六十多年来，古巴将其丰富且训练有素的医疗人员转化为重要出口资源，医疗外交已成为该国最大的外汇来源，每年带来约40亿美元的收入。然而，第二任特朗普政府采取了极其严厉的制裁政策，严厉打击这一政权生命线。美方以涉嫌“现代奴隶制”为由，对接收古巴医疗队的国家官员实施签证限制。自2025年中期以来，至少有10个接收国撤回了古巴医疗队。受此打击，海外古巴医疗人员数量从十年前的50,000多人急剧下降至如今的不足20,000人。

尽管古巴政府从接收国收取的费用中抽走50%至80%，但对于月薪仅约6,600古巴比索（约合14美元）的古巴医生而言，参与海外医疗任务仍是维持生计的重要选择。古巴拥有一套人均医生比例极高的医疗体系，在2021年达到每千人9.5名医生，是世界平均水平的五倍，也是美国的两倍以上。但严峻的国内经济危机与禁运导致国内医疗体系濒临瘫痪，2021至2024年间，古巴流失了超过77,000名卫生工作者，许多人选择放弃医疗岗位转向商业或出租车行业。

美国对古巴医疗任务的打压以及实施的极限制裁与封锁，使古巴经济陷入严重困难。由于油料短缺和频繁停电，大量关键医疗手术被迫中断，数万名患者受到影响。面对国内急剧恶化的生存条件与海外任务中被边缘化的境况，越来越多的古巴医生面临着在奉献与投诚叛逃之间的艰难抉择。

For over six decades, Cuba has leveraged its abundance of well-trained medical professionals as a valuable export, turning healthcare missions into its primary source of foreign currency, generating approximately $4bn annually. However, the second Trump administration launched a targeted campaign against these medical missions, restricting visas for officials in host countries. As a result, at least ten host nations have ended their agreements since mid-2025, causing the number of overseas Cuban healthcare workers to plummet from over 50,000 a decade ago to fewer than 20,000 today.

Although the Cuban government retains 50% to 80% of foreign payments, participating in international missions remains a primary financial lifeline for doctors whose domestic monthly salary averages around 6,600 Cuban pesos ($14). Cuba built an expansive public health model, achieving a density of 9.5 doctors per thousand people in 2021—five times the global average and more than twice that of the United States. Nevertheless, domestic economic collapse and resource scarcity forced over 77,000 healthcare workers to leave the medical field between 2021 and 2024 to pursue higher-paying informal jobs.

The Trump administration's aggressive enforcement of fuel blockades and financial sanctions has exacerbated severe domestic shortages across the island. Frequent power outages and lack of medical supplies have disrupted critical surgical procedures for tens of thousands of citizens. Under mounting geopolitical and financial strain, Cuban medics deployed abroad increasingly face agonizing choices between continuing to support their families back home and defecting to escape systemic poverty.

Source: Medics are the country’s most valuable export. Now Trump has his sights on them

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Dateline: Jul 23rd 2026