Resilience of the health sector in Cuba: challenges and achievements in 2024.

The healthcare sector in Cuba has faced a series of challenges in 2024 that have tested its resilience and responsiveness. The adversities, which include the energy crisis, natural disasters such as hurricanes Oscar and Rafael, and a series of earthquakes in the eastern region, have deepened the crisis plaguing the healthcare system. This is compounded by a shortage of medical supplies, exacerbated by the unilateral coercive measures imposed by the United States, which have severely limited funding and access to vital resources. Despite these difficulties, more than 400,000 healthcare professionals in Cuba have demonstrated unwavering commitment. Significant efforts have been made to ensure the continuity of medical services, although there are still complaints regarding the attention given to the population, stemming from both objective and subjective issues. The Ministry of Public Health (Minsap) has indicated that systematic work continues to improve the quality of care amid a complicated context. A positive aspect amidst the adversity has been the progress of the Maternal and Child Care Program, which has managed to reduce the infant mortality rate to 7.0 per thousand live births, an indicator that improves each year. This reflects the collective effort of healthcare professionals, who have focused their efforts on improving the most critical health indicators despite the lack of resources. Infectious diseases continue to be a challenge, although the mortality rate from these has been relatively low, at only 0.9%. HIV/AIDS is also being managed comprehensively, ensuring free antiretroviral treatments and access to diagnostic tests. Public health initiatives, such as the "Sigue tu ritmo. PrEP" campaign, aim to prevent the transmission of HIV and reduce the stigma associated with vulnerable populations. One of the highlighted achievements of the year has been the absence of cases of Hepatitis B in children under five for five consecutive years and the elimination of mother-to-child transmission of HIV/AIDS and syphilis since 2015. Despite these advances, the country has had to deal with a complicated epidemiological context, affected by outbreaks of arboviral diseases such as Dengue and Oropouche, which has led to an increase in patient hospitalizations. In terms of vaccination, Cuba has introduced new vaccines into its national scheme, including the Pneumosil-10 pneumococcal vaccine to protect children under one year old. Vaccination against influenza and booster shots for COVID-19 have also been prioritized, along with the imminent introduction of the human papillomavirus vaccine, which promises to be a significant advancement in the health of young women in the country. At the primary care level, the healthcare system has seen an increase in medical and dental consultations, as well as an uptick in home visits, revealing an effort by medical staff to reach the most remote communities. The Family Doctor and Nurse Program has been fundamental in this process, bringing more specialties and services closer to the population. Comprehensive mental health care has taken center stage in the sector, with the establishment of psychiatric services and educational programs to raise awareness about mental health. The altruistic work of Cuban collaborators abroad has also contributed to strengthening the country's image in the health field, with over 25,000 professionals working in various nations. Innovation has been another pillar of the Cuban healthcare system, with the development of Natural and Traditional Medicine products aimed at meeting the demand for treatments in a context of scarcity. These products, whose effectiveness has been proven, are increasingly utilized and allow patients with health limitations to access treatments without harmful interactions. With the intention of recognizing the efforts of workers in the sector, a series of tributes have been launched that extend over time, highlighting their commitment and contribution to the well-being of the Cuban people. The activities proposed during this period include commemorative events and public health campaigns, emphasizing the importance of their work in building a healthcare system that, despite its challenges, continues to show signs of strength and social commitment.