Trump and the Crusade against the More Doctors Program

Donald Trump, in his new season of attacks on the Global South, has chosen a target that says a lot about the worldview he defends: the More DoctorsThe program was created in 2013, during the government of President Dilma Rousseff, to address the chronic shortage of doctors in remote and hard-to-reach regions of Brazil. Guaranteeing basic care through the Unified Health System (SUS), it relied on thousands of Cuban professionals who did what private medicine never bothered to do—serve populations invisible to the market.

Between 2013 and 2018, Cuban doctors made up the majority of professionals in More DoctorsIn 2015, for example, they represented 60% of the 18,1 practicing physicians (approximately 11 professionals). They worked mainly in municipalities with high vulnerability rates, rural areas, urban peripheries, and Special Indigenous Health Districts (DSEIs).

In 2018, Cuba withdrew its doctors from Brazil after the government of Jair Messias Bolsonaro demanded the revalidation of diplomas (Revalida) and full direct payment to professionals, breaking with the nature of the program which, in addition to humanitarian work, is an export product for Cuba.

In 2023, the program was restructured as More Doctors for Brazil, prioritizing Brazilian professionals (93% of vacancies in 2025).

In practice, the Cuban medical mission program is one of Cuba's most successful exports—not of sugar, nickel, or tobacco, but of knowledge, service, and public health. Since 1963, doctors from the island have been to more than 150 countries, bringing care wherever the presence of a doctor is needed. Finding a local professional was either unlikely or economically unfeasible.

In March 2025, it was estimated that Cuba had approximately 24.180 doctors working in 56 countries, with many of them in Caribbean and Latin American countries, where they address serious shortcomings in local public health systems.

In crisis situations, this cooperation network has shown its strength: after the earthquake in Haiti in 2010, Cuba was the first country to send medical teams; during the Ebola outbreak in West Africa in 2014, more than 250 Cuban professionals worked on the front lines; during the Covid-19 pandemic, brigades from Henry Reeve International Medical Contingent — specially formed for emergencies — were sent to 40 countries. All this while the island remained under economic embargo by the United States (USA), which since 1962 has been trying to stifle its economy and its health system.

For Trump, this humanitarian mission is nothing more than "forced labor" and "diplomatic fraud." It's a repetition of an old narrative that the Washington propaganda machine has been repeating for over 60 years: any Cuban action abroad cannot be seen as solidarity, but as political manipulation. This time, the attack came with sanctions against former officials of the Brazilian Ministry of Health, accused of "facilitating" an exploitation scheme.

The idea that these doctors are exploited ignores the context. Part of their remuneration is indeed sent directly to the Cuban government, but this sustains a free healthcare system for 11 million people on the island, which maintains health indicators comparable to or better than those of rich countries: infant mortality of 4,0 per thousand live births (lower than that of the US), vaccination coverage exceeding 95%, and a life expectancy of 78 years. The logic is simple and transparent: the State trains, maintains, and sends these professionals, and the financial return is collective, not individual.

It is important to remember that medical training in Cuba is public and fully funded by the state. This applies not only to Cubans, but also to thousands of foreigners who study for free at the Latin American School of Medicine (ELAM) in Havana. Many of the Brazilian doctors who worked in More Doctors They graduated from this school, returning to their country with a deep-rooted social commitment. In this model, medicine is not seen as a business, but as a social function, and the service provided abroad is part of a global solidarity pact.

In Brazil, the impact of More Doctors It was concrete and measurable. Created in 2013, during its period of greatest coverage (until 2017) it served more than 63 million people in areas with a chronic shortage of doctors, covering approximately 81% of the national territory – the Legal Amazon, the northeastern hinterland, and urban peripheries. In many cities, it was the first time the population had a doctor permanently stationed at the health post. Studies by IPEA showed that the program reduced hospitalizations for conditions sensitive to primary care and expanded vaccination coverage. Its presence was crucial in thousands of highly vulnerable municipalities, where it resolved up to 80% of primary health problems. There are no specific official statistics on the exact number of patients treated exclusively by Cuban doctors, as the data is consolidated by the program.

Since Cubans made up the majority of the professionals, it is plausible to infer that they treated tens of millions of Brazilian citizens. Opinion polls indicated approval ratings exceeding 80% among SUS (Brazilian public healthcare system) users who had contact with Cuban doctors.

Behind the US “humanitarian” rhetoric against the More DoctorsWhat is being hidden is an attempt to delegitimize Cuban medical cooperation around the world, whether in Brazil, Africa, or the Caribbean. It's about stifling a policy that simultaneously saves lives and demonstrates that it's possible to organize public health outside the logic of profit. Millions of Brazilians have, for the first time, had a permanent doctor in their communities.

O More Doctors It was, and continues to be, a reality check for those who believe that healthcare only works if it is subordinated to the market.

The hatred he spews towards Trump stems from the fact that Cuba demonstrates that, even under blockade, a small country can offer the world something more valuable than any other. commodityThe right to health. Washington may try to sabotage it. More DoctorsBut it cannot erase the memory of those who saw the difference between abandonment and care.