Preparing for the Consequences of Collapse in Cuba

Only days after the January 3 military action to remove Nicolas Maduro from power in Venezuela, the Trump administration signaled that it wanted some type of regime change in Cuba, with the president telling the island’s leaders to “make a deal, before it is too late.” The United States swiftly imposed an oil blockade to apply economic and social pressure on the Cuban regime, stopping any Venezuelan shipments and threatening other suppliers with tariffs should they send oil to the island. The oil embargo has also collapsed the tourism industry, a crucial source of hard currency for the regime. While speaking on March 27 about U.S. military action in Venezuela and Iran, President Donald Trump said “Cuba is next.” These measures have produced some initial discussions with members of the Cuban leadership, as well as signs of potential economic opening, including an announcement that members of the Cuban diaspora would be allowed to invest in and own businesses on the island. But on March 30, President Trump allowed a Russian tanker to make a delivery of crude to the island. The reversal can be understood as (1) the administration wishing to avoid a confrontation with Russia as the United States is consumed with the conflict with Iran, (2) a gesture of goodwill because negotiations with the Cuban regime might be proceeding well, (3) an acknowledgement that the humanitarian situation on the island is reaching a breaking point which could threaten stability, or (4) all three. Much has been written on what comes next for Cuba—in terms of U.S. pressure, regime change or regime management, and who might be Cuba’s “Delcy”—with less focus on the impact that U.S. policy is having on the people of Cuba, who already faced a dire humanitarian situation created by their leaders. What consequences would stem from a sudden collapse of the regime, and what should the United States and the international community be doing to prepare for this eventuality?

Q1: How might Cuba reach the breaking point?

A1: A recent New York Times interactive article interviewing Cubans on the island in February describes how the country’s deepening fuel crisis is disrupting nearly every aspect of daily life. To be sure, conditions on the island were terrible even before the Trump administration began stopping the deliveries of oil. The Cuban Human Rights Observatory’s 2025 annual report (describing conditions in 2024) points to a deep and systemic crisis. According to the report, extreme poverty affects 89 percent of the population, while 91 percent negatively view the government’s economic and social management. Food insecurity is widespread: 70 percent of Cubans have skipped meals due to lack of resources, and only 15 percent can consistently maintain three daily meals, with the elderly, unemployed, and those without remittances most affected. As conditions worsen with the U.S. imposed oil blockage, frustration is rising among citizens, increasing the risk of social unrest and further destabilizing an already fragile economy.

Thus far, there have not been nation-wide protests similar to the ones that occurred on July 11, 2021, when the largest demonstrations in Cuba since the 1990s took place. Following the 2021 protests, the Cuban government brutally cracked down on dissent, and imprisoned almost 2,000 people. Despite the fear of a new crackdown, a growing number of Cubans are banging pots at night in protest. During the month of March, the Cuban Observatory of Conflicts recorded 1,245 protests, including a new record of 556 “Challenges to the Police State.” On March 13, protesters ransacked the headquarters of the ruling Communist Party in the city of Morón, making a bonfire with the office furniture, after the city had been without electricity for 30 hours. Conditions today are much worse than in the years before the 2021 social explosion.

There is no doubt that the pressure brought by the U.S. oil blockade is increasing the chances of a new island-wide challenge to the regime. The risk is that the Trump administration will wrongly calibrate the balance between creating enough pressure to force concessions, and societal collapse. Should the regime fall or should the existing slow-motion humanitarian crisis simply continue for a prolonged period, there would be grave humanitarian consequences for the people of Cuba.

Q2: What impacts would lack of oil and the collapse of the electrical sector have?

A2: The U.S. embargo and sanctions on fuel shipments are crippling Cuba’s power systems. Imported fuels make up two-thirds of Cuba’s total energy supply, according to the International Energy Agency. The same source states that oil and natural gas, in particular, generate 95.9 percent of the island’s electricity. Deprived of sufficient fuel, Cuba’s electric grid has suffered multiple nationwide blackouts. Rationing, shortages, and prolonged power outages affect multiple territories around the country.

Ongoing energy shocks threaten cascading breakdowns across power-dependent water, food, and public health systems. Water and sanitation services, for example, require reliable energy to collect, treat, and deliver safe water. The United Nations estimates that 84 percent of Cuba’s water pumping equipment rely on electricity, while one-in-ten Cubans receive their drinking water from tanker trucks—which need fuel to make their rounds. The energy crisis hobbles these vital distribution networks, disrupting supplies and pushing underserved communities to draw on potentially unsafe alternative sources.

