Everything seems to be in short supply in communist Cuba, including medicine. With no sign of the situation improving any time soon, many Cubans are forced to choose between eating and medicating. The response by the Castro dictatorship is to double down on the failed socialist policies that put the island into this predicament in the first place. But that is how socialism works. This is socialism in action.
Medicine shortage in Cuba: No light at the end of the tunnel
“Do you have inhalers, salbutamol, or fluticasone?” asks a woman to the pharmacy attendant. “We don’t have them,” the employee responds.
The woman expresses annoyance. “I suffer from asthma and use a salbutamol inhaler, but it has been unavailable for a year. I have to continue buying medications on the street. They are very expensive, but it’s the only way to prevent asthma attacks. The last salbutamol I bought cost me 1,000 pesos,” says Gloria Nodales Estévez.
The shortage of medications is compounded with the lack and the high prices of basic goods. The combination of accumulated needs over the years puts Cubans in the dilemma of choosing between eating, dressing, wearing shoes, or managing their illnesses.
Lorenzo Madrigal Quesada is in such a situation. “Now I am eating less because I used part of the money allocated for food to buy furosemide for hypertension and heart failure. I am going hungry, but I cannot do without the medication,” says the man, who earns a monthly salary of 2,500 pesos.
Pedro Pascual Contreras stabilizes his blood pressure with enalapril, a medication he hasn’t been able to buy since July 2023, as indicated in his prescription record, a sales control method to prevent hoarding. His salary of 3,588 pesos is insufficient to purchase the blister pack of 20 enalapril tablets, priced at 200 pesos on the black market.
“My blood pressure is unbalanced; they measured it at the polyclinic, and it’s at 150 over 100. High blood pressure is very dangerous, and if I don’t undergo treatment, it could lead to a heart attack or stroke, and I could die. But I can’t buy enalapril because I have to prioritize my children’s food,” says Pascual Contreras.
For the past three months, Carmen Oropesa Araujo has been calling the pharmacy almost every day inquiring about tramadol, a medication her sister needs for pain relief. The response is always the same: unavailable.
“I’ve called so many times that the pharmacy attendants recognize my voice, and before I ask, they tell me they don’t have it. Tramadol is a medication my elderly sister needs to alleviate pain. I can’t afford the 800 pesos they ask for in the black market with my 1,694 peso check and my sister’s 1,568 peso check. It’s not enough for food; imagine for medications,” she says.
The queues are endless on the rare occasions when medications arrive at the pharmacies. “I’ve been here since 8:00 in the morning, and it’s almost 3:00 in the afternoon. I want to buy diclofenac, which they haven’t sold for months,” says Sofía Pérez Almeida.
The fact that medications missing in pharmacies are available on the black market raises suspicions. “How do you explain that the products scarce in the pharmacy are found on the black market? They are still stealing medications because the salary of those working in the pharmacy is very low, and they are forced to resell to survive. The ones harmed are low-income people who can’t afford the high prices of the black market. The population is aging, and the elderly always need medications they can’t acquire with their low pensions,” says Mariano Cardona Fernández.
Among the most expensive medications on the black market are those for psychiatric disorders. Kirenia Ferrer Mendoza’s mother suffers from a psychiatric illness. She was prescribed alprazolam, a drug for anxiety treatment. “The alprazolam cost us 1,000 pesos for the blister pack with 20 tablets, at 50 pesos each. Medications for nerves are priced through the roof,” Ferrer Mendoza asserts.
Faced with shortages, Cubans travel abroad and import medications, which they later resell on the island. Consuming them is risky as most are of dubious manufacturing and may not be effective or even cause harm.
In response to several regrettable incidents, health authorities have urged the population to “avoid buying drugs on the street.”
“Everything is empty in the pharmacy. There is nothing. Enalapril is lost; people resell it for 200 pesos for the blister pack of 10 tablets. It’s a problem to be sick and not have the medication,” says Estela Barreras Pérez, who has a pacemaker and needs to take amiodarone, an antiarrhythmic agent. “It’s been a year since they haven’t sold it in pharmacies. On the street, the blister pack costs 1,000 pesos, and I can’t afford it; my pension is 1,528 pesos, and it’s not enough,” laments the woman.
Ana Gloria Parra Corrales’s grandmother is hypertensive, diabetic, and has suffered three heart attacks. The woman is undergoing treatment with several medications that are unavailable in pharmacies, including isosorbide dinitrate to control angina due to coronary artery disease and glibenclamide for type 2 diabetes mellitus.
“It’s been more than three months since they sold these medications in the pharmacy. I buy them in the black market at exorbitant prices. I have to make that sacrifice because if my grandmother dies due to a lack of medications, it will weigh on our conscience,” says Ana Gloria.