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How to assess global health at the close of 2018 and project achievable goals for the new year? WHO began on a somber and urgent note by identifying Ten Threats to Global Health in 2019. They are: air pollution and climate change; noncommunicable diseases; global infl uenza pandemic; fragile and vulnerable settings; antimicrobial resistance; Ebola and other high-threat pathogens; weak primary health care; vaccine hesitancy, dengue and HIV. Cuba is vulnerable to many of these threats, but perhaps more importantly, it’s already taking them on, proposing more intersectoral actions to address social determinants building upon the country’s robust primary health care system.