1.  Cuba is a unitary republic with a sui generis system of government. For some authors, it is as an assembly or conventional system of government under the 1976 Constitution,¹ considering the concentration of power in the legislative organ. The Constitution of 10 April 2019,² which is the second socialist constitutional charter promulgated since the change of regime in 1959, added several modifications. It regulates a conventionalized system, (a system based on the structure of a Convention) with presidential and parliamentary profiles, which draws inspiration from the organization of power in the socialist States of Eastern Europe. It is structured under the principle of unity—although it is no longer explicitly recognized—and rejects the tripartite separation of powers. The National Assembly of People’s Power is the ‘supreme organ of the State’ or the ‘supreme organ of people’s power’, placing it as the centre of the entire system. This entails the subordination of the Council of Ministers and the President of the Republic to the National Assembly in terms of election, appointment, revocation, accountability, and control, among other decisions.

2.  The National Assembly is made up of deputies, elected for a period of five years. Deputies must be persons who have reached the age of 18. They are nominated as candidates by the corresponding Municipal Assemblies of People’s Power. The nomination process has several phases: to be nominated by the Municipal Assemblies, the person must be part of the ‘pre-candidate’ projects that are prepared and presented by the National Candidacy Commission to the Municipal Candidacy Commissions of each municipality. The Candidature Commissions are ‘made up of representatives of the Cuban Workers Central, the Committees for the Defence of the Revolution, the Federation of Cuban Women, the National Association of Small Farmers, the University Student Federation and the Federation of High School Students, designated by the respective national, provincial and municipal directorates.’³ The Electoral Law establishes that ‘the number of pre-candidates for deputy who is selected from among the delegates to the municipal assemblies of People’s Power must not exceed fifty (50) percent of the total of those who must be elected for that position each municipality.’⁴

3.  According to Article 133 of the 2019 Constitution, the Council of Ministers, which constitutes the Government of the Republic, is the ‘highest executive and administrative organ’. It is composed of the Prime Minister—a political figure that reappears in the Cuban constitutional design with this new constitution of 2019—who must be a representative within the National Assembly of People’s Power, the deputy prime ministers, the ministers, the Secretary, and other members determined by Article 9(1) of Law No 134 on the Organization and Functioning of the Council of Ministers (Ley No 134 de Organización y Funcionamiento del Consejo de Ministros).⁵ In this case, the Minister-President of the Central Bank of Cuba, and the presidents of different institutions are organs of the central administration of the State. The President of the Republic shall determine, in consultation with the Prime Minister, the number of deputy prime ministers.

4.  The Constitution also establishes that the Secretary General of the Workers’ Central Union of Cuba may participate in the sessions of the Council of Ministers by their own right. The Council of Ministers is a collegiate body, and all of its decisions are adopted through the favourable vote of a simple majority of its members. Both the Prime Minister, who is the Head of Government, and the rest of the members of the Council of Ministers, are appointed by the National Assembly of People’s Power or the Council of State, a body that ‘represents’ the National Assembly ‘between one session and another’, upon the proposal of the President of the Republic, who serves as Head of State.

5.  Cuba is a unitary State, divided into provinces and municipalities for political-administrative purposes. At the provincial level, ‘the Governor is the highest executive-administrative officer in his province.’⁶ At the municipal level ’the Municipal Assembly of People’s Power is the highest body of State power in its demarcation and, consequently, it is vested with the highest authority in its territory.’⁷ Article 166 of the Constitution provides for the possibility of establishing other divisions. It is also possible to attribute regimes of administrative subordination and systems of special regulations to the municipalities or other territorial demarcations. For this purpose, their geographical location or economic and social importance must be considered. The municipalities can also be organized in administrative districts, which, according to Law No 139 of Organization and Functioning of the Municipal Administration Council (Ley No 139 de Organización y Funcionamiento del Consejo de la Administración Municipal),⁸ in its Article 14(h)(1), are proposed by the Municipal Administration Council to the Municipal Assembly of People’s Power, and this assembly in turn proposes the organization of these districts to other bodies with competence in the matter. The National Assembly of People’s Power has the power to approve these modifications and creations, according to Article 108(o) of the Constitution.

6.  The Ministry of Public Health (MINSAP), an organ of the central administration of the State, directs and controls the implementation of the State and Government policy in terms of public health and of the development of the medical sciences careers.⁹ Besides the Ministry of Public Health, the organization and provision of public health services in Cuba is under the responsibility of the health directorates of the local bodies of the people’s power within the framework of their competencies, and other entities, as established by Law No 41 on Public Health (Ley No 41 de Salud Pública), dated 15 August 1983.¹⁰ This law stipulates that services management, production, teaching, and research in charge of comprehensive health care constitute a national health system.

7.  In the case of administrative units dependent on the local bodies of the people’s power, the relationship with the rest of the units is governed by the principle of ‘double subordination’. Thus, the national health system has a ‘three-tier administrative structure (national, provincial, and municipal) and four service levels (national, provincial, municipal, and sectors). The provincial and municipal health directorates were administratively subordinated to the provincial and municipal assemblies of local government organs, from which they received their budget, supplies, labour force, and maintenance. Each province forms local health systems in its municipalities.’¹¹ However, the provincial assemblies no longer exist under the 2019 Constitution, today there is a governor, a vice-governor, and a provincial administration council instead. In this sense, ‘[t]he health funds come together in MINSAP from the State budget destined to the health sector, and which in turn distributes it among the different levels and service units, through provincial (consider the previous explanation about the extinction of these assemblies) and municipal assemblies.’¹²

8.  In case of emergency response, every State organ acts within the framework of its competencies and hierarchies established by the Constitution and the laws. It is not likely that there will be conflicts since there is a clear split of responsibilities; therefore, each organ has to face emergency situations, within the framework of its competencies, functions, and missions. The response to the pandemic did not change the constitutional and legal provisions regarding the basic State and administration organization.

9.  None of the exceptional and disaster situations enshrined in Chapter IV of the 2019 Cuban Constitution have been formally declared. Under this title, ‘extraordinary situations’ such as a state of war, general mobilization, and state of emergency can be temporarily decreed.¹³ It aims at ‘guaranteeing national defence and security in the case of military aggression or imminent threat, or those circumstances that affect the nation’s security and defence’¹⁴. In the case of disasters, the law stipulates that a situation of disaster may be decreed. Both situations entail the possibility to regulate ‘in a different manner’ the exercise of the rights and duties recognized by the Constitution.¹⁵

10.  Article 45 of the Constitution establishes that ‘the exercise of these rights of the people are only limited by the rights of others, collective security, general well-being, respect for public order, the Constitution, and the laws’.¹⁶ This article has been invoked in several legal provisions during the pandemic to impose sanitary and epidemiological measures restricting the exercise of several constitutional rights.

