José Ángel Portal Miranda, ministro de Salud Pública. Foto: Enrique González (Enro)/ Cubadebate.
Cuba’s recent Public Health Law, approved in December 2023, solidifies healthcare as a fundamental human right and emphasizes social justice, medical ethics, and public participation. The law, which will go into effect in the coming months, updates regulations that had been in place since 1983 and reflects a more comprehensive vision of health, according to officials.
The Ministry of Public Health recently discussed the scope, conceptual innovations, and implementation challenges of the new law. Health Minister José Ángel Portal Miranda explained that the legislation affirms the country’s commitment to health and life as inalienable human rights.
“In the first place, I believe It’s essential to point out that the upcoming entry into force of this text is an affirmation of a state will, a reaffirmation of a social model, and an expression that health and life are inalienable human rights,” Portal Miranda said. He added that the law recognizes health as a collective construction encompassing physical, mental, social, and environmental well-being, rooted in Cuban history and focused on the future.
The new law wasn’t prompted by urgency, but rather by the political and institutional maturity Cuba has achieved over decades, Portal Miranda explained. The previous health law, enacted in 1983, was revolutionary for its time, establishing universal and free access to healthcare and a coherent National Health System.
However, Cuba has evolved significantly since 1983, with changes in demographics, epidemiological patterns, family dynamics, constitutional frameworks, and global challenges. Programs like the Family Doctor and Nurse program were not reflected in the previous legislation, nor were advancements in scientific research, modern bioethics, or the increasing awareness of citizen rights and responsibilities.
José Ángel Portal Miranda, ministro de Salud Pública. Foto: Enrique González (Enro)/ Cubadebate.
The new law builds on the humanist principles of its predecessor, updating the legal language to align with Cuba’s 2019 Constitution and Family Code. The legislation also incorporates the concept of “One Health,” integrating human, animal, plant, and environmental health, recognizing the interconnectedness of global health challenges like pandemics and climate change.
The development of the law involved extensive consultation with over 76,000 people, including healthcare professionals, legal experts, academics, students, workers, and members of social organizations. This collaborative process, Portal Miranda emphasized, makes the law a truly collective work.
The law explicitly reaffirms health as a fundamental human right legally protected and guaranteed by the state. It also recognizes Public Health as a social good, dependent not only on the healthcare sector but on the coordinated efforts of society as a whole. This approach moves beyond a purely medical model, emphasizing social determinants of health, intersectoral collaboration, and shared responsibility.
The legislation establishes a comprehensive catalog of rights and duties, legally enforceable and backed by a higher-ranking legal framework. It guarantees the right to free, timely, and quality healthcare, dignified treatment, confidentiality, informed consent, non-discrimination, and respect for progressive autonomy. It also outlines citizens’ responsibilities to strengthen social responsibility and respect for healthcare professionals.
José Ángel Portal Miranda, ministro de Salud Pública. Foto: Enrique González (Enro)/ Cubadebate.
The law also addresses sensitive issues such as sexual and reproductive health, care for vulnerable groups, and end-of-life care, with a focus on human dignity, autonomy, and ethical support. While the law acknowledges the right to a dignified death, euthanasia will not be permitted until further regulations are approved.
Portal Miranda acknowledged the challenges facing Cuba’s healthcare system, including material shortages, resource limitations, and the emigration of healthcare professionals, but emphasized that these difficulties do not justify abandoning the principles that have historically underpinned the National Health System. He assured the public that essential services will not be closed and rights will be protected.
The implementation of the law will require new regulations, training, institutional control, and public participation. The Ministry of Public Health is also prioritizing digital transformation, integrating technology to improve efficiency, accessibility, and data protection within the healthcare system. This move underscores Cuba’s broader government strategy to embrace digital solutions.
“This law is what Cuba needs and deserves,” Portal Miranda said. “It deserves its health history, its challenging present, and its future.”
