• This Blog on The Cuban Economy is dedicated to Cuba's Generation "A". Although inspired by Yoani Sánchez' blog "Generation Y" this is not dedicated to those with names starting with the letter "A". Instead, it draws from Douglas Coupland's novel Generation A which begins with a quotation from Kurt Vonnegut at a University Commencement that was brought to my attention by Andrew Johnston of Ottawa: ".. ... I hereby declare you Generation A, as much as the beginning of a series of astounding triumphs and failures as Adam and Eve were so long ago."

    The objective of this Blog is to facilitate access to research resources and analyses from all relevant and useful sources, mainly on the economy of Cuba.

CUBA AND THE ART OF THE DEAL

Tough talk is cheap, but at the end of the day, you have to deliver the goods.

By WILLIAM M. LEOGRANDE & MARGUERITE ROSE JIMÉNEZ • April 19, 2017

Original article: https://www.theamericanconservative.com/articles/cuba-and-the-art-of-the-deal/

One of the main criticisms of President Barack Obama’s opening to Cuba is that he did not extract any concessions from Raúl Castro on human rights—a criticism amplified whenever Cuban police break up a dissident meeting or demonstration. But making quid pro quo human-rights demands would have been a non-starter, just as it has been for the past 58 years. That approach would have made it impossible for the United States and Cuba to reach agreements on prisoner exchanges, diplomatic relations, and cooperation on issues of mutual interest.

Cuba always rejects such quid pro quo conditions, fearful that any concession will be interpreted as a sign of weakness. It’s a negotiating style that President Donald Trump will understand. “The worst thing you can possibly do in a deal is seem desperate to make it,” he wrote in The Art of the Deal. “That makes the other guy smell blood, and then you’re dead. The best thing you can do is deal from strength.”

The idea that the best way to support a political opening in Cuba is for the United States to demand human-rights concessions as a condition of engagement is not just a bad negotiating strategy. It also represents a fundamental misunderstanding of how the United States can most effectively influence Cuba’s political future. Although Cuban leaders have always defiantly rejected direct U.S. demands, they change their behavior of their own accord when it serves their interests. In 1978, for example, knowing that human rights were a priority for President Jimmy Carter, Fidel Castro released 3,000 Cuban political prisoners in hopes of improving relations with Washington.

The U.S. policy of engagement follows a similar logic: rather than make demands Cuba is sure to reject, engagement aims to create conditions that provide Cuban leaders with self-interested reasons to allow greater political and economic freedom. Cuba’s interest in normalizing relations with the United States is economic—that’s what Mr. Trump calls leverage. Building bilateral economic ties creates the incentive for Cuba to maintain an open flow of people and ideas, and to be more responsive to U.S. concerns on a whole range of issues, including human rights.

Engagement also gives U.S. diplomats greater opportunities to interact with Cuban civil society, including dissidents, and to travel around the island to assess conditions outside Havana and verify Cuban compliance with 1995 migration accord that prohibits persecution of illegal migrants returned to Cuba. In addition, U.S. and Cuban officials now have a human-rights dialogue in which broad issues and specific cases can be raised directly—something that did not exist before. Backpedaling on engagement would reverse these important gains.

As the Department of State’s 2016 human-rights report documents, the U.S. and Cuban conceptions of human rights are far apart. Of particular concern to Washington is the arbitrary short-term detention of Cuban dissidents (a practice that has largely replaced the long prison sentences previously handed out). The fact that the number of detentions in the last four months is half of what it was in the first eight months of 2016 (down from an average of 913 per month to 444 according to the Cuban Commission for Human Rights and National Reconciliation) does not excuse the mistreatment of people trying to peacefully exercise rights guaranteed under Cuba’s constitution. But neither should the harassment of dissidents obscure the progress in other areas, including the expansion of public space for civil discourse, increased access to information, and the growth of the private sector.

When Raúl Castro called for more open debate about Cuba’s problems in 2012, Cuban intellectuals launched spirited discussions, at first in print journals and magazines like Espacio LaicalVitral, and Palabra Nueva, produced by the Catholic Church, and Revista Temas, a journal of social and cultural criticism that tackles sensitive topics like inequality, racial discrimination, the role of religion, and the nature of socialist democracy. Even the official newspaper Juventud Rebelde began conducting investigative reports of official malfeasance and corruption.

As internet access and cell-phone availability have expanded, these discussions have moved online. More and more Cubans have access to new sources of digital information and connect with one another via social media. Blogs and digital journalism have appeared—dissident, officialista, and everything in between—engaging in debates and polemics in the expanding digital town square.

While internet access in Cuba continues to be limited, Freedom House, a staunch critic of human-rights abuses on the island, acknowledges that access has improved (albeit slowly) since 2013. Their annual “Freedom of the Net” report shows that Cuba has made progress on all indicators of internet freedom—internet penetration, obstacles to access, limits on content, and violation of the rights of users.

