On June 30, 2016, the U.S. Department of State released its 2016 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.”
For this Report, “severe forms of trafficking in persons” is defined in the U.S. Trafficking in Persons Victims Act (TVPA) as:
- “sex trafficking in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age; or
- “the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.”
In this Report, the Department placed 188 countries (including the United States) into the following four tiers plus “Special Cases” (Libya, Somalia and Yemen) 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 TVPA:
- TIER 1  “countries whose governments fully meet the . . . [TVPA’s] minimum standards.”
- TIER 2  “countries whose governments do not fully meet the TVPA’s minimum standards, but are making significant efforts to meet those standards.”
- TIER 2 WATCH LIST  “countries whose governments do not fully meet the TVPA’s minimum standards, but are making significant efforts to meet 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, including increased investigations, prosecution, and convictions of trafficking crimes; increased assistance to victims; and decreasing evidence of complicity in severe forms of trafficking by government and convictions of trafficking crimes; or c) The determination that a country is making significant efforts to meet the minimum standards was based on commitments by the country to take additional future steps over the next year.”
- TIER 3  “countries whose governments do not fully meet the minimum standards and are not making significant efforts to do so.”
Susan Coppedge, the U.S. Ambassador-at-Large to Monitor and Combat Trafficking in Persons, made remarks at the ceremony. She said the Report was the U.S.’ “principal diagnostic tool to assess government efforts across what we call the three Ps: prosecution, protection and empowerment of victims, and preventing future trafficking crimes.” She also said there had been 27 downgrades in this Report compared with the prior report and 20 upgrades. In addition, she responded to journalists’ questions, but none was asked about Cuba.
The Report’s Assessment of Cuba’s Record on Human Trafficking 
In the 2016 Report Cuba was again placed in the Tier 2 Watch List with the following explanation.
“Cuba is a source and destination country for adults and children subjected to sex trafficking and forced labor. Child 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 the country. Traffickers also subject Cuban citizens to sex trafficking and forced labor in South America and the Caribbean. The government indirectly acknowledged the presence of foreign national trafficking victims in Cuba. The government is the primary employer in the Cuban economy, including in foreign medical missions that employ more than 84,000 workers and constitute a significant source of Cuban government revenue. Some participants in foreign medical missions and other sources allege Cuban officials force or coerce participation in the program; however, the Cuban government and some participants say the program is voluntary and well paid compared to jobs within Cuba. The government uses some high school students in rural areas to harvest crops and does not pay them for their work but claims this work is not coerced.”
“The Government of Cuba does not fully meet the minimum standards for the elimination of trafficking; however, it is making significant efforts to do so. Despite these measures, the government did not demonstrate overall increasing antitrafficking efforts compared to the previous reporting period; therefore Cuba is placed on Tier 2 Watch List for the second consecutive year. The government reported continued efforts to address sex trafficking, including the prosecution and conviction of 18 sex traffickers in 2014 (the most recent available data) and the provision of services to 13 victims in those cases. The government publicly released a written report on its anti-trafficking efforts in October 2015. Multiple ministries engaged in anti-trafficking efforts, including the Ministries of Justice, Information Science and Communication, Interior, Foreign Affairs, Education, Tourism, Labor and Social Security, Culture and Health, and the attorney general’s office. The penal code does not criminalize all forms of human trafficking, although the government reported its submission of some trafficking-related penal code amendments to the National Assembly for review during the reporting period. The Cuban government was more transparent in providing details of anti trafficking efforts and the government’s overseas medical missions program. However, the government did not prohibit forced labor, report efforts to prevent forced labor, or recognize forced labor as a possible issue affecting its nationals in medical missions abroad. The government provided funding for child protection centers and guidance centers for women and families, which serve all crime victims, including trafficking victims. These centers had the ability to screen cases, make referrals to law enforcement, assist with arranging cooperation with law enforcement up to prosecution, and provide victim services.”
“RECOMMENDATIONS FOR CUBA”
“Draft and enact a comprehensive anti-trafficking law that prohibits and sufficiently punishes all forms of human trafficking, including forced labor, sex trafficking of children ages 16 and 17, and the full range of trafficking “acts” (recruiting, transporting, transferring, harboring, or receiving persons); vigorously investigate and prosecute both sex trafficking and forced labor offenses; provide specialized training for managers in state-owned or controlled enterprises in identifying and protecting victims of forced labor; implement policies to prohibit force, fraud, or coercion in recruiting and retaining employees in such enterprises; 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; draft and adopt a comprehensive written national anti-trafficking action plan and dedicate resources to implement it in partnership with international organizations; provide specialized victim identification and referral training for first responders; establish formal policies and procedures to guide officials in the identification of all trafficking victims and their referral to appropriate services; 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; and schedule a visit and cooperate with the UN special rapporteur on trafficking in persons.”
