A group of Cuban doctors, once part of Brazil's Mais Médicos program, are seeking $129 million in damages from the Pan American Health Organization (PAHO). They accuse the organization of facilitating a scheme by the Cuban regime that allegedly forced them into labor under harsh conditions while withholding a significant portion of their earnings.
The New York Post reported on Thursday that the federal lawsuit claims PAHO acted as a mediator between the Cuban and Brazilian governments. This arrangement allegedly allowed Havana to profit significantly from the labor of its medical professionals.
According to the plaintiffs, between 2013 and 2018, Cuba sent approximately 3,500 healthcare professionals to Brazil, generating over $2.3 billion. The lawsuit alleges that 85% of this revenue was retained by the Cuban government, while PAHO allegedly took a 5% commission for managing the program. The doctors reportedly received less than 10% of the income derived from their work.
The main plaintiffs in the case, Ramona Matos Rodríguez, Tatiana Carballo Gómez, Fidel Cruz Hernández, and Russela Margarita Rivero Sarabia, are Cuban professionals who later received humanitarian parole in the United States and now reside in South Florida.
Withheld Salaries and Restricted Freedoms
The doctors claim they were not informed prior to their deployment of the actual compensation Cuba would receive or the amount the state would retain. Matos revealed that she learned of her payment conditions just one day before leaving the island.
"They were going to give us $1,000, of which $400 would be given to us in cash, and $600 would go to a bank account in Cuba," she recounted, as per the New York Post.
Her testimony also highlights restrictions on their movements during the mission. Stationed in the Brazilian Amazon, she claims she faced a 6 p.m. curfew and was threatened by Cuban agents after visiting a bakery.
Meanwhile, Tatiana Carballo Gómez alleges she was instructed to encourage patients to vote against the incumbent mayor and support leftist candidates favored by Havana.
The plaintiffs further assert that the Cuban regime used their families back home as leverage, warning them that "1,000 people were waiting in line in Cuba to replace them."
Leaving the missions subjected the doctors to penalties, including a multi-year ban on returning to Cuba.
Legal Battle Since 2018
Filed in November 2018 in Miami, the case was moved to Washington D.C., where PAHO has attempted to halt proceedings by claiming immunity. However, in March 2022, a unanimous panel of the D.C. Circuit Court of Appeals allowed part of the lawsuit to proceed. The judges found that claims related to PAHO's financial transactions in the U.S. could fit within the commercial activity exception to immunity.
According to the lawsuit, Brazil's payments went through a PAHO bank account in the United States before being transferred to Cuba, with the organization keeping a 5% fee for its involvement in the program.
The legal struggle continues. On August 14, the D.C. Circuit Court dismissed another PAHO appeal against an order permitting the doctors to obtain documents and other evidence related to the organization's immunity claims. The court determined it couldn't review that order at this stage, meaning the litigation will proceed in district court.
The plaintiffs' attorney, Sam Dubbin, accused PAHO of deliberately delaying the process: "PAHO has cynically chosen to drag out the case, hiding behind immunity arguments it continues to lose," he stated to the New York Post.
PAHO, however, has consistently denied the allegations, defending its role in the program. The organization told the newspaper it "acted legally in providing technical cooperation under the Mais Médicos Program" and declined further comment while the litigation remains active.
U.S. Pressure Mounts on Cuban Medical Missions
This legal dispute is occurring amid increasing pressure from Washington against Havana's model for deploying healthcare professionals abroad. In August 2025, Secretary of State Marco Rubio imposed visa restrictions on Brazilian officials and former PAHO executives linked to the Mais Médicos program.
Earlier this year, the Inter-American Commission on Human Rights recommended that regional countries avoid Cuban medical cooperation schemes lacking adequate labor and rights guarantees for professionals.
The U.S. State Department's Trafficking in Persons reports have long flagged signs of forced labor in Cuban medical missions, noting that the regime profits substantially from these programs.
Key Questions on Cuban Doctors' Lawsuit Against PAHO
What is the main accusation against PAHO in the lawsuit?
The lawsuit accuses PAHO of facilitating a scheme that allowed the Cuban regime to profit from the forced labor of its doctors, withholding most of their salaries.
How much of their earnings did the Cuban doctors reportedly receive?
According to the lawsuit, the Cuban doctors received less than 10% of the income generated by their work in Brazil under the Mais Médicos program.
What recent actions has the U.S. taken regarding Cuban medical missions?
The U.S. has increased pressure by imposing visa restrictions on officials connected to the Mais Médicos program and recommending against participation in similar Cuban medical cooperation schemes.