Since the summer of 2015 the Cuban government has established over 328 public wi-fi hotspots for Cuban users, and in December of 2016 Cuban officials signed an agreement with Google to improve internet speed on the island. At the same time, Cuba’s state-owned telecom company launched a pilot program to expand home internet access starting in Old Havana. It also lowered the price of internet access by 25 percent, thereby reducing one of the main obstacles to greater connectivity. The government plans to provide internet access to 50 percent of the population and mobile-telephone services to 60 percent by 2020. Increased access is helping reunite families, increasing information flows, creating new venues for public debate, and supporting the Cuban private sector.

Expanded travel also fosters the exchange of ideas. The policy of engagement has stimulated a rush of U.S. visitors to Cuba—almost 300,000 in 2016, a 74 percent jump from the year before—in addition to the 330,000 Cuban Americans who traveled to the island to visit family. Engagement has also brought Cubans to the United States—scientists, journalists, artists, and students. Some 40,000 them visit the United States annually on non-immigrant visas. These exchanges are possible because the U.S. government relaxed restrictions on travel to Cuba to encourage people-to-people engagement, and the Cuban government lifted the requirement that Cubans get its permission before traveling abroad.

Equally important, though it gets less attention, is how engagement fosters greater economic freedom. In recent years, Cubans have enjoyed new opportunities to open small private businesses and cooperatives, and they’ve rushed to take advantage of it. The number of private businesses has increased more than 300 percent in the past six years, and the private sector’s share of the labor force has expanded to 28 percent, with plans to reach as much as 50 percent in the future. Most of the seed capital fueling this entrepreneurial boom comes from remittances that Cuban Americans send to relatives on the island, and the supply chains for many of these new businesses reach back to south Florida. These linkages are a direct result of U.S. engagement. That’s why more than 100 Cuban private entrepreneurs wrote a letter to President Trump asking him not to abandon them by cutting off those lifelines.

In short, U.S. engagement with Cuba is fostering and reinforcing positive developments on human rights in myriad ways, expanding the flow of information, ideas, people, and capital—all of which nurture Cuba’s expanding public discourse and vibrant entrepreneurial sector.

After the U.S. election, President-elect Trump declared he wanted a new deal with Cuba that was good for the Cuban people, Cuban Americans, and the United States. A return to the policy of hostility fails that test because Cuba will predictably respond just as Donald Trump himself advises: when attacked, “Fight back: Always hit back against critics and adversaries,” harder than they hit you. That leads to a dead end of perpetual antagonism. On the other hand, a policy of engagement built on the bedrock of everyone’s self-interest will produce the best deal possible and set the stage for even better ones in the future. Tough talk is cheap, but at the end of the day, as The Art of the Deal notes, you have to “deliver the goods.”

William M. LeoGrande is professor of government at American University in Washington, DC. Marguerite Rose Jiménez is the senior associate for Cuba at the Washington Office on Latin America.

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SUN, SAND AND SOCIALISM: WHAT THE TOURIST INDUSTRY REVEALS ABOUT CUBA

Stuck in the past: The revolutionary economy is neither efficient nor fun.

The Economist, April 1, 2017

Original Article: STUCK IN THE PAST

TOURISTS whizz along the Malecón, Havana’s grand seaside boulevard, in bright-red open-topped 1950s cars. Their selfie sticks wobble as they try to film themselves. They move fast, for there are no traffic jams. Cars are costly in Cuba ($50,000 for a low-range Chinese import) and most people are poor (a typical state employee makes $25 a month). So hardly anyone can afford wheels, except the tourists who hire them. And there are far fewer tourists than there ought to be.

Hotel at Vinales; apparently constructed with Mafia money as part of their major money-laundering 1950s tourism investment project. (Photo by Arch Ritter, 2015)

Few places are as naturally alluring as Cuba. The island is bathed in sunlight and lapped by warm blue waters. The people are friendly; the rum is light and crisp; the music is a delicious blend of African and Latin rhythms. And the biggest pool of free-spending holidaymakers in the western hemisphere is just a hop away. As Lucky Luciano, an American gangster, observed in 1946, “The water was just as pretty as the Bay of Naples, but it was only 90 miles from the United States.”

There is just one problem today: Cuba is a communist dictatorship in a time warp. For some, that lends it a rebellious allure. They talk of seeing old Havana before its charm is “spoiled” by visible signs of prosperity, such as Nike and Starbucks. But for other tourists, Cuba’s revolutionary economy is a drag. The big hotels, majority-owned by the state and often managed by companies controlled by the army, charge five-star prices for mediocre service. Showers are unreliable. Wi-Fi is atrocious. Lifts and rooms are ill-maintained.

Despite this, the number of visitors from the United States has jumped since Barack Obama restored diplomatic ties in 2015. So many airlines started flying to Havana that supply outstripped demand; this year some have cut back. Overall, arrivals have soared since the 1990s, when Fidel Castro, faced with the loss of subsidies from the Soviet Union, decided to spruce up some beach resorts for foreigners (see chart). But Cuba still earns less than half as many tourist dollars as the Dominican Republic, a similar-sized but less famous tropical neighbour.

But investment in new rooms has been slow. Cuba is cash-strapped, and foreign hotel bosses are reluctant to risk big bucks because they have no idea whether Donald Trump will try to tighten the embargo, lift it or do nothing. On the one hand, he is a protectionist, so few Cubans are optimistic about his intentions. On the other, pre-revolutionary Havana was a playground where American casino moguls hobnobbed with celebrities in raunchy nightclubs. Making Cuba glitzy again might appeal to the former casino mogul in the White House.

