Cuban health care services have been continuously threatened by the United States' policy of blockade. The restrictions imposed on the acquisition of medical supplies and technology from the United States for use in the national health care system, the obstacles to medical treatment that this entails, and the lack of access to advanced scientific and medical information have caused considerable damage to Cuban public health care services.

The impossibility of acquiring the necessary medicines or equipment has sometimes prevented Cuban doctors from saving lives or relieving suffering, resulting in physical and psychological damage to patients, their families and medical professionals themselves.

Following are a few of the most recent cases that illustrate these consequences:

- A current example is related to Severe Acute Respiratory Syndrome (SARS). The Pedro Kourí Tropical Medicine Institute in Cuba has been unable to acquire the Vitrogen diagnostic kit used to detect the coronavirus that causes the disease. As a result, it has been obliged to acquire other diagnostic means through third parties, at much higher prices.

- The companies that manufacture equipment and reagents for diagnostic purposes are, in 70% of cases, U.S.-owned. As a consequence, the supplies needed for the work of clinical laboratories must be imported from Europe, at much higher prices. For example, the companies Beckman-Coulter, Dade-Behring, Abbot and Bayer do not allow the sale of their technologies to Cuba, and some of these are the only ones of their kind in the world.

- The effects on the availability of medicine, disposable material and replacement parts for equipment, particularly those used in the treatment of patients in emergency, intensive therapy and surgical wards, as well as other services for both adults and children, have made the conditions in which medical personnel carry out their work extraordinarily difficult.

- The care of children with cancer is one of the areas most severely affected by the measures of the blockade:

The purchase of cytostatics, vital for these children's survival, has been seriously affected by the fact that U.S. transnationals have bought the pharmaceutical laboratories that formerly had contracts with Cuba.

The U.S. company Varian Medical Systems acquired the brachytherapy business of Canadian company MDS Nordion, which formerly supplied brachytherapy equipment to Cuba. As a result, the Cuban public health system has been unable to purchase the sources of Ir-192 radioactive isotopes used for radiation treatment of cancerous tumors.

- There has also been a profound effect on the health care program established for children who need transplants, due to the impossibility of acquiring the necessary technology. The struggle to save the lives of the children who need to undergo these risky surgical procedures has often made it necessary to take them to other countries, resulting in extremely high financial costs and major inconveniences for their families.

- The quality of medical care for disabled children has been limited by the scarcity of medicines like corticosteroids, third-generation antibiotics, antioxidants and children's catheter bags, all of which are sold at lower prices in the U.S. market, to which Cuba does not have access in practice.

- Restrictions in the epidemiological sector extend even to cooperation between scientific institutions in the United States and Cuba. For example, a rotavirus study project to be funded by U.S. scientific centers was recently turned down. The rotavirus causes a severe diarrheic disease in children that leads to a high number of deaths, particularly in the countries of the Third World.

This study would have made it possible to determine the scope of the spread of the rotavirus in Cuba, an essential element in the search for a possible vaccine against the virus, which would have a tremendous impact on preventing diarrhea-related deaths in children around the world.

- Dr. Roberto Fernández, head of the Biosecurity Department of the Pedro Kourí Tropical Medicine Institute, requested a biosecurity catalogue from a major U.S. company, a normal practice used by scientific centers around the world to obtain updated information on products available on the world market. Dr. Fernández received a fax from the above-mentioned company informing him that it would be impossible to send the catalogue, given the prohibitions imposed by the U.S. State Department.

- Another area with a direct impact on the health of the population is the supply and chlorination of water for human consumption. Up until now, no suppliers have been found for replacement parts for water chlorination equipment from the U.S. companies Wallace & Tiernan and Capitol. Given the impossibility of buying the parts directly from the suppliers, potential vendors have been found in third countries, although the cost would be 60,000 dollars more than it would have been in the United States.

- The criminal application of the policy of blockade against Cuba extends even to the activities of U.S. non-governmental organizations. This is the case of the Disarm Education Fund, an NGO that was prohibited from sending a donation of medicine to Cuba until two antibiotics were removed from the shipment; the antibiotics in question, Cipro and Doxycyclin, are used, among other things, for treating patients infected with anthrax. The U.S. authorities alleged that the decision was based on reasons of national security.

- On April 10, 2003, the U.S. Department of Trade issued its definitive decision to deny an export license to USA/Cuba Info Med, a humanitarian non-governmental organization based in California, which was planning, as on previous occasions, to donate 423 computers to health care institutions in Cuba. The computers donated are installed in Cuban hospitals and clinics as part of the diagnostic and medical information network.

On this particular occasion, the computers were to be sent to the Nephrology Institute and the national network for the treatment of kidney diseases, to facilitate an epidemiological study for the prevention of chronic kidney ailments. Computers were also to be given to the cardiology department of the William Soler Pediatric Hospital, the national pediatric cardiology network, and the Latin American School of Medical Sciences, which is attended by more than 7 000 young people from humble families in Latin America, the Caribbean, the United States and Africa.

These computers were similar to others donated previously, with the same processing capacity as computers sold in any retail store in the United States. However, according to the letter in which the request for a license was denied, the U.S. Trade, State and Defense Departments had reached the conclusion that this export would be detrimental to the interests of U.S. foreign policy. The U.S. government had reviewed the letter sent by the organization challenging the initial denial of a license, and had determined to maintain its decision to deny the request, due to the allegedly high levels of processing capacity of the computers in question and the risk that they would be diverted for unauthorized uses or users.