herd immunity results. Herd immunity protects those who may be immunocompromised and cannot get a vaccine because even a weakened version would harm them. The effectiveness of vaccination has been widely studied and verified. Vaccination is the most effective method of preventing infectious diseases; widespread immunity due to vaccination
5952-657: A sugar planter, freed his slaves to fight with him for an independent Cuba. On 27 December 1868, he issued a decree condemning slavery in theory but accepting it in practice and declaring free any slaves whose masters present them for military service. The 1868 rebellion resulted in a prolonged conflict known as the Ten Years' War . A great number of the rebels were volunteers from the Dominican Republic , and other countries, as well as numerous Chinese indentured servants . The United States declined to recognize
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6144-466: A tool for political influence, domestically, Cuba faces challenges including medication shortages and disparities between medical services for locals and foreigners. Despite the income from these missions, only a small fraction of the national budget has been allocated to public health, underscoring contrasting priorities within the nation's healthcare strategy. Modern Western medicine has been practiced in Cuba by formally trained physicians since at least
6336-550: A total ban on trade between the countries and a freeze on all Cuban-owned assets in the U.S. In February 1960, Castro signed a commercial agreement with Soviet Vice-Premier Anastas Mikoyan . In March 1960, U.S. President Dwight D. Eisenhower gave his approval to a CIA plan to arm and train a group of Cuban refugees to overthrow the Castro government. The invasion (known as the Bay of Pigs Invasion ) took place on 14 April 1961, during
6528-610: A vaccination campaign. In the same year a law was passed in Sweden to require the vaccination of children against smallpox by the age of two. Prussia briefly introduced compulsory vaccination in 1810 and again in the 1920s, but decided against a compulsory vaccination law in 1829. A law on compulsory smallpox vaccination was introduced in the Province of Hanover in the 1820s. In 1826, in Kragujevac , future prince Mihailo of Serbia
6720-583: A vast expedition through the American Southeast , in search of gold, treasure, fame and power. On 1 September 1548, Gonzalo Perez de Angulo was appointed governor of Cuba. He arrived in Santiago, Cuba, on 4 November 1549, and immediately declared the liberty of all Natives. He became Cuba's first permanent governor to reside in Havana instead of Santiago, and he built Havana's first church made of masonry. By 1570, most residents of Cuba comprised
6912-542: A year for the Cuban economy. Cuba has been serving health tourists from around the world for more than 20 years. The country operates a special division of hospitals specifically for the treatment of foreigners and diplomats. Foreign patients travel to Cuba for a wide range of treatments including eye-surgery , neurological disorders such as multiple sclerosis and Parkinson's disease , cosmetic surgery , addictions treatment, retinitis pigmentosa and orthopaedics . Most patients are from Latin America, Europe and Canada, and
7104-640: A year, providing training to the Algerian army. In 1964, Cuba organized a meeting of Latin American communists in Havana and stoked a civil war in the capital of the Dominican Republic in 1965, which prompted 20,000 U.S. troops to intervene there. Che Guevara engaged in guerrilla activities in Africa and was killed in 1967 while attempting to start a revolution in Bolivia . Starting in 1968
7296-474: Is José Angel Portal Miranda. Like the rest of the Cuban economy , Cuban medical care suffered following the end of Soviet subsidies in 1991. The United States embargo against Cuba also has an effect. The Cuban healthcare system has emphasized the export of health professionals through international missions, aiding global health efforts. However, while these missions generate significant revenue and serve as
7488-417: Is a small increase in the chance of having a local reaction to a vaccine with an aluminium salt (redness, soreness, and swelling), there is no increased risk of any serious reactions. Certain vaccines once contained a compound called thiomersal or thimerosal, which is an organic compound containing mercury . Organomercury is commonly found in two forms. The methylmercury cation (with one carbon atom)
7680-522: Is associated with extinctions of the islands native fauna, particularly its endemic sloths . The Arawakan -speaking ancestors of the Taíno people arrived in the Caribbean in a separate migration from South America around 1,700 years ago. Unlike the previous settlers of Cuba, the Taíno extensively produced pottery and engaged in intensive agriculture. The earliest evidence of the Taíno people on Cuba dates to
7872-767: Is considered part of Latin America. It is a multiethnic country whose people , culture and customs derive from diverse origins, including the Taíno Ciboney peoples, the long period of Spanish colonialism, the introduction of enslaved Africans and a close relationship with the Soviet Union during the Cold War. Cuba is a founding member of the United Nations, G77 , Non-Aligned Movement , Organisation of African, Caribbean and Pacific States , ALBA , and Organization of American States . It has one of
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8064-501: Is effective in poverty diseases and promises benefits in pandemic waves, e.g. in COVID-19 , when vaccine supply is limited. Allegations of vaccine injuries in recent decades have appeared in litigation in the U.S. Some families have won substantial awards from sympathetic juries, even though most public health officials have said that the claims of injuries were unfounded. In response, several vaccine makers stopped production, which
8256-404: Is found in mercury-contaminated fish and is the form that people might ingest in mercury-polluted areas ( Minamata disease ), whereas the ethylmercury cation (with two carbon atoms) is present in thimerosal, linked to thiosalicylate . Although both are organomercury compounds, they do not have the same chemical properties and interact with the human body differently. Ethylmercury is cleared from
8448-570: Is implemented by the Cuban National Center for Sex Education . According to a 2005 report by UNAIDS and the World Health Organization , "Cuba’s epidemic remains by far the smallest in the Caribbean." They add however that, ... new HIV infections are on the rise, and Cuba’s preventive measures appear not to be keeping pace with conditions that favour the spread of HIV, including widening income inequalities and
8640-409: Is insufficient evidence to assess the effectiveness of requiring vaccinations as a condition for specified jobs as a means of reducing incidence of specific diseases among particularly vulnerable populations; that there is sufficient evidence supporting the effectiveness of requiring vaccinations as a condition for attending child care facilities and schools; and that there is strong evidence supporting
8832-646: Is largely responsible for the worldwide eradication of smallpox and the elimination of diseases such as polio and tetanus from much of the world. According to the World Health Organization (WHO), vaccination prevents 3.5–5 million deaths per year. A WHO-funded study by The Lancet estimates that, during the 50-year period starting in 1974, vaccination prevented 154 million deaths, including 146 million among children under age 5. However, some diseases have seen rising cases due to relatively low vaccination rates attributable partly to vaccine hesitancy . The first disease people tried to prevent by inoculation
9024-608: Is legal in Cuba as long as money is not exchanged. Cuba is the only country in Central and South America where medical genetics is part of the healthcare system and where there are a large number of healthcare workers in this field. In 2023, there were 474 masters-level genetic counsellors and 104 medical geneticists , all of whom work under the National Centre of Medical Genetics of the Ministry of Public Health. However,
9216-430: Is made up of multiple tiers: 1) the community containing individuals and families, 2) family doctor-and-nurse teams, 3) basic work teams, 4) community polyclinics, 5) hospitals, and 6) medical institutes. Cuba's Family Physician and Nurse program is made up of physician and nurse teams that serve individuals, families, and their communities. They live above their government-built family medicine offices, living directly in
9408-408: Is often used interchangeably with "vaccination." However, while related, the terms are not synonymous. Vaccination is treatment of an individual with an attenuated (i.e. less virulent) pathogen or other immunogen , whereas inoculation, also called variolation in the context of smallpox prophylaxis, is treatment with unattenuated variola virus taken from a pustule or scab of a smallpox patient into
9600-590: Is still among the highest in Latin America. The abortion rate in Cuba is 72.8 per 100 births. Economic constraints and restrictions on medicines have forced the Cuban health system to incorporate alternative and herbal solutions to healthcare issues, which can be more accessible and affordable to a broader population In the 1990s, the Cuban Ministry of Public Health officially recognized natural and traditional medicine and began its integration into