The other embargo is the many ways in which the Cuban state shackles entrepreneurs. The owner of a small private hotel complains of an inspector who told him to cut his sign in half because it was too big. He can’t get good furniture and fixtures in Cuba, and is not allowed to import them because imports are a state monopoly. So he makes creative use of rules that allow families who say they are returning from abroad to repatriate their personal effects (he has a lot of expat friends). “We try to fly low under the radar, and make money without making noise,” he sighs.

Cubans with spare cash (typically those who have relatives in Miami or do business with tourists) are rushing to revamp rooms and rent them out. But no one is allowed to own more than two properties, so ambitious hoteliers register extra ones in the names of relatives. This works only if there is trust. “One of my places is in my sister-in-law’s name,” says a speculator. “I’m worried about that one.”

Taxes are confiscatory. Turnover above $2,000 a year is taxed at 50%, with only some expenses deductible. A beer sold at a 100% markup therefore yields no profit. Almost no one can afford to follow the letter of the law. For many entrepreneurs, “the effective tax burden is very much a function of the veracity of their reporting of revenues,” observes Brookings, tactfully.

The currency system is, to use a technical term, bonkers. One American dollar is worth one convertible peso (CUC), which is worth 24 ordinary pesos (CUP). But in transactions involving the government, the two kinds of peso are often valued equally. Government accounts are therefore nonsensical. A few officials with access to ultra-cheap hard currency make a killing. Inefficient state firms appear to be profitable when they are not. Local workers are stiffed. Foreign firms pay an employment agency, in CUC, for the services of Cuban staff. Those workers are then paid in CUP at one to one. That is, the agency and the government take 95% of their wages. Fortunately, tourists tip in cash.

The government says it wants to promote small private businesses. The number of Cubans registered as self-employed has jumped from 144,000 in 2009 to 535,000 in 2016. Legally, all must fit into one of 201 official categories. Doctors and lawyers who offer private services do so illegally, just like hustlers selling black-market lobsters or potatoes. The largest private venture is also illicit (but tolerated): an estimated 40,000 people copy and distribute flash drives containing El Paquete, a weekly collection of films, television shows, software updates and video games pirated from the outside world. Others operate in a grey zone. One entrepreneur says she has a licence as a messenger but wants to deliver vegetables ordered online. “Is that legal?” she asks. “I don’t know.”

Cubans doubt that there will be any big reforms before February 2018, when Raúl Castro, who is 86, is expected to hand over power to Miguel Díaz-Canel, his much younger vice-president. Mr Díaz-Canel is said to favour better internet access and a bit more openness. But the kind of economic reform that Cuba needs would hurt a lot of people, both the powerful and ordinary folk. Suddenly scrapping the artificial exchange rate, for example, would make 60-70% of state-owned firms go bust, destroying 2m jobs, estimates Juan Triana, an economist. Politically, that is almost impossible. Yet without accurate price signals, Cuba cannot allocate resources efficiently. And unless the country reduces the obstacles to private investment in hotels, services and supply chains, it will struggle to provide tourists with the value for money that will keep them coming back. Unlike Cubans, they have a lot of choices.

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HUSTLING, CRADLE TO GRAVE

As Cuba’s economy flat-lines, retirement has become notional, tiny pensions must be supplemented by whatever work is available

 The Economist, Mar 23rd 2017 | HAVANA

NORBERTO MESA, a 66-year-old grandfather, stands in the hot sun 11 hours a day, six days a week, guiding cars in and out of the parking spaces in front of a bustling farm stand. The 4,000 Cuban pesos ($170 at the official exchange rate) he earns each month in tips is more than ten times his monthly old-age pension of 340 pesos. Without it, the retired animal geneticist could not afford fruit and meat, or help his children, who work for low salaries, to feed his four grandchildren.

Though revolutionary Cuba had one of the region’s earliest and most comprehensive pension systems, in recent years retirement has almost vanished. Without further economic reform, and the cheap oil that used to come from Venezuela, the economy has stalled. Pensions have been frozen, and their value eaten up by inflation. According to the most recent government statistics, from 2010, a third of men past retirement age are working. Three-fifths of older people say they often have to go without necessities.

The insular socialist paradise supposedly offers a social safety-net, cradle to grave. But it is full of holes. Medical care is free, but most medicine is not. Retirement homes are scarce, and rules that mean residents must give up their pensions and homes put off many, since these are often a lifeline for younger relatives in equally distressed circumstances.

So old people can be seen on the streets of Havana selling newspapers and peanuts, or recycling cans. They are scrubbing floors in affluent homes or cooking for a growing number of private restaurants and bakeries. Ernesto Alpízar, an 89-year-old former agronomist, goes door-to-door selling strawberries and flowers. Even so, he remains an ardent “Fidelista”, grateful to the island’s late dictator for the free cataract surgery that saved his eyesight.

