Editing Openai/69439ed2-a934-800b-ad0f-4b1320a3650b (section)

===== When a mosquito-borne disease spreads, it does not care about politics. =====
It cares about standing water, heat, fuel, timing, and whether the trucks show up on Tuesday.

That is the first thing worth saying out loud.

Dengue is not new. It is not rare. And right now it is surging across much of the Americas. That matters, because it means Cuba is not being singled out by biology. The virus is already on the field. The real question is why Cuba is having such trouble defending the zone.

Think of this like a defensive breakdown in sports. The opposing team did not suddenly invent a new offense. The problem is that defenders are late, out of position, or cannot get to the play at all.

So what are the defenders, in this case?

They are not doctors first.
They are sanitation crews.
They are fumigation teams.
They are truck drivers with fuel.
They are workers repairing leaks so water does not pool.
They are people removing trash before it becomes a breeding ground.

Mosquito control is logistics, not rhetoric.

Now split the problem cleanly in two.

First: what happens before people get sick.
Second: what happens after they do.

Most public arguments skip this step. That is where scale errors begin.

Before infection, the game is about prevention. You reduce mosquito populations by spraying, by cleaning, by fixing infrastructure fast enough to keep water from sitting. That requires fuel, equipment, spare parts, and coordination. Miss one of those and coverage drops. Miss several and the mosquitoes win.

After infection, the game changes. Now it is about clinics, diagnostics, IV fluids, fever control, hospital staffing, and keeping people alive long enough to recover.

Both matter. But they fail differently.

Here is the key point that often gets lost:

A country can still have doctors and hospitals and lose the outbreak if prevention collapses. Once dengue spreads widely, medical care is already playing defense from behind.

Now place Cuba into that picture.

Cuba is dealing with a regional dengue surge and a strained economy and aging infrastructure and fuel shortages and supply constraints that ripple through everything from garbage collection to fumigation schedules.

When fuel is scarce, trucks do not run on time.
When trucks do not run, spraying coverage drops.
When coverage drops, mosquito populations explode quietly.
By the time clinics fill up, the damage is already done.

This is not ideology. It is mechanics.

Where do sanctions enter the picture?

Not as a single switch labeled “medicine on” or “medicine off.” That framing is too simple to be useful.

Sanctions operate like friction in the system. Even when exceptions exist on paper, money still has to move, ships still have to dock, insurers still have to sign off, suppliers still have to decide whether the transaction is worth the risk and delay.

That friction does not announce itself. It shows up as lateness. As gaps. As things that used to arrive now arriving inconsistently or not at all.

Fuel shortages are especially unforgiving in this kind of outbreak. You cannot spray neighborhoods by Zoom. You cannot fog mosquitoes with a press release. Prevention is physical work, done on a schedule, using machines that burn fuel.

So when people say sanctions are “contributing,” the only responsible question is: through which mechanisms, and how much?

The strongest, most direct contribution is not actually at the hospital bedside. It is upstream, in operations: fuel, parts, logistics, and maintenance capacity. When those weaken, mosquito control weakens. When mosquito control weakens during a regional surge, outbreaks accelerate.

That does not mean sanctions are the only cause. It does not mean domestic governance choices do not matter. It does not mean weather, storms, or infrastructure age are irrelevant. They all stack.

Public health failures almost never have a single cause. They are pile-ups, not assassinations.

The mistake many arguments make is treating responsibility like a spotlight instead of a floodlight. They want one thing to blame because one thing is easier to chant.

But systems do not care about chants. They care about throughput.

If you want to understand why dengue is spreading in Cuba, you have to follow the trucks, the fuel, the schedules, the maintenance logs, and the timing—not just the slogans.

That is the work.

And once you see it that way, something important happens:
you stop arguing about who is “good” or “bad,” and you start asking what actually has to move for people to stop getting sick.

That shift—from moral compression to mechanical clarity—is not just more accurate.
It is the only way complex problems ever get solved.