Degrowth and public health in Cuba: lessons from the past?
Highlights
► The economic crisis in Cuba in the 1990s as case study for possible future transitions towards degrowth. ► Positive results: public health and human well-being can be maintained or improved when prioritized. ► Unsolved problem: how to reconcile fundamental restructuring processes with democratic principles.
Section snippets
Introduction: the special period and degrowth
The concept of degrowth emerged in the 1970s when scholars like Nicholas Georgescu-Roegen and Herman Daly challenged the conventional economic concept that unlimited economic growth was possible on a finite planet (Georgescu-Roegen, 1971, Daly, 1977).
In 1972 the Limits to Growth, written mainly by Dennis and Donella Meadows at the Massachusetts Institute of Technology, concluded that continued trends in resource utilization and waste production would eventually lead to socio-economic collapse.
Material and methods
This paper analyzes how the Cuban society adapted to a prolonged economic crisis and how the coping strategies allowed a remarkably positive health outcome. The focus is principally on health, because public health in Cuba at the period of difficult economic transition offers some impressive successes worth considering. It also provides a plausible indicator of well-being in general. Health, with its combination of material, physical, social and psychological aspects, is a reasonably
The crisis
In 1989, the collapse of the Soviet Bloc abruptly upset a Cuban economy, which relied heavily on foreign trade, conducted at preferential terms within the Soviet Bloc. Almost overnight, Cuba saw the end of a system which had supplied 85 percent of its imports. Between 1990 and 1993, overall imports shrank by 75% and oil imports were cut in half (Table 1). This loss of oil was doubly disastrous because since 1983 Cuba had resold part of the oil imported at below-market price which had turned
Health care
A consistent commitment of the government to universal access to high quality health care reflected a commitment to Socialist humanitarianism but was also tied to the political agenda of the post-1959 government where public health was adopted as an arena for national prestige and as a foreign policy instrument. Achieving excellent public health data and creating a modern, universal and effective health care system were seen as priority challenges after the 1959 revolution and undeniable
Relevance to degrowth
Can the Special Period in Cuba serve as a model for a degrowth scenario that presupposes economic crisis as an entry? The Cuban reaction to a drastic decline in material resources and finances, a reliance on local economies, promotion of labor-intensive activities and reduction of any type of consumption, resonates with visions of a socially and environmentally sustainable economy. Indeed, key policies look eerily like the “macro-economic interventions needed to achieve ecological and economic
Conclusions
Accepting the Cuban Special Period as one degrowth trajectory provides some valuable lessons for possible transitions:
- 1.
Cuba was able to maintain public health even under extremely difficult circumstances because health was an uncontested priority. Safeguarding human well-being during a transition period will require a strong sense of priority which guides difficult policy decisions.
- 2.
To a large extent fossil fuels could be replaced by biological energy (walking, cycling, animal traction) even in a
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