US did not influence Jamaica's decision to end Cuban medical programme, says Johnson Smith

Foreign Affairs Minister Kamina Johnson Smith told Parliament on Thursday that the Government's decision to discontinue the 50-year-old medical cooperation programme with Cuba was not influenced by the United States. She said the move stemmed from unresolved issues in renegotiating the agreement.

"No," Johnson Smith replied after Opposition lawmaker Alfred Dawes asked at a parliamentary committee meeting Thursday night whether Washington had a hand in Kingston's push to renegotiate terms.

Jamaica's decision comes amid increasing pressure from the United States over Cuba’s overseas medical missions, which Washington has accused of constituting forced labour and human trafficking.

Caribbean governments, including Jamaica, have repeatedly rejected those claims.

Johnson Smith acknowledged that the US had raised concerns about the Cuban programmes internationally but said Jamaica had sought to ensure the arrangement complied with its laws and international labour standards.

“We are in a, in an environment where it is clear that there have been concerns expressed by the United States government about the operation of Cuban medical programmes across the world. So, clearly, they have expressed concerns about all programmes and, accordingly, would have expressed concerns about Jamaica.

She added, “You would have heard us defending the programme in various contexts because when they come here, we do our very best to be respectful and ensure that our treatment of them accords with the laws of Jamaica and best international labour law practice."

"Where the programme came into conflict with those things, unfortunately, we were unable to reach agreement on correcting them and that is why the programme has ended.”

Dawes responded: “So, we just decided to change the rules of the game after 50 years.” But the minister shot back: “However, you wish to interpret it, is fine.”

Johnson Smith was rleading the Ministry of Foreign Affairs and Foreign Trade’s appearance before before Parliament’s Standing Finance Committee reviewing the proposed 2026–2027 national budget.

Her appearance followed Health Minister Christopher Tufton, who outlined the Government’s plans to address potential gaps in the public health system if Cuban medical personnel leave Jamaica.

The foreign minister confirmed that negotiations with Cuba failed primarily over how payments to the medical professionals would be structured. "It’s regrettable that we were unable to reach agreement on the most fundamental point - the manner of payment," Johnson Smith told lawmakers.

Opposition Spokesman on Energy Phillip Paulwell asked whether there was any prospect of restoring the original agreement with the Cuban government.

Johnson Smith said the existing arrangement had expired in 2023 and both sides had been attempting to renegotiate a new framework. She explained that some aspects of the discussions were straightforward.

"There were things that were less problematic. There were issues that were easily solved - we’re gonna put the eye programme and the general medical programme together in one document, we’re not gonna have two anymore. We’re going to look at the issue of the ability to celebrate Cuban national day here, etc. things that were very easily solved.. And then there were some which were not."

But Johnson Smith said some of the disputed issues conflicted with Jamaican law.

"Those issues problematic under Jamaican law, they have not been reviewed historically. In the closer review, it was clear that they needed to change and we had hope that with sensitivity and good faith and, relative, let me leave it at, sensitive way in which the negotiations were conducted, not in the public domain, that we would have in good faith been able to reach an agreement and it is regrettable that we were unable to so do."

Meanwhile, Daws, the opposition spokesman on health, questioned why the government sought to renegotiate terms that had governed the programme for decades.

He argued that Jamaica had maintained the arrangement with Cuba for about 50 years under “practically the same terms of the MOU” and asked whether the push for changes followed complaints from Cuban workers about their conditions.

He also suggested that the terms proposed by Jamaica may have been unacceptable to the Cuban authorities. "I was reliably informed that you gave them a deal that they just could not accept - you wanted to pay them directly, they would pay taxes and then..." Dawes said before he was interrupted.

Committee chairman Heroy Clarke urged Dawes to remain focused on the relevant budget line item as members on both sides of the committee interjected.

Opposition MP Fitz Jackson later pressed the minister to disclose the specific issues that proved contentious in negotiations. “Are you prepared to say what specifically are those issues?” Jackson asked.

Johnson Smith declined to provide details, citing the sensitivity of bilateral negotiations.

“I think most persons in here would understand that while it could be possible to share that information at some point, the truth is that it is not usual to share the specifics of bilateral negotiations between countries, and I believe the member knows this," she said.

“And in regard to the very same sensitivity that I alluded to earlier, is why the reason wasn’t shared. But perhaps the information will emerge eventually.”

Earlier, Tufton told the committee the government was already taking steps to address potential shortages in the health system resulting from the programme’s end.

“We have a multipronged approach to dealing with the human resource challenge,” he said, noting that the policies were developed to respond to the global shortage that preceded the Cuba decision.

He noted that Jamaica currently has about 280 Cuban medical professionals in the public health system, down from just under 350 in recent months as work permits expired under the previous agreement.

“Any fallout from the Cuban agreement, meaning persons going back as opposed to exercising the option to stay, will amplify that problem. It’s a risk and we understand that… but we’re not just sitting down and not doing anything,” Tufton said.

The minister said the government has been expanding recruitment, training, and retention measures, including scholarship programmes with bonding obligations and overseas recruitment.

More than 100 trainees in specialised areas are expected to enter the system later this year, while the government is also seeking healthcare workers from countries including Ghana, the Philippines and India.

The ministry has also begun a diaspora recruitment drive which has so far generated 136 expressions of interest.

Dawes warned that the loss of Cuban personnel could significantly affect access to care in some areas, particularly eye services. “The eye programme is the main source of eye care for Jamaicans who can’t afford to go privately and pay $500,000 for a cataract surgery,” he said.

The Jamaican government announced earlier Thursday that it had discontinued the medical cooperation programme with Cuba after both countries were “unable to agree on the terms and conditions of a new technical cooperation arrangement” following the expiration of the previous agreement in February 2023.

The programme, which began in 1976, has for decades provided doctors, nurses and other specialists to help fill gaps in Jamaica’s public health system. Jamaica's move comes almost a year after US Secretary of State Marco Rubio, on a visit to Jamaica, criticised the programme in the Caribbean. Prime Minister Dr Andrew Holness insisted that Jamaica did not engage in labour violations.

On Monday, Dominica, a CARICOM member, said it would enter into personal contracts with medical professionals from Cuba as it sought to modify its long standing arrangement with Cuba.

Guatemala and Honduras ⁠both said in February they would also end a programme with Cuba.

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