The Trump administration is imposing visa restrictions and revoking the visas of several Brazilian government officials, former Pan American Health Organization officials and their family members for “their complicity with the Cuban regime’s labor export scheme in the Mais Médicos program,” the State Department said Wednesday

The sanctions target officials involved in a program under which former Brazilian President Dilma Rousseff hired over 10,000 doctors from Cuba between 2013 and 2018 to provide services in Brazil’s remote areas. The program received intense criticism after government records published in Brazil showed that Brazilian officials tapped the Pan American Health Organization, or PAHO, to facilitate payments to Cuba and avoid oversight by Brazil’s Congress.

Several Cuban doctors who deserted the mission sued PAHO, claiming the organization benefited from a labor-trafficking scheme in which the Cuban government pocketed about 85% of the salary payments made by Brazil. The State Department did not say how many officials have been sanctioned but said it revoked the visas of Mozart Julio Tabosa Sales and Alberto Kleiman, two former Brazilian Ministry of Health officials who the agency identified as having played a role in planning and implementing the Mais Médicos program.

“Brazil’s Mais Médicos program was a diplomatic scam that exploited Cuban doctors, enriched the corrupt Cuban regime, and was covered up by both Brazilian and former PAHO officials,” a senior State Department official told the Herald. “Let there be no doubt, the United States will continue to hold accountable all individuals linked to this coercive labor export scheme.”

Tabosa worked in the implementation of the Mais Médicos program as secretary of Labor Management and Health Education at Brazil’s Ministry of Health. He is still a senior ministry official, working as the secretary of Specialized Health Care.

During the years the Mais Médicos program was in place, Kleiman worked as a special adviser for the Ministry of Health and as the head of its international relations department. He later worked for PAHO as its director of external relations, partnerships and resource mobilization. He is currently holding a similar position at the Amazon Cooperation Treaty Organization, according to his LinkedIn profile. He is one of the defendants in the Cuban doctor’s lawsuit against PAHO.

The State Department said that the sanctioned officials used PAHO “as an intermediary with the Cuban dictatorship to implement the program without following Brazilian constitutional requirements, dodging U.S. sanctions on Cuba, and knowingly paying the Cuban regime what was owed to Cuban medical workers.” It added that “dozens of Cuban doctors who served in the program have reported being exploited by the Cuban regime as part of the program.”

The Herald sent comment requests via email to Kleiman and PAHO and reached Tabosa’s office in Brazil by phone with a comment request. None responded.

In a separate announcement Wednesday, the State Department said it imposed visa restrictions against officials from Cuba, unidentified African nations, and Grenada, in the Caribbean, for their “complicity in the Cuban regime’s medical mission scheme.”

The Cuban government has denied allegations of force labor in its medical missions. On Wednesday, Cuba’s foreign minister reacted to news of the new sanctions and wrote in a post on X in Spanish: “The U.S. Secretary of State threatens visa restrictions against governments that have legitimate medical cooperation agreements with Cuba. It demonstrates that imposition and aggression are the new foreign policy doctrine of the government.”

“Cuba will continue providing services,” he added.

Since 2019, the U.S. State Department has labeled Cuba’s medical missions as “forced labor.” The Trump administration and Secretary of State Marco Rubio have made the issue a policy priority, expanding visa sanctions against those involved in the Cuban medical missions, including foreign officials. In June, the Department imposed visa restrictions on unidentified Central American officials linked to the Cuban medical missions.

The lawsuit against PAHO, which is still ongoing, alleges that the Cuban government pocketed about 85% of the money Brazil paid for the doctors’ salaries. Brazil made the payments to PAHO, which retained a 5% fee, around $129 million, and forwarded about $2.5 million to Cuba’s government, the lawsuit claims.

The Cuban doctors who sued said part of the money received through PAHO was frozen in Cuban bank accounts until the doctors’ return from the “official missions.” The lawsuit also details how Cuban authorities, and sometimes Cuban government officials working for PAHO as “consultants,” controlled the doctors’ movements and seized their travel documents

“It is good news that the Department is beginning to enforce the law requiring visa sanctions for individuals who were involved in the Mais Médicos program, and it should vigorously enforce the law against every culpable party,” Sam Dubin, a lawyer representing the Cuban doctors.

“There is substantial documentation in the public record about Brazilian, PAHO, and Cuban officials who were responsible for the creation and enforcement of the Mais Médicos program, and the Department has undoubtedly uncovered even more evidence,” he added. “The Cuban doctors I represent, who were trafficked to Brazil through PAHO’s direct engagement, believe there is no justification for omitting any individual or organization from these Congressionally mandated sanctions.”

The sanctions against the Brazilian officials will increase diplomatic tensions with Brazil. President Trump imposed a 50% tax on some Brazilian products over charges against former president Jair Bolsonaro, who has been accused of a coup plot. And the Treasury Department sanctioned the Brazilian Supreme Court justice Alexandre de Moraes overseeing the case.

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