On July 27 the U.S. Department of State released its 2015 Trafficking in Persons Report, which is “the U.S. Government’s principal diplomatic tool to engage foreign governments on human trafficking” and “ the world’s most comprehensive resource of governmental anti-human trafficking efforts.”
In this Report, the Department placed 187 countries into one of the following four tiers based on the extent of their governments’ efforts to comply with the “minimum standards for the elimination of trafficking” found in Section 108 of the Trafficking Victims Protection Act:
- “TIER 1 [Thirty-one] countries whose governments fully comply with the Trafficking Victims Protection Act’s (TVPA) minimum standards.
- TIER 2 [Eighty-nine] countries whose governments do not fully comply with the TVPA’s minimum standards, but are making significant efforts to bring themselves into compliance with those standards.
- TIER 2 WATCH LIST [Forty-four] countries whose governments do not fully comply with the TVPA’s minimum standards, but are making significant efforts to bring themselves into compliance with those standards AND: a) The absolute number of victims of severe forms of trafficking is very significant or is significantly increasing; b) There is a failure to provide evidence of increasing efforts to combat severe forms of trafficking in persons from the previous year; or c) The determination that a country is making significant efforts to bring itself into compliance with minimum standards was based on commitments by the country to take additional future steps over the next year.
- TIER 3 [Twenty-three] countries whose governments do not fully comply with the minimum standards and are not making significant efforts to do so.”
At the Department’s release of this Report, Secretary of State John Kerry made comments. In part, he said, “the purpose of this document is not to scold and it’s not to name and shame. It is to enlighten and to energize, and most importantly, to empower people. . . . [We] want to bring to the public’s attention the full nature and scope of a $150 billion illicit trafficking industry. . . . We want to provide evidence and facts that will help people who are already striving to achieve reforms to alleviate suffering and to hold people accountable. We want to provide a strong incentive for governments at every level to do all that they can to prosecute trafficking and to shield at-risk populations.”
Additional comments and responses to journalists’ questions were provided at the launch of this Report by Sarah Sewell, Under Secretary of State for Civilian Security, Democracy and Human Rights. She pointed out that “in this year’s report, some 18 countries moved up in the tier rankings, some 18 countries moved down in the tier rankings” and quoted the above statutory definitions of the different rankings.
The Report’s Assessment of Cuba’s Record on Human Trafficking
In the 2015 Report Cuba was placed in the Tier 2 Watch List, which was an upgrade from the prior year’s report that had Cuba in Tier 3. The new Report states that although “information on the scope of sex trafficking and forced labor in Cuba is limited, [c]hild sex trafficking and child sex tourism occur within Cuba. Cuban authorities report people from ages 13 to 20 are most vulnerable to human trafficking in Cuba. Traffickers also subject Cuban citizens to forced prostitution in South America and the Caribbean. . . . “
As a result, the Report concludes, “The Government of Cuba does not fully comply with the minimum standards for the elimination of trafficking; however, it is making significant efforts to do so. For the second consecutive year, the government reported efforts to address sex trafficking, including the prosecution and conviction of 13 sex traffickers in 2013 and the provision of services to victims in those cases. The Cuban government reported at the beginning of 2015 that the Ministry of Labor and Social Security assumed the lead role in a committee responsible for combating gender and sexual violence, including sex trafficking. The penal code does not criminalize all forms of human trafficking, though the government reported continuing efforts to amend its criminal code, including bringing it into conformity with the requirements of the 2000 UN TIP Protocol, to which it acceded in July 2013. . . .”
In addition, the Report states the Cuban “government did not report any trafficking-specific shelters, but offered services to trafficking victims through centers for women and families harmed by violence. The Federation of Cuban Women, a government affiliated non-governmental organization, provided some outreach and education about human trafficking within the context of violence against women, but did not specifically address it as a crime involving sex trafficking and forced labor or affecting men and boys.”