“PROSECUTION: The government sustained law enforcement efforts by prosecuting and convicting sex traffickers, but took no action to address forced labor. The penal code does not criminalize all forms of trafficking, in particular forced labor and sex trafficking of children ages 16 and 17. The government did not report any labor trafficking investigations, prosecutions, or convictions. In January 2016, the government reported it was in the process of amending the code, including submitting amendments to the National Assembly to raise the age of consent; it is unclear whether the government will make additional amendments to improve the legal framework to address trafficking. Cuba prohibits some forms of trafficking through several penal code provisions, including: article 302 (procuring and trafficking in persons); article 310.1 (corruption of minors younger than 16 for sexual purposes); article 312.1 (corruption of minors younger than 16 for begging); and article 316.1 (sale and trafficking of a child younger than 16). The penal code’s definition of sex trafficking conflates sex trafficking with prostitution and pimping. The law criminalizes inducement to or benefiting from prostitution, but treats force, coercion, and abuse of power or vulnerability as aggravating factors rather than an integral part of the crime. Legal provisions addressing “corruption of minors” criminalize many forms of child sex trafficking but define a child as an individual younger than 16 years of age; below the age set in international trafficking law, which is 18 years of age. Forced prostitution is illegal irrespective of the victim’s age, and the government has reportedly prosecuted individuals benefiting from child sex trafficking. Provisions for adult and child sex trafficking do not explicitly criminalize the acts of recruitment, transport, and receipt of persons for these purposes. In December 2013, the government amended article 346.1 of the criminal code to mandate sentences of five to 12 years’ imprisonment for various crimes, including for laundering funds obtained from trafficking in persons. Labor code article 116 prohibits entities from directly establishing labor relations with adolescents younger than age 17, even if adolescents may be authorized to join the work force.”
“In 2015, the government publicly presented official data on 147 prosecutions and convictions of sex traffickers during calendar year 2014, the most recent data available. Authorities reported 13 prosecutions and 18 convictions of sex traffickers, compared with 13 prosecutions and convictions in 2013. At least nine convictions in 2014 involved suspects accused of subjecting children to trafficking within Cuba, including the facilitation of child sex tourism in Cuba. The average sentence was seven years’ imprisonment. The government also identified a group of Cubans abroad recruiting and transporting women with false promises of employment and fraudulent work contracts in order to subject the victims to debt bondage and forced prostitution. The government has not sought extradition in this case, and therefore no prosecutions or convictions of suspected traffickers in Cuba have resulted. Students at the Ministry of Interior Academy and police assigned to tourist centers reportedly received specific anti-trafficking training and victim assistance. The government demonstrated its willingness to cooperate with other governments on investigations of possible traffickers. The government arranges for high school students in rural areas to harvest crops and allegedly forces or coerces participation in medical missions, but it denies such claims. The government did not report any investigations, prosecutions, or convictions of government officials complicit in human trafficking in 2014.”
“PROTECTION: The government sustained efforts to protect sex trafficking victims, but did not make efforts to identify or protect victims of forced labor. Authorities identified 11 child sex trafficking victims and four adult sex trafficking victims in 2014; it did not identify any labor trafficking victims or male sex trafficking victims. Identified sex trafficking victims received government assistance; detailed information on assistance provided to the 15 identified victims was unavailable. Other government-organized NGOs, like the Federation of Cuban Women (FMC), the Prevention and Social Assistance Commission, and the Committees for the Defense of the Revolution contributed by identifying victims of trafficking to state authorities and providing victim services. Independent members of civil society expressed concern about the government’s anti-trafficking efforts and limited information on the scope of sex trafficking and forced labor in Cuba given sparse independent monitoring by NGOs and international organizations. The government reportedly developed procedures to proactively identify sex trafficking victims, whereby first responders work with social workers to identify potential cases and refer them to law enforcement.”