11.  Cuba is a member state of the Pan American Health Organization, which is a ‘specialized organization for health of the inter-American system’ and also functions as the ‘Regional Office for the Americas of the World Health Organization.’¹⁷ The State of Cuba is not party to any other relevant international agreement to deal with pandemics. There is no evidence that it has revoked any of the provisions of the international conventions to which it is party. Cuba has not signed the American Convention on Human Rights, nor has it ratified the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social, and Cultural Rights. The national authorities directly cited the World Health Organization (WHO) standards in several official guidelines. The different protocols issued by the Ministry of Public Health recognized expressly the ‘main clinical characteristics’ recognized by the WHO.¹⁸ The WHO standards were also used to assess cases.¹⁹ The most relevant provisions issued to confront the pandemic included Resolution 82/20 of the Ministry of Public Health,²⁰ which appealed through its preamble to the declaration by the WHO of the pandemic to provide a set of organizational and epidemiological measures, inter alia.²¹

12.  Cuba has faced Covid-19 through legal regulations enacted prior to the emergence of the disease and with others that have been approved or issued during the pandemic. In the latter case, none of them have consisted of a general law providing emergency powers to respond to Covid-19. Among the legal provisions enacted prior to the pandemic, the fundamental legal framework is Law No 41/1983 on Public Health (Ley No 41 de Salud Pública)²² and its regulations of 4 February 1989.²³ Article 64 of this law states that ‘in situations occasioned by natural disasters or other nature that involves grave and immediate threats to health, the Ministry of Public Health dictates the sanitary and anti-epidemic measures that the situation demands and fulfils the missions foreseen for these cases by our State and Government’. In addition, under Decree 139/1989 (Article 109(a)), emergency situations include epidemics and pandemics. According to Article 108 of Decree 139/1989, the Ministry of Public Health is empowered to issue regulations and measures for the organization and operation of the hygienic-epidemiological services in these types of circumstances. Article 110 of Decree 139/1989 establishes that provisions issued by the Ministry of Public Health shall be of obligatory compliance for all entities and their dependencies, social and mass organizations, as well as for the entire population. For its part, Decree-Law 54 on ‘Basic Health Provisions’ of 23 April 1982,²⁴ states that the Minister of Health is also empowered to issue provisions for the better organization and operation of the hygienic-sanitary service of the country.

13.  Facing the pandemic has involved an intense regulatory activity with regards to the executive and administrative functions of the Government. From January 2020, the Government created a Temporary National Working Group to fight Covid-19 and approved a Plan for Covid-19 Prevention and Control, which was subsequently updated.²⁵ The regulatory scopes of the decrees of the Council of Ministers have covered labour, wage, and social security policies in order to prevent and fight Covid-19 (see further Part V below).²⁶ Those measures had to be implemented for the post-Covid-19 recovery phase,²⁷ and for the establishment of ‘Infractions Against Communal Hygiene and Sanitary Measures for the Stage of Fighting Covid-19 in the Province of Havana’,²⁸ which were later extended to the whole national territory,²⁹ among others. As organs of the central administration of the State, ministries have deployed an intense standard-setting activity in relation to the pandemic within the framework of their competences, mainly through resolutions.

14.  These legal regulations related to Covid-19 are temporary in nature. In some legal provisions this is express. In other provisions it is deduced by its object of regulation and in others the temporality is subject to compliance with certain recovery phases. There is no judicial system for the control of constitutionality in Cuba; therefore, none of these legal provisions may be challenged in court on the grounds of unconstitutionality. The control of constitutionality is regulated by the Law No 131/2019 on the Organization and Functioning of the National Assembly of People‘s Power and the Council of State of the Republic of Cuba,³⁰ which is carried out by the National Assembly of People’s Power itself. This control includes laws, decree-laws, presidential decrees, decrees, and other general provisions and the agreements and provisions of the municipal assemblies of the people’s power (Articles 152(1) et seq Law No 131/2019). The National Assembly is also competent to control the legality of decree-laws, presidential decrees, decrees, agreements, or other general provisions and that of agreements or general provisions of the municipal assemblies of the people’s power (Articles 168 et seq Law No 131/2019). The current Administrative, Labour, and Economic Procedure Act of 1977 (Ley de Procedimiento Administrativo, Laboral y Económico de 1977)³¹ excludes ‘the constitutional matters’ of the civil and administrative chambers, even if for some authors it is possible to defend constitutional rights before the administrative court, although this jurisdiction is not designed for such purposes.³²

15.  Regarding constitutional rights that may be violated by these legal provisions, although Article 99 of the current Constitution favours a preferential, expedited, and reduced procedure in the courts for the defence of human rights, there is still no law that develops this constitutional precept. This does not exclude the fact that the 2019 Constitution establishes legal guarantees to rights such as the writ of habeas corpus, the right to issue a complaint and receive the corresponding redress or indemnity for undue prejudice or harm by leaders, functionaries, or employees of the State (Article 98), habeas data (Article 97), the rights to direct complaints and petitions (Article 61), besides the effective protection of rights and legitimate interests (Article 92) and due process (Article 94).

16.  The Council of Ministers, as the Government of the Republic, has been entrusted with a leading role in directing the implementation of public health measures during the current pandemic. It has carried out the ‘preparation of a single national intersectoral Government plan’.³³ Among its constitutional attributions is ‘to direct the administration of the State, as well as to unify, coordinate, and supervise the activity of the organizations of the central administration of the State, the national entities, and the local administrations’ (Article 137(j) of the Constitution). As part of the central administration of the State, the Ministry of Public Health plays a lead role in adopting sanitary and anti-epidemic legal provisions to face Covid-19 that are mandatory for everyone. The Council of Minister must also ‘provide for the national defence, the maintenance of internal security and order, and the protection of citizens‘ rights, as well as safeguard lives and property in case of disasters’. Public health is a constitutional right of all people, and the State has the responsibility to guarantee access to quality medical attention, protection, and recovery services free of charge (Article 72 of the Constitution). The Council of Ministers is also responsible for the organization and direction of the execution of political, economic, cultural, scientific, social, and defence activities agreed to by the National Assembly (Article 137(b) of the Constitution), as well as the execution of the laws and agreements of the National Assembly, the decrees with the force of law and the decrees of the Council of State, and presidential decrees (Article 137(ñ) of the Constitution), among others.