The Report’s forced labor allegation is focused on Cuba’s “foreign medical missions, which employ more than 51,000 workers in over 67 countries and constitute a significant source of Cuban government income. Some participants in foreign medical missions as well as other sources allege that Cuban officials force or coerce participation in the program; [but] the Cuban government denies these allegations. Some Cubans participating in these work missions have stated the postings are voluntary and well paid compared to jobs within Cuba. There have also been claims that Cuban authorities coerced participants to remain in the program, including by allegedly withholding their passports, restricting their movement, or threatening to revoke their medical licenses or retaliate against their family members in Cuba if participants leave the program. There are also claims about substandard working and living conditions and the existence of ‘minders’ to monitor victims outside of work. Some medical professionals participating in the missions are in possession of their passports when they apply for and obtain special United States visa and immigration benefits, indicating passport retention is not a consistent practice across all work missions.”
Consistent with its denial that its foreign medical missions involve forced labor, the Cuban government “did not recognize forced labor as a problem within Cuba and did not report efforts to prevent forced labor.”
The Report goes on to make the following recommendations for Cuba: (1) “draft and pass a comprehensive anti-trafficking law that prohibits all forms of human trafficking, including an offense of forced labor;” (2) “vigorously investigate and prosecute sex trafficking and forced labor offenses;” (3) “schedule a visit and engage in robust discussions with the UN special rapporteur on trafficking in persons on all forms of human trafficking;” (4) “provide specialized training for managers in state owned or controlled enterprises in identifying and protecting victims of forced labor and implement policies to verify the absence of coercion in such enterprises;” (5) “train those responsible for enforcing the labor code to screen for trafficking indicators and educate workers about trafficking indicators and where to report trafficking-related violations;” (6) “strengthen efforts, in partnership with international organizations, to provide specialized victim identification and referral training for first responders; (7) establish formal policies and procedures to guide officials in the identification of all trafficking victims and their referral to appropriate services;” (8) “expand upon the Ministry of Labor and Social Security’s anti-trafficking responsibilities to include all forms of trafficking and male as well as female victims, and develop an action plan to address sex trafficking and forced labor for males and females;” and (9) “adopt policies that provide trafficking-specific, specialized assistance for male and female trafficking victims, including measures to ensure identified sex and labor trafficking victims are not punished for unlawful acts committed as a direct result of being subjected to sex trafficking or forced labor.”
Under Secretary Sewell, elaborating on this assessment of Cuba in response to a journalist’s question, said, “Cuba was upgraded to the Tier 2 Watch List because of the progress that the government’s made in addressing and prosecuting sex trafficking, as well as the commitments that the Cuban Government has made to become compliant with the minimum standards. As noted in other cases, a Tier 2 Watch List ranking does not mean that a country is free from problems or free from human trafficking.”
According to Sewell, the Cuban “government reported significant efforts to address sex trafficking, including the conviction of sex traffickers, the provision of services to sex trafficking victims, and continued efforts of the ministry of tourism to address sex tourism and the demand for commercial sex. We also recognize the commitments the government has made to reform its laws to become compliant with the UN Palermo Protocol, which is a significant step, as well as the Cuban Government’s willingness to welcome the UN special rapporteur to the island.”
Nevertheless, Sewell continued, the U.S. has “a number of concerns such as the failure to recognize forced labor as a problem or to act to combat it. And so this will be very much a topic in our dialogue with Cuban officials as we work over the next year to try to help Cuba make more concrete progress in the realm of human trafficking.”
Reactions to the Report’s Assessment of Cuba
News media immediately highlighted the Report’s upgrades of Malaysia and Cuba, and a New York Times editorial was most critical of the assessment of Malaysia. Some U.S. Senators and Representatives launched criticism of those assessments in particular. Prominent with respect to Cuba, as expected, was Senator Robert Menendez (Dem., NJ), who said that by upgrading Malaysia and Cuba the administration had “elevated politics over the most basic principles of human rights” and vowed to do all he could “from hearings to legislation to investigations” to challenge the moves.” Representative Chris Smith (Rep., NJ) was upset by the same upgrades as well as relatively lenient ratings for Vietnam and China and stated the report had “careened off into a new direction where the facts regarding each government’s actions in the fight against human trafficking are given almost no weight when put up against the president’s political agenda.” Similar criticism came from Senator Marco Rubio (Rep., FL). 
