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To combat AIDS
Cuba mobilized before first diagnosis
Lavender & red, part 98
Published May 21, 2007 9:06 PM
The Reagan administration tried to whip up world anger at Cuba’s handling
of the AIDS epidemic. In reality, Cuba took an immediate, scientific and humane
approach to people with AIDS.
In the U.S., AIDS was first diagnosed in 1981. By May 1983, simultaneous gay
and lesbian protests of tens of thousands had to take to the streets in New
York City, San Francisco, Los Angeles, Houston, Atlanta, Chicago and Milwaukee
under banners reading “Fighting for our lives!” to demand federal
funds to battle AIDS, and for research, services and Social Security
A day later, activists organized a telephone blitz of the White House to
protest government inaction and to demand funds. It was to date the largest
number of calls to the Oval Office in a single day in its history. The
president had still not publicly said the word AIDS, while theo-cons demonized
the emerging health crisis as a “gay plague.”
By contrast, Cuba’s health care workers began preparations to defend the
whole population from the AIDS epidemic two years before the first case was
diagnosed on the island in 1985. Cuba spared no expense despite the chokehold
of the U.S.-led blockade.
Cuba—unlike the U.S.—mobilized against AIDS, not against people
with AIDS. Researchers Lourdes Arguelles and B. Ruby Rich observed in the
autumn of 1987 that, “Cuba is unusual in publicizing the disease, not as
a gay disease, but rather as a sexually transmitted disease regardless of
specific sexual practice.”
Planning to protect population
After members of the Cuban Health Ministry took part in a workshop organized by
the Pan-American Health Organization in August 1983, they immediately set up a
national commission to research and create a plan of action to prevent AIDS
Cuba. (Karen Wald, Guardian, Oct. 28, 1987)
The National Commission to Face AIDS Syndrome formed in 1983. (Denver Post,
Feb. 10, 2003)
The commission immediately blocked the import of all blood products from
countries in which the epidemic was already documented.
The commission recommended discarding more than 20,000 vials of imported blood,
worth millions of dollars.
Getting rid of all imported blood products greatly burdened the Cuban health
system and forced the country to ratchet up local production. However, this
urgent action resulted in avoiding HIV transmission to almost all hemophiliacs
and others who needed blood transfusions. (Financial Times, Feb. 16, 2003)
A multi-disciplinary team of doctors and researchers was assigned to work full
time on AIDS. Political journalist Wald wrote, “Their first move was to
prepare a diagnostic screening program based on concrete symptoms that could be
seen in hospitals, such as repeated cases of pneumonia or Kaposi’s
sarcoma type of cancer, which indicated possible AIDS. Hospitals were asked to
give weekly reports on findings of these symptoms.”
Doctors tested more than 135,000 Cubans for HIV in 1983.
Science, not stigma
In 1985, a Cuban who had returned from abroad was the first in the country to
be diagnosed with AIDS. The Cuban was one of 300,000 heroes of the revolution
who helped defend the people of Mozambique—an African country
impoverished by colonialism and battling the forces of imperialism.
In the U.S., Africa and Haiti were being scapegoated as the source of the
epidemic, without any scientific proof. In Cuba, however, where many are of
African descent because of the history of slavery, health officials did not
stigmatize the African continent.
In an interview in Cuba International, circa 1987, Dr. Rodolfo Rodríguez,
then the national director of epidemiology for the Cuban Ministry of Health,
said that while some of the mass media at that time might have been trying to
blame the African continent for AIDS, “It is known worldwide that it is
the developed Western countries—Europe and the U.S.—that have the
largest number of AIDS cases and the largest number of asymptomatic
In the U.S., homosexuality was still against the law and viciously repressed.
The right wing labeled AIDS a “gay disease.” This only drove the
epidemic deeper into the population. So too did the criminalization of drug
addiction and prostitution, both highly profitable industries in the U.S.
There was no known intravenous drug addiction in Cuba, and same-sex love was
not against the law.
Cuban health workers tested all pregnant women, people with sexually
transmitted diseases, and anyone who might have had sexual contact with someone
who was HIV positive. Testing equipment was installed in blood bank centers.
