The introduction of the Cuban healthcare system in 1961 marked a landmark occasion in the history of public health and the social protection. By making health and healthcare a national priority through the creation of a free, universal and comprehensive system, the Cuban model has garnered international praise and has been the subject of extensive research. Concerning the latter, scholarship has mainly focused on policy outputs and outcomes of the system post-adoption; however, studies examining factors leading to the model’s inception are less common. This chapter employs the transnational interdependencies approach to examine the role of national and international dynamics in shaping the introduction and generosity of the Cuban healthcare model. The central question we explore is what national and international factors set the stage for the emergence of Cuba’s response to the need for social protection in health. By tracing key historical developments from the colonial period through to the Cuban Revolution, we reveal how healthcare served as part of a socialist stance on a complex interplay of domestic and international factors that created a demand for services to address the severe health damages of conflicts, including the protracted ramifications of slavery and diseases in the colonial era, the socio-economic impacts of neo-colonial interests and the hostile political and economic realities of the Cold War period.