For even as the island’s old and infirm must hustle to survive, they have benefited from its success at providing health care. Life expectancy at birth is 79, not far short of most developed countries, and widely available birth control helps explain why family size has fallen further and faster than in most other countries (see chart). The flip side, though, has been a breakneck demographic transition—exacerbated by the large share of young and middle-aged Cubans who have fled to America. Over-65s now make up 14% of the population. The national statistical office estimates that the total number of pensioners will overtake the number of state-sector workers by 2025.

A few churches and charities, mostly funded from abroad, are trying to fill the gap. Rodolfo Juárez, a pastor of the International Community Church, a Protestant congregation, helps 60 indigent elderly people in Havana. His scheme provides fruit, vegetables and beans to supplement government rations of a daily piece of bread; and 7lb of rice, 2lb of sugar, five eggs and a piece of chicken a month. Although running it costs just 18,000 pesos a month, funding is a constant problem.

Mr Juárez and his wife, at 80 and 75, are older than many of those they help. Between their church duties and his teaching at a seminary, they make 3,600 pesos a month. Though that does not go far, it dwarfs Mr Juarez’s pension. As long as Cuba’s economy flat-lines, its elderly will have no rest till they drop.

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ALTERNATE FUTURES FOR CUBA’S EMERGING NON-STATE ECONOMIC SECTOR

Presented at Florida International University, Cuban Research Institute Conference: “Beyond Perpetual Antagonism: Re-imagining U.S. – Cuba Relations.”

February 24, 2017

Complete Presentation:  FIU CRI 2017 Presentation


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CHINA PILES INTO CUBA AS VENEZUELA FADES AND TRUMP LOOMS

Reuters, Tue Feb 14, 2017 | 8:17 PM EST

Original Article: China piles into Cuba

CUBA ISN’T WAITING AROUND FOR U.S. WHEN IT’S GOT CHINA

By Marc Frank | HAVANA

From buses and trucks to a $500 million golf resort, China is deepening its business footprint in Cuba, helping the fellow Communist-run state survive a crisis in oil-benefactor Venezuela and insulate against a possible rollback of U.S. detente.

Cuban imports from China reached a record $1.9 billion in 2015, nearly 60 percent above the annual average of the previous decade, and were at $1.8 billion in 2016 as the flow of oil and cash slowed from Venezuela due to economic and political turmoil in the South American country.

China’s growing presence gives its companies a head start over U.S. competitors in Cuba’s opening market. It could leave the island less exposed to the chance U.S. President Donald Trump will clamp down on travel to Cuba and tighten trade restrictions loosened by his predecessor Barack Obama.  A deterioration in U.S.-China relations under Trump could also lead Beijing to dig in deeper in Cuba, some analysts say.

“If and when the Trump administration increases pressure on China … China may decide to double down on its expanding footprint in the United States’ neighborhood,” said Ted Piccone, a Latin America analyst at the Brookings Institution think tank.

China, the world’s second largest economy, sells goods to Cuba on soft credit terms. It is Cuba’s largest creditor and debt is regularly restructured, though amounts and terms are considered state secrets.  While Cuba does not publish investment data, the state press has been abuzz with news of Chinese projects lately, covering infrastructure, telecoms, tourism and electronics.

Yutong (600066.SS) buses, Sinotruk (3808.HK) trucks, YTO (600233.SS) tractors, Geely (0175.HK) cars, Haier (1169.HK) domestic appliances and other products are prominent in Cuba, where the main U.S. products on display are cars dating back to the 1950s, thanks to the ongoing economic embargo.

Cubans flock every day to hundreds of Huawei supplied Wi-Fi hot spots and the firm is now helping to wire the first homes.

“Business is really booming, more than we could have ever imagined,” said the manager of a shipping company which brings in Chinese machinery and transport equipment and who asked not to be identified.

The foreign ministry in Beijing described China and Cuba as “good comrades, brothers, and partners,” and said the relations “were not influenced by any third party,” when asked whether U.S. policy was encouraging China to deepen its presence.  “We are happy to see that recently countries around the world are all expanding cooperation with Cuba. I think this shows that all countries have consistent expectations about Cuba’s vast potential for development,” Chinese Foreign Ministry spokesman Geng Shuang told reporters.

The U.S. State Department and White House did not immediately respond to requests for comment.

INCREASED INVESTMENT

Over the past two decades, China has become a major player in Latin America and the Caribbean, second only to the United States in investment flows and diplomatic clout.  But the Asian giant was reluctant to invest in Cuba because of the poor business climate and fear of losing opportunities in the United States, according to Asian diplomats in Havana.

That began to change after Obama moved to normalize relations two years ago and Cuba sweetened investment rules, sparking new interest among U.S. businesses and competitors around the world.  China was well placed because the local government preferred doing business with long-term friends offering ample credit to work with state-run firms.

In return, Cuba has shared contacts and knowledge about the region, and taught hundreds of Chinese translators Spanish.

A report on the government’s official Cubadebate media web site last month said the two countries agreed to strengthen cooperation in renewable energy and industry, with 18 Chinese firms taking part in a three-day meeting in Havana.

Plans for several projects were signed, including a joint venture with Haier to establish a renewable energy research and development facility, the report said.  A few weeks earlier, Cuba opened its first computer assembly plant with Haier with an annual capacity of 120,000 laptops and tablets, state media reported.