A Reuters investigation concluded that the State Department’s office responsible for the TIP reports was overruled by senior Department officials on 14 of the 18 upgrades, including Malaysia, Cuba, China, India, Uzbekistan and Mexico. The final decision on disputed rankings this year, said Reuters, was made in meetings attended by some of the State Department’s most senior diplomats, including Deputy Secretary of State Tony Blinken, Under Secretary of State for Political Affairs Wendy Sherman and Kerry’s Chief of Staff, Jonathan Finer.
On July 29 the Chairman (Bob Corker (Rep., TN)) and the Ranking Member (Ben Cardin (Dem., MD)) of the Senate Foreign Relations Committee in a joint letter asked Secretary of State John Kerry for a briefing on the Report in order “to better understand” the basis for its upgrade of several countries, including Malaysia and Cuba. They added, “We recognize that U.S. policy and engagement on trafficking does not exist in a vacuum, and we appreciate the many varied and nuanced trade-offs that are necessary between competing policy issues. We also believe that it is critical that the impartial reliability of the TIP Report be safeguarded and maintained if it is to have utility on this critical issue in the future.” 
Senate Foreign Relations Committee Hearing
On August 6 that Committee held a hearing on this subject with Under Secretary Sewell as its sole witness.
She testified that in “most cases, this assessment process [of different countries’ record on human trafficking] clearly places governments into one of the tiers; in other cases, further discussion among senior Department officials is required to clarify information and assess the totality of government efforts. This ultimately leads to the Secretary of State’s designation of Tier rankings for each country and approval of the TIP Report. Tier rankings do not assess the severity of human trafficking in a given country, but rather that government’s efforts in addressing human trafficking problems over the current reporting period compared to its own efforts in the prior year. Determinations about the direction and quality of that progress in a given country are guided by complex criteria outlined in the TVPA and described on pages 45 through 50 of the TIP Report.”
More specifically for the six countries, including Cuba, that moved up to Tier 2 Watch List this year, Sewell testified, “the Department closely evaluated the efforts those governments had made during the reporting period as well as the commitments they made for next year. Our posts are working with host governments to encourage them to implement the recommendations outlined in this year’s Report, and the TIP Office is finalizing assistance programming strategy to help make those recommendations a reality. I am receiving reports from the field on the frank and focused dialogues Embassy personnel are having with host government officials on how to overcome the challenges they face to better combat this crime and protect their citizens.”
With only Chairman Corker, Ranking Member Cardin and Senator Menendez in attendance, most of the questions focused on the upgrade of Malaysia. Corker, for example, said, “The administration’s policies toward those countries trumped any real regard for humans being trafficked.” The Department, he continued, “threw the trafficking phase under the bus to ensure that . . . [the Administration was] successful with [the Trans-Pacific Partnership (TPP) that included Malaysia].”  Menendez added a few comments and questions about the Cuba upgrade.
Sewell declined to answer questions about internal Department discussions about these upgrades and instead repeatedly emphasized that the statutory framework for tier rankings created a complex set of factors to be analyzed and that a Tier 2 Watch List ranking did not indicate a country had a great record on trafficking.
At the conclusion of the hearing, Chair Corker said it had been the “most heartless, lacking of substance” presentation and that he and the two other Senators in attendance had the strong impression that inappropriate political considerations had influenced some or all of the tier upgrades. As a result, the Committee would be asking for the Department to produce records about its internal consideration of the tier rankings. Senator Cardin also said he was interested in exploring whether Congress should amend the relevant statutes in light of what a further hearing might disclose.
After the hearing, a State Department spokesman said that the Department was waiting for the committee to submit a formal request, “but speaking generally, of course we try to be responsive to Congress.”
