[I post this only I distinctly remember watching a documentary in the early 90s about how horribly AIDS patients were treated in Cuba. It got a lot of press at the time, both mainstream and left.]
Financial Times; Feb 17, 2003
WORLD NEWS: Cuba leads way on Aids treatment and prevention
By Clive Cookson in Denver
Cuba has much to teach the world about tackling Aids, the American Association for the Advancement of Science heard yesterday.
A wide-ranging prevention and treatment programme, backed by strong political action, has given the Caribbean country the lowest prevalence of Aids and HIV infection in the western hemisphere - and one of the lowest rates in the world.
Since 1985, when Cuba's first Aids case was diagnosed, 4,500 people have been infected and 1,050 have died of Aids, according to Jorge Perez, the country's leading infectious disease specialist.
Today just 0.03 per cent of the 11m population is HIV-positive. The infection rate in the US was 14 times higher, said Byron Barksdale, director of the Cuba Aids Project, an American medical charity licensed by the US government to circumvent the economic embargo of Cuba for humanitarian reasons.
Monica Ruiz, a public health specialist with the US National Institute for Allergy and Infectious Diseases, said the Cuban experience "shows the important role of political will in dealing with an epidemic. And this is a country where public health is seen very broadly as an important public good".
Cuba took drastic action even before Aids had reached the country. On the advice of Dr Perez, the government set up a National Aids Commission in 1983 and destroyed all foreign-derived blood products.
Although this put a great strain on the country's health system, Dr Perez's "educated hunch" enabled Cuba to escape the transmission of HIV to haemophiliacs and other blood recipients.
As soon as Aids appeared on the island, an aggressive HIV screening programme swung into action, with compulsory testing for all expectant mothers, people with sexually transmitted diseases and sexual contacts of HIV patients.
There was also extensive voluntary testing. More than 20m HIV tests had been performed on the Cuban population since 1986, Dr Barksdale said. At the same time condoms were introduced to prevent sexual transmission.
The most controversial part of the programme was compulsory quarantining of everyone who tested positive in special HIV sanatoria. This was relaxed in 1994, but anyone newly diagnosed still had to go to a sanatorium for "eight weeks of education," Dr Barksdale said.
Treatment of Cuban Aids patients has improved greatly over the past two years, because the country's pharmaceutical industry has started producing generic copies of the main anti-HIV medicines.
The next challenge will be to maintain and improve Cuba's HIV/Aids programme in the face of an enormous increase of tourism.
www.ft.com/science