9792-446: Is the second country in the world with such a product, only preceded by France. Cuba is preparing a computerized health register, hospital management system, primary health care, academic affairs, medical genetic projects, neurosciences, and educational software. The aim is to maintain quality health service free for the Cuban people, increase exchange among experts and boost research-development projects. An important link in wiring process
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#17327829485759984-787: Is to guarantee access to Cuba's Data Transmission Network and Health Website (INFOMED) to all units and workers of the national health system. During the 1990s the ongoing United States embargo against Cuba caused problems due to restrictions on the export of medicines from the US to Cuba. In 1992 the US embargo was made more stringent with the passage of the Cuban Democracy Act resulting in all U.S. subsidiary trade, including trade in food and medicines, being prohibited. The legislation did not state that Cuba cannot purchase medicines from U.S. companies or their foreign subsidiaries; however, such license requests have been routinely denied. In 1995
10176-499: The 9th century AD. Descendants of the first settlers of Cuba persisted on the western part of the island until Columbian contact, where they were recorded as the Guanahatabey people, who lived a hunter-gatherer lifestyle. After first landing on an island then called Guanahani on 12 October 1492, Christopher Columbus landed on Cuba on 27 October 1492, and landing in the northeastern coast on 28 October. Columbus claimed
10368-525: The Cayman Islands . Havana is the largest city and capital. Cuba is the third-most populous country in the Caribbean after Haiti and the Dominican Republic , with about 10 million inhabitants. It is the largest country in the Caribbean by area. The territory that is now Cuba was inhabited as early as the 4th millennium BC , with the Guanahatabey and Taíno peoples inhabiting the area at
10560-588: The East India Company stationed in China and another by Clopton Havers . In France, Voltaire reports that the Chinese have practiced variolation "these hundred years". In 1796, Edward Jenner , a doctor in Berkeley in Gloucestershire , England, tested a common theory that a person who had contracted cowpox would be immune from smallpox. To test the theory, he took cowpox vesicles from
10752-843: The Inter-American Commission on Human Rights of the Organization of American States informed the U.S. Government that such activities violate international law and has requested that the U.S. take immediate steps to exempt medicine from the embargo. The Lancet and the British Medical Journal also condemned the embargo in the 90s. The embargo forced Cuba to use more of its limited resources on medical imports, both because equipment and drugs from foreign subsidiaries of U.S. firms or from non-U.S.sources tend to be higher priced and because shipping costs are greater. The Democracy Act of 1992 further exacerbated
10944-710: The Scottish physician Helenus Scott vaccinated dozens of children in Bombay against smallpox using Jenner's cowpox vaccine. In the same year Scott penned a letter to the editor in the Bombay Courier , declaring that "We have it now in our power to communicate the benefits of this important discovery to every part of India, perhaps to China and the whole eastern world". Subsequently, vaccination became firmly established in British India . A vaccination campaign
11136-558: The Sergeants' Revolt , led by Sergeant Fulgencio Batista , overthrew Céspedes. A five-member executive committee (the Pentarchy of 1933 ) was chosen to head a provisional government. Ramón Grau San Martín was then appointed as provisional president. Grau resigned in 1934, leaving the way clear for Batista, who dominated Cuban politics for the next 25 years, at first through a series of puppet-presidents. The period from 1933 to 1937
11328-478: The Social Security Act are among the major sources of financial support for vaccination of those in lower-income groups. The Centers for Disease Control and Prevention ( CDC ) publishes uniform national vaccine recommendations and immunization schedules, although state and local governments, as well as nongovernmental organizations, may have their own policies. Before the first vaccinations, in
11520-541: The South Asian tsunami and the 2005 Kashmir earthquake . Nearly 2,000 Cuban doctors are currently working in Africa in countries including South Africa , Gambia , Guinea Bissau and Mali . Since the Chernobyl nuclear plant exploded in 1986, more than 20,000 children from Ukraine , Belarus and Russia have traveled to Cuba for treatment of radiation sickness and psychologically based problems associated with
11712-632: The Spanish Caribbean . Spain's alliance with the French pitched them into direct conflict with the British , and in 1762, a British expedition consisting of dozens of ships and thousands of troops set out from Portsmouth to capture Cuba. The British arrived on 6 June, and by August, had placed Havana under siege . When Havana surrendered, the admiral of the British fleet, George Pocock and
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#173278294857511904-555: The United Nations and was discontinued in the 1990s. Since 1996 Cuba began the production of generic anti-retroviral drugs reducing the costs to well below that of developing countries. This has been made possible through the substantial government subsidies to treatment. In 2003 Cuba had the lowest HIV prevalence in the Americas and one of the lowest in the world. Education in Cuba concerning issues of HIV infection and AIDS
12096-715: The United Nations Food and Agriculture Organization (FAO), the United Nations Population Fund ( UNFPA ) and the United Nations Development Fund ( UNDP ). Since 1989, this collaboration has played a very important role in that Cuba, in addition to obtaining the benefits of being a member country, has strengthened its relations with institutions of excellence and has been able to disseminate some of its own advances and technologies Cuban doctors have been part of
12288-431: The United States . Payments are made through banks in third countries, since direct banking relationships are prohibited. The Cuban delegation concluded that restrictions on importing medical products were "so extensive that they make such imports virtually impossible". The World Health organization/PAHO and UNFPA concurred that it was impossible for Cuba to purchase equipment, medicines and laboratory materials produced by
12480-400: The dissolution of the Soviet Union , Cuba faced a severe economic downturn in the 1990s, known as the Special Period . In 2008, Fidel Castro retired after 49 years; Raúl Castro was elected his successor. Raúl Castro retired as president in 2018 and Miguel Díaz-Canel was elected president by the National Assembly following parliamentary elections . Raúl Castro retired as First Secretary of
12672-564: The encomienda system, which resembled the feudal system in medieval Europe. Within a century, the Indigenous people faced high incidence of mortality due to multiple factors, primarily Eurasian infectious diseases , to which they had no natural resistance (immunity), aggravated by the harsh conditions of the repressive colonial subjugation. In 1529, a measles outbreak killed two-thirds of those few Natives who had previously survived smallpox . On 18 May 1539, conquistador Hernando de Soto departed from Havana with some 600 followers into
12864-406: The intestines . Live attenuated polio, rotavirus, some typhoid, and some cholera vaccines are given orally to produce immunity in the bowel. While vaccination provides a lasting effect, it usually takes several weeks to develop. This differs from passive immunity (the transfer of antibodies , such as in breastfeeding), which has immediate effect. A vaccine failure is when an organism contracts
13056-426: The right to strike . He then aligned with the wealthiest landowners who owned the largest sugar plantations , and presided over a stagnating economy that widened the gap between rich and poor Cubans. Batista outlawed the Cuban Communist Party in 1952. After the coup, Cuba had Latin America's highest per capita consumption rates of meat, vegetables, cereals, automobiles, telephones and radios, though about one-third of
13248-408: The 1959 Revolution were policemen, politicians, and informers of the Batista regime accused of crimes such as torture and murder, and their public trials and executions had widespread popular support among the Cuban population. The United States government initially reacted favorably to the Cuban Revolution, seeing it as part of a movement to bring democracy to Latin America. Castro's legalization of
13440-437: The 1970s was "extremely spartan" and discontent was rife. Fidel Castro admitted the failures of economic policies in a 1970 speech. In 1975, the OAS lifted its sanctions against Cuba, with the approval of 16 member states, including the United States. The U.S., however, maintained its own sanctions. During the Cold War, Cuban forces were deployed to all corners of Africa, either as military advisors or as combatants. During
