14 July 2017
During my five days official visit to Cuba from 10 to 14 July 2017, I met with representatives of the Ministry of Foreign Affairs, the Ministry of Education, the Ministry of Higher Education, the Ministry of Public Health, the Ministry of Foreign Trade and Investment, the Civil Defense National Staff, as well as with the Institute for Sports, Physical Education and Recreation (INDER), the Latin American School of Medicine (ELAM) and the Cuban Institute for Friendship with the Peoples (ICAP). I also met with representatives of Cuban civil society organizations, visited the Elderly’s Community Home, based at the Belén Convent, and an out-patient clinic located in Vedado. In addition, I had an opportunity to engage in informal conversation with the foreign scholars of ELAM, who spoke with me on their vision of someday being able to help in developing countries, upon completing their medical education in Cuba. I would like to express my gratitude and thanks to the Cuban Government for its support and cooperation during my visit. I would like to also thank the UNCT for taking the time to meet with me. Finally, I thank all those who took the time to exchange views with me.
The purpose of my visit was primarily to observe and learn about how human rights are integrated into Cuba’s international solidarity efforts. Efforts to promote the right to international solidarity by Cuba are all the more noteworthy in light of the international challenges towards the realization of all human rights within the country. During the 35th session of the Human Rights Council in June this year, I presented a Draft Declaration on the right to international solidarity, in accordance with my mandate. In effect, this country visit to Cuba has given me the opportunity for the first time, to frame my observations, with a particular focus, in the present statement, on the fields of education, health and sports, in the context of the Draft Declaration, in particular the following three essential features of international solidarity as stated in its Article 2:
Preventive solidarity as characterized by collective actions by States to safeguard and ensure the fulfilment of all human rights while fully respecting and complying with their obligations under international law; and that individuals, peoples, civil society, the private sector and international organizations complement the efforts of States through their activities in this regard.
Reactive solidarity, characterized by collective actions of the international community in response to, for example, the adverse impacts of natural disasters, health emergencies, epidemic diseases and armed conflict.
International cooperation refers to the duty of States through which States that are in a position to do so, should contribute to the fulfilment of human rights in other States that may not possess the resources or capacity to comply with their own human rights obligations without international assistance.
The observations that follow below at the end of my visit are simply a broad overview with some preliminary recommendations, to be followed by a more comprehensive and detailed report to be presented to the Human Rights Council at its 38th session in June 2018.
“Solidarity of the peoples” is recognized in the Preamble of the Cuban Constitution that enshrines the principle of “human solidarity” in its article 1, and equality and non-discrimination, in its articles 41 to 44.
The Cuban Constitution guarantees the right to education and is implemented through a free and comprehensive schools system. All educational materials are free of charge which gives all children and the youth equal opportunity for learning and for developing their inherent capacities and skills, regardless of their economic conditions. The formal schools programme is supplemented by other programmes offered by the Ministry of Education such as Educa a tu Hijo (Educate your Child) that involves the participation of families as well as communities in the education of children up to six years of age who have special needs.
International collaboration is an important aspect in educational development whether at the national level or across country borders. Cuba has strong partnerships with more than thirty countries and these partnerships are characterized by the good practices that Cuba offers and shares with the rest of the world. For example, since it was first implemented in 2002, the literacy programme called Yo si Puedo (Yes I can) has been translated into English, French, Portuguese and several languages of indigenous peoples such as Quechua, Aymara or Swahili. Yo si Puedo is considered one of the main cooperation programmes of Cuba that gained recognition with the UNESCO King Sejong Literacy Prize. Consequently, the new programme, called Yo si Puedo Seguir (Yes I can Continue) was also established, aimed at continuing and refining literacy in countries where the Yo si Puedo programme has been successful with a total of more than 30 million people acquiring literacy.
At the higher education level where scholarships are available for foreign students, more than fifty-six thousand students from countries of Africa, Latin America and the Caribbean have graduated in Cuba through more than two thousand ministerial and academic agreements. After graduation, these students return to their countries of origin. Educational cooperation is further strengthened through the participation of fifteen thousand professors of the Ministry of Education who provide academic services abroad each year. Currently, there are eleven projects of collaboration with the United Nations (UNFPA, FAO, UNICEF, among others), that are designed around and complementary with, the priorities of Cuba. Notably, the values component, including human rights, cuts across the various disciplines in higher education.
There are more than 200 doctors working with sportsmen/women within the country. The project Por la Vida (Project for Life) is a project of community physical activity. Its main objective is to contribute to the improvement of the social care, health and quality of life of the population and their coexistence in solidarity, with an emphasis on disadvantaged groups of the population. It is articulated around the axes of education, health and prevention. This project has also being replicated in El Salvador, Venezuela, Panama, Timor-Leste and Peru.
