U.S.-Cuba Cooperation on Ebola: Disgrace or Diplomacy?


Sherri L. Porcelain

She teaches global public health in world affairs at the University of Miami where she is also a Senior Research Associate at the Institute for Cuban and Cuban-American Studies.


The spread of the deadly Ebola virus underscores why international cooperation is both complicated and necessary. When the Pan American Health Organization (PAHO) extended an invitation for the United States to participate in a recent hemispheric meeting on Ebola, the location and timing of the meeting became a point of contention to some Cuban American leaders in South Florida. U.S. House Representative Mario Diaz –Balart called the U.S. participation “a disgrace.”


First, the Ebola Regional Technical Meeting prompted criticism because the U.S. sent a government representative to Havana. On October 29 -30, 2014, with thirty- four countries in attendance, participants met to identify gaps in preparedness, discuss regional strategies and expand training, resources, and risk communication. The White House sent Dr. Nelson Arboleda, the Center for Disease and Control and Prevention (CDC) Central America’s Regional Director, to Cuba. Dr. Arboleda was the perfect choice. He is a CDC Disease Detective, a global health leader, a Colombian- American raised in Miami who is knowledgeable about events in Latin America and an Adjunct Professor of Global Health at his alma mater, the University of Miami.


Second, disapproval was voiced that the U.S. government’s participation in the Cuba meeting took place during an expanded summit of the Bolivarian Alliance for the People of Our America (ALBA) - a regional organization formed to minimize U.S. hegemony in the region. The reality of establishing global health security by reducing the scourge of deadly diseases cannot always be conducted through traditional approaches in international relations. History reminds us of such efforts.


PAHO has played a key role in facilitating regional health diplomacy actions.


Some examples include:


  • As early as 1901 the Pan America Sanitation Bureau, today known as PAHO, demonstrated the power of regional health cooperation during the deadly outbreaks of cholera, plague, malaria and yellow fever.


  • In 1924 a PAHO regional meeting convened in Havana to draft the first Pan American Sanitary Code. The purpose was to prevent the spread of diseases, promote cooperation to protect health, standardize data collection and disease protection methods and improve the exchange of health information in the region.


  • PAHO coined the phrase ‘Health as a Bridge to Peace’ in 1984 during the Contra War’s impact in Central America. Vaccination campaigns were designed to promote cooperation and foster greater negotiations between the guerrilla fighters and governments. Such Days of Tranquility, or formal truces, have been well documented in El Salvador from 1985- 1991.


Other significant global health cooperation challenges include both governmental and nongovernmental actions:


  • The early collaborative scientific and epidemiologic research between Panama, United States and Cuba on yellow fever was a key factor in the successful completion of the Panama Canal.


  • The U.S. and former Soviet Union’s cooperation during the height of the Cold War placed ideological differences aside to jointly eradicate smallpox.


  • The bringing together of local mayors from Israel, Jordan and Palestine on Jordan’s Bakoora Island (also referred to as Peace Mountain), to discuss the threats of water, environment and public health in communities along the Jordan River Valley. I was honored to participate in the first meetings on March 9, 2005 to promote peace initiatives through nongovernmental actors, such as the Friends of the Earth Middle East in collaboration with local leaders from their perspective countries.


  • The notable role of the Kuvin Center for the Study of Infectious and Tropical Diseases at Hebrew University where scientific cooperation in research engages partnerships with Israel and Palestine as another example of coming together to wage war against deadly diseases without formal diplomatic relations.


These examples are meant to show that it is not necessary to be “friends” to join forces and fight against plagues. Sometimes it takes academic, scientific and other non- state actors, such as PAHO to promote diplomacy. However, when this is done at an official governmental level, countries must acknowledge their collective responsibility.


Cuba’s policy to withhold official reporting on disease outbreaks, in spite of their well-developed epidemiologic system, jeopardizes the efficacy of such regional efforts. You need look no further than Cuba’s official reporting on cases of dengue and chikungunya.


  • PAHO’s Epidemiologic Week, November 6, 2014, documents Cuba reporting 0 cases of dengue this year in the face of surrounding countries having acknowledged thousands of cases. Even the United States has reported 297 suspected cases.


  • PAHO’s Epidemiologic Week, November 7, 2014, shows Cuba reporting 20 imported cases, and no locally acquired cases of chikungunya. Every other Latin Caribbean country reported thousands of suspected cases, with 64,695 and 498,916 in Haiti and Dominican Republic respectively.


Cross border coordination of activities and disclosing a country’s health risks are necessary factors in preventing and controlling the spread of diseases. Ebola! We know that without effective transparency, health diplomacy becomes an empty façade, and worse, global health security is seriously compromised. This is the real “disgrace,” unless PAHO takes a position to seek truthful data.



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