A former Cuba intelligence chief claimed in 2006 that 634 assassination plots and attempts were made to kill Fidel Castro. The CIA was behind some of them, NBC News reported, citing a 1975 U.S. Senate report.

The CIA’s efforts included hiring mobsters Sam Giancana and Santos Trafficante Jr., both on the FBI’s 10 Most Wanted List, and poisoning Castro’s cigars, pills and scuba-diving suits, and using dynamite. A plot to have his lover poison his drink ended up in a love-making bout. A 1961 invasion by CIA-backed U.S.-based Cuban exiles at the Bay of Pigs was thwarted and a sustained economic and diplomatic embargo failed to dislodge the Marxists in power. Castro died at age 90 in his sleep in 2016 and the Communist regime which he and his allies imposed in 1959 after toppling the Fulgencio Batista government remains in power 65 years now.

Now, another attempt is being made to destabilize the government, led by one of the fiercest anti-Cuba/Communist foes in the country. Marco Antonio Rubio, whom President Donald Trump appointed Secretary of State, was born in Miami, home of the most die-hard opponents of the Cuban regime, who, according to some news reports, burnished his political credentials by claiming to be the son of refugees but they immigrated before Castro seized power. He has denied that accusation but not his sustained campaign to try to bring down the regime.

The United States has, for years, accused the government in Havana of promoting terrorism but, like the diplomatic and economic embargo, that did not prevent most countries from establishing relations with the regime. Now, just like the weird attempts to kill Castro, Rubio has charged that Cuba’s decades-old program of sending doctors and other medical personnel to work in other countries amounts to human trafficking.

Countries which host those doctors must send them home or their officials will be denied visas to enter the United States, Rubio announced. The visa ban will includie foreign government officials “who are believed to be responsible for, or involved in, the Cuban labor export program, particularly Cuba’s overseas medical missions.” It is not a new allegation. What is new is that officials of third countries will be penalized.

As a U.S. senator, Rubio and his then New Jersey Democratic counterpart Bob Menendez sponsored a “Combating Trafficking of Cuban’s Doctors Act” more than four years ago but it was not enacted into law. However, a State Department press release quoted Rubio as accusing the Cuban government of perpetrating a “diplomatic scam” and of having “perfected the art of state-sponsored human exploitation while illegally enriching themselves” through the medical program. Rubio claimed that the doctors were “subjected to deplorable working conditions, confiscation of their legal forms of identification and significantly reduced compensation.”

A Congressionally mandated report listed 74 countries “that may have hosted Cuban government-affiliated workers over the past five years.” That determination was inserted in a $1,2 trillion spending bill to which the Republican majority in Congress had tacked on a requirement for sanctions against countries that “are directly paying the Government of Cuba for coerced and trafficked labor of Cuban medical professionals.” It did not name the countries but cited, as an example, the Venezuelan government’s paying Cuba $60,000 per year per doctor assigned under the program but the doctor receiving only between $1,244 and $1,295, plus a bonus of $480 on returning home.

Such allegations may have been fueled by a claim by a Cuban doctor, Rotceh Rios Molina, who, according to The Hill, defected from a work brigade assigned to Mexico. He stated, “The [medical] missions are a Cuban government scam where you don’t know how much you’ll get paid but one is so desperate to leave Cuba and get some money that one leaves for whatever reason.”

The view from the other side is vastly different. Several Caribbean countries are among those that host Cuban doctors and some of their leaders expressed outrage at Rubio’s accusation. They include Prime Minister Keith Rowley of Trinidad and Tobago and Prime Minister Ralph Gonsalves of Vincent and the Grenadines. The two leaders declared that “they would lose no sleep if their visas were ever cancelled and they never returned to the U.S.,” Caribbean Life reported.

Rowley stated that he “will ensure that the sovereignty of Trinidad and Tobago is known and respected by all.” He explained that his nation receives healthcare help also from other countries, including India and the Philippines and added, “Out of the blue we are called human traffickers because we hire technical people who we pay top dollars equal to local rates but we’re now being accused of taking part in the program where people are being exploited.”

Gonsalves, in a radio program, acknowledged that Cuban doctors serving overseas pay a percentage of their salaries to the Cuban government – “I don’t know if it’s 10 percent of 15 percent” – but that did not mean they were being exploited. The doctors receive free education in Cuba, he said, and “if they’re going overseas and making money from that education, it’s not unreasonable for them to put back something in the kitty for more people to be educated. We put our people on bond. The American government lends money and people have to pay back the loans.”

This latest effort to weaken Cuba comes almost 10 years after President Barack Obama restored diplomatic relations with the country, ending am embargo imposed in 1961. In his July 1, 2015, announcement, Obama acknowledged that “there have been very real, profound differences between our governments and sometimes we allow ourselves to be trapped by a certain way of doing things.” The U.S., Obama said, was “clinging to a policy that was not working. Instead of supporting democracy and opportunity for the Cuban people, our efforts to isolate Cuba despite good intensions increasingly had the opposite effect – cementing the status quo and isolating the United States from our neighbors in this hemisphere.”

Obama met with Cuba’s then President Raúl Castro – Fidel Castro’s brother – in April, 2015, the first such meeting in 50 years. Obama also removed Cuba from the U.S. list of state sponsors of terrorism. In March 2016, he became the first U.S. president to visit Cuba since Calvin Coolidge did in 1928.

But that détente did not last long. As President Donald Trump’s first term was ending in early 2020, Cuba was again placed on the terrorism list. The State Department announced that the change was due to Cuba’s “repeatedly providing support for acts of international terrorism in granting safe harbor to terrorists.” Among those the statement named was Joanne Chesimard – now Assata Olugbala Shakur– a former member of the Black Liberation Army. She was convicted In 1977 in the killing of state trooper Werner Foerster during a shootout on the New Jersey Turnpike in 1973. She was serving a life sentence when she escaped from prison.

The Cuba policy change became bipartisan when President Joe Biden signed the spending bill last June that accused Cuba of using forced labor in its medical assistance program and directed the State Department to impose sanctions on officials of third countries that hire them. That statement stopped short of accusing the entire program of forced labor, “both because some host countries can and do provide worker protections to the Cuban professionals and because some are in dire need of any medical aid they can get,” Rubio ended that distinction, The Hill reported.

There is, of course, a great irony in Rubio’s boasting about the scrapping of aid, including for health issues, to small nations and now trying to blackmail them into terminating such assistance from another country.

Gonsalves said his country provides dialysis for dozens of its citizens with help from Cuban doctors without which the program will collapse. “So,” he added, “does anybody expect that I, because I want to keep a visa, would allow 60 people from the poor and working people to die? It will never happen.”