RESPONSE TO REVIEW FOR SUSPENSION OF TITLE III OF

C O N F I D E N T I A L ASUNCION 000843 SIPDIS STATE FOR WHA/CCA DMCFARLAND, CA/VO/F/P PMARIGLIANO AND WHA/BSC MDASCHBACH E.O. 12958: DECL: 12/31/2033 TAGS: ETRD ETTC PREL KDEM CVIS PHUM PREF CU PA SUBJECT: RESPONSE TO REVIEW FOR SUSPENSION OF TITLE III OF THE LIBERTAD ACT REF: A. STATE 126578 ¶B. ASUN 373 ¶C. ASUN 720 Classified By: DCM Michael J. Fitzpatrick for reasons 1.4 (b) and (d). ¶1. (U) This cable responds to questions regarding implementation of Title III of the LIBERTAD Act and the relationship between the Cuban and Paraguayan governments (ref A and B). ¶2. (C) Has the host country, in Post's opinion, worked to promote the advancement of democracy and human rights in Cuba? Paraguay's government changed hands in August after national elections in April. That said, neither Paraguayan government has actively worked to promote the advancement of democracy and human rights in Cuba. The Paraguayan and Cuban governments have cordial bilateral relations that emphasize mutual assistance. Although the Paraguayan government expresses a commitment to democracy and human rights, it typically opposes initiatives that promote the advancement of democracy and human rights in Cuba. Paraguay supported the removal of the Cuban embargo in the 63rd United Nations General Assembly. Paraguay enjoys the benefits of a number of Cuban medical support and educational programs. These Cuban programs may well be expanding in the coming months. ¶3. (C) Has the host country made other public statements or undertaken other governmental actions? Paraguay has not made public statements or undertaken other governmental actions in support of the advancement of democracy and human rights in Cuba. ¶4. (C) Have there been any high-level diplomatic visits between Cuba and host country in the past six months? Cuban Vice President Jose Machado Ventura attended the August 15 inauguration of President Fernando Lugo. ¶5. (C) Did the host country offer or deliver humanitarian or other assistance to the Cuban people in the wake of the major damage caused by Hurricanes Gustav and Ike? No. ¶6. (U) What is the nature of investments that host country businesses have in Cuba? Paraguayan businesses do not have substantial investments in Cuba, and Paraguay conducts little bilateral trade with Cuba. The 2008 balance of payments between Cuba and Paraguay was negligible according to Paraguayan Central Bank figures. �0A; ¶7. (U) Are there any bilateral trade agreements or other cooperative agreements between host country and Cuba? Paraguay and Cuba signed a bilateral agreement in 2002 to promote trade and investment. Cuba and Paraguay initially signed an agreement in 1999 allowing Cuban doctors to operate in Paraguay; the agreement was renewed in 2004 but expired in 2006 -- even as a number of Cuban medical programs exist in country today. The two countries also signed a convention in 2002 on cultural and educational exchanges that provided the legal basis for Cuban medical doctors to operate in Paraguay and Paraguayan students to study medicine in Cuba. Both countries are 2007 co-founders of the Bank of the South. ¶8. (C) Are there any exchange programs between host country and Cuba? The Cuban government offers Paraguayan students full-ride scholarships to study medicine for three years in Cuba. However, Paraguayan medical students returning from Cuba face difficulties entering the local medical field because the Paraguayan government refuses to issue medical licenses to students who graduate from Cuban medical schools. The Health Ministry confirmed December 12 that over 500 Paraguayans are now studying in Cuba and that at least 130 graduates have returned to Paraguay. (NOTE: Paraguayan medical licenses require at least four years of academic study, and Paraguayan medical students returning from Cuba lack one year of requisite training. The returnees, furthermore, are said not to have anything close to required standards or substantive knowledge to operate as doctors. END NOTE.) The Health Ministry announced October 25 that it would establish a special training program for medical students returning from Cuba that allows them to earn their Paraguayan medical licenses after completing one-year internships in local health facilities. The Cuban government offers paid medical travel for Paraguayans to receive medical treatment and surgeries in Cuba, including cataract surgery. The press reported December 14 that over 5,000 Paraguayans took advantage of this program. (NOTE: The U.S. Embassy's medical diplomacy initiative provides a counter-balance to Cuban and Venezuelan medical programs. This initiative helps facilitate the donation of medical supplies to the Health Ministry, local clinics, and medical assistance NGOs that locally perform free eye surgeries, follow-up care, and other related medical treatment (ref C). END NOTE.) Although the bilateral medical agreement expired in 2006, Cuba continues to provide medical assistance to the Paraguayan government. Cuban medical experts provide training and support to the Ministry of Public Works and Communications' Epidemiology Surveillance Section. Whenever Paraguay experiences epidemiological outbreaks -- including recent yellow fever and dengue outbreaks -- the Cuban government offers to send doctors, medicines, and vaccines to treat and innoculate Paraguayans. The Cuban government sent three Cuban doctors to treat Paraguayans in Asuncion, San Pedro Department, and Caaguazu Department during the February yellow fever outbreak. Cuban epidemiologists also assist with the analysis of clincial cases and vector control efforts during dengue fever outbreaks. The municipal government of Maria Auxiliadora, Itapua Department, signed an agreement in 2006 with the Cuban government that allows Cuban doctors and support staff to provide eye surgery and other health care (ref C). The agreement permits the local NGO Cuban Medical Services to operate a local eye care center on behalf of the Cuban government. The center is affliated with "Miracle Mission," a Venezuelan-sponsored program that offers free eye surgeries and other medical treatment in Cuba and Venezuela (ref C). Approximately 17 Cubans reside in Maria Auxiliadora as part of this agreement, and the Cuban government provided eye surgery equipment to the center. President Lugo visited the eye care center in Maria Auxiliadora December 14 and praised the work of the eye care center and "Miracle Mission" Program. Although Lugo has been personally supportive of Cuba's medical missions in Paraguay, Health Ministry officials expressed concern regarding the center. Dr. Luz Marina Quintana, director of the Health Ministry's Ocular Health Program, expressed concern in July that the eye care center operates without Health Ministry oversight (ref C). The Health Ministry announced October 8 that it will launch its own eye surgery campaign in cooperation with local NGO Fundacion Vision, which receives assistance from the U.S. Embassy. The Health Ministry and Fundacion Vision plan to perform up 4,000 eye surgeries annually. Most Cuban doctors who worked in Paraguay under the 1999 bilateral agreement returned to Cuba after the agreement expired in 2006. Of this initial wave of Cuban doctors, 18 Cuban doctors and their families residing in Paraguay have applied for admission to the United States under the Cuban Medical Professional for Significant Public Benefit Parole Program. Of these, nine have been approved by DHS, five denied, and one cancelled. Three have pending applications. ¶9. (U) POC for this request is Embassy Asuncion Human Rights Officer Michael Edwards, telephone: 011-595-21-213-715, e-mail: edwardsmg@state.gov. Please visit us at http://www.state.sgov.gov/p/wha/asuncion AYALDE