Other projects include pharmaceuticals, vehicle production, a container terminal in eastern Santiago de Cuba, backed by a $120 million Chinese development loan, and Beijing Enterprises Holdings Ltd. (0392.HK) venture for a $460 million golf resort just east of Havana.  Shanghai Electric (601727.SS) is providing funds and equipment for a series of bioelectricity plants attached to sugar mills.

Barrio Chino, La Habana

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WHY OXEN REMAIN VITAL TO CUBA’S ECONOMY

Cuba Standard, February 10, 2017
Original Article: OXEN

The collapse of the Soviet Union hit the Cuban economy severely. The island nation lost approximately 80% of its imports, 80% of its exports and its Gross Domestic Product dropped by a third, virtually overnight.

Entirely dependent on fossil fuels to operate, the major buttresses of Cuban society – its transport, industrial and agricultural systems – were frozen. There were extensive losses of productivity in both Cuban agriculture – which was dominated by Soviet modern industrial tractors, combines, and harvesters, all of which required petroleum to run – and in Cuban industrial capacity.

As a result, animals returned to the agriculture scene, and ox, in particular, carried most of the farming burden in the slow recovery that lasted until the last 1990s. After the hurricanes of 2008 (Hurricane Ike, Hurricane Gustav, Tropical Storm Fay), Raul Castro cited ox as essential for recovery. “For this program we should forget about tractors and fuel, even if we had enough. The idea is to work basically with oxen,” Castro told parliament August 1, 2008.  “An increasing number of growers have been doing exactly this with excellent results.”

Cuba imports most of its agricultural machinery and is in need of high ­quality, consistent machinery and spare parts. Cuban imports of agricultural machinery rose from $11.4 million in 2005 to a peak of $92.8 million in 2013 before falling to $57.5 million in 2014. In 2014, Brazil was the leading supplier of agricultural machinery to Cuba, followed by the EU (largely Spain and Italy).

The Cuban drivers for increased imports of agricultural machinery have been the need to improve agricultural performance and reduce reliance on imported agricultural products. Nonetheless, any attempts by Cuba’s agricultural sector to replace its old and obsolete agricultural machinery are making slow progress. In 2013, approximately 1% of Cuba’s 66,128 tractors were less than five years old, nearly 12 percent were between 6 and 30 years old, and 87% were more than three decades old.

 

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CUBA WANTS MORE BABIES, SO IT’S GIVING PARENTAL LEAVE TO GRANDPARENTS, TOO

By Nick Miroff February 10, Washington Post
Original Article: Grandparents and Fertility Rates!

MEXICO CITY — Cuba is giving parental leave to the grandparents of newborns, the country’s latest attempt to reverse its sagging birthrate and defuse a demographic time bomb.

The island already has one of the most generous parental leave policies in the Americas, allowing mothers and fathers to take more than a year off from work at partial pay. The new decree extends those benefits to maternal and paternal grandparents.

But so far, such attempts haven’t brought any sort of Cuban baby boom.  The island of 11 million has one of the lowest fertility rates in the Western Hemisphere, with 1.7 births per woman. There are several factors that explain this figure, but they mostly come down to a combination of effective socialist medical care and a dysfunctional state-run economy.

Cuba’s health-care system makes contraceptives widely available, and abortions are available on demand. At the same time, Cuban women are a growing portion of the country’s professional workforce, and many choose to delay motherhood until their late 30s, often because they don’t have the financial means to care for children.

It’s hardly the only demographic problem Cuba faces: Some  60,000 to 80,000 Cubans emigrate each year, many of them young people looking for better opportunities in the United States, Europe and Latin America.

The Cubans who stay behind are going gray. Nearly one-fifth of the island’s population is 60 or older, and they depend on a shrinking pool of Cuban workers to keep the state-run economy afloat. Cuba’s life expectancy is 78, on par with the United States, so there’s a larger and larger pool of dependents.

According to the Communist Party newspaper Granma, the decision to extend parental leave to grandparents was necessary “to deal with the high degree of aging among the population, and to encourage fertility in the short term.”  “The challenge of raising the birthrate in Cuba is a challenge that cannot be put off,” Granma said.

The decrees also reduce day-care costs for Cuban parents with multiple children, and provide tax breaks for women who work in the country’s small but growing private sector.

Offering partial salary to Cuban parents on leave is not the kind of burden for the government — which employs about 70 percent of the workforce — that it would be in more prosperous nations.

The average official state salary hovers around $20 a month. Paying parents and grandparents a fraction of that to care for children is costly in a country where economic growth is stagnant, but nothing like the expenditure it would be elsewhere.

The United Kingdom has adopted a leave policy for grandparents who still work, and while a similar law has been proposed in Argentina, Cuba appears to be the first Latin American country to offer the benefits to grandparents.

 

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HOW DOES CUBA MANAGE TO ACHIEVE FIRST-WORLD HEALTH STATISTICS?

The island’s medical system is envied throughout the region and is a major foreign revenue earner

ÁLVARO FUENTE; EL PAÍS, Havana 10 FEB 2017

Original Article: Cuba’s Medical System

Cuba’s healthcare system is a source of pride for its communist government. The country has well-trained, capable doctors, the sector has become an important export earner and gives Cuba valuable soft power – yet the real picture is less rosy. A lot of health infrastructure is deteriorating and there is a de facto two-tier system that favors those with money.

