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February 21, 1996

Relations Between the United States and CubaA Proposal for Action

JAMA. 1996;275(7):559-560. doi:10.1001/jama.1996.03530310065035

One of the oft-neglected questions in the debate about Cuba is whether policies that adversely affect the health of Cubans should be used in the US government's efforts to force changes in the Castro government.

Following the Cuban revolution of 1959, health and education services improved significantly in Cuba as a result of the Castro government's decision to make health and education priorities. Along with Costa Rica, Cuba achieved some of the best health indicators among the Latin American and Caribbean countries.1 Those gains are now being reversed, as a result in part of the continuing embargo against Cuba, which will be even stricter if the Helms-Burton bill is finally made into law.

Since 1962, the United States has maintained an economic embargo against Cuba. Because of political and economic support from the former Soviet Union, this embargo had only a limited impact for many years. In 1992, the