Energy shortages similarly risk weakening food security at each stage of agricultural production. Three-quarters of Cuba’s irrigated farmland relies on electric or diesel pumps to move water from source to field for growing food. Lack of fuel could curtail farmers’ use of machinery to properly harvest and process certain crops. Post-harvest, power cuts and fuel constraints could compromise food storage, transport, and preparation, upending supply chains and undermining affordability, especially for vulnerable populations.

The U.S. fuel blockade compounds long-standing strains on Cuba’s energy, water, and food systems. Decades of inadequate investment (limited by restricted access to foreign capital), deferred maintenance, and reliance on substandard crude oil—which exacerbates wear and tear from power generation—have saddled the nation with neglected energy infrastructure, precipitating recurrent grid failures. Outdated policies and inadequate regulations likewise afflict the water sector, curbing progress toward ensuring safe water availability. In Havana alone, 40 to 70 percent of water produced is lost to leaks in the increasingly dilapidated pipe system.

Natural disasters have worsened matters. Hurricanes Oscar and Rafael in 2024 and Melissa in 2025 repeatedly damaged critical water infrastructure with little interval for recovery. One-third of the population in the affected areas, on average, lack safely managed water services. Cuban farmers, too, have long faced multiple challenges, including energy shortages and limited access to fertilizer, seeds, and machinery. From 2016 to 2024, production of major crops such as corn and rice plunged 38–58 percent. By 2025, the UN World Food Programme furnished 1.5 million Cubans with direct assistance for food security and nutrition. Now, as the current crisis deepens, risks of a potential “humanitarian collapse” in Cuba are rising.

Q3: As systems degrade, what would a deepening humanitarian crisis look like?

A3: For several decades, affordable, accessible high-quality primary healthcare was a key element of Cuba’s revolutionary program. A high ratio of doctors per person, elevated spending per capita on health, and investments in biomedical research and development all contributed to low infant mortality and rates of infectious disease transmission comparable to those in higher-income countries.

But in recent years, the Cuban health system has experienced significant stress, with limited resources for repairs and infrastructure improvements at labs, hospitals and care centers. Recent hurricanes also damaged clinics, and the ongoing fuel shortages are choking a once promising model of community-based health care.

U.S. export regulations limiting the sale to Cuba of items having 10 percent or more U.S.-origin components have made it challenging for the island’s health system to procure critical pharmaceuticals, medical devices, and supplies. The U.S. government exempts medical supplies for humanitarian purposes from the economic embargo and allows exporters to request waivers to the Export Administration Regulations, but the government’s process of determining that medical supplies will be used to deliver care and not sold or reexported can be time-consuming. Supply constraints are making it difficult for clinics to deliver routine services, such as dialysis for people living with chronic kidney disease, and they are affecting treatments for infectious diseases as well. With limited access to antibiotics, doctors are reporting higher rates of maternal and child death. Estimated deaths among children under the age of one have risen from 4.8 per 1,000 in 2012 to 6.8 per 1,000 in 2024. Deaths among children under the age of five have also risen sharply, from 6.0 per 1,000 in 2012 to 8.6 in 2024.

The ongoing fuel shortage is further stymying the health sector, as fuel is needed to run water pumps, power hospitals with electricity, and transport patients, as well as care providers, to clinical care sites. The Cuban government reports a current backlog of nearly 100,000 surgeries that have had to be postponed due to lack of electricity and available staff.

Many supplies, such as vaccine components, arrive by air, but deliveries have been canceled because of airlines’ inability to refuel in Havana. If fuel to support backup generators runs out, the refrigerators in which vaccines are stored may break down, leading to spoilage of existing supplies and increasing the number of children—currently an estimated 30,000—who have missed critical immunizations. The prevention and treatment of vector-borne diseases is also at risk. With limited fuel for transportation, delivering insecticide to sites where mosquitoes proliferate has been a challenge, increasing the risk of dangerous dengue, oropouche, and chikungunya outbreaks, which a struggling health system may not be prepared to address.

Q4: How would a weakened or absent central authority impact governance?

A4: A recent UN report on the situation in Venezuela after Nicolas Maduro’s ouster provides a key lesson for the future of governance in Cuba. The report states that while the president has been removed, the repressive engine of the state continues unabated. While President Delcy Rodriguez has stated that Venezuela is entering a new era and has released some political prisoners, the country has seen 87 arrests of human rights defenders since Maduro’s ouster, and “ongoing harassment of opposition figures and journalists.”

This reality demonstrates a fundamental dichotomy in dictatorships: Political leadership may change rapidly, sometimes even espousing policy that is both more open and more free, but it takes substantial effort and time to dismantle the day-to-day engine of oppression. 

