How the Brazilian government bypassed Congress to bring in Cuban doctors

Last week, the Cuban government announced it was pulling out of the More Doctors Program, which sends healthcare professionals to remote areas around Brazil. The move came after statements made by President-elect Jair Bolsonaro, who wanted to impose conditions on Cuba in order to keep the program going. At the time, we argued that Brazil seriously needs these doctors. Today, however, we will focus on the problems with the More Doctors Program, beginning with how Brazil and Cuba negotiated to bypass Congress.

Telegrams from the Brazilian embassy in Cuba allow us to reconstruct the negotiations between the two countries in order to create the More Doctors Program. Classified as confidential and kept secret for five years, these cables belie part of the official story told to Brazilians.

The documents show, for example, that the program was offered by Cuba and was already negotiated a year before then-President Dilma Rousseff presented it, in response to the June 2013 protests. The negotiations were kept secret to avoid negative reactions from the medical community. At these meetings, Havana made the demands which have now been criticized by President-elect Jair Bolsonaro, and whose threats of cancellation spurred Cuba to unilaterally pull the plug.

No formal attachment to the Cuban doctors

In order to bypass Congress, the Dilma Rousseff administration decided to triangulate the business: the Brazilian government would pay the Pan-American Health Organization (PAHO), which would hire the Cuban Government, which, only then, would hire the doctors.

In fact, when Cuban doctors sued in Brazil order to lift the restrictions imposed on them by Havana, the Brazilian government responded that it had no direct relationship with them. In October 2011, Cuba created private companies with government ties. One of them was Comercializadora de Servicios Médicos Cubanos (CSMC), which exported medical workers and supplies. Medical services are one of the main components of Cuba’s foreign trade agenda,...