17.  One of the most challenging issues in the legal order for the implementation of epidemiological measures has been the activation of provincial and municipal defence councils from the very beginning of the pandemic.³⁴ Even though the National Defence and Security Law (Ley de Defensa y Seguridad Nacional), which regulates the current Articles 222–225 of the Constitution referring to extraordinary situations and disaster, is still pending, these bodies are subject to the current Law No 75 ‘On National Defence Act’ of 1994,³⁵ approved under the 1976 Constitution and amended in 1992. This law establishes that exceptional situations, in accordance with the constitutional text of 1976, may be declared temporarily, throughout the entire national territory or in a part of it, to ‘guarantee national defence or protect the population and the economy in the event or in view of imminent military aggression, natural disasters, or calamities or other circumstances which, by their nature, proportion or importance, affect the internal order, the security of the country or the stability of the State’ (Article 9 of Law No 75). Consequently, a state of war or war, general mobilization, and state of emergency may be declared as exceptional circumstances. The declaration of these situations was consistent with the composition of the organs of the State under the 1976 Constitution, according to Law No 75. Therefore, the state of war or war is declared by the National Assembly or the Council of State—the latter decrees the general mobilization, and the state of emergency is declared by the President of the Council of State.

18.  In addition to the duties incumbent on the National Defence Council, there are the provincial and municipal defence councils, which, together with the areas of defence, ‘are established and prepared during times of peace to direct in their respective territories, under state of war conditions, during a war, in a general mobilization or a state of emergency, based on a general plan for defence and for the role and responsibilities that correspond to the military councils of the armies’ (Article 28 of Law No 75). Likewise, ‘during exceptional situations, they are the highest organs of State and political power of its level and assume immediately their responsibilities in their respective territories’ (Article 29 of Law No 75); and ‘may be activated in peacetime to carry out tasks related to the preparation for defence, according to the plan approved for this purpose by the President of the Military Council’ (Article 31 of Law No 75).

19.  As indicated, the Defence Councils, called up in the Plan for Covid-19 Prevention and Control, are those that ‘coordinate and oversee the missions and measures taken in each entity and community to shore up health promotion (information, education, and communication), encourage social distancing, monitor borders, mitigate risk factors, and ensure the protection of the most vulnerable populations’.³⁶ The activation of these provincial and municipal Defence Councils has raised some concerns because this activation has not been preceded by the declaration of any of the exceptional situations established in the Constitution, as established by Law No 75 ‘On National Defence’ of 1994. According to media reports, these defence councils are responsible for, besides other functions, decreeing quarantines, reinforcing surveillance, ‘curfews’ (among others) in zones and localities under their jurisdiction.

20.  Authorities have deployed a comprehensive set of non-legally binding hygiene recommendations to fight the pandemic in people’s daily lives, with a call for self-responsibility. These recommendations have been posted on several institutional websites—such as the Ministry of Public Health’s website—and have been widely disseminated by the country’s media daily since the beginning of the pandemic.³⁷

21.  The National Assembly of People’s Power, which is the supreme organ of State power with legislative power, supervises or controls the actions of the Government. The Government is accountable and reports all of its activities to it (Articles 101(f) and 136 of the Constitution). In the Cuban power structure, the National Assembly is at the top of the hierarchy. It is not only a legislative body, but it is a body that exercises many functions, including the legislative function. In this sense, it cannot be identified as a legislative power, as it is common to refer to this type of body in a state system based on the principle of tripartite powers.

22.  According to Article 108 of the Constitution, the National Assembly of People’s Power is also competent to: exercise the highest levels of supervision over the organs of the State; ensure the constitutionality of the laws, decree-laws, presidential decrees, decrees, and other general provisions, in accordance with the procedure provided for in Law No 131/2019 on the Organization and Functioning of the National Assembly of People’s Power and the Council of State of the Republic of Cuba; ratify the decrees-laws and agreements of the Council of State; and completely or partially revoke decrees-laws, presidential decrees, decrees, agreements, or general provisions that contradict the Constitution or the laws. The Constitution also recognizes the right of representatives to ask questions to the Council of State and the Council of Ministers or the ministers, and the right to receive a response during the session in which they are asked (Article 117).

23.  Article 110 of the Constitution regulates the functioning of the National Assembly which deals with the control of Government actions. Moreover, it has the following characteristics: two ordinary sessions each year and extraordinary sessions when convened by the Council of State or at the request of one third of its members. Generally, the National Assembly is called to session in the middle and at the end of the year. For the performance of the functions of the Assembly, permanent commissions are also created in accordance with Law No 131/2019 on the Organization and Functioning of the National Assembly of People’s Power and the Council of State of the Republic of Cuba. These commissions deal with specific areas and are temporary in nature—appointed for the term of the legislature. However, the Council of State, the organ that represents the National Assembly between periods of sessions, may suspend decrees, agreements, and other provisions that contradict the Constitution and the laws, for which it reports to the National Assembly, in addition to exercising control and supervision of the organs of the State, pursuant to Article 122 of the Constitution.

24.  The members of the Council of Ministers are ‘appointed’ by the National Assembly of People’s Power or the Council of State for a period of five years, upon the proposal of the President of the Republic, who is the Head of State. The Prime Minister must be a representative within the National Assembly of People’s Power. The functions of the Council of Ministers end when the new legislature is designated. The Prime Minister, the deputy prime ministers, the Secretary, and the other members of the Council of Ministers are not among the elective offices revocable under Law No 135/2020 on Revocation of Mandates of the Elected to the Organs of People’s Power (Ley No 135/2020 de Revocación de los elegidos a los órganos del Poder Popular).³⁸ However, the Prime Minister may be dismissed by the National Assembly upon the proposal of the President of the Republic;³⁹ and the deputy prime ministers, the Secretary, and the other members of the Council may be dismissed or replaced by the National Assembly of People’s Power or the Council of State, upon the proposal of the President of the Republic.⁴⁰

25.  The Government’s activity is scrutinized by the National Assembly during its ordinary and extraordinary sessions, and by the Council of State between sessions. However, the following issues hinder effective control by the National Assembly: the lack of professionalization of the representatives, the short time allotted for sessions (two ordinary sessions per year), the under-representation of ideological diversity that exists today in Cuban society, the group ratification of the decree-laws and agreements of the Council of State, among others.

26.  The Cuban Constitution does not enshrine any mechanism aimed at enabling the National Assembly to control the Government, such as a motion of confidence or a motion of censure with political consequences. However, the extension of the Government’s powers can be subject to the control of constitutionality carried out by the National Assembly itself (for example, in the case of unconstitutional presidential decrees), to the dismissal of its members, to extra-constitutional mechanisms carried out by the Cuban Communist Party—the members of the Council of Ministers are usually Communist Party militants, and in some cases, they hold important positions—inter alia.

27.  In 2020, the pandemic affected the work of the legislative body. By constitutional mandate, the National Assembly must hold two ordinary sessions per year, traditionally in July and December. However, since there is no legal obligation for meeting during these months, ordinary sessions were held in October and December.

