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Drug Wars: Revolution, Embargo, and the Politics of Scarcity in Cuba, 1959–1964

Abstract
Abstract

The Cuban Revolution of 1959 ushered in many radical changes, both socio-economic and political. Yet the macropolitical upheaval of the period also manifested in concrete ways in the lives of ordinary Cubans. The sudden scarcity of everyday medications, closely linked to diplomatic tensions with the United States, was one such outcome. This article traces the transnational battles provoked by the sudden disappearance of US prescription drugs from Cuban shelves. It seeks to understand pharmaceutical shortages not only as a political side effect but also as a social reality, which provided a venue for the articulation of new forms of sociability and body politics.

Spanish abstract

La Revolución Cubana de 1959 marcó el comienzo de muchos cambios radicales, tanto socioeconómicos como políticos. Ahora bien, las convulsiones macropolíticas del momento también se manifestaron de forma concreta en las vidas de cubanos ordinarios. La repentina escasez de medicamentos diarios, vinculada estrechamente a las tensiones diplomáticas con los Estados Unidos, fue una de ellas. Este artículo rastrea las batallas transnacionales provocadas por la repentina desaparición de drogas farmacéuticas norteamericanas de los anaqueles cubanos. El material trata de entender las carencias farmacéuticas no sólo como un efecto político sino como una realidad social que proveyó un espacio para la articulación de nuevas formas de sociabilidad y políticas alrededor del cuerpo.

Portuguese abstract

A Revolução Cubana de 1959 marcou o início de muitas mudanças radicais, tanto socioeconômicas quanto políticas. Contudo, a convulsão macropolítica do período também manifestou-se de forma concreta nas vidas dos cidadãos cubanos comuns. A escassez repentina de medicamentos cotidianos, relacionada diretamente com tensões diplomáticas com os Estados Unidos, foi um destes resultados. Este artigo revisita as batalhas transnacionais provocadas pelo desaparecimento repentino de medicamentos estadunidenses das prateleiras cubanas. Busca-se compreender a escassez de itens farmacêuticos, não apenas como um efeito colateral, mas também como uma realidade social que proporcionou um palco para a articulação de novas formas de sociabilidade e corpo-política.

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1 Letter from Anonymous to Antonio Maceo, August 1964, Antonio Maceo y Mackle Papers, Cuban Heritage Collection, University of Miami Libraries, Coral Gables, FL (hereafter AMMP), Box 4, Folder 37. N. B. I will render letter writers by their initials rather than their names to protect anonymity.

2 Daemmrich Arthur, Pharmacopolitics: Drug Regulation in the United States and Germany (Chapel Hill, NC: University of North Carolina, 2011).

3 See Hoffman Beatrix, Tomes Nancy, Grob Rachel, and Schlesinger Mark (ed.), Patients as Policy Actors (New Brunswick, NJ: Rutgers University Press, 2011); and Greene Jeremy A., Prescribing by Numbers: Drugs and the Definition of Disease (Baltimore, MD: Johns Hopkins University Press, 2007).

4 See Hernández Erasmo Roldán, Las creencias populares: el pasmo, el cáncer, los remedios caseros (Santiago de Cuba: Editorial Oriente, 1998); Cabrera Lydia, La medicina popular de Cuba: médicos de antaño, curanderos, santeros y paleros de hogaño (Miami, FL: Ediciones Universales, 1996); and Rojas Ricardo Riverón (ed.), El ungüento de la Magdalena: humor en la medicina popular cubana (Havana: Ediciones La Memoria, Centro Cultural Pablo de la Torriente Brau, 2008). On self-medication in a later period, see Potterf Traci, ‘The Future of Health in Cuba’, in Font Mauricio A. (ed.), Cuba: In Transition? Pathways to Renewal, Long-Term Development and Global Reintegration (New York: Bildner Center for Western Hemispheric Studies, 2006), pp. 8395 ; Briggs Charles L., ‘“All Cubans Are Doctors!”: News Coverage of Health and Bioexceptionalism in Cuba’, Social Science and Medicine, 73 (2011), pp. 1037–44; Navarro Lygia, ‘Tropical Depression in Cuba’, Virginia Quarterly Review (Winter 2009), available at http://www.vqronline.org/vqr-portfolio/tropical-depression; and Brotherton P. Sean, Revolutionary Medicine: Health and the Body in Post-Soviet Cuba (Durham, NC: Duke University Press, 2012).