By the end of 1985, Wald wrote, the Cuban government had purchased, despite
great expense, all the technical means to screen the island’s entire
blood supply. “Cuba spent more than $3 million to buy the reactive agents
and equipment, and to set up labs in blood banks and hygiene and epidemiology
centers around the country.”
That year, the Cuban public health system allocated $2 million for the National
HIV/AIDS Prevention and Control Program, which focused on providing the first
750,000 diagnostic kits and centers. (MEDICC Review, Vol. II, No. 1,
Capitalism and contraception
The years of sex education that preceded the outbreak of the epidemic helped to
create the basis for a more scientific and compassionate approach to people
However, when faced with a sexually transmissible epidemic like AIDS, Cuba had
to overcome a particular capitalist legacy regarding safer-sex education and
Dr. Celestino Álvarez Lajonchere, a gynecologist and ground-breaking sex
educator in Cuba, reminded interviewers in 1988, “You know this country
inherited a system in which the rural areas and small towns had little or no
medical care before the revolution.”
He added that before the revolution, illegal abortions were common. They were
most often performed by doctors, without anesthesia, in unsanitary
Álvarez Lajonchere explained: “At the triumph of the revolution, the
majority of these abortion doctors left the country. There was no habit in the
country of using contraceptives, and contraception did not even appear in the
medical school curriculum. ... The private physicians at the time didn’t
give contraceptive services to their patients because they could charge much
more doing abortions.”
As a result, he said, “Since people didn’t have contraceptive
habits, we encountered serious difficulties in the first years after the
triumph of the revolution.”
While half of all Cuban doctors left the island and went to capitalist
countries, 97 percent of the physicians in obstetrics and gynecology emigrated.
As a result, Álvarez Lajonchere noted, overnight he became the oldest
gynecologist/obstetrician in the country.
Álvarez Lajonchere said that, in addition, within months after the workers
and peasants took state power, “[A]ll of the professors at the medical
school quit voluntarily, thinking mistakenly that the government could not
replace them. The government accepted their resignations. It was a policy in
the country, and still is, that if you really don’t want to live in this
country under socialism you should leave. You can’t create a socialist
society with people who are disaffected.
“So the Ministry of Education and the Ministry of Public Health got
together a course for new professors,” he continued, “people who
could never have been professors before the revolution because of their low
social class origins—they didn’t come from the upper middle
The medical school faculty was replaced with new professors. “We all left
private practice and went to teach. It was an extraordinary advantage that we
knew the conditions of medical practice in the country. I became chief of the
department of obstetrics and gynecology at the one and only medical school. The
first thing I did was to put contraception into the medical school curriculum.
There were never any restrictions about who could have access to contraceptives
in this country: not by age, not by race, not by anything.”
Álvarez Lajonchere added, “Medical services from the very beginning
have been free.” And the new medical teachers received a higher salary
than the president. (International Journal of Health Services, Vol. 18, Number
“The habit of using contraceptives,” Álvarez Lajonchere
explained, “is a habit that takes time to build. For a population that
was accustomed to having abortions, it was easier for them to go to the
hospital and have an abortion.”
After the revolution, underground abortions in unsanitary conditions increased
until 1965. “When we started to do all of them in hospitals, obviously
deaths as a result of abortion disappeared.”
He added that the number of abortions began to decrease in 1974 as a result of
mass education about sex and contraception.
Álvarez Lajonchere concluded: “Our current policy on population is
the same policy that we’ve had from the first day of the revolution.
It’s a policy of principle. A woman has the right to have the number of
children she wants, and to have them when she wants. The government is
obligated to assure that her right becomes a reality. So we educate people
about all of the contraceptive methods. We include abortion, even though we
don’t view it as a contraceptive method, so that people will know about
it. We have never said that having a small family is good; we have never
pressured people to reduce the birth rate.”
Next: Cuba directed war against AIDS, not people with AIDS.
To read more about Cuba, read parts 86-97 of Lavender & Red at
E-mail: [email protected]
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