13632-419: The 1970s, Fidel Castro dispatched tens of thousands of troops in support of Soviet-backed wars in Africa. He supported the MPLA in Angola ( Angolan Civil War ) and Mengistu Haile Mariam in Ethiopia ( Ogaden War ). In November 1975, Cuba deployed more than 65,000 troops and 400 Soviet-made tanks in Angola in one of the fastest military mobilizations in history. South Africa developed nuclear weapons due to
13824-485: The 19th century, the practice of coartacion had developed (or "buying oneself out of slavery", a "uniquely Cuban development"), according to historian Herbert S. Klein. Due to a shortage of white labor, blacks dominated urban industries "to such an extent that when whites in large numbers came to Cuba in the middle of the nineteenth century, they were unable to displace Negro workers." A system of diversified agriculture, with small farms and fewer slaves, served to supply
14016-406: The 20th century in the U.S. Vaccines are a way of artificially activating the immune system to protect against infectious disease . The activation occurs through priming the immune system with an immunogen . Stimulating immune responses with an infectious agent is known as immunization . Vaccination includes various ways of administering immunogens. Most vaccines are administered before
14208-429: The 20th century. Vaccination and immunization have a similar meaning in everyday language. This is distinct from inoculation, which uses unweakened live pathogens. Vaccination efforts have been met with some reluctance on scientific, ethical, political, medical safety, and religious grounds, although no major religions oppose vaccination, and some consider it an obligation due to the potential to save lives. In
14400-596: The Batista government. In 1958, Castro's July 26th Movement emerged as the leading revolutionary group. The U.S. supported Castro by imposing a 1958 arms embargo against Batista's government. Batista evaded the American embargo and acquired weapons from the Dominican Republic. By late 1958, the rebels had broken out of the Sierra Maestra and launched a general popular insurrection . After Castro's fighters captured Santa Clara , Batista fled with his family to
14592-489: The British occupation of the city proved short-lived. Pressure from London on sugar merchants, fearing a decline in sugar prices, forced negotiations with the Spanish over the captured territories. Less than a year after Britain captured Havana, it signed the 1763 Treaty of Paris together with France and Spain, ending the Seven Years' War. The treaty gave Florida to Britain in exchange for Cuba. Cubans constituted one of
14784-593: The Central American isthmus had 123 physicians and 30 dentists per 100,000. As of 2005, Cuba became the world leader in the ratio of doctors to population with 67 doctors per 10,000 population as compared with 43 in the Russian Federation and 24 in the United States. Abortion rates, which are high in Cuba, increased dramatically during the 1980s, but had almost halved by 1999 and declined to near-1970s levels of 32.0 per 1000 pregnancies. The rate
14976-465: The Communist Party and retained broad authority, including oversight over the president. Cuba approved a new constitution in 2019. The optional vote attracted 84.4% of eligible voters. 90% of those who voted approved of the new constitution and 9% opposed it. The new constitution states that the Communist Party is the only legitimate political party, describes access to health and education as fundamental rights, imposes presidential term limits, enshrines
15168-565: The Communist Party in 2021 and Díaz-Canel was elected. Cuba is a socialist state , in which the role of the Communist Party is enshrined in the Constitution . Cuba has an authoritarian government where political opposition is not permitted. Censorship is extensive and independent journalism is repressed; Reporters Without Borders has characterized Cuba as one of the worst countries for press freedom. Culturally, Cuba
15360-506: The Communist Party and the hundreds of executions of Batista agents, policemen, and soldiers that followed caused a deterioration in the relationship between the two countries. The promulgation of the Agrarian Reform Law , expropriating thousands of acres of farmland (including from large U.S. landholders), further worsened relations. In response, between 1960 and 1964 the U.S. imposed a range of sanctions, eventually including
15552-610: The Cuban Revolutionary Party in New York City in 1892. The aim of the party was to achieve Cuban independence from Spain. In January 1895, Martí traveled to Monte Cristi and Santo Domingo in the Dominican Republic to join the efforts of Máximo Gómez . Martí recorded his political views in the Manifesto of Montecristi . Fighting against the Spanish army began in Cuba on 24 February 1895, but Martí
15744-514: The Cuban government had imposed broad restrictions on travel to prevent the mass emigration of people after the 1959 revolution; it approved exit visas only on rare occasions. Requirements were simplified: Cubans need only a passport and a national ID card to leave; and they are allowed to take their young children with them for the first time. However, a passport costs on average five months' salary. Observers expect that Cubans with paying relatives abroad are most likely to be able to take advantage of
15936-479: The Cuban government often do so against their will and without monetary compensation similar to doctors from other countries. Sánchez wrote that nearly 7,000–8,000 doctors since 2006 have gone into hiding or failed to return to Cuba after having gone on abroad as part of the Cuban government's "volunteering" them to provide healthcare to foreign nationals without remuneration. While Cuban doctors are sent abroad to assist in medical missions, domestically, although wages in
16128-553: The Cuban military involvement in Africa was the significant presence of black or mixed-race soldiers among the Cuban forces. According to one source, more than 300,000 Cuban military personnel and civilian experts were deployed in Africa. The source also states that out of the 50,000 Cubans sent to Angola, half contracted AIDS and that 10,000 Cubans died as a consequence of their military actions in Africa. Soviet troops began to withdraw from Cuba in September 1991, and Castro's rule
16320-479: The Cuban national was able to make it to a U.S. embassy anywhere in the world. The program was ended by the Obama administration as part of an effort to warm relations between the United States and the Cuban government. 7,117 applications by Cuban doctors working abroad have been approved since 2006. The Cuban healthcare system, renowned for the quality of its medical services, has largely strategized its approach around
16512-581: The Dominican Republic on 1 January 1959. Later he went into exile on the Portuguese island of Madeira and finally settled in Estoril, near Lisbon. Fidel Castro's forces entered the capital on 8 January 1959. The liberal Manuel Urrutia Lleó became the provisional president. According to Amnesty International , official death sentences from 1959 to 1987 numbered 237 of which all but 21 were carried out. The vast majority of those executed directly following
16704-783: The Government. Most resistance came from Cuban construction workers, while the Grenadan People's Revolutionary Army and militia surrendered without putting up much of a fight. 24 Cubans were killed, with only 2 of them being professional soldiers, and the remainder were expelled from the island. U.S. casualties amounted to 19 killed, 116 wounded, and 9 helicopters destroyed. During the 1970s and 1980s, Castro supported Marxist insurgencies in Guatemala , El Salvador , and Nicaragua . Cuba gradually withdrew its troops from Angola in 1989–91. An important psychological and political aspect of
16896-565: The Miami Herald cited "insufficient healthcare" as one of the reasons why nearly 425,000 Cubans had fled the country during the previous two years. As at 2024, Cuba spends 11.4 per cent of its GDP on healthcare, which is more than twice as much as most Latin American countries, and has nine doctors per thousand residents. Child mortality in 2023 was four per thousand, which is similar to that of rich industrialised countries. Cuba had 128 physicians and dentists per 100,000 people in 1957. This
17088-464: The OAS". Fidel Castro wrote that Cuba would not rejoin the OAS, which, he said, was a "U.S. Trojan horse" and "complicit" in actions taken by the U.S. against Cuba and other Latin American nations. Effective 14 January 2013, Cuba ended the requirement established in 1961, that any citizens who wish to travel abroad were required to obtain an expensive government permit and a letter of invitation. In 1961
17280-598: The Republic of Cuba. Under Cuba's new constitution, the U.S. retained the right to intervene in Cuban affairs and to supervise its finances and foreign relations. Under the Platt Amendment , the U.S. leased the Guantánamo Bay Naval Base from Cuba. Following disputed elections in 1906, the first president, Tomás Estrada Palma , faced an armed revolt by independence war veterans who defeated
17472-532: The Special Period as "the first, and probably the only, natural experiment, born of unfortunate circumstances, where large effects on diabetes, cardiovascular disease and all-cause mortality have been related to sustained population-wide weight loss as a result of increased physical activity and reduced caloric intake". In 2007, Cuba announced that it has undertaken computerizing and creating national networks in blood banks, nephrology and medical images. Cuba