Cuba’s child mortality rate is on par with some of the world’s richest countries. With six deaths for every 1,000 births, according to World Bank data from 2015, Cuba is level with New Zealand. In 2015, the global average was 42.5 deaths for every 1,000 births. Despite more than half a century of a US economic embargo, Cuba’s average life expectancy matches that in the US: 79.1 years, just a few months shorter than Americans who, on average, live to 79.3 years, according to 2015 data from the World Health Organization (WHO).

Much of Cuba’s success in these areas is due to its primary healthcare system, which is one of the most proactive in the world. Cuba’s population of 11.27 million has 452 out-patient clinics and the government gives priority to disease prevention, universal coverage and access to treatment.

Cuba has also produced innovations in medical research. In 1985 the country pioneered the first and only vaccine against meningitis B. The country’s scientists developed new treatments for hepatitis B, diabetic foot, vitiligo and psoriasis. They also developed a lung cancer vaccine that is currently being tested in the United States. Cuba was also the first country on earth to eliminate the transmission of HIV and syphilis from mother to child, a feat recognized by the WHO in 2015.

In 2015, Cuba spent 10.57% of its GDP on health, slightly higher than the global average. According to the World Bank in 2014, the European average spending GDP spending was 10%, compared to 17.1% in the United States.

TWO-TIER SYSTEM

A lesser-known characteristic of Cuba’s healthcare system is the existence of special clinics, reserved for tourists, politicians and VIPs. The state reserves the best hospitals and doctors for the national elite and foreigners, while ordinary Cubans sometimes must turn to the black market or ask expatriate friends or family to send medicine.

“Cuba’s health service is divided in two: one for Cubans and the other for foreigners, who receive better quality care, while the national population has to be satisfied with dilapidated facilities and a lack of medicines and specialists, who are sent abroad to make money for Cuba,” says Dr. Julio César Alfonzo, a Cuban exile in Miami and director of the NGO Solidaridad Sin Fronteras.

In 2015, Cuba spent 10.57% of its GDP on health, slightly higher than the global average

In 1959, the country had only 6,000 doctors, half of whom emigrated after the Cuban revolution. By 2014, Cuba had 67.2 doctors for every 10,000 inhabitants, with only Qatar and Monaco ahead of it.

However, despite these impressive statistics, the quality of primary healthcare, which has been fundamental to Cuba’s success, has been declining in recent years. Between 2009 and 2014 there was a 62% fall in the number of family doctors, from 34,261 to 12,842, according to Cuba’s National Statistics Office (ONEI).

AN ARMY OF WHITE COATS

In the words of Fidel Castro, Cuba’s “army of white coats” was formed in 1960, when a medical brigade was sent to Chile after an earthquake left thousands dead. Since then, Cuba has sent more than 300,000 healthcare workers to 158 countries in Latin America, Africa and Asia, according to Cuba’s state news agency. Today, around 50,000 Cuban medical workers are present in 67 countries.

“Cuban doctors are rooted in solidarity and in the Hippocratic Oath. Our job would be unthinkable without foreign missions,” says Salvador Silva, a doctor specializing in infectious diseases who has worked in Haiti and Liberia.   “Yes, our salary is low and maybe that pushes us to go abroad, but it also makes us proud when we see our work recognized throughout the world, on top of just helping in our own country,” he adds.

Doctors are arguably Cuba’s most profitable resource and the country’s medical missions have proved to be a lucrative diplomatic tool. The healthcare industry is also one of the country’s main sources of income. In 2014, Cuban authorities estimated overseas healthcare services would bring in $8.2 billion, putting it ahead of tourism.

Cuba has a different deal with each country it works with. For example, in exchange for sending 3,500 health care workers to work in and provide training in Venezuela, a close Cuban ally, Venezuela sends oil.

With such a high demand for personnel, some suspect that the Cuban government has been reducing educational requirements to hasten students’ entry into the work force.  “They are giving doctors licenses in record time to meet the need to export them, and this has been detrimental to the quality of training and medicine, which used to be the best. This has been happening since they started the program in Venezuela, between 2003 and 2004,” says Dr Alfonzo.

Doctors are also eager to be sent abroad, not only to help the less fortunate, but also for money. Salaries are higher – depending on the location, with doctors abroad reportedly making up to $1,000 per month (minus taxes), whereas those in Cuba make around $50. On the island, it isn’t rare to find taxi drivers, shopkeepers or construction workers with medical degrees.

Juan drives a 1950s Chevrolet he bought with his brother and he uses it as a taxi from 6pm to midnight. He’s also a doctor in the clinic Hermanos Ameijeiras. “The wage is a pittance. We find ourselves obligated to make a living doing other things. I have coworkers who sell prescriptions to pharmacies, who work in unlicensed clinics or help their families in shops. It’s frustrating,” he says. “It’s like they’re pushing us to enlist in international missions, the business of Cuba.”