UNICEF has been supporting projects in the area of sports. Among these projects, the project Fútbol para Todos y Todas (Football for All), coordinated by the National Institute of Sports, Physical Education and Recreation (INDER) and the Ministry of Education aims at promoting gender equality, in which teams composed by boys and girls allow them to share the football field in equal conditions. The Olympic Committee and the Pan American Sports Organization have also supported projects in the field of sport, as well as other projects of solidarity, mainly in rural areas.
Cuba also offers international support to other countries, by sending Cuban sportsmen/women to Haiti and African countries, among others. There are more than 200 Cuban collaborators in more than 30 countries with Venezuela, Mexico, Panama, Dominican Republic and Italy, among others. I was also informed that all Cuban athletes are tested at school to make sure that they are not taking any doping product. UNESCO has undertaken eight projects with the Institute of Sports Medicine for anti-doping education.
Cuba’s food subsidy programme had been a significant factor in its achieving the target of the MDGs relating to the reduction of hunger and undernourishment to below 5% since 2005. It is also important to note its achievements in the fields of health and education in relation to the MDGs. Today, Cuba looks upon the 2030 Sustainable Development Agenda as a roadmap to guide its national and international efforts aimed at eradicating poverty and hunger. I was also informed that the Cuban Parliament has just approved the basic outline for the National Plan for Social and Economic Development that will guide its agenda until 2030.
The right to health protection and care is enshrined in the Cuban Constitution and the State guarantees this right by providing free medical and hospital care in polyclinics and preventive and specialist treatment centres, along with free dental care, and by promoting health education and awareness, vaccinations and other measures to prevent the outbreak of disease. The average life expectancy in Cuba is 78.45 years old and child mortality is 4.2 per 1,000 live births.
The health system in Cuba puts an emphasis on the promotion of health and prevention, in which polyclinics are the entry point in the health system for the population, where they can receive primary attention and care and where 70-80% of health problems are solved. I was informed that there is an average of one doctor and one nurse for 1094 individuals, and that one polyclinic covers 5,000 to 50,000 individuals.
In June 2015, Cuba became the first country in the world to receive validation from WHO that it has eliminated mother-to-child transmission of HIV as well as syphilis. WHO/PAHO has been working with partners in Cuba since 2010 to implement a regional initiative to eliminate mother-to child transmission of these diseases.
Over the years, Cuba has made significant contributions in the area of reactive solidarity, in the form of its outstanding responsiveness to health crises brought about by epidemics such as the Ebola virus, and disasters such as the earthquake that reduced Haiti to rubble and where many lives were lost. Medical teams from Cuba went to Sierra Leone, Liberia and Guinea Conakry even as others were pulling back because of the dangerously high levels of contamination. Cuban medical teams were in Haiti during the height of the emergency, and stayed to assist in rebuilding the health service system.
Cuba has a Comprehensive Health Programme, a cooperation project sending emergency brigades composed of doctors, nurses and other health workers even to isolated places affected by extreme weather events and epidemics. The Henry Reeves International Medical Contingent was created in September 2005, in response to such emergencies and it has attended to the needs of 21 countries so far, involving the care of more than 3.5 million people. It is in this context that Fidel Castro conceived the creation of the Latin American School of Medicine (ELAM) to train physicians free of charge in these countries, and which offers medical school scholarships for students from low income families all over the world, with the requirement that they return home after graduation to serve as health workers. The majority of students in ELAM come from humble families who live in remote places. More than one hundred ethnic groups are represented among these students, and it is in this cultural unity in diversity where the strength of this project lies. I was also very touched to hear one of the students of ELAM telling me that it was a privilege for him to study in that school, and be enabled to transmit the knowledge acquired, through sharing with others. Another student, a young woman, expressed her conviction that young people are really the only ones who can bring about the change they want to see in the world, stressing that students are there to help their countries and to change the reality – especially in the health system.
Cuba has a long-standing tradition of solidarity with other countries that are working to overcome underdevelopment and has invested important resources, in particular human resources with the aim of promoting health equity within Cuba and in other countries.
My visit to Cuba has been a productive and enriching endeavour. It was also an important learning of a solidarity cooperation model that is uniquely Cuban – “giving from what we have, not from our left-over”.
I look forward to the adoption of Cuba’s National Plan for Economic and Social Development until 2030 towards the achievement of the Sustainable Development Goals, and also look forward to favourably considering its ratification of the International Covenant on Civil and Political Rights, the International Covenant on Economic, Social and Cultural rights, and their optional protocols.
Finally, I would like to commend Cuba for leading the efforts in the creation and the recent extension of my mandate through resolution 35/3 adopted in June this year by the Human Rights Council.
The above comments are preliminary in nature and are not comprehensive in scope. As mentioned in the introduction, a full detailed account will be included in my country visit report on Cuba, which will be submitted to the Human Rights Council in its 38th session in June 2018 and presented by my successor.