I agree that the annual T.I.P. reports are important tools in combatting trafficking in persons and that these reports should be free of political influence. On the other hand, I believe that the relevant statutes appropriately create a complex set of factors that require analysis in reaching conclusions about placing countries in the different tiers and that it is appropriate for senior Department officials to be involved in that process.
With respect to Cuba, for at least the following reasons I disagree with the Report’s assertion that Cuban medical personnel’s participation in foreign medical missions is illegal forced labor:
- First, the Report admits that “information on the scope of . . . forced labor in Cuba is limited.”
- Second, the Report admits that there is conflicting information and allegations on the foreign medical mission work. Coercion is alleged by “some participants” and “other sources.” On the other hand, the Cuban government denies these allegations, and other participants “have stated the postings are voluntary and well paid compared to jobs within Cuba.” The Report also concedes there is conflicting information on whether other means, including withholding Cuban passports, are used to coerce or force participants to remain in the program.
- Third, there apparently has not been any fair adjudicative process to determine which of these conflicting sets of information is valid.
- Fourth, the accusation of forced labor for such participants has been rejected in a study by Indiana State University’s Emeritus Professor of International Politics and Latin America, Dr. H. Michael Erisman. He says, although there may be “some cases where . . . [Cuban medical professionals] are pressured into accepting overseas assignments, . . . most evidence indicates that the overwhelming majority are motivated by philosophical and/or pragmatic considerations. In the first instance, one needs to understand that the Cuban medical profession . . . is permeated by norms which stress self-sacrifice and service to the community, both at home and abroad. At the core of this ethos is the principle, which is firmly entrenched in the curriculum of the island’s medical schools and reinforced throughout one’s career, that health care should not be seen as a business driven by a profit motive, but rather as a human right that medical personnel have an unconditional duty to protect. Such convictions often underlie participation in the medical aid brigades. There are, however, also some pragmatic factors that can come into play. Overseas service could . . . help to further one’s professional aspirations and for some assignments the total remuneration involved is more generous than what is available back in Cuba. . . . [T]hese are the considerations which apply to the vast majority of people” in such programs, not involuntary servitude.
- Fifth, the Report does not cite to the relevant legal definition of “forced labor” to assess this claim. Most pertinent is Article 2(2) of the Forced Labour Convention, 1930, which states, in part, ”the term forced or compulsory labour shall not include . . . any work or service which forms part of the normal civic obligations of the citizens of a fully self-governing country.” (Emphasis added.)  Cuba is a “fully self-governing country” and the participants in the foreign medical missions are Cuban “citizens,” and as Professor Erisman states, such participation is regarded as “part of the normal civic obligations” of such citizens with the appropriate medical qualifications.
- Sixth, relevant to this issue, but not mentioned in the Report, is the fact that medical education in Cuba (at the Latin American School of Medicine) is free. As a result requiring medical graduates to pay the country back by such participation seems entirely appropriate and may indeed be a contractual or quasi-contractual obligation. Indeed, as Professor Erisman reports, Cuban medical professionals, especially doctors, may apply to leave Cuba after they have obtained their free medical education and thereafter provided three to five years of service in the country.
We now await the Committee’s formal request for Department documents, the production of such documents and additional hearings on the subject. In the meantime, as always, I welcome comments of correction or amplification.
 A prior post examined in detail the prior human trafficking report about Cuba.
 Reuters, U.S. Softens View of Malaysia, Cuba in Human Trafficking Report, N.Y. Times (July 27, 2015); Reuters, Obama Administration Faces Criticism Over Human Trafficking Report, N.Y. Times (Aug. 3, 2015); Editorial: Obama Administration Ignores Malaysia’s Trafficking Record, N. Y. Times (July 31, 2015); Menendez, Press Release: Sen. Menendez on Human Trafficking Report Politicization (July 27, 2015); Rubio, Press Release: Rubio: State Department’s Human Trafficking Report Should Be Based on Reality Not Politics (July 27, 2015).
 Reuters, Special Report-U.S. State Department Watered Down Human Trafficking Report, N.Y. Times (Aug. 3, 2015).
