Report on the Epidemiological Crisis in Cuba and its Intersection with Sustainable Development Goals

Executive Summary

Cuba is experiencing a severe and complex epidemiological crisis characterized by the simultaneous circulation of multiple vector-borne diseases, including dengue, Oropouche fever, and chikungunya. This public health emergency is exacerbated by systemic failures in essential public services and infrastructure. The situation represents a significant challenge to the nation’s progress towards key Sustainable Development Goals (SDGs), most notably SDG 3 (Good Health and Well-being), SDG 6 (Clean Water and Sanitation), SDG 11 (Sustainable Cities and Communities), and SDG 16 (Peace, Justice and Strong Institutions).

Public Health Emergency: A Challenge to SDG 3 (Good Health and Well-being)

The health crisis has manifested through widespread infections across the country, with Matanzas province identified as a primary epicenter. The failure to contain these outbreaks directly contravenes SDG Target 3.3, which aims to end the epidemics of communicable diseases. The capacity of the public health system is severely strained, undermining SDG Target 3.d concerning early warning and management of health risks.

• Reported Symptoms: High fever (up to 40°C), body aches, joint swelling, vomiting, diarrhea, headaches, and skin blemishes.
• Confirmed Circulating Diseases:
  • Dengue fever (confirmed in at least 12 provinces)
  • Oropouche fever (confirmed in at least 12 provinces)
  • Chikungunya (confirmed in approximately 8 provinces)
  • Acute diarrheal diseases and Hepatitis A
  • Nine distinct respiratory viruses
• Healthcare System Deficiencies: The response is critically hampered by a lack of laboratory reagents for accurate diagnosis and an estimated 70% shortage of essential medicines in pharmacies, making symptom management difficult and increasing health risks for the population.

Systemic Failures and Setbacks for Foundational SDGs

The epidemiological crisis is not an isolated event but a symptom of deeper, systemic issues in public infrastructure and environmental management. These deficiencies represent significant setbacks for several interconnected SDGs.

1. SDG 11 (Sustainable Cities and Communities): The proliferation of solid waste in urban areas has created ideal breeding grounds for disease vectors. This is a direct failure to meet SDG Target 11.6 (reduce the adverse per capita environmental impact of cities, including waste management). In Havana alone, a significant portion of the municipal garbage collection fleet (over 40%) is reportedly non-operational.
2. SDG 6 (Clean Water and Sanitation): Progress towards SDG 6 is undermined by inadequate water and sanitation infrastructure. Widespread water shortages prevent the population from maintaining necessary hygiene standards, while persistent leaks from water pipes create stagnant pools that facilitate mosquito breeding, directly opposing the objectives of SDG Target 6.2 (achieve access to adequate sanitation and hygiene).
3. SDG 7 (Affordable and Clean Energy): The crisis is compounded by energy deficits. Frequent and prolonged blackouts disrupt sanitation efforts, while a lack of fuel has reportedly curtailed government-led mosquito fumigation campaigns, a critical public health intervention. This highlights how failures in energy infrastructure (related to SDG 7) can have cascading negative impacts on public health.

Institutional Response and Public Trust in Relation to SDG 16

The official response to the crisis has been characterized by a lack of transparency, which challenges the principles of SDG 16 (Peace, Justice and Strong Institutions). Initial denials and a delay in acknowledging the scale of the outbreak and the number of fatalities have eroded public trust.

• Transparency and Accountability: The discrepancy between official statements claiming the situation is “under control” and widespread citizen reports of overwhelmed hospitals and uncounted fatalities points to a failure to uphold SDG Target 16.6 (develop effective, accountable and transparent institutions).
• Citizen Action: In the absence of a sufficient institutional response, citizens have utilized social media to report on the crisis and have mobilized private networks, including support from the Cuban diaspora, to alleviate shortages of medicine and other essential supplies. This reliance on informal support networks underscores a significant gap in state capacity and public services.

Analysis of the Article in Relation to Sustainable Development Goals (SDGs)

1. Which SDGs are addressed or connected to the issues highlighted in the article?

• SDG 3: Good Health and Well-being
• SDG 6: Clean Water and Sanitation
• SDG 11: Sustainable Cities and Communities
• SDG 16: Peace, Justice and Strong Institutions

2. What specific targets under those SDGs can be identified based on the article’s content?

• SDG 3: Good Health and Well-being

  • Target 3.3: By 2030, end the epidemics of AIDS, tuberculosis, malaria and neglected tropical diseases and combat hepatitis, water-borne diseases and other communicable diseases.
    
