The Economist 04Apr2020

The EconomistApril 4th 2020 The Americas 37

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two patients with covid-19.

With disaster looming, the regime and

the opposition, led by Juan Guaidó, the

head of the democratically elected Nation-

al Assembly, had begun to talk to each oth-

er. On March 25th three opposition mayors

appeared with Héctor Rodríguez, the pro-

regime governor of Miranda state, which

includes parts of Caracas, at an event to

promote joint public-health measures.

Henrique Capriles, who ran against Mr Ma-

duro in an election in 2013, called on the

opposition and the regime to face facts: Mr

Maduro controls the country while Mr

Guaidó, who is recognised by the United

States and dozens of other democracies as

Venezuela’s interim president, has inter-

national support. “This pandemic has to

create an opportunity to seek an accord,” he

said. Mr Maduro, who has repeatedly said

that he is open to “dialogue” with the oppo-

sition even as he persecutes it, renewed the

offer on March 25th. If the opposition did

not want to recognise him as president he

would participate “just as Nicolás Maduro”.

There was talk of forming a unity govern-

ment to deal with the pandemic.

Mr Barr may have torpedoed that. The

charges allege that in the late 1990s Mr Ma-

duro, Mr Cabello, Hugo Carvajal, a former

director of military intelligence, and Clíver

Antonio Alcalá, then an officer in the

armed forces, founded a drug-running or-

ganisation called the Cartel of the Suns,

named for an insignia on army uniforms.

In league with the farc, a Colombian guer-

rilla outfit, the group “sought to flood” the

United States with cocaine, say the indict-

ments. Computer discs discovered in a raid

on a farccamp in Ecuador in 2008 alleged-

ly revealed contacts between the group and

Chávez’s government, in which Mr Maduro

was foreign minister. Separate charges

claim that Vladimir Padrino López, the de-

fence minister, conspired to transport co-

caine on American-registered aircraft from

Venezuela to Central America. Its destina-

tion was the United States.

“There’s no doubt that there is wide-

spread corruption and penetration of the

Venezuelan state by organised crime, par-

ticularly drug-trafficking,” says Geoff Ram-

sey of the Washington Office on Latin

America, a think-tank. But he doubts that

all the charges could be proved in court.

“Some of the evidence is from witnesses

who have...a clear incentive to play along

with prosecutors,” he says. Venezuela is a

relatively small player in the cocaine trade.

In 2018 six times more passed though Gua-

temala than through Venezuela. Many ob-

servers suspect that the Trump administra-

tion cares less about dislodging Mr Maduro

than about winning Florida, home to many

Venezuelan and Cuban exiles, in the Amer-

ican presidential election this year.

The main indictments had been sealed

for several years. Pushing for publication

were hardline advisers to the president, in-

cluding Marco Rubio, a senator from Flori-

da. Arguing against was the State Depart-

ment. It worried that revealing the charges

would undermine efforts to persuade Mr

Maduro’s associates, including the defence

minister, to betray him. The United States

has minimum sentences for people con-

victed of large-scale drug-trafficking, notes

Mr Ramsey. Although the constitution bars

extradition, “these people now know they

could end up in a jail cell in Miami” if the

government in Venezuela changes.

Perhaps recognising that the truncheon

alone would not work, the State Depart-

ment has offered a plan that sounds more

conciliatory. The National Assembly would

choose a transitional government, which

would prepare for free elections, under a

formula that would give pro-government

chavistalegislators a say in its composi-

tion. Neither Mr Maduro nor Mr Guaidó

could lead it. American sanctions would be

lifted, which would help Venezuela cope

with the pandemic. But nothing in the

State Department plan spares Mr Maduro

the threat of extradition should he lose

power, as he surely would in a free election.

For now, he is using the pandemic to re-

assert control. He has prohibited public

gatherings. In the midst of nationwide fuel

shortages, he has given control of petrol

distribution to the army, which will cash in

on the black market as it now does in food.

His threats against Mr Guaidó are more

menacing. On March 30th, without naming

the opposition leader, he warned that the

regime would soon be “coming to knock on

your door”. While Mr Maduro and Mr Barr

are brandishing handcuffs, the threat from

covid-19 can only grow. 7

W

hen thenumber of patients mounts

but the number of healers does not,

whom do you call? That was the question

for Giulio Gallera, the health minister in

Lombardy, the Italian region worst hit by

covid-19. The army was erecting a field hos-

pital with 32 beds in a car park in Crema,

50km (30 miles) south-east of Milan. But

what about doctors to attend them? “Some-

one said to me: ‘Write to the Cuban minis-

try of health,’” recalls Mr Gallera. Barely a

week later, on March 22nd, 52 medics ar-

rived from Havana, waving Cuban and Ital-

ian flags. Locals sent them warm clothing

and bicycles for their commute.

Cuba’s Central Medical Collaboration

Unit, which for six decades has sent doc-

tors across the world, is having a busy

month. Some 14 countries, from Angola to

Andorra, have received a total of 800 doc-

tors and nurses. Politicians in Buenos Aires

and Valencia in Spain, and indigenous

groups in Canada, are pressing national

governments to request Cuban brigades.

Cuba trains a staggering number of doc-

tors for its size and wealth (see chart). Even

though its population of 11m is not young, it

has doctors to spare. More than usual are

available. In the past 18 months 9,000 have

left Brazil, Bolivia, El Salvador and Ecuador,

where leftist presidents have recently lost

power. According to Granma, Cuba’s state-

owned daily newspaper, the number of

doctors and nurses abroad fell from more

than 50,000 in 2015 to 28,000 in 2020.

Cuba started exporting doctors out of a

mix of humanitarianism and a desire for

good publicity. Since 2006, when Raúl Cas-

tro assumed the presidency from his broth-

er, Fidel, the practice has become a vital

prop to the economy. Portugal, which has

received Cuban doctors since 2009, pays

€50,000 ($55,000) a year for each one.

Venezuela has long supplied cheap oil to

Cuba in exchange for its 20,000-strong

medical contingent. Last year, when Cuba’s

government published detailed trade sta-

tistics for the first time, medical services

made up 46% of exports and 6% of gdp.

Cash-for-carer deals are less good for

the doctors themselves. The communist

government typically keeps three-quarters

of health workers’ salaries (which still

leaves them better off than they would be at

home). Many complain of horrid working

conditions. To discourage defection (or

“brain theft”) Cuban officials in host coun-

tries confiscate doctors’ passports and

withhold part of their share of their salary

until they come home. It does not always

work. The United States, which damns the

programme as human trafficking, offered

permanent residency to Cuban doctors in

FLORENCE AND MEXICO CITY

The pandemic boosts the communist

island’s main export

Cuban doctors

Mercy and money

A gap in the market

Doctors per 1,000 people, 2018 or latest available

Countries newly importingor

recently expellingCuban doctors

Sources: World Bank; UN

Median age

Angola of population

Haiti

Bolivia

Ecuador

Brazil

Andorra

Italy

Cuba

86420

16.7

24.0

25.6

27.9

33.5

44.3

47.3

42.2