The Atlantic Philanthropies dared to invest in Cuba, a country where few other funders have gone.

Over 15 years—2002 through 2016—the foundation made grants totaling more than $68 million to 58 grantees in Cuba and elsewhere. The vast majority of the investment, $59.7 million, supported the health sector and broad dissemination of lessons from the Cuban primary health care system, which focuses on disease prevention and health promotion.

This effort, along with the Cuban government’s considerable investment, has resulted in improved health care, medical education, health research and good health for the island nation’s population as well as millions of people in the 66 countries currently receiving either Cuba’s medical aid and/or medical educational assistance.

Many more people across the globe also have benefited indirectly from Cuba’s influence in international public health circles as a model system that, in a low-resource environment, has produced mortality results that rival those of the United States and other wealthy countries.

Atlantic—more specifically the Atlantic Charitable Trust (ACT), a charity registered with the Charity Commission for England and Wales—provided support that allowed Cuba’s already highly qualified medical researchers, health system staff and educators to deepen and expand work that has had, and will continue to have, global impact. One striking example is the significance of the longitudinal study on the Isle of Youth (ISYS) to understand and combat vascular diseases. Its findings are now influencing health care across the region.

One of Atlantic’s great untold stories is its effort to normalize U.S.–Cuban relations. From 2008 to 2016, the Atlantic Advocacy Fund (AAF), a 501(c)(4) organization, invested $6.5 million to support U.S. nongovernmental organizations (NGOs), think tanks and advocacy groups representing many views and approaches to improve diplomatic and economic relations. In the first three years, the foundation also created and coordinated the results-oriented Cuba Coalition, a group of key players unaccustomed to working together closely, to achieve an end to the travel ban from the United States to the island nation.

Atlantic saw an opportunity to use what it learned from working in Cuba to refine and validate the population health strategies that it was implementing in Viet Nam and South Africa.

AAF’s big bet on improving U.S.–Cuban relations was successful beyond anyone’s wildest dreams and its impact was historic. Atlantic funded a constellation of NGOs and institutions that demonstrated, in advance, widespread public support for President Barack Obama’s eventual decision to reestablish diplomatic relations with Cuba.

These grantees mobilized civil society, changed the narrative from antiengagement to pro-engagement, and supported Congressional and administration representatives in their efforts to improve U.S–Cuban relations. This was exactly the kind of public support that gave elected officials the confidence to act.

AAF viewed this coordination as necessary so those organizations could have greater impact by strategizing together and developing unified messaging.

This coordinated effort resulted in important background studies and legal briefs; Congressional and administration briefings and fact-finding trips; media campaigns; opinion polling; and other advocacy efforts, which helped lay the groundwork for President Obama’s reestablishment of diplomatic relations with Cuba in 2015 after a 54-year estrangement.

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