The country’s medical missions abroad have been an important escape route for Cubans looking to defect. Before migratory reforms were passed in January 2013 allowing Cubans with passports and visas to travel abroad, the preferred way to abandon Cuba was via Venezuela. In 2013 and 2014, more than 3,000 doctors deserted the island to go to the United States through a special visa program called Cuban Medical Professional Parole, a program started by George W. Bush to help healthcare workers who had escaped while working abroad.

Lucia Newman, a former CNN correspondent in Habana, said Cuban doctors complain that travel restrictions prevent them from attending conferences or keeping abreast of the latest medical advances. The US trade embargo on Cuba includes some textbooks, but the major problem is that Cuban doctors cannot buy medical equipment from the United States or from any US subsidiaries.

For Odalys, a young patient waiting at the Hospital Salvador Allende, “the situation is becoming unsustainable in this country and it’s not because of a lack of specialists, it’s because we have to bring everything ourselves. I just bought a light bulb for the hospital room. I’ve called home so that they can bring me bedding, towels and even toilet paper. There aren’t even stretchers, I saw a family carrying their sick son into a room. Free and universal health care, yes, but it’s a bit of a mess and very informal,” she says.

English version: Alyssa McMurtry.

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DEBATING U.S.-CUBAN RELATIONS: HOW SHOULD WE NOW PLAY BALL? 2nd Edition

Edited by Jorge I. DomínguezRafael M. HernándezLorena G. Barberia

© 2017 – Routledge

To Order: Routledge

ABOUT THE BOOK

The boundary between Cuba and the United States has become more and more porous, as have those with Latin America and the Caribbean. Never in the past half-century has Cuba’s leadership or its social and political fabric been so exposed to the influence of the outside world. In this book, an all-star cast of experts critically address the recent past and present in U.S.-Cuban relations in their full complexity and subtlety to develop a perspective on the evolution of the conflict and an inventory of forms of cooperation. This much needed approach provides a way to answer the questions “what has been . . .?” and “what is . . .?” while also thinking seriously about “what if . . .?”

To illustrate the most significant areas of U.S.-Cuban relations in the contemporary era, this newly updated edition of Debating U.S.-Cuban Relations adds six more themes to the study of this complex relation: political, security, economic, and cultural/academic issues; the triangular relations of the United States, Cuba, and Europe; and the politics of Cuban migration/emigration. Each topic is represented by perspectives from both Cuban and non-Cuban scholars, leading to a resource rich in insight and a model of transnational dialogue.

The future course of U.S.-Cuban relations will likely be more complex than in the past, not only because of the matrix of factors involved but also because of the number of actors. Such a multiplicity of domestic, regional, and global factors is unique; it includes the rise to power of new administrations in both countries since 2008. Raúl Castro became president of Cuba in February 2008 and Barack Obama was inaugurated president of the United States in January 2009. And it will feature the inauguration of a new president of the United States in January 2017 and a new president of Cuba, likely in February 2018.

 

TABLE OF CONTENTS

Chapter 1: Introduction: A Baseball Game. Jorge I. Domínguez and Rafael M. Hernández

Chapter 2: Intimate Enemies: Paradoxes in the Conflict between the United States and

Cuba. Rafael M. Hernández

Chapter 3: Reshaping the Relations between the United States and Cuba. Jorge I. Domínguez

Chapter 4: Cuba’s National Security vis-à-vis the United States: Conflict or Cooperation? Carlos Alzugaray Treto

Chapter 5: Cuban-United States Cooperation in the Defence and Security Fields: Where Are We? Where Might We Be Able to Go? Hal Klepak

Chapter 6: Terrorism and the Anti-Hijacking Accord in Cuba’s Relations with the United States. Peter Kornbluh

Chapter 7: The European Union and U.S.-Cuban Relations. Eduardo Perera Gómez

Chapter 8: European Union Policy in the Cuba-U.S.-Spain Triangle. Susanne Gratius

Chapter 9: U.S.-Cuba Relations: The Potential Economic Implications of Normalization. Archibald R. M. Ritter

Chapter 10: United States-Cuba Economic Relations: The Pending Normalization. Jorge Mario Sánchez Egozcue

Chapter 11: Cuba, Its Immigration and U.S.-Cuba Relations. Lorena G. Barberia

Chapter 12: U.S.-Cuba: Emigration and Bilateral Relations. Antonio Aja Díaz

Chapter 13: The Subject(s) of Academic and Cultural Exchange: Paradigms, Powers, and Possibilities. Sheryl Lutjens

Chapter 14: Academic Diplomacy: Cultural Exchange between Cuba and the United States. Milagros Martínez Reinosa

 

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CHARCOAL — FIRST LEGAL CARGO FROM CUBA IN MORE THAN 50 YEARS — ARRIVES AT PORT EVERGLADES

Original Article:  http://www.miamiherald.com/news/nation-world/world/americas/cuba/article128433209.html#storylink=cpy

BY MIMI WHITEFIELD

The first Cuban exports since the embargo went into effect over a half century ago arrived at Port Everglades Tuesday as port officials prepared to receive a business delegation from Cuba later in the week.

The delegation also plans to visit the Port of Palm Beach, which is located in Riviera Beach, and Port Tampa Bay durina a swing through the United States that has already included a stop at the Port of Houston. Also on the itinerary are visits to the Port of New Orleans and the Port of Virginia in Norfolk and meetings with the U.S. Chamber of Commerce in Washington D.C., members of Congress and the American Association of Port Authorities, which is holding a conference in Tampa.