28.  The fifth regular session of the IX Legislature of the National Assembly was held virtually for the first time in history at the end of October 2020.⁴¹ In compliance with sanitary measures, deputies from Havana and those who resided in Havana but had been elected by other municipalities were present at the Palacio de las Convenciones, along with the Council of State. However, deputies from other provincial capitals participated remotely.⁴²

29.  Likewise, the sixth ordinary session of the National Assembly was convened by videoconferencing on 16 December 2020. The physical attendance of representatives was in accordance with the provisions of the previous session.

30.  The information resulting from these regular sessions did not reflect whether these forms of virtual meetings imposed restrictions on the voting process. During the first session, four bills and opinions were approved by deputies after a discussion in which a variety of questions had been analysed. In addition, agreements and provisions of the Council of State were ratified.⁴³ During the second session, representatives also approved two bills and analysed other relevant issues.⁴⁴ There are no limitations on the number of people authorized to participate in the plenary debates and no restrictions on questions and answers by the representatives.

31.  However, during the time that the Assembly was not in session, its permanent committees and those of the Council of State did not stop their activities.⁴⁵ There are recorded sessions of the Council of State held via videoconferencing; control and monitoring by the permanent committees of programs and policies of social and economic impact; videoconference sessions of the permanent committees of the National Assembly; meetings of the National Assembly’s President with directors of the permanent committees; and videoconferences of the permanent committees.

32.  Likewise, during 2021,⁴⁶ several meetings have been held between the President of the National Assembly and the heads of the Permanent Working Commissions of the Assembly. These meetings have been held in a hybrid way in some cases. For its part, the Council of State has approved decree-laws and agreed on the creation of independent departments of the National Assembly in each province. Furthermore, such events have included meetings of the Secretary of the National Assembly with presidents of the municipal assemblies; coordination meetings for the development of the high control of certain ministries under the responsibility of the National Assembly; monitoring of the implementation of certain State policies by representatives; and coordination meetings via videoconferencing among permanent commissions with the mission of supporting the fight against Covid-19.

33.  There are no opposition parties in the Cuban political model—which is a one-party State—to discuss possible political restrictions to parliamentary scrutiny during the pandemic. The most important complaints on this issue have been made by the alternative media or digital platforms that are outside the so-called ‘official’ media—among them, El Toque, which launched ‘Information Services about Covid-19 in Cuba’.⁴⁷ Other non-State media that have given coverage to the pandemic are Periodismo de Barrio and OnCuba, which focused mainly on the delay in holding the ordinary sessions.⁴⁸

34.  Sanitary measures approved by the People’s Supreme Court of Cuba, when the first case of Covid-19 was confirmed in Cuba, included ‘the suspension and immediate temporary halt of the processing and procedural management of ongoing judicial matters or processes’.⁴⁹ However, ‘those matters and procedures that, due to their nature and content and for justified reasons, make it necessary to continue their care and treatment, ensuring in each case the respect of due process and the rights and guarantees of the parties’ were exempted from the previous measure. In the event of the filing of a complaint or exercise of an action, courts had to rule on these as appropriate, in compliance with the above provisions. This suspension was temporary in nature and conditioned on its being valid during the situation that determined its adoption. According to the President of the People’s Supreme Court of Cuba, 19,577 judicial proceedings were suspended throughout the country, of which 4,568 in criminal matters and 15,009 in others (family, labour, administrative, economic). Therefore, only 24–29% of the court system staff continued to work—regarding the Supreme Court, 55 out of 256 workers attended regularly. The court system staff, composed of 5,322 people, had a non-regular attendance of 3,780 people, while 1,952 worked remotely and 1,290 took advantage of protective modalities in conformity with labour law.⁵⁰

35.  Through Instruction No 250 of 18 June 2020, issued by the Supreme Court, provincial courts that entered the ‘recovery phase’ could resume judicial processes. However, the instruction insisted on ‘graduality’ and ‘rationality’ in the processing according to circumstances, the territorial epidemiological situation, and the ability of people to appear before the judicial bodies.⁵¹ For its part, Instruction 254 of 12 October 2020 stated that courts could resume in a ‘gradual and progressive manner’, and ‘judicial activity in general during the three phases of the recovery plan’. For such purposes, they would ‘carry out judicial proceedings of all kinds and the new cases that may arise, except for those in which, for reasons of force majeure related to Covid-19 measures, or other fully justified reasons, it is not possible’.⁵²

36.  Nevertheless, during the pandemic, the Cuban People’s Supreme Court has issued various ‘instructions’ (directions), which are legal provisions for the continued functioning of the courts. Instruction 251/2020 established that ‘videoconferencing can be used in proceedings in all jurisdictional matters where necessary, hearings and other judicial process provided for in procedural laws, through audio and video system that promotes bilateral, direct, secure, and real-time oral and visual communication’.⁵³ Likewise, it authorized ‘the use of digital platforms and applications, email, and other telematic means in all judicial instances and jurisdictional matters of the court system to carry out procedural acts of communication to the parties that must be verified personally, or by identity cards, which includes the notifications of all the resolutions pronounced in the judicial processes under the security conditions that make their effectiveness viable, with the exception of those that, due to their content and nature, are so exempted by the court; without prejudice and in support to the obligation that the parties have to remain permanently in contact with the judicial body’.⁵⁴

37.  It also established some measures to extend the filing of proceedings for non-compliance with the duties arising from a resolution until the court issues a final sentence or even the execution of the sanction.⁵⁵ Regarding the implementation of Decree No 14 on infractions against communal hygiene and sanitary measures for the stage of response to Covid-19, approved by the Council of Ministers on 28 August 2020, Opinion No 463/2020 corrected the administrative and judicial procedure for these cases before the provincial courts of Havana.⁵⁶ There was no express provision referring to health risks for taking legal action. In any case, the provisions made by the Supreme Court were intended to protect the health of all the people involved. It is not known if any judicial process involved the participation of parties or victims through digital means.

38.  Cuban courts of justice are not empowered to revise any exceptional or emergency decree, nor can they control the constitutionality of any law containing regulations on emergency situations, as has been the case of Public Health Law No 41. In any event, the Council of Government of the People’s Supreme Court may advise the National Assembly that laws, decree with the force of laws, presidential decrees, decrees, and other general provisions be declared unconstitutional.⁵⁷

39.  During the pandemic months of 2020 and the early months of 2021, no elections (municipal and national of provincial governors and deputy governors) or referendums were planned to take place in Cuba under Law No 127 ‘Electoral Law’ of 19 August 2019 (Ley No 127 ‘Ley Electoral’ de 19 de agosto de 2019).⁵⁸ However, specific elections have been carried out to fill vacancies within the Council of State⁵⁹ and representatives to municipal assemblies of the people’s power,⁶⁰ among others.