17664-407: The U.S. after World War II . In 1959, the WHO called for the eradication of smallpox worldwide, as smallpox was still endemic in 33 countries. In the 1960s six to eight children died each year in the U.S. from vaccination-related complications. According to the WHO there were in 1966 about 100 million cases of smallpox worldwide, causing an estimated two million deaths. In the 1970s there was such
17856-631: The US federal government, including the CDC and FDA, and independent agencies are constantly re-evaluating vaccine practices. As with all medications, vaccine use is determined by public health research, surveillance, and reporting to governments and the public. The World Health Organization (WHO) has estimated that vaccination prevents 3.5–5 million deaths per year, and up to 1.5 million children die each year due to diseases that could have been prevented by vaccination . They estimate that 29% of deaths of children under five-years-old in 2013 were vaccine preventable. In other developing parts of
18048-413: The US government believed could be a threat to public health , so laws were passed to shield manufacturers from liabilities stemming from vaccine injury claims. The safety and side effects of multiple vaccines have been tested to uphold the viability of vaccines as a barrier against disease. The influenza vaccine was tested in controlled trials and proven to have negligible side effects equal to that of
18240-579: The United States declared war on each other in late April 1898. After the Spanish–American War , Spain and the United States signed the Treaty of Paris (1898) , by which Spain ceded Puerto Rico , the Philippines , and Guam to the United States for the sum of US$ 20 million and Cuba became a protectorate of the United States. Cuba gained formal independence from the U.S. on 20 May 1902, as
18432-548: The United States is the largest donor of humanitarian assistance to Cuba and much of this consists of medicines and medical equipment. The US government states that since 1992, 36 out of 39 license requests from U.S. companies and their subsidiaries for sales of medical items to Cuba have been approved. The dollar amount of these sales is over $ 1,600,000. Furthermore, the U.S. government licensed more than $ 227 million in humanitarian donations of medicines and medical supplies to Cuba between 1993 and 1997. There are other factors beside
18624-410: The United States or covered by United States patents, even though those products were purchased through multilateral cooperation. Cuba was not able to purchase the isotope I-125 that is used to treat eye cancer in children. The companies manufacturing reagents and equipment are 70 per cent United States owned, which makes it difficult to purchase necessary medical equipment and other items. One effect of
18816-515: The United States, leaving the country with only 3,000 doctors and 16 professors in the University of Havana ’s medical college. Beginning in 1960, the Ministry of Public Health began a program of nationalization and regionalization of medical services. In 1965, Cuba became the first Latin American country to legalize abortion. In 1976, Cuba's healthcare program was enshrined in Article 50 of
19008-513: The United States, people may receive compensation for alleged injuries under the National Vaccine Injury Compensation Program . Early success brought widespread acceptance, and mass vaccination campaigns have greatly reduced the incidence of many diseases in numerous geographic regions. The Centers for Disease Control and Prevention lists vaccination as one of the ten great public health achievements of
19200-533: The United States. Additionally, while the embargo between the United States and Cuba was not immediately lifted, it was relaxed to allow import, export, and certain limited commerce. Raúl Castro stepped down from the presidency on 19 April 2018 and Miguel Díaz-Canel was elected president by the National Assembly following parliamentary elections . Raúl Castro remained the First Secretary of
19392-669: The already well established Western medicine model. A 2002 report stated that there had been a significant increase in STIs in Cuba due to an increase in prostitution and lack of prevention. According to the UNAIDS report of 2003 there were an estimated 3,300 Cubans living with HIV / AIDS (approx 0.05% of the population). In the mid-1980s, when little was known about the virus, Cuba compulsorily tested thousands of its citizens for HIV . Those who tested positive were taken to Los Cocos and were not allowed to leave. The policy drew criticism from
19584-576: The attacks on the Cuban government, manufacturing a reason for the United States to invade Cuba. This plan was rejected by President Kennedy. By 1963, Cuba was moving towards a full-fledged communist system modeled on the USSR. In 1963, Cuba sent 686 troops together with 22 tanks and other military equipment to support Algeria in the Sand War against Morocco. The Cuban forces remained in Algeria for over
19776-486: The base of the already teetering legitimacy of the Cuban political system, in particular by undermining the deeply flawed, though not entirely ineffectual, Congress and Supreme Court. Carlos Prío Socarrás , a protégé of Grau, became president in 1948. The two terms of the Auténtico Party brought an influx of investment, which fueled an economic boom, raised living standards for all segments of society, and created
19968-415: The beginning of the 19th century and the first surgical clinic was established in 1823. Cuba has had many world-class doctors, including Carlos Finlay , whose mosquito-based theory of yellow fever transmission was given its final proof under the direction of Walter Reed , James Carroll , and Aristides Agramonte . During the period of U.S. presence (1898–1902) yellow fever was essentially eliminated due to
20160-480: The body faster than methylmercury and is less likely to cause toxic effects. Thimerosal was used as a preservative to prevent the growth of bacteria and fungi in vials that contain more than one dose of a vaccine. This helps reduce the risk of potential infections or serious illness that could occur from contamination of a vaccine vial. Although there was a small increase in risk of injection site redness and swelling with vaccines containing thimerosal, there
20352-442: The cities with produce and other goods. In the 1820s, when the rest of Spain's empire in Latin America rebelled and formed independent states , Cuba remained loyal to Spain. Its economy was based on serving the empire. By 1860, Cuba had 213,167 free people of color (39% of its non-white population of 550,000). Full independence from Spain was the goal of a rebellion in 1868 led by planter Carlos Manuel de Céspedes . De Céspedes,
20544-551: The clinical trials, safety tests, purity tests, and manufacturing methods and establish that the manufacturer itself is up to government standards in many other areas. After regulatory approval, the regulators continue to monitor the manufacturing protocols, batch purity, and the manufacturing facility itself. Additionally, vaccines also undergo phase IV trials, which monitor the safety and efficacy of vaccines in tens of thousands of people, or more, across many years. The Centers for Disease Control and Prevention (CDC) has compiled
20736-468: The commander of the land forces George Keppel , the 3rd Earl of Albemarle , entered the city, and took control of the western part of the island. The British immediately opened up trade with their North American and Caribbean colonies, causing a rapid transformation of Cuban society. Though Havana, which had become the third-largest city in the Americas, was to enter an era of sustained development and increasing ties with North America during this period,
20928-834: The communities they serve and available 24 hours a day. These teams work to improve the public health concerns in the environment as well as provide medical care. They perform a neighborhood health diagnosis biannually where community risk factors are evaluated to focus priorities for improving the health of the community. Clinically, family doctor-and-nurse teams follow the Continuous Assessment and Risk Evaluation (CARE) method which monitors individual and family health by examining community and home environments, current health, and medical history. The teams make home visits to each family at least once yearly to assess and evaluate their health. Individuals with chronic illness are seen at least every three months. These teams' role combine
21120-552: The components used in vaccinations or strongly held objections. In countries with limited financial resources, limited vaccination coverage results in greater morbidity and mortality due to infectious disease. More affluent countries are able to subsidize vaccinations for at-risk groups, resulting in more comprehensive and effective coverage. In Australia, for example, the Government subsidizes vaccinations for seniors and indigenous Australians. Public Health Law Research, an independent US based organization, reported in 2009 that there
