Cuba announced Wednesday it will pull thousands of its doctors out of Brazil in response to president-elect Jair Bolsonaro's "direct, contemptuous and threatening" remarks about its medical aid program.
The far-right leader has repeatedly criticized the Communist-run island's "More Doctors" program -- which sends thousands of Cuban doctors to work in deprived areas of Brazil -- and said his government would introduce changes.
"In the light of this unfortunate reality, the Ministry of Public Health of Cuba has decided to discontinue its participation," Havana said in a statement.
Bolsonaro has been scathing about Cuba's management of the five-year-old program, known in Brazil as "Mais Medicos," saying the doctors received only a quarter of what Brazil was paying the Cuban government for their services.
His government would counteract that by directly hiring doctors who wanted to remain in the country, but would first demand they submit to a "capacity test."
The Cuban health ministry angrily accused Bolsonaro of questioning its doctors' qualifications, and said all Cuban cooperation workers had been paid "their full salary in Cuba."
Bolsonaro hit back on Twitter.
"We made continuity of the More Doctors program conditional on a capacity test, (payment of) full salary to Cuban professionals, most of which is currently going to the dictatorship, and the freedom to bring their families."
"Unfortunately Cuba did not accept," he wrote.
In another tweet, he accused Cuba of exploiting its citizens by not fully paying their salaries and said Havana was "irresponsibly" ignoring the negative impacts its decision will have on Brazilians.
Cuban President Manuel Diaz-Canel jumped to the program's defense, paying tribute on Twitter to the doctors' "dignity, deep sensitivity, professionalism, dedication and altruism."
They had "rendered a valuable service to the people of Brazil," he added.
In a pointed response to Bolsonaro, he said their work "must be respected and defended."
The program has been in place since August 2013, and since then nearly 20,000 Cuban doctors have treated 113.5 million Brazilians, according to the ministry.
- Strong words -
In its strongly worded statement, Cuba said the conditions being imposed by Bolsonaro -- who takes office on January 1 -- were "unacceptable."
It added Cuban doctors, currently serving in 67 countries, have brought medical care to areas of "extreme poverty" whether in Rio de Janeiro's favelas, Sao Paulo, Salvador de Bahia or the 34 Special Indigenous Districts, particularly Amazonia.
"More than 700 municipalities were able to count on a doctor for the first time ever."
The Brazilian people "recognized their virtues," the health ministry said, and knew who should be "held responsible for our doctors not being able to continue offering their fraternal contribution in that country."
Cuba's "white-coat diplomacy" began under Fidel Castro after the 1959 revolution, and has grown to become the island's most valuable export, bringing in an estimated $11 billion a year.
Cuban media reported this week that Havana is sending 500 more doctors to crisis-wracked Venezuela.
Cuba had held out hope of being able to work with Bolsonaro's government after years of cooperation with his leftist predecessors, Luiz Inacio Lula da Silva and Dilma Rousseff. The More Doctors program began when Rousseff was president.
"We have no problems in having relations with people who think differently from us," said Cuban Foreign Trade and Investment Minister Rodrigo Malmierca ahead of the Brazilian election.
However, the withdrawal of its doctors, and Bolsonaro's barbed comments on Twitter, sets relations at a new low even before the right-winger has officially taken power.