“The government did not report having procedures to proactively identify victims of forced labor. Some participants in foreign medical missions and other sources allege Cuban officials force or coerce participation in the program; however, the government and other participants have stated the postings are voluntary. In support of their applications to receive immigration benefits from the United States, some Cubans working in missions abroad have stated Cuban authorities withheld their passports and restricted their movements. At the same time, some participants who left medical missions abroad have been able to obtain new passports from their embassies in neighboring countries. There have also been reports that Cuban authorities coerced participants to remain in the program by allegedly threatening to revoke their medical licenses or retaliate against their family members if participants leave the program. Reports of substandard working and living conditions and the presence of “minders” to monitor medical professionals outside of work also continued. Last year, Cuba reinstituted restrictions on travel for specialized doctors and some medical personnel, requiring them to obtain an exit permit from their superiors before leaving the island. On September 9, 2015, the government agreed to reinstitute medical personnel that left their positions while abroad. As of April 1, 2016, the Cuban authorities claimed that 274 medical professionals returned to Cuba and were rehired at the same salary and level of responsibility.”
“The FMC received funding from international organizations and operated centers for women and families nationwide to assist individuals harmed by violence, including victims of sex trafficking. These centers provided services such as psychological treatment, health care, skills training, and assistance in finding employment. The government reportedly developed a referral process to transfer trafficking victims to law enforcement custody, secure evidence for prosecutions, and provide victim services and follow-on care. Neither the government nor the government-organized NGOs operated shelters or provided services specifically for male trafficking victims. Police encouraged child sex trafficking victims younger than age 16 to assist in prosecutions of traffickers by gathering children’s testimony through psychologist-led videotaped interviewing, usually removing the need for children to appear in court. There were no reports of the government punishing sex trafficking victims for unlawful acts committed as a direct result of being subjected to human trafficking. The government indirectly acknowledged the existence of some foreign trafficking victims in Cuba.”
“PREVENTION: The government sustained prevention efforts to combat sex trafficking; however, authorities did not make efforts to prevent or address the demand for forced labor. The attorney general’s office continued to operate a 24-hour telephone line for individuals needing legal assistance, including sex trafficking victims, and received calls related to potential trafficking cases in 2015 that led to investigations. State media continued to produce newspaper articles and television and radio programs to raise public awareness about sex trafficking. Authorities maintained an office within the Ministry of Tourism charged with monitoring Cuba’s image as a tourism destination, combating sex tourism, and addressing the demand for commercial sex acts. The Cuban government cooperated with foreign law enforcement in investigating foreign citizens suspected of sexual crimes against children, including child sex trafficking. Under Cuban law, authorities may deny entry to suspected sex tourists and expel known sex offenders, but reported no related convictions in 2014. The government did not report whether it provided anti-trafficking training for its diplomatic personnel. The government publicly released a written report on its anti-trafficking efforts in October 2015. In March 2015, authorities invited the UN special rapporteur on trafficking in persons to visit, but the visit had not been scheduled by the end of the reporting period. The government did not report specialized training for labor inspectors to screen for indicators of potential forced labor.”
Reactions to the Report
Senator Bob Corker (Rep., TN), the Chairman of the Senate Foreign Relations Committee, attended the State Department’s ceremony for launching the Report and afterwards stated, “ the committee will closely study the report to determine the integrity of the findings. . . . In order for the TIP report to be an effective tool for holding governments accountable, all judgments must be based on measurable progress on anti-trafficking efforts. Following what were clear flaws in last year’s TIP process, the committee will carefully examine the 2016 report and conduct public hearings [this July] to determine the integrity of the findings. Senator Ben Cardin, (Dem., MD), the committee’s Ranking Member, also issued a statement approving of the Report’s upgrading Thailand from Tier 3 to Tier 2 Watch List and the downgrading of Uzbekistan from Tier 2 Watch List to Tier 3. He also expressed continuing concern about Malaysia. Neither of them said anything about Cuba.”
Two other members of the Senate Foreign Relations Committee, Senators Robert Menendez (Dem., NJ), and Marco Rubio (Rep., FL), also issued statements. Menendez criticized the rankings for Malaysia, Cuba and unnamed other countries that “do not match the facts on the ground” and stated his expectation that “Congress . . . [will] be aggressive in its oversight and thoroughly investigate the methodology used to justify this year’s rankings. Further, I am convinced that new legislation to reform the ranking process is the only way to restore credibility to this broken system and I plan on introducing a bill to do just that.” Rubio asserted that last year’s upgrade of Cuba to Tier 2 Watch List, and by implication its maintenance of that position in this Report, “was not justified by the facts on the ground.” He also criticized China’s maintenance on the Tier 2 Watch List and Thailand’s upgrading to that List.
