THE Caribbean Development Bank is preparing to finance health sector initiatives in the Caribbean for the first time in decades, as regional governments face uncertainty over the future of Cuban medical missions.

Speaking at the bank’s annual news conference in Barbados last week, CDB President Daniel Best said the institution’s newly approved 2026-2035 strategic plan now formally recognises health as an area in which the regional lender may intervene — a notable shift for an institution traditionally focused on infrastructure, climate resilience, and economic development.

“For the first time in quite some time in the Caribbean Development Bank’s history we have actually included health as a sector that we would intervene in,” Best said.

The issue surfaced during the conference when a journalist asked how Caribbean countries might cope if Cuban medical practitioners were to exit the region.

Days later, Jamaica announced it would discontinue its decades-old medical cooperation programme with Cuba after the two countries failed to reach agreement on new terms following the expiration of their previous arrangement.

For decades the programme helped fill critical staffing gaps in Jamaica’s public health system, providing doctors, nurses, and specialists who served in hospitals and clinics across the island.

The decision has already triggered visible ripple effects. At the Jamaica-Cuba eye care clinic at St Joseph’s Hospital in St Andrew, large numbers of patients recently turned out seeking treatment ahead of the anticipated departure of Cuban specialists who have long supported the programme.

Similar concerns have surfaced elsewhere in the Caribbean, where several health systems rely heavily on Cuban medical personnel to fill shortages in specialised care.

The issue has also drawn wider geopolitical attention. In recent years the United States has stepped up criticism of Cuba’s overseas medical missions, alleging that the programme amounts to forced labour — an accusation Cuba and many Caribbean governments have rejected.

Some countries in the region have since begun reviewing how their arrangements with Cuban medical professionals are structured, with several exploring the option of hiring doctors directly rather than through State-to-State agreements.

Best acknowledged that such shifts could create development challenges for small island states already grappling with workforce shortages and rising health-care costs.

“With Cuban medical practitioners perhaps exiting the region, this could certainly become a developmental issue,” he said. “And as the region’s development bank, we are here to support our countries.”

While the CDB is not preparing to directly build hospitals or manage medical programmes, Best said the bank intends to support governments through partnerships, technical assistance, and financing aligned with national development strategies.

“This is not to say that we are going to rush over there and build a lot of hospitals,” he said, noting that the bank currently lacks the specialised expertise required to supervise large medical infrastructure projects.

Instead, potential interventions would likely emerge through the bank’s country engagement strategies — the frameworks used to guide development financing in borrowing member states.

“If they capture within that the health concerns or challenges within the health sector, then we will seek to respond, whether directly or through partnership,” Best said.

The shift reflects a growing recognition that health outcomes are increasingly shaping economic resilience across the Caribbean.

Several countries in the region face some of the world’s highest rates of non-communicable diseases, such as diabetes, hypertension, and heart disease — conditions that place significant strain on national health systems and public finances.

Best pointed to Barbados as an example, noting that the country consistently ranks high in global statistics on chronic illnesses.

“For Barbados and some of our other Caribbean countries, health is actually a developmental issue,” he said.

broader development implications

Under the bank’s new strategic plan, health falls within its wider push to strengthen social resilience, one of three pillars guiding the institution’s work over the next decade alongside economic and environmental resilience. The approach reflects a broader shift in development thinking, with institutions increasingly recognising that economic growth depends heavily on the strength of human capital, including access to reliable health care.

For Caribbean governments already operating under tight fiscal constraints, the possibility of development financing for health sector improvements could become increasingly relevant if pressures on medical systems intensify. And as the region grapples with ageing populations, chronic disease burdens, and uncertainty surrounding long-standing medical cooperation arrangements, health is emerging as a new frontier in Caribbean development policy.