Significantly, the decline in infant mortality is relatively even throughout the country, with no major differences between urban and rural areas. This is a sign of the progress since the Cuban Revolution of 1959 that took affirmative action measures to even out differences between city and countryside and develop areas of the country where little or no access to medical treatment existed before. Eight of the fifteen provinces in Cuba had infant mortality rates below the national average with rates as low as 1.8 on the Isle of Youth. Havana, Guantánamo, and Santiago de Cuba—the most populous provinces—had the highest rates, although none surpassing 8.5.

The decline in infant mortality is a product of the cumulative gains of the revolution, one of which has been providing free, lifetime health care for all. In 1958, Cuba’s official infant mortality rate was 39 per 1,000 live births, according to UNICEF statistics, and did not begin to drop significantly until 1971. Since then, it has steadily declined into the single digits.

One of the reasons for this achievement is the family doctor program, a primary, preventive care service, under which a doctor and nurse is placed in every neighborhood, workplace, childcare center, and school—both in rural areas and the cities. According to Periódico 26, a newspaper published in Cuba’s Las Tunas province, “Ninety-nine percent of the island’s population is covered by this program, through 14,671 family doctors’ offices.”

One duty of these family doctors, or “army of white coats,” as they are called in Cuba, is to visit pregnant women, infants, the sick, and the elderly in their homes for routine examinations. Every pregnant woman is scheduled for as many as 11 medical checkups during her term, which include regular blood and genetic testing and other lab tests. The doctor-patient ratio in Cuba is at one doctor for every 165 people. In 1956, there was barely one doctor for every 1,000 people and the most impoverished working-class neighborhoods and rural areas had little if any access to a health care services.

The Cuban government has made possible this kind of comprehensive health care because from the early days of the revolution, it has viewed medical care as a fundamental right guaranteed universally from cradle to grave.

By comparison, the U.S. infant mortality rate was 7 per 1,000 live births last year, according to UNICEF. The U.S. rate is higher among oppressed nationalities—13.6 for Blacks, 8.2 for Native Americans, and 7.8 for Puerto Ricans.

The highest infant mortality rates in the Caribbean and Latin America are in the Dominican Republic, 29; Nicaragua, 30; El Salvador, 32; Brazil, 33; Guatemala, 35; and Haiti, a staggering 76. These figures are national averages. The mortality rates are higher in rural areas and impoverished working-class communities in these countries, where access to health-care services is more limited or nonexistent.

As Cuba continues to lower its infant mortality rate, it has also made progress in AIDS prevention and treatment. Cuba currently has the lowest AIDS infection rate in the western hemisphere. In a letter to the editor published in the January 2 New York Times, Sanford Kuvin, a medical doctor in Palm Beach, Florida, and chairman of the Sanford Kuvin Center for Infectious Diseases, wrote: “Cuba recognized early on that the most important factor in preventing HIV-AIDS was to treat it like every other infectious disease by carrying out universal routine HIV testing, confidential name reporting to public health officials and mandatory partner notification, with treatment to all those infected.” In a final comment reflecting the cynicism toward the Cuban Revolution among many professionals in the United States, even those who recognize the gains of the revolution, Kuvin said: “Few things in Cuba are good these days, but the Cuban approach to controlling H.I.V.-AIDS is excellent.”

Cuba has also continued to develop its biotechnology industry and is currently one of the largest exporters of medicine and pharmaceuticals to Latin America and other parts of the semicolonial world. In 1999, Cuban doctor Concepción Campa Huergo, president of the Finlay Institute, developed the world’s first meningitis B vaccine, testing it by injecting herself and her children. A Cuban-developed vaccine that stimulates the immune system against lung cancer cells is now being tested by CancerVax, a California-based biotech company.

At the same time, Cuba is unsurpassed in selfless internationalist solidarity on the medical field. Tens of thousands of Cuban doctors and nurses are currently working in nations in Latin America, the Caribbean, Asia, and Africa. More than 10,000 Cuban doctors are now working on a volunteer basis in Venezuela as part of the Barrio Adentro program, offering quality health care and free medications through neighborhood clinics across the country.  
 
 
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