Belize Won’t Renew Its Medical Agreement With Cuba After 36 Years

Belize will not renew the Cuba medical agreement in place since 1990 and will directly hire the members of the Cuban brigade who remain in the country, its Ministry of Foreign Affairs said in a statement dated October 31 and released November 3. The move closes a 36-year program.

The statement says “the Government of Belize and Cuba” will not renew the agreement. Health and Wellness Minister Kevin Bernard told Greater Belize Media the decision came from the Cabinet: “As government through cabinet had agreed that we will end the brigade in terms of its program.”

The change does not mean the health workers are being expelled or that their work will stop right away. Belize chose to keep their services but removes the institutional agreement with Cuban authorities as the intermediary. The professionals can stay in their posts under individual contracts with the Ministry of Health and Wellness.

The Cuban brigade in Belize

The decision has a concrete reach: the Cuban brigade in Belize has about 92 workers, including 45 doctors, according to official figures reported by the Belizean press. The rest of the staff includes nurses, radiologists and health technicians who fill different roles in the Central American country’s health system.

In its official statement, Belize’s Foreign Ministry said that “to ensure the continued delivery of the medical services,” the government, through the Ministry of Health and Wellness, “will sign individual contracts of employment with each Cuban professional that will allow them to remain and work in Belize.” Authorities have not yet said when those contracts will be signed or how much the professionals will be paid.

The announcement separates the delivery of medical services from the contractual structure the Cuban regime managed for decades. Prime Minister John Briceño had already said on May 27, in remarks reported by Greater Belize Media, that “we are paying the doctors directly and not the government.”

Cuba Archive questions direct contracts for Cuban doctors

According to the organization Cuba Archive, the new arrangement does not settle one of the main international objections to Cuba’s medical missions: the control that the island’s authorities exercise over their professionals’ income.

In its fact sheet on the brigades, Cuba Archive says that in certain cases where payment is deposited into the worker’s bank account, the worker is required to send most of it to the Cuban state.

Its executive director, María Werlau, warned Martí Noticias that, according to reports from other Caribbean countries, direct payment allows brigade officials to force workers to send part of their salary to a Cuban government account. “I wonder what guarantees there will be that, even without an agreement behind it, this won’t continue,” she said, in remarks translated from Spanish. Werlau acknowledged that such informal arrangements are hard to track: “There is no way to prove it.”

Washington credits its pressure for countries leaving the program

Belize’s decision also comes amid growing U.S. diplomatic pressure on the international hiring of Cuban professionals. Washington questions the labor conditions of the brigades and warns host countries of the possible consequences of facilitating agreements that, according to its findings, may enable human trafficking.

In its 2026 Trafficking in Persons Report, released October 8, the State Department urged governments to end cooperation agreements that preserve the Cuban regime as an intermediary and to consider hiring workers directly. It also issued a warning:

“Serving as active facilitators of trafficking, including as partners in this program, raises concerns of complicity and undermines anti-trafficking measures,” the State Department said.

The warnings have not been limited to diplomatic statements. Washington has also used visa restrictions and economic measures to increase pressure on the structures that run the medical missions.

The Belizean outlet 7 News read the decision as an attempt to appease Washington’s demands on forced labor and said it remains to be seen whether this middle ground will satisfy the United States. Katharine Beamer, chargé d’affaires at the U.S. Embassy in Belize, told Greater Belize Media in June: “We are very supportive of the government’s decision to wind down this programme in Belize.”

7 News also said the move seeks to keep the public health system from collapsing. Minister Bernard declined to say whether diplomatic tensions played a role and referred that question to the Foreign Ministry, according to Greater Belize Media.

On July 23, the State Department sanctioned Comercializadora de Servicios Médicos Cubanos S.A. (CSMC), the state-owned company that manages Cuba’s medical missions abroad, under Executive Order 14404. Blocked property must be reported to the Treasury Department’s Office of Foreign Assets Control (OFAC).

According to Washington, the missions are among the Cuban regime’s largest sources of foreign currency and exploit workers in more than 50 countries. Adding CSMC to the sanctions list targets one of the structures Havana uses to market its health personnel.

The Trafficking in Persons Report says diplomatic pressure cut the number of exported Cuban workers from 24,000 at the beginning of 2025 to between 15,000 and 18,000 in 2026, present in 53 countries. Cuban Foreign Minister Bruno Rodríguez rejected the report as “unilateral and mendacious,” according to a translation of his statement from Spanish.

Belize’s decision not to renew the Cuba medical agreement adds to the setbacks for a hiring system that for decades provided the Cuban state with a major source of income.

More coverage in Spanish: U.S. pressure on Cuban doctors in Belize, the July sanctions on the medical missions and Havana’s response to the trafficking report.