21312-412: The concept through his work in microbiology. The immunization was called vaccination because it was derived from a virus affecting cows ( Latin : vacca 'cow'). Smallpox was a contagious and deadly disease, causing the deaths of 20–60% of infected adults and over 80% of infected children. When smallpox was finally eradicated in 1979, it had already killed an estimated 300–500 million people in
21504-407: The construction of a new bathroom in the splenic surgery wing; anecdotal evidence suggests that this pattern is common in Cuban hospitals. President George W. Bush in 2006 initiated a program called the "Cuban Medical Professional Parole Program", this program allowed for any Cuban doctor serving outside of Cuba to be granted political asylum and permanent resident status in the United States, if only
21696-485: The department of anthropology of the University of Oklahoma , said that doctors have incentives to falsify statistics, as a spike in infant mortality may cost them their jobs. She also said pregnant women may be pressured to undergo abortions if fetal abnormalities are detected or forcibly placed under monitoring if complications arise. Hirschfeld said Cuba does not allow for independent verification of its health data. Loss of Soviet subsidies brought food shortages to Cuba in
21888-566: The early 1990s. The famine during the Special Period was caused by an authoritarian regime that denied people the food to which they were entitled when the public food distribution collapsed; priority was given to the elite classes and the military. The Cuban government began accepting US donations of food, medicines and cash in 1993. It established a system of private farmers' markets in 1994 to provide citizens with easy access to locally grown food. Epidemiologist Manuel Franco describes
22080-400: The effectiveness of standing orders, which allow healthcare workers without prescription authority to administer vaccine as a public health intervention. Fractional dose vaccination reduces the dose of a vaccine to allow more individuals to be vaccinated with a given vaccine stock, trading societal benefit for individual protection. Based on the nonlinearity properties of many vaccines, it
22272-543: The efforts of Clara Maass and surgeon Jesse William Lazear . In the 1950s the number of doctors per thousand of the population ranked above Britain, France and the Netherlands. In Latin America it ranked in third place after Uruguay and Argentina. There remained marked inequalities, however. Most of Cuba's doctors were based in the relatively prosperous cities and regional towns, and conditions in rural areas, notably Oriente , were significantly worse. The mortality rate
22464-501: The embargo contributed to malnutrition, poor water access, lack of access to medicine and other medical supplies and concluded that "a humanitarian catastrophe has been averted only because the Cuban government has maintained a high level of budgetary support for a health care system designed to deliver primary and preventative medicine to all its citizens." In 2000, the Trade Sanctions Reform and Export Enhancement Act
22656-489: The embargo explaining the lack of imports, in particular Cuba's lack of hard currency. Those with dollars can easily buy medicines and food in Cuba from Latin America and Canada. Cuba defaulted on its debt to Western banks in 1986 and lacks access to the international credit system in order to get foreign currency. In addition, the collapse of the Soviet Union caused the loss of several billions of dollars in yearly subsidies and overnight required hard currency for all imports. In
22848-431: The embargo has been to make it necessary for Cuba to create its own biotech industry to produce drugs which it is unable to access. One of its innovations is the drug CimaVax , which is used to treat lung cancer. While the embargo forbids US citizens from seeking medical treatment in Cuba, some cancer patients from the US have defied the embargo and travelled to Cuba for treatment with CimaVax. Cuba's national health system
23040-492: The eradication of polio was only possible if the supply of drinking water and sanitation facilities were improved in slums . The deployment of a combined DPT vaccine against diphtheria , pertussis (whooping cough), and tetanus in the 1950s was considered a major advancement for public health. But in the course of vaccination campaigns that spanned decades, DPT vaccines became associated with large number of cases with side effects. Despite improved DPT vaccines coming onto
23232-463: The export of health professionals through international medical missions. These missions have enabled Cuba to establish a medical presence across various regions of the world, especially in areas with healthcare deficiencies. During the COVID-19 pandemic , medical brigades were deployed to 41 territories, spanning nations in Latin America, the Caribbean, Africa, and Europe. Historically, these professionals have conducted millions of operations and have had
23424-738: The extent to which children missed out on vaccinations from 2020 onwards due to the COVID-19 pandemic . By summer 2023, the organisation described vaccination programs as getting "back on track". To eliminate the risk of outbreaks of some diseases, at various times governments and other institutions have employed policies requiring vaccination for all people. For example, an 1853 law required universal vaccination against smallpox in England and Wales, with fines levied on people who did not comply. Common contemporary U.S. vaccination policies require that children receive recommended vaccinations before entering public school. Beginning with early vaccination in
23616-405: The following compounds: aluminium hydroxide , aluminium phosphate , and aluminium potassium sulfate . For a given element, the ion form has different properties from the elemental form. Although it is possible to have aluminium toxicity , aluminium salts have been used effectively and safely since the 1930s when they were first used with the diphtheria and tetanus vaccines. Although there
23808-614: The frequent absence of essential drugs. A 2023 study by the Cuban Observatory of Human Rights (OCDH), estimated 88% of the population is living in extreme poverty. The traditional diet is of international concern due to micronutrient deficiencies and lack of diversity. As highlighted by the World Food Programme (WFP) of the United Nations, rationed food meets only a fraction of daily nutritional needs for many Cubans, leading to health issues. Historians believe
24000-462: The future of Cuban healthcare in an essay entitled On Revolutionary Medicine , stating: "The work that today is entrusted to the Ministry of Health and similar organizations is to provide public health services for the greatest possible number of persons, institute a program of preventive medicine, and orient the public to the performance of hygienic practices." These aims were hampered almost immediately by an exodus of almost half of Cuba's physicians to
24192-554: The government arrested and imprisoned a large number of civil activists, a period known as the "Black Spring" . In February 2008, Fidel Castro resigned as President of the State Council due to the serious gastrointestinal illness which he had suffered since July 2006. On 24 February, the National Assembly elected his brother Raúl Castro the new president. In his inauguration speech, Raúl promised that some of
24384-426: The government as an international role model due to its free access and broad coverage. However, in practice, there are reports indicating issues such as the deterioration of hospital facilities and the need for patients to provide basic supplies. Challenges for healthcare in Cuba include low salaries for doctors, poor facilities, poor provision of equipment, and the frequent absence of essential drugs. In October 2023,
24576-432: The health sector have increased in recent years, they are still considered low compared to the prices of basic goods in Cuba. The medical missions have also been a subject of critiques and controversies. There are testimonies from professionals indicating human rights violations during their participation in these missions across different countries. These accounts reflect concerns over limitations on fundamental freedoms and
24768-413: The importance of focusing on both public health and clinical medicine. Polyclinics are community-based clinics that house primary care specialists. They exist in every Cuban community and are well-acquainted with the people and the communities they serve. They can see the social determinants and environment that affect the community's health, bettering their ability to serve their patients. Specialists at
24960-534: The introduction of the measles vaccine in 1963. WHO figures demonstrate that in many countries a decline in measles vaccination leads to a resurgence in measles cases. Measles are so contagious that public health experts believe a vaccination rate of 100% is needed to control the disease. Despite decades of mass vaccination polio remains a threat in India, Nigeria , Somalia , Niger , Afghanistan , Bangladesh and Indonesia . By 2006 global health experts concluded that
25152-446: The island followed. The U.S. battleship USS Maine was sent to protect American interests, but soon after arrival, it exploded in Havana harbor and sank quickly, killing nearly three-quarters of the crew. The cause and responsibility for the sinking of the ship remained unclear after a board of inquiry. Popular opinion in the U.S., fueled by active yellow press , concluded that the Spanish were to blame and demanded action. Spain and
