To the Editor.
—In his Commentary, Dr Chelala1 offers a laudable if naive approach to improving Cuba's health situation, suggesting that providing food and medicine will help. That is like treating the complications of diabetes and not the hyperglycemia.The lack of food and medicine is not, popular wisdom notwithstanding, the result of the embargo, but of mismanagement by a centralized collective farming system and by the crushing economic burden of maintaining the most powerful armed forces in Latin America.2 Cuba's widespread, rich, and varied soils, 200 inland rivers, and tropical rainfall allow for year-round cultivation of vegetables and other food crops,3 yet only recently have farmers been allowed to grow some staples on small plots, not enough to meet the population's needs for vegetables and protein. Cuba should permit farmers to cultivate the land, without restrictions on what crops to grow or which livestock to raise,