5 For more on healthcare and the transition to socialism, see Hernández Roberto E., ‘La atención médica en Cuba hasta 1958’, Journal of Inter-American Studies, 11: 4 (October 1969), pp. 533–57; Danielson Ross, Cuban Medicine (New Brunswick, NJ: Transaction Books, 1979); Díaz-Briquets Sergio, The Health Revolution in Cuba (Austin, TX: University of Texas Press, 1983); McGuire James W. and Frankel Laura B., ‘Mortality Decline in Cuba, 1900–1959: Patterns, Comparisons, and Causes’, Latin American Research Review, 40: 2 (2005), pp. 83116 ; Hirschfeld Katherine, Health, Politics, and Revolution in Cuba since 1898 (New Brunswick, NJ: Transaction Publishers, 2007); Beldarraín Enrique, ‘Cambio y revolución: el surgimiento del Sistema Nacional Único de Salud en Cuba, 1959, 1970’, DYNAMIS, 25 (2005), pp. 257–78; and Brotherton P. Sean, Revolutionary Medicine: Health and the Body in Post-Soviet Cuba (Durham, NC: Duke University Press, 2012). On the extension of rural healthcare, see García Gregorio Delgado, ‘El Servicio Médico Rural en Cuba: antecedentes y desarrollo histórico’, Revista cubana de administración de salud, 12: 2 (April–June 1986), pp. 169–75.

6 See Rodríguez Aníbal, Transitando por la psicología (Havana: Editorial de Ciencias Sociales, 1990), p. 95.

7 See Tobbell Dominique A., Pills, Power, and Policy: The Struggle for Drug Reform in Cold War America and Its Consequences (Berkeley, CA: University of California Press, 2012), p. 90.

8 Ibid. For more on politics and Cold War science, see Wang Jessica, American Science in an Age of Anxiety: Scientists, Anticommunism, and the Cold War (Chapel Hill, NC and London: University of North Carolina Press, 1999); Cueto Marco, Cold War, Deadly Fevers: Malaria Eradication in Mexico, 1955–1975 (Baltimore, MD: Johns Hopkins Press, 2007); Ramos Marco, ‘Psychiatry, Authoritarianism, and Revolution: The Politics of Mental Illness during Military Dictatorships in Argentina, 1966–1983’, Bulletin of the History of Medicine, 87: 2 (Summer 2013), pp. 250–78; Oreskes Naomi and Krige John (eds.), Science and Technology in the Global Cold War (Cambridge, MA: MIT Press, 2014); and Bridger Sarah, Scientists at War: The Ethics of Cold War Weapons Research (Cambridge, MA: Harvard University Press, 2015).

9 ‘Cuba Again Cuts Medicine Prices’, The Washington Post, 16 Jan. 1960, p. A1.

10 See Beldarraín, ‘Cambio y Revolución’, p. 263.

11 On the overhaul of public health in the 1960s, see Danielson, Cuban Medicine, pp. 127–60.

12 ‘2 Exiles Tell of Medical Chaos in Cuba’, Chicago Daily Tribune, 22 December 1962, p. 2.

13 ‘U. S. Committee Formed to Send Drugs and Medicines to Cuba’, National Guardian, 19 Feb. 1962, reprinted in ‘U. S. Communist Party Assistance to Foreign Communist Governments (Medical Aid to Cuba Committee and Friends of British Guiana)’, Hearings before the Committee of Un-American Activities, House of Representatives, Eighty-seventh Congress, Second Session, 14 Nov. 1962 (Washington, DC: U. S. Government Printing Office, 1963), p. 1854.

