On February 25, US secretary of state Marco Rubio announced restrictions on visas for both government officials in Cuba and any others worldwide who are “complicit” with the island nation’s overseas medical-assistance programs. A US State Department statement clarified that the sanction extends to “current and former” officials and the “immediate family of such persons.” This action, the seventh measure targeting Cuba in one month, has international consequences; for decades tens of thousands of Cuban medical professionals have been posted in around sixty countries, far more than the World Health Organization’s (WHO) workforce, mostly working in under- or unserved populations in the Global South. By threatening to withhold visas from foreign officials, the US government means to sabotage these Cuban medical missions overseas. If it works, millions will suffer.

Rubio built his career around taking a hard line on Cuban socialism, even alleging that his parents fled Fidel Castro’s Cuba until the Washington Post revealed that they migrated to Miami in 1956 during the Fulgencio Batista dictatorship. As Trump’s secretary of state, Rubio is in prime position to ramp up the belligerent US-Cuba policy first laid out in April 1960 by deputy assistant secretary of state Lester Mallory: to use economic warfare against revolutionary Cuba to bring about “hunger, desperation and overthrow of government.”

Cuba stands accused by the US government of human trafficking, even equating overseas Cuban medical personnel to slaves. Rubio’s tweet parroted this pretext. The real objective is to undermine both Cuba’s international prestige and the revenue it receives from exporting medical services. Since 2004, earnings from Cuban medical and professional services exports have been the island’s greatest source of income. Cuba’s ability to conduct “normal” international trade is currently obstructed by the long US blockade, but the socialist state has succeeded in converting its investments in education and health care into national earnings, while also maintaining free medical assistance to the Global South based on its internationalist principles.