Cuba helps Venezuela develop healthcare services

“It is in some sense almost an anti-model,” according to Eric Swanson, the programme manager for the Bank’s Development Data Group, which compiled the WDI, a tome of almost 400 pages covering scores of economic, social, and environmental indicators.

Indeed, Cuba is living proof in many ways that the Bank’s dictum that economic growth is a pre-condition for improving the lives of the poor is over-stated, if not, downright wrong.

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It has reduced its infant mortality rate from 11 per 1,000 births in 1990 to seven in 1999, which places it firmly in the ranks of the western industrialised nations. It now stands at six, according to Jo Ritzen, the Bank’s Vice President for Development Policy, who visited Cuba privately several months ago to see for himself.

By comparison, the infant mortality rate for Argentina stood at 18 in 1999;

Chile’s was down to ten; and Costa Rica, at 12. For the entire Latin American and Caribbean region as a whole, the average was 30 in 1999.

Similarly, the mortality rate for children under the age of five in Cuba has fallen from 13 to eight per thousand over the decade. That figure is 50% lower than the rate in Chile, the Latin American country closest to Cuba’s achievement. For the region as a whole, the average was 38 in 1999.

“Six for every 1,000 in infant mortality - the same level as Spain - is just unbelievable,” according to Ritzen, a former education minister in the Netherlands. “You observe it, and so you see that Cuba has done exceedingly well in the human development area.”

Indeed, in Ritzen’s own field, the figures tell much the same story. Net primary enrolment for both girls and boys reached 100% in 1997, up from 92% in 1990. That was as high as most developed nations - higher even than the US rate and well above 80-90% rates achieved by the most advanced Latin American countries.

“Even in education performance, Cuba’s is very much in tune with the developed world, and much higher than schools in, say, Argentina, Brazil, or Chile.”

It is no wonder, in some ways. Public spending on education in Cuba amounts to about 6.7% of gross national income, twice the proportion in other Latin American and Caribbean countries and even Singapore.

There were 12 primary school pupils for every Cuban teacher in 1997, a ratio that ranked with Sweden, rather than any other developing country. The Latin American and East Asian average was twice as high at 25 to one.

The average youth (age 15-24) illiteracy rate in Latin America and the Caribbean stands at 7%. In Cuba, the rate is zero. In Latin America, where the average is 7%, only Uruguay approaches that achievement, with one percent youth illiteracy.

“Cuba managed to reduce illiteracy from 40% to zero within ten years,” said Ritzen. “If Cuba shows that it is possible, it shifts the burden of proof to those who say it’s not possible.”

Similarly, Cuba devoted 9.1% of its gross domestic product (GDP) during the 1990s to health care, roughly equivalent to Canada’s rate. Its ratio of 5.3 doctors per 1,000 people was the highest in the world.

The question that these statistics pose, of course, is whether the Cuban experience can be replicated. The answer given here is probably not.

“What does it, is the incredible dedication,” according to Wayne Smith, who was head of the US Interests Section in Havana in the late 1970s and early 1980s and has travelled to the island many times since.