KINGSTON, Jamaica — When Jamaica ended its half-century medical cooperation programme with Cuba in March, Havana answered within a day by recalling its entire brigade. Seven months later, most of those health workers are back. On 7 October, Health and Wellness Minister Dr Christopher Tufton told a post-Cabinet briefing that 157 Cuban doctors, nurses and other professionals had returned on individual contracts with the Government of Jamaica, joining 43 who never left. That puts 200 Cuban professionals in the public health system, against 277 before the split.
The obvious question is whether this was the outcome Kingston was steering towards all along. The public record suggests the answer is yes, with one large qualification: Jamaica planned the destination, but it did not control the detour.
The numbers at a glance
What happened
Jamaica’s cooperation with Cuba dates to 1976. The most recent technical cooperation agreement expired in February 2023, but Cuban staff kept working while the two governments tried to agree on a replacement. On 5 March 2026 the Ministry of Foreign Affairs and Foreign Trade announced it was discontinuing the arrangement because the two sides could not agree on terms.
Jamaica’s stated objections were about how the workers were treated, not whether they were wanted. A review had found that Cuban staff were not holding their own passports, and that salaries, calculated at the same rates as Jamaican counterparts, were being paid by Jamaica to the Cuban state rather than to the workers. The passport issue was reportedly fixed. The payment issue was not, and Kingston said it could not square that arrangement with local labour and tax law.
Havana saw it differently. Cuba’s foreign ministry said the Government of Jamaica “yields to the pressures of the Government of the United States” and ordered its brigade home. The workers then had between four months and two years left on their postings, according to The Gleaner. Only 43 accepted Jamaica’s offer to stay on individual contracts, roughly 15.5% of the brigade.
Cuban health workers in Jamaica’s public system
Headcount fell by 84.5% when Havana recalled its brigade. Seven months on, 72% is back.
before the split
stayed on
after 157 returned
Source: Ministry of Health and Wellness via Jamaica Observer, JIS. Graphic: Jamaica Homes News
So, was this the plan all along?
On the model itself, the paper trail is consistent. Direct payment to individual workers was Jamaica’s proposal long before the break. According to reporting by Caribbean360, Kingston put a restructured proposal to Havana from July 2025 and received no reply. Jamaica’s foreign ministry later said that silence had the practical effect of preserving an arrangement it could not justify, and noted that Cuba had accepted individual contracts in other CARICOM states.
The direct-contract offer was also in the termination statement itself. On the same day Jamaica ended the programme, it said Cuban professionals could be engaged individually under local labour law for the rest of their tenure. Within days, Dr Tufton said offers had gone through the Cuban ambassador, and by May he said every departing worker had received a letter inviting them back on individual terms. When he announced the 157 returns, he described them as the product of a “renegotiated agreement” with the workers themselves.
What was not in Jamaica’s gift was the collapse in between. Havana’s decision to recall the whole brigade turned a change in payment method into an 84.5% drop in Cuban staff. The Government’s own contingency planning shows it took that risk seriously: in March, Cabinet approved outsourcing of radiotherapy and cataract surgery to the private sector, direct overseas recruitment through private recruiters, and a new international recruitment unit inside the ministry. Those are not the moves of a government that expected a smooth handover.
The fairest reading, then: direct contracts were Plan A from at least mid-2025, and the October numbers show the model can attract Cuban professionals back. The seven months of thinner staffing were the price of Havana refusing that model, not part of anyone’s design. Whether US pressure was the real driver remains disputed. Jamaica has consistently denied it. Cuba and Jamaica’s Opposition have argued otherwise, and the timing came after Washington widened visa restrictions on officials tied to Cuban medical missions in February 2025.
How the split, and the return, unfolded
Direct contracts were on the table from the first day.
- Feb 2023 — Jamaica-Cuba agreement expires; Cuban staff keep working while talks continue.
- Feb 2025 — US expands visa restrictions to officials linked to Cuban medical missions.
- Jul 2025 — Jamaica proposes a restructured deal with direct pay; no response from Havana.
- 5 Mar 2026 — Jamaica ends the programme and offers individual contracts.
- 6 Mar 2026 — Cuba recalls its 277-member brigade, citing US pressure.
- Mar 2026 — Cabinet approves outsourcing, private recruiters and a recruitment unit.
- May 2026 — 43 who stayed are on direct contracts; India and Ghana health MOUs signed.
- Jul 2026 — Tufton says about 50 Cuban nurses are expected back.