14 For more on the FPCC, see Gosse Van, Where the Boys Are: Cuba, Cold War America and the Making of a New Left (New York: Verso, 1993); Rojas Rafael, Fighting over Fidel: The New York Intellectuals and the Cuban Revolution (Princeton, NJ: Princeton University Press, 2015); and Gronbeck-Tedescho John A., Cuba, the United States, and Cultures of the Transnational Left, 1930–1975 (New York: Cambridge University Press, 2015).

15 Letter from Melitta del Villar to Freda Kirchwey, 16 Nov. 1961, Freda Kirchway Papers (MC280), Schlesinger Library, Radcliffe Institute for Advanced Study, Cambridge, MA.

17 Letter from Melitta del Villar to Freda Kirchwey, 5 March 1962, Freda Kirchwey Papers.

19 ‘Juanita is dying!’ New York Times, 13 Nov. 1962, Freda Kirchwey Papers.

20 ‘U. S. Communist Party Assistance to Foreign Communist Governments (Medical Aid to Cuba Committee and Friends of British Guiana)’, p. 1837.

21 By this time, the House Un-American Activities Committee no longer commanded a significant degree of prestige; Walter Goodman refers to the early 1960s as the ‘lean years’. See Goodman, The Committee: The Extraordinary Career of the House Committee on Un-American Activities (New York: Farrar, Straus, and Giroux, 1968), pp. 435–81.

22 Hearings before the Committee of Un-American Activities, House of Representatives, Eighty-seventh Congress, Second Session, 14 Nov. 1962 (Washington, DC: U. S. Government Printing Office, 1963), p. 1840.

23 Ibid. , p. 1946.

24 Ibid. , pp. 1847, 1848.

25 Ibid. , p. 1896.

26 Ibid. , p. 1991.

27 Ibid. , p. 1995.

28 Ibid. , p. 1998.

29 Ibid. , p. 2001.

30 See Kornbluh Peter (ed.), Bay of Pigs Declassified: The Secret CIA Report on the Invasion of Cuba (New York: New Press, 1998); and Jones Howard, The Bay of Pigs (Oxford: Oxford University Press, 2008).

31 On this shift in negotiation tactics, see Pérez-Cisneros Pablo, Donovan John B. and Koenreich Jeff, After the Bay of Pigs: Life and Liberty on the Line (Alexandria Library Incorporated, 2007), p. 78. The following account of the negotiations relies on After the Bay of Pigs.

32 Ibid. , p. 99.

34 Ibid. , p. 100.

35 Ibid. , p. 105.

37 Ibid. , p. 110.

38 Ibid. , p. 129.

39 Ibid. , p. 139.

40 Ibid. , p. 150.

41 Ibid. , pp. 164–7.

42 ‘Drug Firm Aid Tells Bid for Cuba Ransom’, Chicago Daily Tribune (UPI), 25 Dec. 1962, p. 2.

46 ‘Cuba Ransom Contributors Listed’, The Washington Post (UPI), 8 Jan. 1963, p. A6.

47 ‘Drug Firm Tells Bid for Cuba Ransom’. On the two controversies and resulting efforts to expand drug regulation, see Daemmrich, Pharmacopolitics, pp. 24–30 and 60–9.

48 ‘U. S. Ransom Drugs Put on Sale in Cuba’, The Washington Post (UPI), 23 Feb. 1963, p. A4.

50 ‘U. S. Hailed in Cuba for Drug Aid’, The Boston Globe, 24 April 1963, p. 4.

53 ‘Anderson Hears Fate of Ransom Supplies’, Chicago Tribune, 9 April 1963, p. 6.

54 ‘Soviet Sub Operates from Cuba, Exile Says’, Los Angeles Times, 18 March 1963, p. 9. Similar allegations were apparently attached to food supplies; I am grateful to Michelle Chase for sharing this point.