40.  One of the most interesting aspects in Cuba of the response to Covid-19 has been the link between the Government and scientific assessment. It has been stated that ‘collaboration between the Government and scientists should constitute a permanent style of work’.⁶¹ According to some, ‘Government management and Cuban science’ reveals a ‘novel system of Government management with science that facilitates commitment and immediacy in the actions of intervention, a sustainable science’.⁶² The emphasis has been placed by the President of the Republic on the need to implement a ‘Government management system based on science and innovation (SGGCI)’.⁶³ The scientific advisers belonged to institutions subordinate to the State administration, including the Ministry of Public Health, the Ministry of Science, Technology, and the Environment, among others.

41.  This approach, which is intended to be extended to all of the activity of the Government in other areas, is based on several programmatic documents and legal norms approved in recent years: the former include Guidelines for the Economic and Social Policy of the Party and the Revolution for the period 2016–2021, the Conceptualization of the Cuban Economic and Social Model of Socialist Development, Bases of the National Plan for Economic and Social Development until 2030: Vision of the Nation, Axes and Strategic Sectors, and articles of the Cuban Constitution which establish the role of the State with respect to science.⁶⁴ The legal regulations approved include Decree No 363/2019 on Science and Technology Parks and Science and Technology Enterprises that Function as an Interface between Universities and Science, Technology and Innovation Entities with Productive and Service Entities; Decree No 2/2020 on High Technology Companies; Decree-Law No 7 on Science, Technology and Innovation System of 16 April 2020; Resolution 286/2019, Regulations for the organization and operation of the national registry of Science, Technology, and Innovation entities; and Resolution 287/2019, Regulations for the Science, Technology, and Innovation Projects and Programs System.⁶⁵

42.  There is no published legal regulation aimed at imposing specific restrictions on reporting on Covid-19. The pandemic in Cuba has been widely reported on, both in the so-called ‘official press’ and the ‘alternative press’. The ‘official’ press reported,⁶⁶ in July 2020, that ‘Covid-19 represented more than 70 percent of the contents of the printed and digital press at the height of the pandemic and 2.1 million pieces in all journalistic genres and platforms of Cuban Radio and TV’.⁶⁷ According to some journalists, it was a ‘systematic and transparent exercise of communication of the Government with people’, which included reports on meetings of the Temporary Working Group to fight Covid-19, daily press conferences from the Ministry of Public Health (MINSAP), and dozens of radio and television broadcasts.⁶⁸ According to the President of the Republic himself, the ‘ethical and responsible use of the media’ figures prominently among the main actions of the Government’s management of the pandemic.⁶⁹ However, and as explained in more detail in the following paragraphs, the ‘great challenge’ is to ‘provide truthful, transparent, and immediate information to the national and international public’.⁷⁰

43.  The dissemination of misleading information on Covid-19 has been sanctioned with a fine under regulations such as Decree Law 370/2018 in force since 4 July 2019.⁷¹ However, the scope of such decree has been extended to include political opinions and the exercise of alternative journalism—all mass media are under Government control. The arbitrary use of these legal provisions created legal uncertainty.⁷² Specifically, the recording and posting of videos of protests on social media (Facebook, YouTube, Twitter, or Instagram) is threatened with fines of up to 3,000 pesos. The Government has been accused of being opportunistic in the way it has used the Covid-19 pandemic to repress anti-Government demonstrations,⁷³ while pro-Government events are authorized.⁷⁴

44.  In this respect, it is also necessary to consider the legislative and programmatic framework that governs the exercise of freedom of the press and the press regime in Cuba to assess potential issues concerning the information on Covid-19. In this case, the official media, which are the ‘socialist property of all the people or of the political, social, and mass organizations’, are the State’s property, or the property of the Communist Party of Cuba and of others that are very close to this party, such as the Union of Young Communists and the Central de Trabajadores de Cuba, among others. In this regard, the Permanent Commission for the Implementation and Development of the Economic and Social Policy Guidelines of the Party and the Revolution approved a social communication policy of the Cuban State and Government, which states that the ‘Communist Party of Cuba governs social communication in the country, draws up the general policy for its development, and exercises its control’.⁷⁵ For these reasons and others, there are concerns from human rights protection entities regarding the ‘State monopoly control over the media’.⁷⁶

45.  Freedom of the press and ownership of the media are covered by Article 55 of the 2019 Cuban Constitution. The National Assembly of People’s Power must still approve decree-laws on social communication and on the creation of the agency of the central State administration in charge of social communication. These legal regulations must specify and clarify how freedom of the press must be exercised for ‘the good of society’; how to define or identify the ‘fundamental’ means of communication that are ‘socialist property of all people or of political, social, and mass organizations and may not be categorized as any other type of property’; and what requirements or conditions will be established for the organization and operation of the non-fundamental means of social communication.

46.  The figure of the Ombudsman does not exist in the Cuban legal and political context, nor was there any special reviewer of the legislation or any public official appointed to follow-up on public response to Covid-19 by the bodies involved in the coordination and organization of these responses.

47.  The Cuban approach in addressing the pandemic has had several phases. Phase 1 covered the period from 11 March 2020, after confirmation of the first case in Cuba, to 10 June 2020, with the approval of a post-Covid-19 recovery plan by the Council of Ministers. It entailed the cancellation or postponement of cultural and sports events, the regulation of entry into the country (except for nationals and residents), the closure of all educational institutions (except for childcare facilities), the cancellation of interprovincial travel by bus, train, and plane, the suspension of all types of transportation, and quarantines. Under Phase 2, from 18 June 2020 to 30 January 2021, authorities implemented the ‘post-Covid-19 recovery’ plan that comprised a three-phase strategy for a gradual reopening culminating in a ‘new normal’ where all productive, economic, and social activities resumed—initially all provinces and municipalities entered into the first phase of the recovery stage, except Havana and Matanzas. In addition, authorities began to ‘relax’ measures, including through the opening of operations in international airports and international tourism, the lifting of ‘curfews’, etc. Therefore, some provinces suffered setbacks in the recovery stage due to the resurgence of new cases. Phase 3 began on 6 February 2021, and it has been marked by an increase in cases, a reduction of the entry of travellers from several countries, setbacks in the recovery stage, the presence of Covid-19 variants, the prohibition of minors in public areas, and the isolation of international travellers in health institutions, among others.

