“Mais Medicos”
Program Factsheet

Cuban doctors who served in Brazil, who defected and came to the United States under the Cuban Medical Professionals Parole Program have filed a class action lawsuit against PAHO, alleging PAHO violated the U.S. Trafficking Victims Protection Act and Racketeering Influenced and Corrupt Organizations (RICO) Act in Federal Court in Miami.
  • Under former President Lula da Silva, Brazil first announced a medical services crisis in 2010. Brazil entered into a relationship with Pan American Health Organization (PAHO) in August of 2013 whereby it would provide “healthcare help and technical cooperation” for the “poor and downtrodden” through Mais Medicos.
  • Mais Medicos was initially designed as an “academic fellowship,” but it became quickly clear that the program was organized to avoid Brazil’s appropriations, labor, immigration and medical standards laws, and for Cuba to profit a substantial amount of money.
  • The program claimed it was short on applicants — at which point PAHO came to the rescue with roughly 5,000 doctors in an August 2013 legal agreement with Brazil’s Ministry of Health. According to official documents, the Cuban doctors saw less than 10% of monies paid by Brazil for their services.
  • PAHO signed an agreement with the Comercializadora de Medicos Cubanos, SA (SMC) – a company established by the Cuban government in 2012 — for the contracting of Cuban Doctors to work in Brazil. In total, Brazil received 15,000 doctors.
  • According to cables between the Cuban and Brazilian Embassies in 2012, SMC’s function was “coordinating commercialization of medical services in Cuba and in the outside.” (SMC does not appear on the OFAC sanctions list.)
  • Those cables showed that doctors would be subjected to Cuba’s standard rules for overseas medical missions, which constitute forced labor and human trafficking under national and international law:
  • Doctors worked for less than 10 percent of the fair market value for their professional services
  • Doctors were separated them from their families and restricted from interaction with locals
  • Doctors were restricted from moving freely in Brazil and deprived of proper identification and travel documents
  • Doctors were placed under 24-hour surveillance by Cuban intelligence officers in Brazil
  • Doctor were required to engage in political indoctrination of the local population
  • Over the past five years alone, PAHO has profited more than $75 million for itself through ‘Mais Medicos’ and sent more than $1.5 billion to Cuba through US bank accounts.
  • After President Bolsonaro determined it was a violation of Brazilian law to pay Cuba for the doctors’ services, Cuba terminated their relations with Brazil and called all the foreign doctors home.
  • The Brazilian government announced it would allow for doctors to stay in Brazil with full wages and condemned the Pan American Health Organization for its role in human trafficking at the United Nations General Assembly in 2019.