25344-463: The island for the new Kingdom of Spain and named it Isla Juana ("John's Island") after John, Prince of Asturias . In 1511, the first Spanish settlement was founded by Diego Velázquez de Cuéllar at Baracoa . Other settlements soon followed, including San Cristobal de la Habana , founded in 1514 (southern coast of the island) and then in 1519 (current place), which later became the capital (1607). The Indigenous Taíno were forced to work under
25536-525: The island of Cuba (largest island), Isla de la Juventud , and 4,195 islands , islets and cays surrounding the main island. It is located where the northern Caribbean Sea , Gulf of Mexico , and Atlantic Ocean meet. Cuba is located east of the Yucatán Peninsula (Mexico), south of both Florida and the Bahamas , west of Hispaniola ( Haiti / Dominican Republic ), and north of Jamaica and
25728-422: The largest labor union privileges in Latin America, including bans on dismissals and mechanization. They were obtained in large measure "at the cost of the unemployed and the peasants", leading to disparities. Between 1933 and 1958, Cuba extended economic regulations enormously, causing economic problems. Unemployment became a problem as graduates entering the workforce could not find jobs. The middle class, which
25920-486: The many diverse units which fought alongside Spanish and Floridan forces during the conquest of British-controlled West Florida (1779–81). The largest factor for the growth of Cuba's commerce in the late eighteenth and early nineteenth century was the Haitian Revolution . When the enslaved peoples of what had been the Caribbean's richest colony freed themselves through violent revolt, Cuban planters perceived
26112-488: The market in the 1990s DPT vaccines became the focus of anti-vaccination campaigns in wealthy nations. As immunization rates fell outbreaks of pertussis increased in many countries. In 2000, the Global Alliance for Vaccines and Immunization was established to strengthen routine vaccinations and introduce new and underused vaccines in countries with a per capita GDP of under US$ 1000. UNICEF has reported on
26304-524: The meager government forces. The U.S. intervened by occupying Cuba and named Charles Edward Magoon as Governor for three years. Cuban historians have characterized Magoon's governorship as having introduced political and social corruption. In 1908, self-government was restored when José Miguel Gómez was elected president, but the U.S. continued intervening in Cuban affairs. In 1912, the Partido Independiente de Color attempted to establish
26496-420: The mobilization of workers from all sectors of the Cuban economy. Economic mobilization also coincided with greater militarization of Cuban political structures and society in general. The ten million ton harvest goal was not reached. The Cuban economy feell into decline after large sectors of the economy were neglected when large amounts of urban labor mobilized to the countryside. The standard of living in
26688-405: The name Cuba comes from the Taíno language ; however, "its exact derivation [is] unknown". The exact meaning of the name is unclear, but it may be translated either as 'where fertile land is abundant' ( cubao ), or 'great place' ( coabana ). Humans first settled Cuba around 6,000 years ago, descending from migrations from northern South America or Central America. The arrival of humans on Cuba
26880-454: The national system from the first years of their training, specifically within primary care facilities rather than hospitals. This is supposed to create a community-based teaching method rather than a typical hospital-based teaching method. Primary care, being the first level of contact to a patient, is ideally located close to the patient's home and work. At primary care facilities, the Cuban government's ethics and values are mandatorily taught as
27072-562: The new Cuban government, although many European and Latin American nations did so. In 1878, the Pact of Zanjón ended the conflict, with Spain promising greater autonomy to Cuba. In 1879–80, Cuban patriot Calixto García attempted to start another war known as the Little War but failed to receive enough support. Slavery in Cuba was abolished in 1875 but the process was completed only in 1886. An exiled dissident named José Martí founded
27264-399: The new policy. In the first year of the program, over 180,000 left Cuba and returned. As of December 2014 , talks with Cuban officials and American officials, including President Barack Obama , resulted in the release of Alan Gross , fifty-two political prisoners, and an unnamed non-citizen agent of the United States in return for the release of three Cuban agents currently imprisoned in
27456-535: The nineteenth century, these policies were resisted by a variety of groups, collectively called antivaccinationists , who object on scientific, ethical, political, medical safety, religious , and other grounds. Common objections are that vaccinations do not work, that compulsory vaccination constitutes excessive government intervention in personal matters, or that the proposed vaccinations are not sufficiently safe. Many modern vaccination policies allow exemptions for people who have compromised immune systems, allergies to
27648-452: The number of children vaccinated in England and Wales . The U.S. Supreme Court upheld compulsory vaccination laws in the 1905 landmark case Jacobson v. Massachusetts , ruling that laws could require vaccination to protect the public from dangerous communicable diseases. However, in practice the U.S. had the lowest rate of vaccination among industrialized nations in the early 20th century. Compulsory vaccination laws began to be enforced in
27840-538: The number of children who did not receive a single dose of the vaccine increased from 13.9 million in 2022 to 14.5 million in 2023. More than half of unvaccinated children live in the 31 countries with fragile, conflict-affected and vulnerable settings.” Vaccines have led to major decreases in the prevalence of infectious diseases in the United States. In 2007, studies regarding the effectiveness of vaccines on mortality or morbidity rates of those exposed to various diseases found almost 100% decreases in death rates, and about
28032-525: The number of genetic counsellors approximately halved between 2017 and 2023 due to emigration, retirement from the workforce, and COVID-19 deaths. Cuba's healthcare system survives, in part, due to its medical education system. In Cuba, the medical university is not a separate entity from health services, but it exists within the system, a model common in the rest of the developing world. In Cuba, this may include more community-based centers than large hospitals. Medical and nursing students mentor and intern within
28224-430: The patient. Items which are paid by patients who can afford it are: drugs prescribed on an outpatient basis, hearing, dental , and orthopedic processes, wheelchairs and crutches . When a patient can obtain these items at state stores, prices tend to be low as these items are subsidized by the state. For patients on a low-income, these items are free of charge. The Cuban health system has been promoted for decades by
28416-534: The period of economic hardship of the 1990s, such as tuberculosis , hepatitis and chicken pox . Other campaigns included a program to reduce the infant mortality rate in 1970 directed at maternal and prenatal care. As of 2012, infant mortality in Cuba had fallen to 4.83 deaths per 1,000 live births compared with 6.0 for the United States and just behind Canada with 4.8. Some experts have said that these statistics may reflect heavy-handed treatment of pregnant patients. Tassie Katherine Hirschfeld, an associate professor at
28608-422: The polyclinic are there to support physicians when they are needed. Each clinic of specialists supports 20-40 doctor-and-nurse teams. Basic work teams within the polyclinics supervise and evaluate the neighborhood and clinical health work of the family medicine offices. While preventive medical care , diagnostic tests and medication for hospitalized patients are free, some aspects of healthcare are paid for by
28800-419: The population was considered poor and enjoyed relatively little of this consumption. However, in his " History Will Absolve Me " speech, Fidel Castro mentioned that national issues relating to land, industrialization, housing, unemployment, education, and health were contemporary problems. In 1958, Cuba was a well-advanced country in comparison to other Latin American regions. Cuba was also affected by perhaps
28992-402: The potential instrumentalization of these doctors for political and propagandistic purposes. Although the salary on these missions is higher than what they might earn in Cuba, a significant portion is retained by the Cuban government. Domestically, the Cuban healthcare system has faced challenges, particularly during the pandemic. The shortage of medications and other essential resources has been
29184-667: The presence of a Cuban tank brigade in the Golan Heights , which was supported by two brigades. The Israelis and the Cuban-Syrian tank forces engaged in battle on the Golan front. In 1979, the U.S. objected to the presence of Soviet combat troops on the island. Following the 1983 coup that resulted in the execution of Grenadian Prime Minister Maurice Bishop and establishment of the military government led by Hudson Austin , U.S. forces invaded Grenada in 1983, overthrowing
