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 re-
ferred 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 for-
eign medical missions in 67 countries under conditions 
that represent forced labor; 
Whereas the Department of States’ 2018 Trafficking in Per-
sons (TIP) report noted that Cuban authorities coerced 
some participants to remain in the foreign medical mis-
sions, including by— 
(1) ‘‘withholding their passports [and] restricting 
their movement’’; 
(2) ‘‘using ‘minders’ to monitor participants outside 
of work’’; 
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•HRES 136 IH 
(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 sala-
ries 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, re-
vealed 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 imple-
mented 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 agree-
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•HRES 136 IH 
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 Corpora-
tion (CMS) for the medical services provided by each 
Cuban doctor serving in Brazil; 
(2) that the for-profit Cuban Medical Services Trad-
ing Corporation (CMS) would pay each Cuban doctor ap-
proximately 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 Corpora-
tion (CMS), would retain approximately 75 percent of the 
monthly payment received from the Pan American Health 
Organization; and 
(4) restrictions preventing participating Cuban doc-
tors 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 in-
cluded the participation of Cuban doctors and doctors of 
other nationalities; 
Whereas the for-profit Cuban Medical Services Trading Cor-
poration (CMS) commenced contracting Cuban doctors 
for the Mais Medı´cos program, and the first Cuban med-
ical 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 doc-
tors 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 ac-
company 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 Per-
sons (TIP) report documented how the Government of 
Cuba also confiscated Cuban doctors’ passports in other 
countries, and stated that ‘‘the Cuban government ac-
knowledges that it withholds passports of overseas med-
ical 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 nation-
alities 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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