An April report by the Center for Economic and Policy Research (CEPR) identified the intensification of United States sanctions against Cuba as the primary cause of a 148% increase in the island’s infant mortality rate (IMR) from 2018 to 2025. The report details how coercive economic measures under the Donald Trump and Joe Biden administrations restricted Cuba’s access to medicine, medical supplies and equipment and fuel, leading to critical health infrastructure failures.
A country’s infant mortality rate is defined as the number of deaths of infants under one year of age per 1000 live births in a given year. It is a key statistical indicator of a population’s overall health and its access to quality healthcare.
Cuba’s infant mortality rate rose from 4.0 to 9.9 deaths per 1000 live births between 2018 and 2025, resulting in an estimated 1800 preventable infant deaths.
Before Trump’s first presidential term, Cuba had better health outcomes — including higher life expectancy at birth and lower infant mortality — than the regional average. Until recently, Cuba’s IMR was among the lowest in the Western Hemisphere — a rate of 4.3 in 2015 according to Cuba’s health authorities, compared to a regional average of 15.6 and a rate of 5.8 in the US.
Like most countries, Cuba’s economy shrank during the COVID-19 pandemic. Cuba’s gross domestic product (GDP) growth was -10.7% in 2020 — one of the worst contractions in the region. However, unlike most other countries, Cuba did not experience a significant post-pandemic economic rebound.
The collapse of tourism — one of Cuba’s biggest industries and sources of foreign currency — during the pandemic compounded the impact of escalating US sanctions.
Trump’s activation of Title III of the Helms-Burton Act in May 2019 and his government’s decision to place Cuba on the so-called State Sponsor of Terrorism (SSOT) list in 2021, just before leaving office, may have done the most damage to Cuba’s economy. These sanctions deterred tourism and made remittances and trade with Cuba prohibitively difficult.
While Trump ramped up imperialist aggression against Cuba, sanctions on the country have always been bipartisan US policy. Aside from a few token gestures — such as Biden briefly removing Cuba from the SSOT list just days before Trump returned to office in January — the Biden administration maintained most Trump-era measures. Trump reversed Biden’s decision less than a week later.
Tourist arrivals in Cuba fell by 53% between 2018 and 2024. The CEPR report found that “Income from tourism fell from $3.3 billion in 2017 to $2.6 billion in 2019, and it then fell drastically during the pandemic to just over $400 million in 2021, but by 2024 it had only recovered to $1.3 billion — just 40 percent of its 2017 level.”
“Remittances peaked at just over $4 billion in 2018; they then fell to $2.8 billion in 2020 and to just $1.8 billion in 2022. The remittances partially recovered ... to $2.3 billion by 2024.”
Cuba spends a significant portion of its GDP on healthcare, consistently ranking among the highest in Latin America. However, the CEPR report notes that “Cuba has struggled to import many basic medical supplies, with formerly reliable suppliers suddenly halting shipments.
“MEDICuba [Medical Product Import-Export Enterprise] has had to seek medical goods from distant locations, often at higher-than-market rates and in many cases has been unable to find alternatives.
“[The] Trump administration’s decision to put Cuba on the SSOT list ... has led to many international financial institutions refusing to engage with Cuban entities.”
Economic sanctions are designed to cause recessions (and political crises) in targeted countries. Any developing country subjected to the same economic strangulation by the US would likely face similar outcomes, or worse.
A 2022 paper published by the Bank for International Settlements found that “child mortality rises in a highly significant way in recessions in EMDEs [emerging market and developing economies], by about 6 deaths per 1000 births”.
The US’s ramped-up fuel blockade this year has further escalated Cuba’s healthcare crisis. Trump threatened heavy tariffs on any country sending oil to Cuba.
Venezuela — previously Cuba’s main source of oil imports — was cut off after the US military’s regime-change operation and bombing of Venezuela on January 3.
Mexico stepped in as Cuba’s primary fuel supplier last year, but then folded under US threats of tariffs in January. The only fuel shipment to reach Cuba this year was sent by Russia, arriving in late March.
Cuba’s energy sector still relies heavily on imported oil to generate electricity, despite the rapid deployment of solar power technology this year. Long and frequent power blackouts interrupt the use of critical medical equipment, including incubators for premature babies and ventilators for sick newborns.
A recent article in the New York Times noted that at Cuba’s leading maternity hospital, “Doctors, nurses, cleaners and mothers all struggle to get to the hospital because of the lack of fuel. This translates into dirtier delivery rooms, fewer health workers to deliver babies and mothers arriving after labor is dangerously far along.”
“We are receiving much more severe cases,” said Dr Liliam Delgado Peruyera, an obstetrician-gynaecologist at the hospital, noting that three newborns died in February, the highest number she could recall in a single month.
The continued expansion of US sanctions is steadily degrading Cuba’s healthcare system.While Democratic politicians occasionally offer performative gestures, such as House Representatives Pramila Jayapal and Jonathan Jackson visiting the country last month, little has been changed to materially improve the situation for Cubans.
The Cuban people are in for darker times, with the most defenceless members of the population — infants — first to face the brunt of the US’s collective punishment.