Caught in the crossfire

CARIBBEAN COUNTRIES, small yet strategically positioned, often find themselves navigating a delicate balance between global superpowers.

Their economies, heavily reliant on trade, tourism and energy imports, are exceptionally vulnerable to geopolitical shifts and international pressure.

In recent years, United States (US) foreign policy – particularly its sanctions and containment strategies toward Cuba, Venezuela and China – has placed Caribbean nations in an increasingly precarious position.

The US pressure to ban Cuban medical professionals, the imposition of tariffs on nations purchasing oil from Venezuela and port fees levied on Chinese ships have had ripple effects across the Caribbean, threatening the stability of these fragile economies.

One of the most humancentred and politically sensitive issues has been the presence of Cuban doctors and nurses in the Caribbean.

For decades, Cuba has provided medical professionals to Caribbean countries and eye care facilities to Caribbean nations, filling critical gaps in regional health care systems that struggle with chronic shortages. Yet, under the Donald Trump and Joe Biden administrations, the US government has ramped up pressure on Caribbean governments to end these partnerships.

Human trafficking

The US has claimed these partnerships amount to human trafficking because Cuban doctors are reportedly underpaid. Most recently, Caribbean government officials were threatened with the revocation of their US visas or future diplomatic isolation if they continue to engage with Cuban medical missions. The US State Department said the restrictions would extend to “current and former officials” as well as the “immediate family of such persons”. For leaders of small island nations that depend on US financial support, tourism flows and security cooperation, these threats are not easily ignored. The result is a painful dilemma: prioritise local health and essential services or protect broader diplomatic and economic relationships with the US.

The second layer of pressure comes from US sanctions on Venezuela, one of the region’s major oil suppliers.

Fourteen Caribbean nations previously benefited from preferential oil arrangements through Venezuela’s PetroCaribe initiative, which allowed the purchase of oil on concessional credit terms. PetroCaribe collapsed in 2019, due in part to US sanctions which made it almost impossible to route bank payments to Venezuela.

Steep tariffs

In March this year, the US imposed steep tariffs and secondary sanctions on countries that engage in oil trade with Venezuela.

Trinidad and Tobago – which has close economic ties to Venezuela, possesses a US licence that permits them to explore gas in Venezuelan waters without sanction at least until 2025 – is directly exposed to this new trade pressure.

The tariffs and sanctions also dash regional hopes for a revival of the PetroCaribe arrangement. For Caribbean nations with limited domestic energy resources and tight fiscal space, the outcome is higher energy costs, inflationary pressures and mounting fiscal deficits.

Compounding these challenges are indirect effects of US tariffs and fees on Chinese shipping. The US has implemented elevated port fees and tariffs on Chinese cargo as part of its broader strategy to contain China’s global influence. While these measures are targeted at Beijing, they reverberate across Caribbean economies that rely on transshipment ports, maritime trade and Chinese imports. Chinese goods constitute a significant share of affordable imports for Caribbean populations, from construction materials to consumer electronics. Higher shipping costs translate into more expensive goods, squeezing household incomes and undermining local business competitiveness. Caribbean transshipment ports, such as those in Jamaica and The Bahamas, also suffer when Chinese shipping routes adjust to avoid costly US port fees, reducing the volume of cargo that passes through the region.

The net effect of these policies is a geopolitical squeeze on Caribbean countries. Forced to choose between compliance with US demands and economic pragmatism, these nations risk losing essential resources – whether affordable health care, fuel security, or trade efficiency.

The pressures ripple through every aspect of their economies: health care systems strained by the loss of Cuban doctors and nurses; energy markets destabilised by Venezuelan sanctions; and inflation driven by disrupted shipping and increased tariffs.

In response, Caribbean leaders walk a tightrope, seeking to preserve relationships with both the US and alternative partners like China and Venezuela. Some have begun to explore renewable energy projects to reduce dependence on oil imports, while others have quietly strengthened ties with European or Latin American suppliers to circumvent sanctions.

Ultimately, the Caribbean’s position reflects the reality for small states in an era of great power competition.

The geopolitical battles will be felt not only in the corridors of power, but also in the clinics, gas stations and supermarkets across Caribbean communities.

Professor Troy Lorde is an economist and Dean of the Faculty of Social Sciences at the University of the West Indies, Cave Hill Campus. Email troy. lorde@cavehill.uwi.edu