48.  Cuba’s response to Covid-19 relied upon previous strengths of the Cuban healthcare system: universal access to care, a high percentage of medical personnel per capita, a well-structured system of primary care, and a history of facing emergency settings during the yearly hurricane season.⁷⁷ There were also other relevant factors of a political nature. According to the economist Carmelo Mesa-Lago: ‘[t]he existence of a centrally planned economy, a high control of information helped mobilize and redirect resources, as well as decision making very often hindered by democratic systems and the compliance of the citizenry’.⁷⁸ The pandemic was declared a ‘public health emergency of international concern’ by the WHO on 30 January 2020. The first Covid-19 death in Cuba was recorded on 18 March 2020. In the meantime, official information from the Ministry of Tourism assured tourists that Cuba was a safe destination and the Government blocked social media users who called for the closure of schools and borders. Two months earlier, in January 2020, Cuban authorities had formed the Temporary Working Group for the Prevention and Control of the New Covid-19, headed by Miguel Diaz-Canel, President of the Republic, and approved the Covid-19 Combat Plan.⁷⁹

49.  As of 22 March 2021, Cuba had reported 401 Covid-19-related deaths.⁸⁰ By that date, on the American continent, 1,321,904 deaths were registered. However, in the case of Cuba, these figures have been questioned. Some demographers and health officials claim that there are cases and deaths that are not reported as related to Covid-19 but rather to pneumonia or heart problems.⁸¹ The pandemic has had a negative impact on the health system, which was already undergoing severe problems, including: the reduced number of hospitals and beds, polyclinics, and the closure of rural and urban hospitals. There was also a scarcity of medication, as well as a deterioration of sanitation due to lack of soap, detergent, and water. There are severe financial restrictions on importing medicines, face masks, and medical ventilators, and the latter are very limited. There is no available data on intensive care units.⁸²

50.  The main health measures adopted were under several legal provisions. Resolution 82/2020 of the Ministry of Public Health dated 9 April 2020 set up a ‘Technical Working Group’ presided over by this Ministry that established obligatory isolation measures for incoming travellers and for individuals suspected of infection or close contacts in the national territory.⁸³ It covered obligatory restrictive isolation for patients who were discharged from hospital; and quarantine as an extraordinary epidemiological measure and its implementation in case of a ‘local transmission of Covid-19’, in order to ‘achieve mandatory confinement of people and protection of citizens’. This provision was compulsory, and applied to all national and foreign legal and natural persons, regardless of their migratory status. The first measures were comprehensive, stringent, and progressive: (1) the temperature-taking of travellers arriving at airports and their quarantine for 14 days in hotels and public buildings—in case of symptoms they had to be hospitalized; (2) the closure of all entry and exit to the country by air and sea and the quarantine of tourists who were already in Cuban territory.

51.  Resolution 128/2020 of the Ministry of Public Health, dated 12 May 2020,⁸⁴ established specific sanitary measures (screening or confirmatory laboratory testing; use of serums, vaccines, and preventive therapy; checks and disinfection of surfaces, properties, passengers; active and systematic screening of the entire population, among others); epidemiological measures (the correct use of face masks when outside the home or place of residence, regular handwashing with soap and water and/or disinfectant, physical distancing in all public and private areas, etc); State health inspectors designated by the health authorities on an exceptional and temporary basis; temporary and complete closure of meeting venues; and a procedure for the epidemiological closure of air and sea borders for people coming from high-risk zones, among others. This resolution is also mandatory for all natural and legal persons in all of the country.

52.  Decree 8/2020 of the Council of Ministers, dated 15 July 2020,⁸⁵ established a three-phase post-epidemic recovery program. In these phases, general and particular measures would be implemented in each case, with the aim of ‘returning to normal life in the country, gradually and asymmetrically’; ‘avoid[ing] a resurgence of the disease and develop coping capabilities’; and ‘reduc[ing] risks and vulnerabilities as a result of the disease’.⁸⁶ The measures were applicable in any of the three phases: hygiene and prevention, workers in the State and non-State sector, trade and services, communications, transportation, among others. This decree is mandatory for both physical and legal persons. For its part, Decree 14, dated 31 August 2020,⁸⁷ established fines for breaches of ‘Communal Hygiene and Sanitary Measures for the Stage of Fighting Covid-19 in the province of Havana’. Decree 14 was mandatory for the province of Havana. Decree 31 of 29 January 2021 imposed infractions for breach of the sanitary measures for the prevention and combat of Covid-19, for the whole national territory.⁸⁸ This decree repealed Decree 14/2020 of the Council of Ministers.

53.  Questions regarding the regulations have been raised at different points in time: delays or lack of publication of regulations in the Official Gazette—the Cuban Government adopted initial measures on 20 March 2020, however, it was not until 1 April 2020 that the first regulation was published in the Official Gazette; imposition of fines without legal basis; officials lacking authorization to implement administrative sanctions; among others. One of the greatest sources of conflict has been the imposition of fines under Decree 14/2020 and Decree 31/2021. The first had a provincial reach (Havana) and the second was extended to the entire national territory. These measures have had a higher impact on social and alternative media, due to the severity of the fines and an arbitrary use of discretion in some cases.⁸⁹

54.  President Miguel Díaz-Canel declared on 6 June 2020 that Cuba had the pandemic ‘under control’ after the country marked one week without any deaths. Francisco Durán, the Health Ministry’s head of epidemiology, estimated that the country had surpassed its peak in cases in late April of the same year.⁹⁰

55.  Consequently, on 11 June 2020, the Government unveiled the reopening plan, which consisted of three phases culminating in the so-called ‘new normal’ process.⁹¹ During the first phase, services resumed, such as hospital services that had been suspended. These reopened at a 50 per cent capacity under phase one, and then increased to 75 per cent under the second phase, while under the third, hospitals returned to normality. The transition from one phase to another was subject to health indicators such as the Covid-19 incidence rate, the number of active Covid-19 cases, the number of positive cases in the last 15 days, the reproductive index, and rate of local transmission.

56.  In the ‘new normal’, the country resumed productive activities and services. ‘Personal responsibility’ would be key to complying with the health measures, such as basic social distancing guidelines, use of masks in closed spaces, and regular disinfecting of work and public spaces. In this case, the Government appealed to the sense of civic responsibility of individuals.⁹²

57.  The strategy foresaw a post-Covid-19 recovery phase and another of economic consolidation to face the crisis. The new mission—ccording to the Cuban President—consisted of preventing Covid-19 from becoming ‘endemic’.