55 Anecdotal evidence from later periods (such as the tense years of the Reagan administration) seems to support this possibility.

56 ‘Cuba Seeks To Buy Drugs from U. S. Firms: State, Commerce Agencies Study Requests’, Wall Street Journal, 14 May 1964, p. 5.

57 ‘Cuba Placing Large Orders for U. S. Drugs’, Chicago Tribune, 13 May 1964, p. 16.

59 Richard Reston, ‘Commerce Dept. Sets Tight Curbs on Food, Drug Sales to Havana’, Los Angeles Times, 15 May 1964, p. 1; ‘Commerce Department Requires Licensing of Each Food, Medicine Shipment to Cuba’, Wall Street Journal, 15 May 1964, p. 3.

60 ‘U. S. Grants Export License for Antibiotics to Havana’, New York Times, 12 Aug. 1964, p. L9.

61 On COMECON pharmaceutical production, see Kaser Michael, Health Care in the Soviet Union and Eastern Europe (Boulder, CO: Westview Press, 1976), pp. 20–1. Cuba would not formally join COMECON until 1971.

62 Al Burt, ‘Cuba Presses Public Health Plan’, Washington Post, Times Herald, 1 April 1965, p. A21.

67 Nathan Cobb, ‘Cuba: Views of 9 Who Fled’, Boston Globe, 5 April 1970, p. B3.

68 van der Geest Sjaak, Whyte Susan Reynolds and Hardon Anita, ‘The Anthropology of Pharmaceuticals: A Biographical Approach’, Annual Review of Anthropology, 25 (1996), p. 169. The literature in this field is vast. See, for example, Whyte Susan Reynolds, van der Geest Sjaak and Hardon Anita (eds.), Social Lives of Medicine (Cambridge: Cambridge University Press, 2003); and Petryna Adriana, Lakoff Andrew and Kleinman Arthur (eds.), Global Pharmaceuticals: Ethics, Markets, Practices (Durham, NC: Duke University Press, 2006).

69 Greene Jeremy A., ‘What's in a Name? Generics and the Persistence of the Pharmaceuticals Brand in American Medicine’, Journal of the History of Medicine and Allied Sciences, 66: 4 (October 2011), pp. 468506 .

70 Greene, ‘What's in a Name?’, p. 489. That ban on brand names would, of course, never be achieved. On later Latin American battles over generics, see Shadlen Ken, ‘Patents and Pills, Power and Procedure: The North-South Politics of Public Health in the WTO’, Studies in Comparative International Development, 39: 3 (2004), pp. 76108 ; Biehl João, Will to Live: AIDS Therapies and the Politics of Survival (Princeton, NJ and Oxford: Princeton University Press, 2007); and Hayden Cori, ‘A Generic Solution? Pharmaceuticals and the Politics of the Similar in Mexico’, Current Anthropology, 48: 4 (August 2007), pp. 475–95.

71 On the Latin American context, see Bauer Arnold J., Goods, Power, History: Latin America's Material Culture (Cambridge: Cambridge University Press, 2001); Bunker Steven, Creating Mexican Consumer Culture in the Age of Porfirio Díaz, 1876–1911 (Albuquerque, NM: University of New Mexico Press, 2012); and Sinclair J. and Pertierr Anna Cristina (eds.), Consumer Culture in Latin America (New York: Palgrave Macmillan, 2012). See also McClintock Anne, Imperial Leather: Race, Gender, and Sexuality in the Colonial Context (New York: Routledge, 1995), pp. 506–17; and Burke Timothy, Lifebuoy Men, Lux Women: Commodification, Consumption, and Cleanliness in Modern Zimbabwe (Durham, NC: Duke University Press, 1996).

72 Pérez Louis A., On Becoming Cuban: Identity, Nationality, and Culture (Chapel Hill, NC: University of North Carolina Press, 2000).

