WASHINGTON — The United States announced sweeping visa revocations and restrictions Wednesday for some foreign officials in Brazil, the Caribbean and Africa over their alleged ties to Cuba’s overseas medical missions. Secretary of State Marco Rubio said the move is meant to penalize what Washington describes as a coercive labor export scheme that sends Cuban doctors abroad while generating revenue for the Cuban government, Aug. 13, 2025.
Rubio said the State Department revoked the visas of Mozart Julio Tabosa Sales, a Brazilian Ministry of Health official, and Alberto Kleiman, a former Pan American Health Organization official. Rubio said additional officials from Africa, Cuba and the Caribbean nation Grenada were also hit with visa restrictions, but he did not publicly identify them.
In his statement, Rubio said the penalties extend to some family members of those targeted. The State Department did not disclose how many officials were affected.
Cuba’s deputy director of U.S. affairs, Johana Tablada, wrote on X that “Cuba’s medical cooperation will continue.” Brazilian Health Minister Alexandre Padilha said his government would not bow to what he called “unreasonable attacks” on Brazil’s Mais Medicos (“More Doctors”) initiative, which has relied on Cuban clinicians to staff underserved communities.
How the dispute over Cuban doctors missions reached U.S. visas
The Trump administration argues that Cuba’s overseas medical deployments amount to forced labor and exploitation, saying participants are often denied basic workplace freedoms while Havana retains most of the proceeds paid by host governments. U.S. officials also contend the missions reduce access to health care inside Cuba by exporting scarce medical personnel.
Cuba rejects the U.S. characterization and says the missions are voluntary and humanitarian, with payments helping fund the island’s public health system. Cuban officials have described the U.S. visa campaign as an attempt to cut off a key source of hard-currency earnings.
The debate has broadened beyond Washington and Havana. A senior Cuban diplomat told the Associated Press this summer that the United States is pressing governments and financial institutions to distance themselves from the medical missions, while an inter-american human rights body has requested details from regional governments about contracts and labor protections tied to Cuban medical workers.
Caribbean leaders say they can’t replace Cuban doctors
Several Caribbean leaders have pushed back publicly, arguing that Cuban medical staff are essential to health systems already strained by worker shortages and limited budgets. Guyana Foreign Minister Hugh Todd told the Associated Press that foreign ministers from Caricom raised concerns with U.S. Special Envoy for Latin America Mauricio Claver-Carone and want the matter addressed by heads of government.
St. Vincent and the Grenadines Prime Minister Ralph Gonsalves said his country would accept U.S. visa consequences rather than shutter critical services, saying, “I will prefer to lose my visa than to have 60 poor and working people die.” Trinidad and Tobago Prime Minister Keith Rowley has also said he would not end cooperation with Cuban clinicians under U.S. pressure, arguing recipient governments can compensate foreign specialists on par with local staff.
Visa restrictions widened beyond Cuba in 2025
The Aug. 13 action follows earlier steps that broadened Washington’s use of visa restrictions linked to Cuba’s labor export programs. Rubio expanded a Cuba-related visa restriction policy to target Cuban officials tied to the program and their immediate family members, Feb. 25. In a June 3 statement, he also announced visa restrictions on unnamed Central American officials accused of exploiting Cuban medical professionals through similar arrangements.
Wednesday’s measures extend that approach to third-country officials alleged to have facilitated or benefited from the missions, with Brazil’s Mais Medicos program singled out as a key example. Rubio did not say which African countries were implicated or whether additional foreign officials could be targeted in future rounds.
Background: debates over pay, contracts and migration
Scrutiny of Cuba’s medical missions predates the latest visa action. Cuban doctors working in Brazil under Mais Medicos received only a fraction of the monthly fee paid by Brazil, with money routed to Cuba through the Pan American Health Organization.
The arrangement became a flashpoint in Brazil’s domestic politics in 2018 after then president-elect Jair Bolsonaro demanded contract changes and labeled the program “slave labor,” prompting Cuba to pull out. Thousands of Cuban doctors began returning home, leaving some Brazilian towns scrambling for replacements.
Brazil later revisited the issue as the coronavirus pandemic strained hospitals. Al Jazeera reported in 2020 that Brazil rehired Cuban doctors who had stayed after the rupture to bolster its COVID-19 response.
Legal challenges followed in the United States. In 2022, a U.S. appeals court said the Pan American Health Organization must face a trafficking lawsuit brought by Cuban doctors who said they were coerced to work in Brazil and paid far less than the value of their labor.
Rubio’s latest visa actions land amid that long-running dispute, with the United States framing the missions as an exploitative labor enterprise and Cuba and many recipient governments describing them as essential public health cooperation. For countries relying on Cuban clinicians, the sanctions raise a stark choice between U.S. travel access for officials and maintaining medical staffing agreements that fill gaps at home.