29376-544: The primary goal of assessing the vaccine's safety. Phase II trials expand the testing to include 50 to several hundred people. During this stage, the vaccine's safety continues to be evaluated and researchers also gather data on the effectiveness and the ideal dose of the vaccine. Vaccines determined to be safe and efficacious then advance to phase III trials, which focuses on the efficacy of the vaccine in hundreds to thousands of volunteers. This phase can take several years to complete and researchers use this opportunity to compare
29568-515: The problems in Cuba's medical system. It prohibited foreign subsidiaries of U.S. corporations from selling to Cuba, thus further limiting Cuba's access to medicine and equipment, and raising prices. In addition, the act forbid ships that dock in Cuban ports from docking in U.S. ports for six months. This drastically restricted shipping, and increased shipping costs some 30%. In 1997, the American Association for World Health stated that
29760-489: The public health safety authority (FDA in the United States) to start a three-phase series of human testing, advancing to higher phases only if they are deemed safe and effective at the previous phase. The people in these trials participate voluntarily and are required to prove they understand the purpose of the study and the potential risks. During phase I trials, a vaccine is tested in a group of about 20 people with
29952-451: The rabies vaccine has been proven effective in preventing rabies in humans when administered several times over 14 days along with rabies immune globulin and wound care. Other examples include experimental AIDS, cancer and Alzheimer's disease vaccines. Such immunizations aim to trigger an immune response more rapidly and with less harm than natural infection. Most vaccines are given by injection as they are not absorbed reliably through
30144-452: The radiation disaster. In response to the 2005 Hurricane Katrina disaster, Castro offered to send a "brigade" of 1,500 doctors to the U.S. to provide humanitarian aid, but the U.S. did not accept. Cuba currently exports considerable health services and personnel to Venezuela in exchange for subsidized oil . Around 30,000 medical professionals were sent to the country in exchange for more than 100,000 barrels of oil per day. Cuban doctors play
30336-586: The region during the Cold War. In 1972, a major Cuban military mission consisting of tank, air, and artillery specialists was dispatched to South Yemen . Cuban military advisors were sent to Iraq in the mid-1970s but their mission was canceled after Iraq invaded Iran in 1980. The Cubans were also involved in the Syrian-Israeli War of Attrition (November 1973–May 1974) that followed the Yom Kippur War (October 1973). Israeli sources reported
30528-436: The region's changing circumstances with both a sense of fear and opportunity. They were afraid because of the prospect that slaves might revolt in Cuba as well, and numerous prohibitions during the 1790s of the sale of slaves in Cuba who had previously been enslaved in French colonies underscored this anxiety. The planters saw opportunity, however, because they thought that they could exploit the situation by transforming Cuba into
30720-469: The restrictions on freedom in Cuba would be removed. In March 2009, Raúl Castro removed some of his brother's appointees . On 3 June 2009, the Organization of American States adopted a resolution to end the 47-year ban on Cuban membership of the group. The resolution stated, however, that full membership would be delayed until Cuba was "in conformity with the practices, purposes, and principles of
30912-535: The revised Cuban constitution which states "Everybody has the right to health protection and care. The State guarantees this right: Cuba's doctor to patient ratio grew significantly in the latter half of the 20th century, from 9.2 doctors per 10,000 inhabitants in 1958, to 58.2 per 10,000 in 1999. In the 1960s the government implemented a program of almost universal vaccinations . This helped eradicate many contagious diseases including polio , tetanus , diphtheria and rubella , though some diseases increased during
31104-445: The right to labor and health care. Batista was elected president in the same year, holding the post until 1944. He is so far the only non-white Cuban to win the nation's highest political office. His government carried out major social reforms. Several members of the Communist Party held office under his administration. Cuban armed forces were not greatly involved in combat during World War II—though president Batista did suggest
31296-507: The right to legal representation upon arrest, recognizes private property, and strengthens the rights of multinationals investing with the state. Any form of discrimination harmful to human dignity is banned under the new constitution. Raúl Castro announced at the Eighth Congress of the Communist Party of Cuba , which began on 16 April 2021, that he was retiring as secretary of the Communist Party. His successor, Miguel Díaz-Canel,
31488-541: The rural population into what he called reconcentrados , described by international observers as "fortified towns". These are often considered the prototype for 20th-century concentration camps . Between 200,000 and 400,000 Cuban civilians died from starvation and disease in the Spanish concentration camps, numbers verified by the Red Cross and United States Senator Redfield Proctor , a former Secretary of War . American and European protests against Spanish conduct on
31680-625: The safest they ever have been in history and each vaccine undergoes rigorous clinical trials to ensure their safety and efficacy before approval by authorities such as the US Food and Drug Administration (FDA). Prior to human testing, vaccines are tested on cell cultures and the results modelled to assess how they will interact with the immune system. During the next round of testing, researchers study vaccines in animals, including mice , rabbits , guinea pigs , and monkeys . Vaccines that pass each of these stages of testing are then approved by
31872-404: The same. The CDC has compiled a list of vaccines and their ingredients that is readily accessible on their website. Aluminium is an adjuvant ingredient in some vaccines. An adjuvant is a type of ingredient that is used to help the body's immune system create a stronger immune response after receiving the vaccination. Aluminium is in a salt form (the ionic version of an element) and is used in
32064-456: The sense of using cowpox to inoculate people against smallpox , people have been inoculated in China and elsewhere, before being copied in the west , by using smallpox, called variolation . The earliest hints of the practice of variolation for smallpox in China come during the 10th century. The Chinese also practiced the oldest documented use of variolation, which comes from Wan Quan 's (1499–1582) Douzhen Xinfa (痘疹心法) of 1549. They implemented
32256-610: The slave society and sugar-producing "pearl of the Antilles" that Haiti had been before the revolution. As the historian Ada Ferrer has written, "At a basic level, liberation in Saint-Domingue helped entrench its denial in Cuba. As slavery and colonialism collapsed in the French colony, the Spanish island underwent transformations that were almost the mirror image of Haiti's." Estimates suggest that between 1790 and 1820 some 325,000 Africans were imported to Cuba as slaves, which
32448-487: The superficial layers of the skin, commonly the upper arm. Variolation was often done 'arm-to-arm' or, less effectively, 'scab-to-arm', and often caused the patient to become infected with smallpox, which in some cases resulted in severe disease. Vaccinations began in the late 18th century with the work of Edward Jenner and the smallpox vaccine. Some vaccines, like the smallpox vaccine, prevent infection. Their use results in sterilizing immunity and can help eradicate
32640-509: The swine flu vaccine. Dengvaxia , the only approved vaccine for Dengue fever , was found to increase the risk of hospitalization for Dengue fever by 1.58 times in children of 9 years or younger, resulting in the suspension of a mass vaccination program in the Philippines in 2017. Pandemrix – a vaccine for the H1N1 pandemic of 2009 given to around 31 million people – was found to have
32832-661: The term of President John F. Kennedy . About 1,400 Cuban exiles disembarked at the Bay of Pigs . Cuban troops and local militias defeated the invasion, killing over 100 invaders and taking the remainder prisoner. In January 1962, Cuba was suspended from the Organization of American States (OAS), and later the same year the OAS started to impose sanctions against Cuba of similar nature to the U.S. sanctions. The Cuban Missile Crisis of October 1962 almost sparked World War III . In 1962 American generals proposed Operation Northwoods which would entail committing terrorist attacks in American cities and against refugees and falsely blaming
33024-602: The threat to its security posed by the presence of large numbers of Cuban troops in Angola . In 1976 and again in 1988 at the Battle of Cuito Cuanavale , the Cubans alongside their MPLA allies defeated UNITA rebels and apartheid South African forces. In December 1977, Cuba sent its combat troops from Angola, the People's Republic of the Congo, and the Caribbean to Ethiopia, assisted by mechanized Soviet battalions, to help defeat