Two containers of artisanal charcoal made from Cuban Marabú, an invasive woody species from Africa that is considered a nuisance on the island, arrived at the Fort Lauderdale port aboard a Crowley Maritime ship called the K-Storm. The charcoal exports, which are produced by private worker-owned cooperatives, are legal under a rule change by the former Obama administration that allows the importation of some products produced by independent Cuban entrepreneurs.

In Cuba, Marabú has taken over wide swaths of idle agricultural land and strangled other plants. But it makes a hardwood charcoal that is winning acceptance as a fuel for pizza and bread ovens in Europe and the Middle East. It will be sold under the Fogo Charcoal brand by various U.S. retailers.

The charcoal deal was put together by Coabana Trading, a subsidiary of Reneo Consulting, a firm chaired by Scott Gilbert, the Washington D.C. lawyer who represented Alan Gross, the USAID subcontractor who was jailed by the Cuban government for five years.

“This is truly a momentous occasion,” Gilbert said when the deal for 40 tons of charcoal was announced earlier this month. “Now U.S. consumers will be able to purchase this product, as have Europeans and others for many years. More importantly, this marks the beginning of a new era of trade between the United States and Cuba.”

The agreement was struck with CubaExport, a Cuban government entity that develops trade opportunities, but Scott said that the Marabú plant is cut and the charcoal produced by private Cuban cooperatives.

The embargo still remains in effect, but executive orders issued by Obama over the past two years eased some Cuba-related travel and trade restrictions.

Although the transaction was negotiated under the Obama opening, the historic Cuban exports are arriving during the Trump administration. Trump has said he might roll back some of Obama’s executive orders on Cuba unless Cuba offers a better deal to the United States and Secretary of State-nominee Rex Tillerson has said that all Obama’s executive orders on Cuba will be reviewed.

Whether Cuban charcoal becomes a staple of U.S. trade with the island remains to be seen.

“It’s experimental, but the importer hopes to have regular shipments,” said Jay Brickman, vice president of government services and Cuba service at Crowley. Brickman called the shipment “the first truly commercial shipment from a Cuban cooperative to a private U.S. business since the U.S.-Cuba trade embargo was imposed more than 50 years ago.”

The shipping line makes thrice-monthly trips from Port Everglades to Cuba’s container port in Mariel and also calls in Honduras and Guatemala before returning to the Fort Lauderdale port. Crowley mostly carries frozen chicken parts and foodstuffs to Cuba but it also handles small amounts of other legal exports to the island and was involved in shipping some of the equipment that the Rolling Stones used in their historic concert in Cuba in March 2016.

Crowley has been calling on Cuba for the past 15 years. “We average about 40 to 45 loads of cargo [for Cuba] per voyage,” said Brickman.

Another port user, Pearl Seas Cruises’ Pearl Mist, is currently on its maiden voyage to Cuba from Port Everglades.

On Thursday, a Cuban delegation will be at Port Everglades to sign a memorandum of understanding between the port and the National Port Administration of Cuba that could pave the way for joint marketing studies, joint training and other cooperation, said Jim Pyburn, the port’s director of business development.

“We would like to see U.S. exports to Cuba increase; imports are good, too,” said Pyburn.

He hopes for a future when large U.S. grocery chains and shopping clubs ship food to Cuba from the port. “Cubans are in dire need of paint and basic building materials and we’d like that to be part of the [export] mix, too,” he said.

At Port Everglades, the seven-member Cuban delegation will begin its day with a meeting with Port Director Steven Cernak, tour the port and then lunch with executives from Crowley and the cruise lines. In the afternoon, the delegation will present a “Doing Business with Cuba” seminar for about 150 invited businesses executives. It will include presentations on inland and sea transportation in Cuba, the Mariel Container Terminal and the Mariel Special Economic Development Zone, which is prospecting for foreign investment projects leading to sustainable economic development.

The Cuban delegation includes Ana Teresa Igarza, general director of the Mariel zone; José Leonardo Sosa Barrios, deputy director of the Mariel Container Terminal; Eradis González de la Peña, president of Almacenes Universales; René Rolando Fernández, director of inland waterway and sea transport for the Ministry of Transportation; Tania Vazquez, an official with the Ministry of Foreign Trade and Investment; Joel Lago from the Cuban Embassy in Washington’s economic and trade office and Ernesto Viñas, an adviser to the deputy minister of transportation.

Pyburn said Port Everglades had been working on an MOU with Cuba since early 2016 but originally it was only going to cover Mariel, which is about 28 miles west of Havana. Now, with the involvement of the National Port Administration, it will cover all Cuban ports.

He said the MOU was completed for signing in May. But there was little action until Brickman visited Washington in December. During the trip, Brickman said he received a call from the Cuban Embassy “saying the Cubans would really like to sign a memorandum of understanding with Port Everglades.” He helped facilitate the visit and the signing.

The Port of Palm Beach also is expected to sign a MOU with the Cuban port administration on Friday.

Unloading Charcoal at Port Everglades, Florida

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