Cuba's Economic Crisis Fuels Rise of Community Medicine Networks

In Havana, Laura Mendoza operates an unofficial pharmacy from her apartment, distributing medications free of charge. Every Thursday and Sunday, dozens of people gather as Mendoza, who runs the "Medicine Is Not for Sale" initiative, checks names against a list and hands out requested drugs like antihistamines, diuretics, eye drops, and antibiotics.

These community projects have become crucial for Cubans navigating a deepening economic crisis, exacerbated by U.S. energy and financial restrictions. Online sellers, street vendors, and private WhatsApp and Telegram groups are also stepping in to fill the void left by state pharmacies, which were historically the primary source of subsidized medicines.

Policy Shift Amid Shortages

The scarcity of medicines has become so acute that Cuban authorities introduced regulations in July to permit private pharmacies. This represents a significant shift in the country's state-controlled health system and is part of broader economic reforms aimed at revitalizing the economy. Until these private pharmacies are operational, initiatives like Mendoza's serve as essential support.

Mendoza estimates that around 100 similar community projects function in Havana, utilizing five WhatsApp groups and a newer one in Guanabo. Her initiative, supported by the Catholic charity Caritas, receives over 13 kilograms (29 pounds) of medicine weekly from humanitarian groups in Canada and the United States, international travelers, and local donors.

Volunteers sometimes extend their reach by delivering medications to patients unable to collect them. However, obtaining drugs that require refrigeration, such as some diabetes treatments, and cancer therapies remains particularly challenging. Patients also face difficulties in acquiring basic supplies like gauze, syringes, and anesthetics, often needed in under-supplied hospitals.

Widespread Scarcity

Cristina Díaz, a 27-year-old physics teacher, noted the increasing difficulty in finding medications. "Six or seven years ago, it was relatively easy to find medicines at state pharmacies," she said, contrasting it with the current situation where "medicines became much harder to find."

The Cuban Health Ministry's basic drug program lists 603 medications, but currently, only about one-third are available. Approximately 400 of these are produced by Cuban laboratories using imported raw materials. Mayda Mauri Pérez, president of the state pharmaceutical company BioCubaFarma, stated in June that shortages of imported materials prevented the production of about 300 of the 395 expected medicines.

The situation is especially critical in the Ciego de Ávila province, where authorities reported that state pharmacies carried only about 10% of the medicines on the basic list. Officials attributed these issues to supply and logistical problems, including fuel shortages.

María Fernández Martínez, head of the province's pharmacy company, acknowledged that while Cuba has a robust medical-pharmaceutical industry, the lack of supplies hinders production. The government also faces difficulties in sourcing packaging materials like blister packs and bottles. Furthermore, U.S. financial sanctions are cited as a complication for import payments, and Cuban authorities claim that shipping companies are hesitant to call at Cuban ports due to fear of U.S. penalties, leading to delayed or stranded medical supply shipments.

Affordability Concerns Remain

The authorization of private pharmacies is part of a larger set of 176 economic measures approved by Cuba's Parliament in June, designed to foster private enterprise and address the country's economic crisis. The government anticipates that entrepreneurs will be able to import medicines, similar to how they handle food and fuel.

While authorities are reviewing approximately 36 proposals for private pharmacies, the existing state-run pharmacies will continue to operate. These private establishments will be government-regulated and prohibited from selling certain categories of drugs, including those exclusively for hospital use and specific controlled substances. Imported medicines will need to pass through state companies, and all medications will require regulatory approval and proper storage.

A primary concern for many Cubans is the potential cost of these medicines. Sara Márquez, a 69-year-old who requires blood pressure medication, shared her worry. She recalled a blister pack costing 0.30 Cuban pesos at state pharmacies, while informal sellers recently charged up to 1,000 pesos ($1.50) for the same quantity—a price exceeding 30% of her monthly pension. "At what price will they sell the medicine? ... It will depend on people’s purchasing power. I can’t afford it," she stated.