58.  In the confrontation with Covid, some measures were imposed to restrict the mobility of people. Although in other Parts of this report reference is made to restrictions on rights in the framework of labour, recreational and economic activity, etc (for example, Part IV.A.3 below), measures such as ‘total restriction of night mobility’ were also taken in several provinces of Cuba. As an example, it is worth highlighting the measures taken by the Provincial Defence Council of Havana as of 5 February 2021, which restricted the mobility of people and vehicles throughout the city between 9:00pm and 5:00am.⁹³ These types of measures were also extended to other provinces throughout the year of 2021.⁹⁴

59.  During the first phase, agreed by the Council of Ministers on 11 June 2020 through Decree 8,⁹⁵ restrictions on entering and leaving the country were implemented. The number of health personnel was increased at air, land, and sea terminals, and passengers with fever or respiratory symptoms were prohibited from boarding transport. Travelers residing in the country were subject to a 14-day quarantine at Government facilities. Commercial international flights were suspended on 2 April 2020,⁹⁶ and during the second phase (mid-June 2000). Only humanitarian, cargo, and Government mission partners flights continued to operate. Commercial flights would resume only from phase three of the recovery plan reopening. However, from 1 July 2020, international charter flights were able to fly to airports in tourist sites (Cayo Coco and Cayo Largo del Sur).⁹⁷ During the first two phases of the recovery plan, the limitation of travelling with one suitcase was implemented, while under the third, regulations allowed a maximum of two pieces. Havana’s José Martí International Airport was reopened on 15 November 2020.⁹⁸

60.  On 1 January 2021, the Government implemented reductions in the number of flights into the island from the United States, Mexico, Panama, the Bahamas, Haiti, and the Dominican Republic. Starting on 14 January 2021, visitors would need to present a negative Covid-19 test, performed no more than 72 hours prior to entry.⁹⁹

61.  Visitors arriving after 6 February 2021 needed to quarantine in hotels until they received their negative results. This coincided with another reduction in the flight frequency of airlines from the United States, Mexico, Panama, the Bahamas, the Dominican Republic, Jamaica, and Colombia. The resumption of normal frequency of flights to Nicaragua, Guyana, Trinidad and Tobago, Suriname, and those to Haiti were also suspended.¹⁰⁰

62.  From 23 March 2020, the customer capacity of catering services was reduced by 50 per cent; social distancing measures were implemented; lunch services were provided through the Family Attention System, including ‘home delivery method’;¹⁰¹ and teleworking was requested, whenever possible. Furthermore, activities involving mass gatherings were suspended (camping activities, hotel accommodation, cinemas, theatres, etc).¹⁰²

63.  Schools closed on 24 March 2020. During the ‘new normal’ phase, they reopened in September 2020, except in Havana, which reopened on 2 November 2020.¹⁰³ However, due to a general spike in infections in January 2021, schools were suspended again. The new school year (2021) changed the traditional dates, now starting on 1 March 2021.¹⁰⁴ On 26 March 2020, the suspension of services provided by notaries’ offices, property registry, the Central Registry of Penalties, and the Compensation Fund was implemented.¹⁰⁵

64.  As of 6 April 2021, the Government announced that centres that were not in continuous production or a priority service would remain closed and that workers would be traced to identify people with symptoms or those who were absent from work due to Covid-19.¹⁰⁶ In view of the resurgence in cases, new measures were taken, aiming at ‘controlling compliance with the provisions in the workplaces and increasing rigor, with the support of the National Revolutionary Police and all the inspection bodies’.¹⁰⁷ It has also been recommended that telecommuting and teleworking should be fostered where possible.¹⁰⁸

65.  Measures were taken to ensure social distancing, ranging from one to two metres between individuals depending on the type of space. One of the challenges in maintaining this measure was the need to wait in long ‘queues’ in view of the very serious shortage of supplies.¹⁰⁹ Other challenges to compliance with social distancing rules are overcrowded housing, the scarcity of public transport services, which facilitates their overuse, and issues related to the risk perception of the public.

66.  In the workplace, to guarantee physical distancing, certification of the conditions and number of employees in workplaces was required. It was also stressed that non-compliance would lead to administrative sanctions.¹¹⁰

67.  Resolution 128/20 of the Health Ministry dated 12 May 2020 imposed the mandatory use of face coverings when individuals were ‘outside of their homes or place of residence’.¹¹¹ Prior to this, the Government had required people to wear a face mask in March and April 2020, imposing fines based on legal provisions not published in the Government’s Official Gazette, and threatened people with prosecution for ‘spreading an epidemic’.¹¹² Before March 2020, the use of masks or face coverings in case of flu and for those who were providing care to sick people was already recommended but not compulsory. However, in Decree 8 of the Council of Ministers on the measures to be implemented for the post-COVID-19 recovery stage of 15 July 2020, the use of masks was still mandatory in public places.¹¹³

68.  As of 23 March 2020, tourists were required to stay in their hotels and those staying in private houses were referred for quarantine in isolation centres. From 24 March 2020, foreigners entering the country were to remain in self-quarantine for 14 days.¹¹⁴ In addition, ‘national epidemiological surveillance tasks were carried out for the early detection of cases’. In this regard, ‘all family, neighbourhood and contacts of confirmed cases were tracked and traced, including follow-up in isolation centres and hospitals throughout the national territory. In addition, international health control measures were implemented at points of entry into the country, and returning individuals were quarantined at designed isolation centres for two weeks after the closure of airspace to commercial flights’.¹¹⁵

69.  As of 9 April 2020, ‘limited autochthonous transmission phase’ (fase de Transmisión Autóctona Limitada de la Covid-19) was declared, and quarantine measures were implemented. Since then, these measures have been continuously adopted according to the epidemiological situation of the different areas in the country. These include the mobility restriction measures, increased activity in the identification, isolation, and treatment of the sick, and disinfection, among others.¹¹⁶ Resolution 82/2020 of the Health Ministry of 9 April 2020 establishes that ‘[t]he quarantine is an epidemiological measure of extraordinary character that is declared upon confirmation of a local transmission of Covid-19, to achieve the mandatory confinement of people and citizen protection.’¹¹⁷

70.  As of 1 April 2020, Cuba extended screening for the diagnosis of Covid-19, including real-time polymerase chain reaction (PCR) and rapid tests, for specific population groups. It is carried out in isolation centres, hospitals, health care units, and communities. PCR tests were applied to all suspected patients—between the third and seventh day of the illness, to the contacts of confirmed cases, to those diagnosed with severe acute respiratory infection, and those who were part of an outbreak of acute respiratory infection. Rapid tests, which offer results within 15–30 minutes from a blood sample, are conducted for all people in the isolation centres and for those who had arrived in the country between 17 March and 23 March 2020, and who had not yet completed 14 days of isolation. In addition, they were applied to people with acute respiratory infection and to a part of the population at risk, such as the elderly who stayed in nursing homes and grandparents’ homes.¹¹⁸

71.  Once the infection was confirmed, drugs such as Interferon Alfa 2B, an antiviral produced by the Cuban medical industry, the CIGB-258 peptide, and Surfacen were administered. MINSAP also provided homeopathic treatment to increase the body’s defences against the virus, a fact that generated criticism both within the scientific community and among citizens.¹¹⁹

72.  Due to the pandemic, additional facilities were made available, such as hospital beds. By the week of 9–16 March 2020, more than 2,400 hospital beds were set aside for Covid-19 cases. These increased in the week of 11–17 May 2020.¹²⁰ Hospital facilities were set up and ‘testing capacity of health laboratories was expanded, isolation centres were created for suspected cases, and protective equipment was provided to health care workers who also received continuous training’. In addition, specific research was initiated to address Covid-19, such as vaccine candidates.