33216-461: The time of Spanish colonization in the 15th century. It was then a colony of Spain , through the abolition of slavery in 1886, until the Spanish–American War of 1898, when Cuba was occupied by the United States and gained independence in 1902. In 1940, Cuba implemented a new constitution , but mounting political unrest culminated in the 1952 Cuban coup d'état and the subsequent dictatorship of Fulgencio Batista . The Batista government
33408-454: The vaccinated volunteers to those who have not been vaccinated to highlight any true reactions to the vaccine that occur. If a vaccine passes all of the phases of testing, the manufacturer can then apply for license of the vaccine through the relevant regulatory authorities such as the FDA in US. Before regulatory authorities approve use in the general public, they extensively review the results of
33600-472: The vaccine from the vaccinated individual's pustule . Early attempts at confirmation were confounded by contamination with smallpox, but despite controversy within the medical profession and religious opposition to the use of animal material, by 1801 his report was translated into six languages and over 100,000 people were vaccinated. The term vaccination was coined in 1800 by the surgeon Richard Dunning in his text Some observations on vaccination . In 1802,
33792-441: The world free of smallpox. In 1974 the WHO adopted the goal of universal vaccination by 1990 to protect children against six preventable infectious diseases: measles , poliomyelitis , diphtheria , whooping cough , tetanus , and tuberculosis . In the 1980s only 20 to 40% of children in developing countries were vaccinated against these six diseases. In wealthy nations the number of measles cases had dropped dramatically after
33984-553: The world's few planned economies , and its economy is dominated by tourism and the exports of skilled labor, sugar, tobacco, and coffee. Cuba has historically—before and during communist rule—performed better than other countries in the region on several socioeconomic indicators, such as literacy, infant mortality and life expectancy. Cuba has a universal health care system which provides free medical treatment to all Cuban citizens, although challenges include low salaries for doctors, poor facilities, poor provision of equipment, and
34176-540: The world, they are faced with the challenge of having a decreased availability of resources and vaccinations. Countries such as those in Sub-Saharan Africa cannot afford to provide the full range of childhood vaccinations. In 2024, a WHO/UNICEF report found “the number of children who received three doses of the vaccine against diphtheria, tetanus and pertussis (DTP) in 2023 – a key marker for global immunization coverage – stalled at 84% (108 million). However,
34368-473: Was a time of "virtually unremitting social and political warfare". On balance, during the period 1933–1940 Cuba suffered from fragile political structures, reflected in the fact that it saw three different presidents in two years (1935–1936), and in the militaristic and repressive policies of Batista as Head of the Army. A new constitution was adopted in 1940, which engineered radical progressive ideas, including
34560-568: Was comparable to that of the United States , became increasingly dissatisfied with unemployment and political persecution. The labor unions, manipulated by the previous government since 1948 through union "yellowness", supported Batista until the very end. Batista stayed in power until he resigned in December 1958 under the pressure of the US Embassy and as the revolutionary forces headed by Fidel Castro were winning militarily (Santa Clara city,
34752-418: Was comparable to the levels in many European countries and allegedly the highest in Latin America. In 1986, Cuba had 219 doctors per 100,000 people (compared with 423.7 doctors in the Soviet Union, which had the most doctors among industrialized countries). In 2005, Cuba had 627 physicians and 94 dentists per 100,000 population. That year the United States had 225 physicians and 54 dentists per 100,000 population;
34944-557: Was four times the amount that had arrived between 1760 and 1790. Although a smaller proportion of the population of Cuba was enslaved, at times, slaves arose in revolt. In 1812, the Aponte Slave Rebellion took place, but it was ultimately suppressed. The population of Cuba in 1817 was 630,980 (of which 291,021 were white, 115,691 were free people of color (mixed-race), and 224,268 black slaves). In part due to Cuban slaves working primarily in urbanized settings, by
35136-459: Was most likely smallpox, with the first recorded use of variolation occurring in the 16th century in China. It was also the first disease for which a vaccine was produced. Although at least six people had used the same principles years earlier, the smallpox vaccine was invented in 1796 by English physician Edward Jenner . He was the first to publish evidence that it was effective and to provide advice on its production. Louis Pasteur furthered
35328-842: Was no increased risk of serious harm or autism . Even though evidence supports the safety and efficacy of thimerosal in vaccines, thimerosal was removed from childhood vaccines in the United States in 2001 as a precaution. CDC Immunization Safety Office initiatives Vaccine Adverse Event Reporting System ( VAERS ) |Food and Drug Administration ( FDA ) Center for Biologics Evaluation and Research ( CBER ) |Immunization Action Coalition (IAC) Vaccine Safety Datalink ( VSD ) |Health Resources and Service Administration ( HRSA ) |Institute for Safe Medication Practices (ISMP) Clinical Immunization Safety Assessment (CISA) Project National Institutes of Health ( NIH ) National Vaccine Program Office ( NVPO ) The administration protocols, efficacy, and adverse events of vaccines are monitored by organizations of
35520-728: Was overthrown in January 1959 by the 26th of July Movement during the Cuban Revolution . That revolution established communist rule under the leadership of Fidel Castro . The country was a point of contention during the Cold War between the Soviet Union and the United States, and the Cuban Missile Crisis of 1962 is widely considered the closest the Cold War came to escalating into nuclear war . Following
35712-416: Was passed. The US became Cuba's single largest source for imported food. The Cuban American National Foundation (CANF) states that should Cuba choose not to purchase from the U.S., it can purchase any medicine or medical equipment it needs from other countries. Such third-country transactions only cost an estimated 2%–3% more than purchases from the U.S. as a result of higher shipping costs. CANF also asserts
35904-509: Was severely tested in the aftermath of the Soviet collapse in December 1991 (known in Cuba as the Special Period ). The country faced a severe economic downturn following the withdrawal of Soviet subsidies worth $ 4 billion to $ 6 billion annually, resulting in effects such as food and fuel shortages. The government did not accept American donations of food, medicines and cash until 1993. On 5 August 1994, state security dispersed protesters in
36096-586: Was started in the new British colony of Ceylon in 1803. By 1807 the British had vaccinated more than a million Indians and Sri Lankans against smallpox. Also in 1803 the Spanish Balmis Expedition launched the first transcontinental effort to vaccinate people against smallpox. Following a smallpox epidemic in 1816 the Kingdom of Nepal ordered smallpox vaccine and requested the English veterinarian William Moorcroft to help in launching
36288-514: Was the first person to be vaccinated against smallpox in the principality of Serbia. Following a smallpox epidemic in 1837 that caused 40,000 deaths, the British government initiated a concentrated vaccination policy , starting with the Vaccination Act of 1840, which provided for universal vaccination and prohibited variolation . The Vaccination Act 1853 introduced compulsory smallpox vaccination in England and Wales. The law followed
36480-615: Was the third lowest in the world. According to the World Health Organization, the island had the lowest infant mortality rate of Latin America. Following the Revolution and the subsequent United States embargo against Cuba , an increase in disease and infant mortality worsened in the 1960s. The new Cuban government stated that universal healthcare would become a priority of state planning. In 1960 revolutionary and physician Che Guevara outlined his aims for
36672-406: Was unable to reach Cuba until 11 April 1895. Martí was killed in the Battle of Dos Rios on 19 May 1895. His death immortalized him as Cuba's national hero. Around 200,000 Spanish troops outnumbered the much smaller rebel army, which relied mostly on guerrilla and sabotage tactics. The Spaniards began a campaign of suppression. General Valeriano Weyler , the military governor of Cuba, herded
36864-401: Was voted in on 19 April. Vaccination Vaccination is the administration of a vaccine to help the immune system develop immunity from a disease. Vaccines contain a microorganism or virus in a weakened, live or killed state, or proteins or toxins from the organism. In stimulating the body's adaptive immunity , they help prevent sickness from an infectious disease . When
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