IV 

116TH CONGRESS 

1ST SESSION H. RES. 136 

Affirming that the Government of Cuba’s foreign medical missions constitute 

human trafficking. 

IN THE HOUSE OF REPRESENTATIVES 

FEBRUARY 14, 2019 

Mr. SIRES (for himself, Ms. SHALALA, Mr. DIAZ-BALART, Mr. ROONEY of 

Florida, Mr. VARGAS, Mr. WALTZ, Ms. WASSERMAN SCHULTZ, and Ms. 

MUCARSEL-POWELL) submitted the following resolution; which was referred to the Committee on Foreign Affairs 

RESOLUTION 

Affirming that the Government of Cuba’s foreign medical 

missions constitute human trafficking. 

Whereas, in 2015, the Government of Cuba maintained more 

than 50,000 Cuban doctors and medical personnel in foreign medical missions in 67 countries under conditions 

that represent forced labor; 

Whereas the Department of States’ 2018 Trafficking in Persons (TIP) report noted that Cuban authorities coerced 

some participants to remain in the foreign medical missions, including by— 

(1) ‘‘withholding their passports [and] restricting 

their movement’’; 

(2) ‘‘using ‘minders’ to monitor participants outside 

of work’’; 


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(3) ‘‘threatening to revoke their medical licenses’’; 

(4) ‘‘retaliat[ing] against their family members in 

Cuba if participants leave the program’’; or 

(5) ‘‘impos[ing] exile if participants didn’t return to 

Cuba as directed by government supervisors’’; 

Whereas, between 2013 and 2018, more than 20,000 Cuban 

medical professionals served in Brazil and had their salaries garnished, movement restricted, and family visits 

limited by the Government of Cuba; 

Whereas investigative reporting by the digital platform Diario 

de Cuba, through an access to information request, revealed that Brazilian diplomatic cables detailed the terms 

of the Government of Cuba’s medical missions to Brazil; 

Whereas, in early 2012, the Government of Cuba proposed to 

the Government of Brazil the establishment of a program 

to send Cuban doctors to geographic regions of Brazil 

that had an insufficient number of medical personnel; 

Whereas, during subsequent negotiations, the administration 

of former Brazilian President Dilma Rousseff proposed 

an agreement between the two governments to be implemented through coordination with the Pan American 

Health Organization (PAHO) in order to avoid oversight 

by the National Congress of Brazil; 

Whereas the Government of Cuba stated that implementing 

the agreement through the United States headquarters of 

the Pan American Health Organization would present 

risks for potential violations of United States sanctions; 

Whereas, in July 2013, the Government of Cuba, acting 

through the for-profit Cuban Medical Services Trading 

Corporation (Comercializadora de Servicios Medı ́cos 

Cubanos, Sociedad Ano ́nima, or CMS), signed an agreeVerDate Sep 11 2014 02:01 Feb 15, 2019 Jkt 089200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6300 E:\BILLS\HR136.IH HR136

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ment with the Brazilian Ministry of Health to formalize 

a commercial arrangement for Cuban doctors to provide 

medical services in Brazil; 

Whereas the agreement between the Government of Cuba and 

the Government of Brazil established— 

(1) that the administration of former Brazilian 

President Dilma Rousseff would pay the Pan American 

Health Organization a monthly fee, which would then pay 

the for-profit Cuban Medical Services Trading Corporation (CMS) for the medical services provided by each 

Cuban doctor serving in Brazil; 

(2) that the for-profit Cuban Medical Services Trading Corporation (CMS) would pay each Cuban doctor approximately 25 percent of the monthly payment received 

from the Pan American Health Organization; 

(3) that the Government of Cuba, acting through 

the for-profit Cuban Medical Services Trading Corporation (CMS), would retain approximately 75 percent of the 

monthly payment received from the Pan American Health 

Organization; and 

(4) restrictions preventing participating Cuban doctors from seeking employment in Brazil outside of the 

formal structure of the program; 

Whereas, in July 2013, the Government of Brazil announced 

the creation of the Mais Medı ́cos program, which included the participation of Cuban doctors and doctors of 

other nationalities; 