73.  Cuba had five vaccine candidates in early stage trials: Soberana 01, Soberana 02, Mambisa (an intranasal, needle-free vaccine), Abdala, and Soberana Plus—the first vaccine candidate in the world to reach clinical trials in convalescents of Covid-19. They are all protein vaccines: they carry the portion of the spike protein that the virus uses to bind to human cells, which in turn generates neutralizing antibodies that block this binding process.¹²¹ Since May 2021, with no exact date specified, the vaccine candidates Abdala and Soberana 02 have been administered as part of an ‘interventional study’ in ‘population and territories at high risk’.¹²²

74.  From 9 July 2021, after meeting the rigorous standards of ‘quality, safety, and efficacy’, the Centre for State Control of Medicines, Equipment, and Medical Devices (CECMED) approved the authorization for emergency use for the Abdala vaccine, developed by the Centre for Genetic Engineering and Biotechnology (CIGB). On 29 July 2021, mass vaccination began for the ‘population over 19 years of age in territories with epidemiological risk and risk groups at the level of all provinces’.¹²³ Vaccination was not compulsory.

75.  Contact tracing procedures have had an important place in the primary health care structure. Since March 2020, an important work of ‘active screening’ in the detection of cases has been carried out through this structure. This work has involved the participation of healthcare professionals, doctors, nurses, and medical students. Likewise, the model of society in Cuba has allowed an active participation of mass and social organizations such as the Committees for the Defence of the Revolution and the Federation of Cuban Women, among others. The country launched an online self-survey system called Pesquisador Virtual Covid-19.¹²⁴

76.  The country deployed a surveillance model that was considered ‘aggressive’ by the Pan-American Health Organization, due to its ability to curb the pandemic through testing, tracing, and isolation of cases.¹²⁵

77.  Thousands of citizens, close contacts of confirmed cases, were referred to health centres and emergency hospitals were installed in schools, university campuses, and other facilities. In addition, 28,000 medical and dentistry students carried out a ‘door-to-door surveillance’ to identify suspected cases. The web application ‘Pesquisador virtual’ was made available to the public to allow people with symptoms of the disease to report on their health on a voluntary basis. Cuban civil society provided support as well with analytical information about the pandemic through various initiatives.¹²⁶

78.  The elderly group in Cuba exceeds two million people in a population of over 11 million people, of which 15 per cent live alone. There are 293 ‘grandparents’ homes’ throughout the country.¹²⁷ According to the Government, people in this age group have received training on the detection of respiratory infection symptoms and on prevention measures. As highlighted by Huenchuan and Fernández Seco, ‘residences must have a subacute care room in order to isolate suspected cases from the rest of the residents and to refer them to hospital’.¹²⁸ In cases where a quarantine period was required, effective psychological and social work support was provided for elderly residents. Drugs have been distributed in nursing homes—this has been the case with Biomodulin T, a biological immunomodulator, natural-based (not a blood product), composed of specific fractions of bovine thymus, and which has been successfully used as a treatment for repeated respiratory infections for the elderly. Homeopathic products have also been administered, such as PrevengHo-Vir, produced in Cuba and aimed at preventing influenza, dengue, and emerging viral infections.¹²⁹ These were then massively administered but their use was not mandatory.

79.  As also stated by Huenchuan and Fernández Seco, ‘[s]ince March 2020, Cuba has administered treatment to elderly patients to strengthen their immune system. It included preventive interventions in communities and in intensive-care units … The country tracked the most vulnerable population, including people with immunodeficiency, chronic disease or comorbidity, dependency, advanced age (over 80 years), and close contact of caregivers and other cohabitants. In addition, geriatric evaluation of the elderly was strengthened. The health of the elderly was reinforced by a series of drugs administered according to the need and level of complexity of the services.’¹³⁰ Fifteen drugs were produced locally and three were imported. ¹³¹

80.  A broad spectrum of Cuban society has been involved in the implementation and enforcement of the aforementioned measures: top echelons of the Ministry of Public Health, for which State health inspectors were appointed; the National Revolutionary Police (PNR); the Revolutionary Armed Forces and its medical, special troops and prevention services; social and mass organizations (Central de Trabajadores de Cuba, Committees for the Defence of the Revolution, etc); educational institutions; local bodies of the people’s power and provincial authorities (governors, vice-governors, administration councils, etc), inter alia.

81.  The Prosecutor’s Office and the courts have been extremely active in enforcing sanitary and epidemiological provisions, considering the severity of the penalties imposed, which included administrative fines and, in some cases, criminal sanctions for the crime of ‘propagation of epidemics’. As of June 2020, the Attorney General had reported 2,629 criminal proceedings associated with Covid-19-related crimes. Of this number, 1,868 were prosecuted with requests for severe criminal penalties under the current ‘criminal policy’.¹³² According to public information provided by the President of the Supreme Court of Cuba, 1,856 people were prosecuted for violating Covid-19 restrictions, of which 1,839 were fined and 17 were acquitted.¹³³

82.  Law No 41/83 on Public Health, and its regulations, Decree 139/88, states that ‘the measures adopted in emergency hygienic-epidemiological situations are mandatory’. Furthermore, in its section on crimes against public health, the Penal Code provides penalties ranging from fines to imprisonment for anyone who violates these provisions. Citizen support is sought for home isolation, whenever possible.

83.  The measures taken by the Cuban government to combat Covid-19 played a prominent role in terms of compliance by the population. However, the application of administrative and criminal sanctions was negatively highlighted in several digital media outlets.¹³⁴ A study carried out on the level of confidence of the Cuban population showed that ‘in general, the citizen’s assessment of the Cuban government’s response to the COVID-19 pandemic is positive. That is to say, the majority of Cuban citizens trust the government, rating its actions positively.’¹³⁵ In this sense, it was concluded that among ‘the best evaluated measures are those of containment, that is, those of closing borders, the closure of schools and universities and compulsory social isolation through confinement at home’.¹³⁶ The positive assessment in this section was 96.8 per cent of the people surveyed. Similarly, 80.7 per cent of the respondents considered ‘the health emergency measures’ adopted by the government in a positive light, and 75 per cent considered ‘social protection measures’ positively.¹³⁷

Prof. Julio César Guanche Zaldívar

Prof. Elena C. Díaz Galán

Prof. Harold Bertot Triana

Authors’ contributions:

Parts I, II, and III by E C Díaz Galán and H Bertot Triana

Parts IV, V, and VI by J C Guanche.

The authors are grateful to Grupo de investigación de alto rendimiento en Libertad, Seguridad y Ciudadanía en el Orden Internacional de la Universidad Rey Juan Carlos INTERCIVITAS for funding this paper.