73 On the debates around official metanarratives and popular efforts to rescript them, see Guerra Lillian, Visions of Power: Revolution, Redemption, and Resistance, 1959–1971 (Chapel Hill, NC: University of North Carolina Press, 2014).

74 ‘CINISMO’, Revolución, 10 March 1961, p. 1.

75 ‘Medicina para obrero ejemplar’, Cartas del Pueblo, Descarga, Revolución, 4 Oct. 1962, p. 6.

76 ‘Recomendación de salud pública’, Cartas del Pueblo, Descarga, Revolución, 21 Nov. 1962, p. 6.

77 ‘Carta del Ministro de Salud Pública’, Cartas del Pueblo, Descarga, Revolución, 24 Nov. 1962, p. 6; ‘Cuba Ends Ban on Flights by Own Air Lines: Minister Attacks Medicine Plea’, Chicago Daily Tribune, 24 Nov. 1962, p. A7.

79 ‘Peticiones de medicina’, Cartas del Pueblo, Descarga, Revolución, 30 Nov. 1962, p. 6.

80 ‘Programa de inicio médico radial’, AMMP, Box 4, Folder 3.

81 Memo from Orlando Álvarez to Antonio Maceo, 9 Dec. 1963, AMMP, Box 4, Folder 3.

82 ‘Programa de inicio médico radial’.

84 Show #353, 4 June 1965, AMMP, Box 5, Folder 1.

85 Since at least 1962, Cuban physicians in exile had galvanised political opposition to the Castro government by unveiling public health disasters; see Jules Dubois, ‘1,750 Children in Cuba Killed by Epidemic’, Chicago Daily Tribune, 4 Sept. 1962, p. 22; ‘2 Exiles Tell of Medical Chaos in Cuba’. The political space afforded to the public health situation on the island also created the conditions for the emergence of a unified bloc of exiled physicians, formalised by the establishment of the ‘University of Havana School of Medicine in Exile’. See Leslie Lieber, ‘Saved! Cuba's Doctors-in-Exile’, Los Angeles Times, 15 Sept. 1963, p. B18.

86 The story was also carried by Free Cuba News, a newsletter published by Citizens Committee for a Free Cuba, Inc. (1: 13, 31 August 1963). Held at the Robert J. Dole Archive and Special Collections, University of Kansas, available at http://dolearchives.ku.edu/sites/dolearchive.drupal.ku.edu/files/files/historyday/originals/hd14_cuba_016.pdf.

87 ‘Asolan las enfermedades a la niñez cubana’ (AIP), AMMP, Box 4, Folder 3.

88 Anonymous to Antonio Maceo, 8 Oct. 1963, AMMP, Box 40, Folder 3.

89 Letter from JS to Antonio Maceo, n.d., AMMP, Box 4, Folder 3.

90 ‘Gastroenteritis’, n.d., AMMP, Box 4, Folder 3.

91 Letter from MCSN to Antonio Maceo, 11 June 1964, AMMP, Box 4, Folder 37.

92 ‘Gastroenteritis’ [follow up], AMMP, Box 4, Folder 3. It was in 1963 that the public health apparatus introduced its Diarrheal Disease Control Program (DDCP), which achieved an impressive and rapid drop in infant mortality from gastrointestinal illnesses. See Corteguera Raúl L. Riverón, ‘Strategies and Causes of Reduced Infant and Young Child Diarrheal Disease Mortality in Cuba, 1962–1993’, Bulletin of Pan American Health Organization, 29: 1 (1995), pp. 7080 ; and Enrique Beldarraín Chaple, ‘Cambio y revolución’, pp. 257–78.