 Reuters, Lawmakers Want State Briefing on Trafficking Report, N.Y. Times (July 29, 2015); U.S. Sen. Foreign Relations Comm., Press Release: Senators Cardin and Corker Request Briefing on State Department’s Trafficking in Person Report in Letter to Secretary Kerry (July 29, 2015); Reuters, Lawmakers to Demand Full Accounting on Human Trafficking Report, N.Y. Times (Aug. 4, 2015).
 Senate Foreign Relations Comm., Review of the 2015 Trafficking in Persons Report (Aug. 6, 2015); Hattem, Senators accuse State Dept. of picking politics over human trafficking, The Hill (Aug. 6, 2015); Reuters, Top Senator Demands State Department Documents on Human Trafficking Report, N.Y. Times (Aug. 6, 2015); Assoc. Press, Senators Demand Documents Over Malaysia Trafficking Upgrade, N.Y. Times (Aug. 6, 2015); Corker, Corker Fears Politicization of State Department’s 2015 Human Trafficking Report Over Questionable Upgrades (Aug. 2015); Cardin, Senator Cardin Statement Regarding 2015 Human Trafficking Report (Aug. 6, 2015).
 Sarah Sewell, Testimony to Senate Foreign Relations Committee (Aug. 6, 2015).
 Secretary of State Kerry, who was in Malaysia on the day of the hearing, categorically denied that politics had played any role in the ranking of Malaysia. “I personally signed off on it. And I had zero conversation with anybody in the administration about the Trans-Pacific Partnership relative to this decision — zero. The reason I made this decision was based on the recommendation of my team, because Malaysia has passed additional legislation in 2014, they’ve consulted with civil society, they drafted amendments to Malaysia’s anti-trafficking law in order to allow the country’s flawed victim protection regime to change.” (Assoc. Press, Kerry: Malaysia Trafficking Upgrade Not Due to Trade Talks, N.Y. Times (Aug. 6, 2015); Reuters, Kerry Says ‘Zero Communication’ on Trade Pact and Malaysian Trafficking Record, N.Y. Times (Aug. 6, 2015).
 The text of the U.S. statutes regarding trafficking in persons is set forth on a State Department web page and the Report contains a summary of “forced labor” without any mention of the exceptions to the definition discussed below.
 Erisman, Brain Drain Politics: the Cuban Medical Professional Parole Programme, Int’l J. Cuban Studies 269, 286-87 (2012).
 This and other parts of the definition of “forced or compulsory labour” were reaffirmed in Article 1(3) of the Protocol of 2014 to the Forced Labour Convention, 1930.
11 thoughts on “U.S. Upgrades Cuba in State Department’s Annual Report on Human Trafficking”
The Minnesota Cuba Committee is in the process of getting Congressional support (Minnesota Congressional Delegation) and approval for a letter to the State Dept and the Administration calling on them to end the Cuba Medical Professional Parole Program which works to coerce Cuban doctors away from their mission of providing health care to the poor of developing countries. They do this by offering free visas, green cards, internships and jobs and a free path to US citizenship. We are looking for help in this effort. Please call Greg Klave or e-mail firstname.lastname@example.org to offer further assistance. 763-228-2899
Comment: Cuba’s International Medical Mission Doctors’ Reflections
According to Granma, Cuba’s Communist Party’s newspaper, “Internationalist medical aid has been a longstanding part of the Cuban people’s tradition of solidarity, since the beginning of the Revolution. As early as 1960 a brigade was sent to Chile following an earthquake there, and to Algeria in 1963, to support the new country recently liberated from colonialism.” The Granma article included the reflection of four Cuban doctors who have participated in such missions and who treasure the positive impact of those experiences on their professional and personal lives.
Ledn, Cuban doctors share their experiences in internationalist missions, Granma (Nov. 26, 2015), http://en.granma.cu/cuba/2015-11-26/cuban-doctors-share-their-experiences-in-internationalist-missions.