In 2012, the South Africa-Cuba Extended Cooperation Agreement in the fields of health and medical sciences was signed. This would lead to an increased number of South African medical students studying in Cuba; thereby contributing to the implementation of the National Health Insurance (NHI). In 2010, South Africa announced the cancellation of Cuba's R1 billion debt; this paved the way for enhanced trade and commercial relations. In 2012, an Economic Assistance Package agreement of R300 million was concluded with Cuba. The challenge has been with the implementation of the agreement due to Cuba's economic structure and the American economic embargo extra- territorially applied on Cuba. The South African government has since addressed the issue of non implementation by designating the Industrial Development Corporation (IDC), as its state agent responsible for administering the economic assistance package.