PRIMARY-CARE IN CUBA - LOW-AND HIGH-TECHNOLOGY DEVELOPMENTS PERTINENTTO FAMILY MEDICINE

Cuba's accomplishments in primary care, while controversial, include s everal developments pertinent to family medicine. These accomplishment s involve low-technology and organizational innovations such as neighb orhood-based family medicine as the focus of primary care; regionalize d systems of hospital services and professional training; innovative p ublic health initiatives and epidemiologic surveillance; universal acc ess to services without substantial barriers related to race, social c lass, gender, and age; and active programs in treatments such as ''gre en medicine'' and ''thermalism.'' High-technology achievements include innovations in pharmacology and biotechnology, surgical procedures, a nd care of patients infected by the human immunodeficiency virus (HIV) . Limited access to Cuban publications, impediments to presentations b y Cuban health cave professionals at professional meetings, and the pr ohibition on importing products of Cuban biotechnology to the United S tates inhibit a detached, scientific appraisal of Cuba's accomplishmen ts. Cuba's isolation from the US clinical and research communities has prevented interchanges that would improve primary care services in bo th countries.