Tldr: "Authorized" sales don't equal actual amount; general difficulty of banking transactions due to embargo overall disuades some U.S. companies from trying; US officials including DONATED goods in their claims for medical "exports" is particularly misleading.
Plus, third-country effects are sizable, especially if foreign pharma and medical device companies are bought out by U.S. corporations/investors.
I would add: It is pernicious/cumbersome/dissuasive enough that all medical sales from U.S. to Cuba aren't authorized by general license. Instead, they require specific authorization as well as end-use verification.
Q I have about article above is to what degree notable decline in actual (not "licensed") medical exports from peak of $6 million in 2016 to $1 million in 2019 is due to declining climate of US-Cuban relations under Trump administration or Cuba's diminished ability to pay.
Likely both, and they're likely related, in so far as other Trump sanctions have hurt Cuba's bottom line and foreign currency earnings it uses for imports.
Note that this imbroglio involved a US govt official criticizing "unsourced" allegations w/o providing/linking to any sources himself. https://twitter.com/WHAAsstSecty/status/1247225201336758273?s=20
I'll help. See this comprehensive 2017 report from US Intl Trade Commission on embargo's overall effects.

https://www.usitc.gov/publications/332/pub4597.pdf
It describes history of regs. and how sales of medical supplies did grow as a portion of total U.S. exports to Cuba under Obama admin...

(Partly thanks, I'm guessing, to greater willingness of banks to facilitate them under climate of normalization).
...but it is also clear that U.S. regulations/licensing requirements still constrain those sales—even as it also notes constrained Cuban purchasing power to ramp up imports exponentially if it wanted to.

(Again, for more up-to-date numbers, see Cubatrade post above.)
But still, it is real, and effects are unconscionable.

Even if this company *could* in theory request license to sell ventilators to Cuba, fact that it doesn't is again evidence of embargo's long, direct, and indirect reach, including outside of the United States.
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