93 Show #380, 6 Aug. 1965, AMMP, Box 5, Folder 1.

94 Letter from EDV to Antonio Maceo, 9 June 1964, AMMP, Box 4, Folder 37.

95 Letter from AHO to Antonio Maceo, n.d., AMMP, Box 4, Folder 37.

96 Letter from FV to Antonio Maceo, n.d., AMMP, Box 4, Folder 37.

97 Letter from MV to Antonio Maceo, 29 April 1964, AMMP, Box 4, Folder 27.

99 Letter from LP to Antonio Maceo, 17 Sept. 1964, AMMP, Box 4, Folder 38.

100 Letter from DU to Antonio Maceo, 2 Feb. 1965, AMMP, Box 4, Folder 38.

101 Letter from GR to Antonio Maceo, 16 July 1965, AMMP, Box 4, Folder 38.

102 Letter from AHO to Antonio Maceo, n.d., AMMP, Box 4, Folder 37.

103 Letter from Anonymous to Antonio Maceo, 8 Oct. 1963, AMMP, Box 4, Folder 3.

104 Ledeneva Alena V., ‘Between Gift and Commodity: The Phenomenon of “Blat”’, Cambridge Anthropology, 19: 3 (1996/7), p. 45. See also Ledeneva Alena, ‘ Blat and Guanxi: Informal Practices in Russia and China’, Comparative Studies in Society and History, 50: 1 (2008), pp. 118–44; Osokina Elena, Our Daily Bread: Socialist Distribution and the Art of Survival in Stalin's Russia, 1927–1941 (Armonk, NY, and London: M. E. Sharpe, 2001); Chelcea Liviu, ‘The Culture of Shortage during State-Socialism: Consumption Practices in a Romanian Village in the 1980s’, Cultural Studies, 16: 1 (2002), pp. 1643 ; Gille Zsuzsa, From the Cult of Waste to the Trash Heap of History: The Politics of Waste in Socialist and Postsocialist Hungary (Bloomington and Indianapolis, IN: Indiana University Press, 2007); Garth Hanna, ‘Things Became Scarce: Food Availability and Accessibility in Santiago de Cuba Then and Now’, NAPA Bulletini, 32: 1 (2009), pp. 178–92; and Wilson Marisa, Everyday Moral Economies: Food, Politics and Scale in Cuba (Oxford: Wiley-Blackwell, 2014).

105 Ledeneva, ‘Between Gift and Commodity’, p. 46.

106 Ibid. , p. 47.

107 Ibid. , p. 54.

108 Guerra, Visions of Power, p. 294.

109 Rosendahl Mona, Inside the Revolution: Everyday Life in Socialist Cuba (Ithaca, NY: Cornell University Press, 1997), pp. 2851 .

110 See Potterf, ‘The Future of Health in Cuba’, pp. 83–95; Briggs, ‘“All Cubans are doctors!”’, pp. 1037–44; Navarro, ‘Tropical Depression’; and Brotherton, Revolutionary Medicine.

111 See, for example, José Alejandro Rodríguez, ‘¿Por qué faltan medicamentos?’ Juventud Rebelde, 2 June 2015, available at http://www.juventudrebelde.cu/columnas/acuse-recibo/2015-06-02/por-que-faltan-medicamentos/.

112 Increasingly, these flows are bidirectional, with Cubans in the diaspora gaining access to drugs that are more restricted in the United States (some psychopharmaceuticals, for example) through their island relatives. See Jennifer Lambe, Madhouse: Psychiatry and Politics in Cuban History (Chapel Hill, NC: University of North Carolina Press, forthcoming), chap. 7.

* I would like to thank Michael Bustamante, Deborah Weinstein, Deborah Levine, Lillian Guerra, Michelle Chase, Mariola Espinosa, Alejandro de la Fuente, Jorge Domínguez, Daniel Rodríguez, John Gutiérrez, Kelly Urban, Steven Palmer, Víctor Fowler, Ethan Pollock, María Antonia Cabrera Arús, as well as three anonymous JLAS readers and participants in the Harvard DRCLAS Cuban Studies Program Roundtable on ‘New Research in the History of Public Health in Cuba’ and the New York University-Tamiment Library Cold War Seminar for their thoughtful comments on different versions of this work. I am also very grateful to Rosa Monzón-Álvarez and the Cuban Heritage Collection for their assistance.

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