    Explanation: The article focuses on a combined epidemiological crisis in Cuba, specifically mentioning the “simultaneous presence of dengue, Oropouche fever and chikungunya.” It also notes an “increase in acute diarrheal diseases and the presence of hepatitis A,” which are communicable and water-borne diseases that this target aims to combat.
  • Target 3.8: Achieve universal health coverage, including… access to quality essential health-care services and access to safe, effective, quality and affordable essential medicines…
    
    Explanation: The article highlights a severe failure in providing essential healthcare services and medicines. It explicitly states there is a “70% shortage of medicines in Cuban pharmacies,” and that hospitals in Matanzas are “overwhelmed by the influx of patients,” indicating a lack of capacity and access to necessary treatments.
  • Target 3.d: Strengthen the capacity of all countries… for early warning, risk reduction and management of national and global health risks.
    
    Explanation: The Cuban health system’s capacity for managing health risks is shown to be weak. The article points to a “lack of laboratory reagents for diagnostic testing,” which prevents proper diagnosis and early warning. Furthermore, the authorities’ initial “silence” and attempts to “ignore” the crisis demonstrate a failure in risk management.

• SDG 6: Clean Water and Sanitation

  • Target 6.2: By 2030, achieve access to adequate and equitable sanitation and hygiene for all…
    
    Explanation: The article describes a breakdown in sanitation services, noting the “proliferation of garbage on every corner has already become part of the daily landscape.” This lack of waste management directly contradicts the goal of achieving adequate sanitation.
  • Target 6.3: By 2030, improve water quality by reducing pollution…
    
    Explanation: The article mentions “constant leaks of water from pipes that becomes stagnant.” This stagnant water not only represents a loss of water resources but also creates breeding grounds for mosquitoes, contributing to the spread of disease and indicating a failure to manage water infrastructure and quality.

• SDG 11: Sustainable Cities and Communities

  • Target 11.6: By 2030, reduce the adverse per capita environmental impact of cities, including by paying special attention to… municipal and other waste management.
    
    Explanation: This target is directly relevant due to the article’s detailed description of the failure of municipal waste management. It states that in Havana, “more than 40% of garbage trucks were out of service last year,” leading to massive accumulations of uncollected garbage and a significant adverse environmental impact on the city.

• SDG 16: Peace, Justice and Strong Institutions

  • Target 16.6: Develop effective, accountable and transparent institutions at all levels.
    
    Explanation: The article heavily criticizes the lack of transparency and accountability from Cuban authorities. It describes “several weeks of silence” from officials, who “tried to ignore” the crisis and were accused of “manipulating” the “extremely serious situation.” The Minister of Public Health initially persisted in “denying any deaths,” which contradicts the principles of transparent and accountable governance.
  • Target 16.10: Ensure public access to information…
    
    Explanation: The government’s failure to provide accurate and timely information is a central theme. The article notes an “absence of transparency in official figures” and that the Deputy Minister of Public Health “did not offer data that could illustrate the scale of the phenomenon.” This forced citizens to “take it upon themselves to denounce, raise awareness, and bring to light a situation,” demonstrating a clear lack of public access to official information.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

• Target 3.3 (End Epidemics)

  • Indicator: Incidence of communicable diseases.
    
    Explanation: The article implies a high incidence by stating that dengue and Oropouche fever are present in “at least 12 provinces” and chikungunya in “about eight.” It also mentions an “increase in acute diarrheal diseases and the presence of hepatitis A.”
  • Indicator: Mortality rate attributed to specific communicable diseases.
    
    Explanation: The article mentions that authorities eventually “acknowledged the deaths of three people from dengue fever,” providing a specific, albeit likely understated, data point for this indicator.

• Target 3.8 (Universal Health Coverage)

  • Indicator: Proportion of the population with access to affordable essential medicines.
    
    Explanation: The article provides a direct quantitative measure for this by stating there is a “70% shortage of medicines in Cuban pharmacies.”

• Target 3.d (Health Risk Management)

  • Indicator: Health system capacity for diagnostics.
    
    Explanation: The “lack of laboratory reagents for diagnostic testing” is a clear indicator of a weakened capacity for early warning and diagnosis of health threats.

• Target 11.6 (Municipal Waste Management)

  • Indicator: Proportion of municipal solid waste collected.
    
    Explanation: The article provides data points that can be used to measure this. It states that in Havana, “30,108 cubic meters of garbage are accumulated daily” and that “more than 40% of garbage trucks were out of service,” implying a very low proportion of waste is being collected.

• Target 16.10 (Public Access to Information)

  • Indicator: Public access to official government data.
    
    Explanation: The article implies this is extremely low, citing the “absence of transparency in official figures” and the fact that officials “did not offer data that could illustrate the scale of the phenomenon.” The need for citizens to report the situation on social media serves as a qualitative indicator of the failure of official channels.

4. Table of SDGs, Targets, and Indicators

Source: english.elpais.com