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Resumen Ejecutivo
Executive Summary
The Cuban Observatory for Citizen Auditing (OCAC) estimates that the number of deaths is at least 185 times higher than the government acknowledges. This is the result of the healthcare collapse generated by a systemic structural crisis.
December 29, 2025 – Cuba is experiencing one of the worst health crises in its recent history. Far from being a temporary phenomenon or an emergency caused exclusively by external factors, the collapse of the Cuban health system is the direct result of political decisions made over many years that have systematically weakened the state’s ability to protect the life and health of its population. This is documented in Dossier 42: The Health Collapse in Cuba, prepared by the Cuban Observatory of Citizen Auditing (OCAC).
The report concludes that the current epidemiological emergency—marked by the simultaneous circulation of dengue, chikungunya, and other viruses—is unfolding in a previously devastated health system. The combination of chronic disinvestment, deteriorating hospital infrastructure, extreme shortages of medicines and supplies, mass emigration of medical personnel, and manipulation of epidemiological information has created a scenario of avoidable, known, and persistent harm.
According to OCAC estimates, at least 8,700 deaths has occurred, that is 185 times more than what the official reports of the Cuban government admits. This figure contrasts dramatically with official reports, which minimize the real scope of the crisis and underestimate both the morbidity and mortality associated with arboviruses. Health professionals interviewed for the Dossier agree that most cases are not recorded, either because of the lack of diagnostic reagents or because patients choose not to go to medical institutions that lack the resources to treat them.
The situation in hospitals and polyclinics is critical. The report documents health centers without running water, with prolonged power outages, medical equipment out of service, and basic shortages such as gloves, syringes, intravenous solutions, and antipyretic medications. Official data cited in the Dossier indicate that more than 64% of the medicines that were to be supplied by the state pharmaceutical industry were in short supply at the beginning of 2025, and since then no updates have been published, which deepens the lack of transparency.
Added to this reality is the drastic reduction in healthcare personnel. In recent years, tens of thousands of doctors and nurses have left the system, either through emigration or by changing occupations, driven by insufficient salaries, work overload, and extreme working conditions. At the same time, the state continues to prioritize sending health professionals abroad as a source of income, while the domestic system is being drained of essential skills.
The Dossier emphasizes that the health crisis cannot be analyzed in isolation. The spread of epidemics occurs in the context of severe food insecurity, collapse of garbage collection services, proliferation of vectors, and a deep energy crisis that subjects the population to prolonged blackouts. Chronic malnutrition and constant stress have weakened the immune response of millions of people, increasing the severity of infections and the risk of complications.
Special attention should be paid to the medium- and long-term impact of Chikungunya. International evidence indicates that between 30% and 60% of those infected may develop chronic sequelae, such as persistent joint pain, extreme fatigue, and functional limitations. In Cuba, these sequelae remain virtually untreated due to the lack of rehabilitation programs, the lack of medicines, and the breakdown of primary care. The result is a growing burden of disability that affects productivity, family income, and quality of life, especially among working-age adults, children, and the elderly.
The report also denounces the deliberate manipulation of mortality statistics. Doctors interviewed describe systematic practices of omitting viral infections as underlying causes on death certificates, a strategy aimed at reducing the political cost of the health disaster. This opacity is reinforced by the uncritical acceptance of official figures by international organizations, which contributes to distorting the global perception of the real situation on the island.
For the Cuban Observatory of Citizen Auditing, the health collapse constitutes a form of structural violence exercised by those in power. Keeping millions of people in conditions of malnutrition, health vulnerability, and permanent exposure to epidemiological risks is not an accident, but the consequence of a model of governance that has ceased to prioritize basic human well-being.
The dossier concludes that the public health crisis in Cuba is inseparable from the comprehensive collapse of the current political and economic system. The combination of the health emergency, the food crisis, environmental deterioration, and lack of transparency constitutes a systematic violation of the state’s fundamental obligations of protecting its citizens. Until profound structural changes are made and an independent assessment of the situation is allowed, millions of Cubans will continue to face preventable diseases, prolonged suffering, and a growing loss of dignity.