The lasting nature of state engines of repression pairs uneasily with the potential for the collapse of the Cuban regime. Should such a collapse transpire, not only is it likely that repressive elements will continue on, but also that the ensuing chaos and lack of formal government will further empower malign actors. This includes the expansion of black markets and illicit economies, potentially putting greater resources into the hands of criminal actors, at the same time as reduced formal security structures but the continued existence of security forces who likely are no longer paid by the government. In Guatemala, individuals who had perpetrated violence on behalf of a military dictatorship seamlessly created and perpetrated violence on behalf of clandestine criminal networks when those dictatorships fell.

A dystopian scenario is not, however, pre-ordained. In situations of national government collapse, local-level and informal governance structures take on a new importance. Informal government structures can reinforce problematic power dynamics, creating a “might makes right” or wholly non-inclusive structure, but they can also serve to reinvigorate inclusive democratic mores and serve as a seed for democracy across the island. In Cuba, neighborhood groups known as Committees for the Defense of the Revolution (CDRs) already exist, creating an easy structure for local-level coordination. CDRs already serve some community functions, including vaccination drives and other social services. However, CDRs will have to contend with a lack of national-level coordination that had previously existed and a deeply autocratic history, having once served as the “eyes and ears” of a repressive regime, to become an agent for democratic reform. 

Q5: What should the United States and the rest of the international community be doing to prepare for collapse?

A5: Current reports suggest the United States is more interested in pursuing a strategy of regime management, not wholesale regime change, in Cuba. However, the precarity of conditions on the island means that developments on the ground could evolve faster than the governments in either Havana or Washington would like, and the possibility of political collapse should not be ruled out. The outbreak of mass anti-regime protests, departure of key Cuban Communist Party leadership like Díaz-Canel, or a breakdown in U.S.-Cuba talks could all seriously exacerbate the humanitarian crisis faced by Cuban citizens. Collapse would most likely trigger a major exodus from the island, while those without the means to migrate—including a significant portion of the 300,000 elderly Cubans who live alone—would be left to confront even more acute food, fuel, and medical shortages.

It is difficult to predict the exact timing of a political collapse, making it all the more imperative that the United States and international community take steps immediately to prepare for a range of humanitarian contingencies. The United States, Canada, and the European Union, among others, need to establish communication channels with international organizations including the World Food Programme, World Health Organization/Pan American Health Organization, and International Committee of the Red Cross. These entities should also stand up a diplomatic contact group to engage whatever authorities remain on the island and coordinate aid, access, and basic order during fragmentation. The United States can also work to pre-position assistance, including generators, fuel, water treatment units, and emergency food logistics to keep electricity, water, and supply chains functioning. Military and Coast Guard assets will likely be among the first responders, and U.S. Southern Command should consider reallocating airlift assets from Joint Task Force Bravo to Naval Station Guantanamo Bay alongside the pre-positioned aid in order to surge assistance on short notice.

Aid providers will also need to be able to cut through sanctions architecture in order to deploy assistance quickly and consistently. Cuba is far more unforgiving territory than Venezuela in this regard, as U.S. sanctions are codified in law thanks to a series of congressional acts, instead of executive branch prerogative. Statutes such as the 1996 Cuban Liberty and Democratic Solidarity Act, for instance, subject the president to stringent requirements for what constitutes a political transition in Cuba, including “public commitments to organizing free and fair elections for a new government to be held in a timely manner within a period not to exceed 18 months.” Meanwhile, the 2000 Trade Sanctions Reform and Export Enhancement Act prohibits “United States Government assistance, including United States foreign assistance . . . for exports to Cuba.” Congress should work with the White House to amend key provisions of these acts in order to decouple life-saving assistance from political transition. To be sure, statutory restrictions have a role to play ensuring U.S. commitments to a democratic transition in Cuba remain more than mere rhetoric, but in the wake of a humanitarian crisis, the U.S. government and its international partners alike will need more flexibility than current sanctions infrastructure offers.

Christopher Hernandez-Roy is a senior fellow and deputy director of the Americas Program at the Center for Strategic and International Studies (CSIS) in Washington, D.C. Katherine E. Bliss is director and senior fellow for Immunizations and Health Systems Resilience in the Global Health Policy Center at CSIS. Andrew Friedman is director and senior fellow in the Human Rights Initiative at CSIS. David Michel is a senior associate (non-resident) with the Global Food and Water Security Program at CSIS. Zane Swanson is deputy director of the Global Food and Water Security Program at CSIS. Henry Ziemer is an associate fellow with the Americas Program at CSIS.