- 7 Oct 2026 — 157 confirmed back on direct contracts; total reaches 200.
Sources: Gleaner, Jamaica Observer, JIS, AP, Caribbean360, Havana Times. Graphic: Jamaica Homes News
Where the returning workers have gone
The ministry gave a breakdown of postings for the 157, reported by the Jamaica Observer. The South East Regional Health Authority, which covers Kingston, St Andrew, St Catherine and St Thomas, took 69, or 44%. Before the split, SERHA had the largest single group of Cubans, 97.
Where the 157 returning Cubans were posted
Almost half went to the South East region.
Source: Ministry of Health and Wellness via Jamaica Observer, 8 Oct 2026. Graphic: Jamaica Homes News
The west felt the departures sharply. At Cornwall Regional Hospital in St James, 27 Cuban nurses, doctors and radiotherapists left in March, and the hospital had to recruit locally and overseas to cover some specialist gaps. The Western RHA has now received 28 of the returnees. Dr Tufton’s own summary of the position was brief: “So, we are close to where we were.”
The gap that remains
77 posts still to fill
Measured against the 277 Cuban professionals serving before March 2026.
Source: Ministry of Health and Wellness. Graphic: Jamaica Homes News
Seventy-seven fewer Cuban professionals is not a rounding error in a system with roughly 1.3 doctors per 1,000 people, according to World Bank figures cited by The Gleaner, and one that the Planning Institute of Jamaica says loses an average of 500 specialist nurses to migration each year. The baseline is also lower than it once was: in 2025, Foreign Minister Kamina Johnson Smith put the number of Cuban participants at more than 400, including biomedical engineers and technicians.
The Government is trying to close the gap from several directions at once:
- Ghana: a four-year MOU signed in May for the voluntary recruitment of Ghanaian nurses and doctors, with specialist nurses expected to serve two to three years.
- India: a health MOU covering staffing and training, plus an agreement with the Apollo hospital group to support Jamaica’s expanding hospital network.
- Home-grown: 100 nurses in the ministry’s specialist programme were due to finish training this month, and 48 nurses and 33 doctors from the Barry Wint Scholarship were expected to join the system.
- Private sector and recruiters: outsourcing for radiotherapy and cataract surgery, and Cabinet-approved direct recruitment through private agencies, with Nigeria and the Philippines also mentioned as sources.
What it means for patients
The service most closely tied to the Cuban presence is eye care. The Jamaica-Cuba Eye Care Programme, launched in January 2010 at St Joseph’s Hospital and other sites, offered free cataract, pterygium and diabetic retinopathy treatment. The ministry said in 2019 that some 30,000 Jamaicans had benefited, and staff told The Gleaner in March that the clinic averaged about 22 surgeries a day. Patients queued from early morning in the days before the Cubans left, and about 130 people were already prepped for surgery when the programme was wound down to post-operative care in late March.
The ministry has not said how many of the 157 returnees are ophthalmology staff, or whether the eye care programme will resume at its former pace. That is the number patients waiting for cataract surgery will want to see.
Across the region
Jamaica is part of a wider shift away from government-to-government deals with Havana as Washington presses Caribbean states over what it calls forced labour. Cuba rejects that characterisation and says the missions are voluntary and help fund its own health system.
| Country | Government-to-government deal | Route now |
|---|---|---|
| Jamaica | Ended March 2026; Cuba recalled 277 | Direct contracts; 200 now serving |
| Guyana | Cuba withdrew a brigade of 200+ after Guyana moved to pay full salaries | Hiring Cubans individually |
| Honduras | Cancelled; 168 left on 4 March 2026 | No replacement Cuban deal reported |
| Dominica | Restructured | Direct contracts with doctors and nurses |
| The Bahamas | Under discussion with the US | Framework for direct hiring |
| St Vincent & the Grenadines | Phasing down | “Localisation” plan for medical staff |
What we still don’t know
- How many of the 200 are doctors, nurses or technicians, and which specialties are covered.
- The length of the new contracts, the pay, and how total costs compare with the old arrangement.
- Whether Havana has accepted or objected to its nationals returning on individual terms.
- When the eye care programme and other specialist services will be back to their pre-March capacity.
Prime Minister Andrew Holness said in March that he hoped a revised framework could keep the partnership alive, adding that “Jamaicans love them and want them to stay.” On the numbers, most of them have. The test now is whether the remaining 77 posts are filled, and whether patients notice the difference.
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