SUNS  4359  Monday  25 January 1999

Havana, Jan 20 (IPS/Dalia Acosta ) -- The possibility of Cuba making medical purchases from the United States will remain a "fantasy" as long as the 37-year embargo is in place, according to the government of Fidel Castro.

Under the current circumstances, given the absence of normal commercial relations or transportation mechanisms between the two countries, "it is not practical or viable to speak of such transactions," said Cuban Minister of Public Health Carlos Dotres.
How to get purchased products to the island seems to be a never-  ending saga, since there are no commercial flights between the two countries, and because any ship that docks in Cuba is prohibited from visiting U.S. ports for the following six months.

Meanwhile, the regulations accompanying last May's decision to streamline procedures for licensing purchases of medicine, supplies and health care equipment, rather than making trading more flexible, have in fact created more obstacles, according to local experts.

The seller, for example, must oversee the product until it reaches its final destination, which according to U.S. policy may not be linked to the Cuban government or be used in biotechnological production under any circumstances.

Dotres noted that the U.S. companies that Cuba has contacted often back away from completing the sale when they realise that they must account for the destination of their exports and who they will benefit.

Although the Ministry of Public Health has not stopped seeking products from U.S. companies, Dotres said his ministry could not take part in any business deal that imposed conditions on medical supplies.

Cuba spends $2.5 million on insulin, which is provided to all diabetics - "active members of the Communist Party as well as non-members" - Dotres underlined.

The debate on the flexibilisation of trade in the health sector, announced by President Bill Clinton as a gesture to the Pope after John Paul II's historic visit to the island a year ago, was reignited after
a new set of measures was approved by Washington.

On Jan. 5, the U.S. government rejected the idea of creating a bipartisan commission to review its Cuba policy and its aim of fomenting the development of civil activities independent of the Castro
government on the Caribbean island.

The measures passed included raising the cap on money remittances that can be sent to residents of Cuba, the establishment of direct flights from any city in the United States to any city on the island, authorisation for the sale of food and agricultural implements to private entities and farmers, and the restoration of direct mail between the two countries.

Clinton told the world that the blockade would remain in effect and that the U.S. would continue its strategy of "undermining us from within," said the president of the Cuban parliament, Ricardo Alarcon.

Havana argues that the latest decision, along with the measures passed on Mar. 20, 1998 - which included the flexibilisation of sales of medical products - could be considered a new phase of the "economic, political and ideological war against the island."

Alarcon said on Jan. 7 that the claim that the measures would facilitate the process of trade in the public health sector was "a monumental lie," since "Cuba has not been able to acquire even a single aspirin" because "it is not possible to do so in the United States."

To back Alarcon's argument, state-owned television transmitted a report on two newborn babies whose lives were in peril due to the lack of medicine from the United States.

However, U.S. sources said that at least five licenses were approved between June and August of last year for the sale of medicinal products to the island for more than $14 million.

Dotres recognised earlier this month that a few purchases of medicine for specific use among newborns and of equipment had taken place, but said that they were bought from subsidiaries of U.S. companies located in third countries.

The Cuban government estimates at around $60 billion the total losses suffered by the local economy due to the sanctions applied by the United States over the past 40 years, 1.2 billion dollars of which correspond to the health sector.

But the effects of the embargo could be calculated as even higher, considering that any impact on the macro-economy necessarily has repercussions on a sector that is subsidised by state funds.

According to the Ministry of Public Health, the government of Fidel Castro channelled 10 percent of the state budget and 8.6 percent of Gross Domestic Product into the health sector last year, while it
follows a policy of continual budget increases.

Cuba, with a population of 11.1 million inhabitants, ended 1998 with an infant mortality rate of 7.1 per 1,000 live births, 6.7 percent underweight births, 3.8 maternal deaths per 10,000 live births, and a life expectancy rate of 75 years.

But although the majority of the island's inhabitants see free of charge health coverage as one of the major achievements of the Cuban revolution, many complain of the deterioration that these services have suffered over the past decade.

A report issued in December acknowledged the "physical deterioration of many institutions," the necessity of a technological renovation, and a general scarcity of medicines and resources for dentistry and optical services.

But availability of medicine in pharmacies, one of the most pressing concerns of Cubans, could rise 25% this year based on an increase in national production.

According to Dotres, the pharmaceutical industry will cover more than 90% of demand for medicine in 1999, at a total cost of more than $70 million.