The comments of Senators Corker, Menendez and Rubio allude to the Senate committee’s criticism of the prior report’s upgrading of Cuba and Malaysia from Tier 3 to Tier 2 Watch List and to the Administration’s alleged political reasons for doing so, all of which was discussed in a prior post.
At the State Department’s recent ceremony to announce the release of the 2016 Report U.S. Secretary of State John Kerry anticipatorily tried to rebut similar criticisms against this Report. He said, “The tier rankings . . . reflect our department’s best assessment of a government’s efforts to eliminate human trafficking. They don’t take into account political and other factors. As I say, they’re based on . . . [established] criteria. And in addition to the rankings, the report outlines our specific concerns as well as the ways we can improve our efforts. This is not meant to be a dunning report; it is meant to be a demarcation, an encouragement process, a process of evaluation and work towards changing rankings.”
We all will have to see what happens at the forthcoming February hearing to assess these criticisms.
In the meantime, we can, in my opinion, effectively rebut this Report’s half-hearted contention that Cuban medical professionals are engaged in forced labor when they work on the government’s foreign medical missions. Here are the bases for that conclusion:
- First, the Report admits that there is conflicting information and allegations on the foreign medical mission work. Coercion is alleged by “some participants” and unnamed “other sources.” On the other hand, the Report admits, the Cuban government denies these allegations, and instead the Government and “some participants” assert 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.
- Second, there apparently has not been any fair adjudicative process to determine which of these conflicting sets of information is valid.
- Third, 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.
- Fourth, 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.
- Fifth, this 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.)
Moreover, as a previous post noted, a respected international journalist, Alma Guillermoprieto, recently reported that Cuban medical doctors serving on the island now earn $67 per month, but $500 per month when serving on a foreign medical mission.
The $67 monthly salary for Cuban physicians in Cuba compared with the $24 or $27 monthly income of other Cubans is a result of Cuba’s adoption of a “pyramid” compensation system whereby highly trained workers like physicians earn more than lower-skilled workers like busboys. This system, however, is being undermined by lower-skilled workers like gas-station attendants and waiters earning additional income from stealing and illegally selling gasoline and from earning tips in hard currency at restaurants and hotels serving foreign tourists. Indeed, Raúl Castro in his speech at the April 2016 Congress of the Communist Party of Cuba called this the “inverted pyramid” problem that had to be solved.
Finally all of this discussion about Cuba’s foreign medical mission program is precipitated by the U.S. Cuban Medical Personnel Parole Program that allows such personnel to apply for parole into the U.S. For reasons previously provided, this program is unjustified and should be ended as soon as possible.
 U. S. State Dep’t, Ambassador-at-Large to Monitor and Combat Trafficking in Persons Susan Coppedge on the 2016 Trafficking in Persons Report (June 30, 2016).
 U.S. State Dep’t, Trafficking in Persons Report 2016 : Country Narratives–Cuba, at 146-47 (June 30, 2016).
 Senator Corker, Corker: U.S. Must Lead Global Effort to End Human Trafficking and Modern Slavery (June 30, 2016). Senator Cardin, Cardin Statement on State Dept. Trafficking in Persons Report (June 30, 2016).
 Senator Menendez, Menendez Reacts to State Department 2016 Trafficking in Persons Report (June 30, 2016); Senator Rubio, Rubio Comments On State Department’s 2016 Trafficking in Persons Report (June 30, 2016).
 U.S. State Dep’t, [Secretary Kerry’s] Remarks at the 2016 Trafficking in Persons Report Ceremony (June 30, 2016).
 Erisman, Brain Drain Politics: the Cuban Medical Professional Parole Programme, Int’l J. Cuban Studies 269, 286-87 (2012).
 Ledn, Cuban doctors share their experiences in internationalist missions, Granma (Nov. 26, 2015).
 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.
 New York Times Calls for End of U.S. Program for Special Immigration Relief for Cuban Medical Personnel, dwkcommentaries.com (Nov. 23, 2014); New York Times Calls for End to Special U.S. Immigration Programs for Cubans, dwkcommentaries.com (Dec. 21, 2015).