Whereas the for-profit Cuban Medical Services Trading Corporation (CMS) commenced contracting Cuban doctors 

for the Mais Medı ́cos program, and the first Cuban medical professionals arrived in Brazil in August 2013; 


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Whereas Cuban doctors were the only medical professionals 

participating in the Mais Medı ́cos program to have their 

salaries directly garnished by their government, and doctors of other nationalities serving in Brazil received the 

full amount of their salary; 

Whereas Cuban doctors participating in the Mais Medı ́cos 

program faced severe limitations on their ability to travel 

inside Brazil and a prohibition on travel to neighboring 

countries; 

Whereas Cuban doctors participating in the Mais Medı ́cos 

program were prohibited from having their families accompany them while stationed in Brazil; 

Whereas the Cuban doctors frequently had their passports 

taken by Government of Cuba officials present in Brazil 

in order to limit their ability to travel; 

Whereas the Department of State’s 2018 Trafficking in Persons (TIP) report documented how the Government of 

Cuba also confiscated Cuban doctors’ passports in other 

countries, and stated that ‘‘the Cuban government acknowledges that it withholds passports of overseas medical personnel in Venezuela’’; 

Whereas the Pan American Health Organization’s external 

auditor, the Spanish Court of Audit— 

(1) stated in its January 2018 report that 198 

Cuban doctors have presented 159 legal challenges in the 

Brazilian court system since the start of the program in 

July 2013 demanding extra free time in their contracts 

and equal working conditions as doctors of other nationalities participating in the Mais Medı ́cos program; and 

(2) stated in its April 2014 report, in recognition of 

the legal risks associated with the Mais Medı ́cos program, 


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that it would be ‘‘prudent that PAHO set a contingency 

plan to face possible negative statements of [the] lawsuits’’; 

Whereas the Government of Cuba has stated that Cuban doctors unwilling to return to the country after their participation in foreign medical missions will not be permitted 

to return to their homeland for eight years; 

Whereas the Government of Cuba directly profits from exporting the services of Cuban professionals, having 

earned more than $8,000,000,000 from their work in 

2016, of which foreign medical missions represent the 

majority of the income; and 

Whereas the term ‘‘severe forms of trafficking in persons’’ is 

defined under section 103(9)(B) of the Trafficking Victims Protection Act of 2000 (22 U.S.C. 7102(9)(B)) as 

‘‘the recruitment, harboring, transportation, provision, or 

obtaining of a person for labor or services, through the 

use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or 

slavery’’: Now, therefore, be it 

1 Resolved, That it is the sense of the House of Rep2 resentatives that— 

3 (1) the Government of Cuba subjected Cuban 

4 doctors and medical professional participating in the 

5 Mais Medı ́cos program to state-sponsored human 

6 trafficking; 

7 (2) Cuban doctors participating in the Mais 

8 Medı ́cos program should have been permitted to 


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1 work under the same conditions as all other foreign 

2 doctors participating in the program; 

3 (3) the Government of Cuba should compensate 

4 Cuban doctors that participated in the Mais Medı ́cos 

5 programs for the full amount of wages that were 

6 garnished by the Government of Cuba; 

7 (4) foreign governments that sign agreements 

8 with the Government of Cuba or the for-profit 

9 Cuban Medical Services Trading Corporation (CMS) 

10 or other companies affiliated with the Government of 

11 Cuba to procure the services of Cuban professionals 

12 directly assume risks related to participation in 

13 forced labor arrangements; 

14 (5) the Pan American Health Organization 

15 must immediately provide greater transparency 

16 about its participation in the Mais Medı ́cos program 

17 and its agreement with the Government of Cuba and 

18 the for-profit Cuban Medical Services Trading Cor19 poration (CMS); 

20 (6) the United States Department of State 

21 must downgrade Cuba to Tier 3 in its annual Traf22 ficking in Persons (TIP) report, given new evidence 

23 on Cuba’s foreign medical missions and the Govern24 ment of Cuba’s longstanding failure to criminalize 

25 most forms of forced labor; and 


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1 (7) the Department of State must reestablish 

2 the Cuban Medical Professionals Parole (CMPP) 

3 program. 

Æ 


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