After the 1959 Cuban Revolution, Cuba established a program to send its medical personnel overseas, particularly to Latin America, Africa, and Oceania, and to bring medical students and patients to Cuba for training and treatment respectively. In 2007, Cuba had 42,000 workers in international collaborations in 103 countries, of whom more than 30,000 were health personnel, including at least 19,000 physicians. Cuba provides more medical personnel to the developing world than all the G8 countries combined. The Cuban missions have had substantial positive local impacts on the populations served. It is widely believed that medical workers are a vital export commodity for Cuba. According to Granma, the Cuban state newspaper, the number of Cuban medical staff abroad fell from 50,000 in 2015 to 28,000 in 2020. A major criticism of Cuban medical internationalism is that the doctors involved that are sent by Cuba are sometimes sent against their will, and with little to no compensation for their services—as opposed to medical international aid from nearly any other country. A 2007 academic study on Cuban internationalism surveyed the history of the program, noting its broad sweep: "Since the early 1960s, 28,422 Cuban health workers have worked in 37 Latin American countries, 31,181 in 33 African countries, and 7,986 in 24 Asian countries. Throughout a period of four decades, Cuba sent 67,000 health workers to structural cooperation programs, usually for at least two years, in 94 countries ... an average of 3,350 health workers working abroad every year between 1960 and 2000". In November 2019, the United Nations estimated that there were around 30,000 Cuban doctors active in 67 countries. Since 1963, more than 600,000 Cuban health workers have provided medical services in more than 160 countries. In 2020, Cuban doctors were active in over 60 countries. The term "disaster tourism" arose in response to a growing number of large-scale natural disasters.