Report - Belfer Center for Science and International Affairs, Harvard Kennedy School

Report – Havana Syndrome: American Officials Under Attack

| Nov. 04, 2021

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Executive Summary

In September 2021, the CIA recalled its Vienna station chief reportedly over his response to a series of “anomalous health incidents” experienced by over two dozen personnel. These incidents mark the latest entry in a series of mysterious afflictions more commonly referred to as “Havana Syndrome.” Since 2016, over 200 U.S. diplomats, intelligence officials, and their family members across the globe have reported similar experiences of severe headaches, vertigo, and other cognitive difficulties while in their homes or hotel rooms on assignments. The effects can persist for years, leading to early retirement, impacting quality of life, and harming close-knit communities that represent Washington abroad and provide America’s first line of defense.

The initial U.S. government response to Havana Syndrome lacked coordination across agencies and left many victims without adequate medical care. Senior officials questioned whether the symptoms were the result of deliberate attacks but did little to investigate other explanations even as the frequency of incidents increased. Some suggested the victims were simply experiencing mass hysteria. The Biden administration and CIA Director William Burns have redoubled their efforts to uncover the cause of Havana Syndrome and provide care to affected officials, but the U.S. government’s policy response options remain limited by the nature of an opaque threat with no definitive attribution. How the White House and partners in Congress identify and respond to these aggressive actions will have policy implications in the years ahead.

Paul Kolbe opens the discussion.

This report is based on a discussion hosted by the Belfer Center’s Intelligence Project between former CIA officer Marc Polymeropoulos and New Yorker journalist Adam Entous. Moderated by the Director of the Intelligence Project, Paul Kolbe, the panelists discussed the geopolitical impact of Havana Syndrome and its effects on the U.S. diplomatic and intelligence communities. This report examines Havana Syndrome as a unique challenge at the nexus of policy and intelligence.

Washington must protect and care for its diplomats, intelligence officials, and their families. More broadly, the U.S. must consider how it can deter and defend against asymmetric warfare without definitive evidence. Doing so will require renewing focus on traditional intelligence tradecraft to uncover threats, improving defensive detection and mitigation measures, and developing novel policy strategies to protect America’s intelligence officers and diplomats serving abroad. Failure to address these attacks will impair U.S. diplomatic and intelligence activities, challenge strategic warning capabilities, and hinder crisis response.

What is Havana Syndrome?

The first case of Havana Syndrome was reported in December 2016 by a CIA officer stationed in Havana, Cuba under diplomatic cover. He noted to medical staff that he experienced painful headaches and dizziness coupled with strange sensations of sound and pressure while in his residence. Cuban intelligence regularly harassed U.S. intelligence officers stationed in Havana, but they had never caused physical harm. This appeared to be something entirely different. The same officer experienced a second incident two weeks later, and by February 2017, nearly every officer in the small Havana station had been affected. Similar incidents were reported in spring 2018 in Guangzhou, China. Since then, hundreds of incidents have been reported across six continents.

Victims of Havana Syndrome report a similar range of neurological ailments including headaches, vertigo, tinnitus, visual problems, cognitive difficulties, cranial pressure, and unfamiliar audiological sensations. They often state that it felt like they were hit with a “blast wave” of energy. A report by the National Academies of Sciences published in December 2020 examined a range of possible causes and suggested that “directed, pulsed radio frequency energy” is the most plausible explanation. Variations in positioning, anatomy, and length of exposure could also explain the varying symptoms and severity experienced by victims. Recent victims have found that “getting off the X”—immediately leaving the area they first experienced the symptoms—has been the most effective way to stop the symptoms and limit their lasting severity.

Marc Polymeropoulos shares his story.

Marc Polymeropoulos suffered from Havana Syndrome on a trip to Russia in late 2017. Having operated in the Middle East for most of his career, the trip was part of routine area familiarization for a new assignment, including meetings with the U.S. ambassador, as well as Russian intelligence counterparts. While staying at a hotel near the U.S. embassy, Polymeropoulos woke up in the middle of night to a blinding headache, tinnitus, and extraordinary vertigo. The symptoms resurfaced later in the trip and eventually led to his 2019 retirement from the CIA after 26 years of service.

Officers like Polymeropoulos faced an uphill battle in getting treatment for their symptoms and recognition from the U.S. government that their ailments were legitimate. Polymeropoulos reported that he had to ask to be screened for Havana Syndrome after symptoms persisted and was initially told his case did not resemble that of other victims. His request to be examined at Walter Reed’s National Intrepid Center of Excellence specializing in traumatic brain injuries was similarly rebuffed until he took the unusual step of going public with his story. Once examined at Walter Reed, he was diagnosed with a traumatic brain injury from an exposure event.

Geopolitical Motivations

Adam Entous recounts the first incident of Havana syndrome.

The first incident occurred in Havana when U.S.-Cuba relations were rapidly changing amidst the Obama-Trump presidential transition. Throughout the Obama administration’s second term, relations with Cuba had steadily improved. Secret talks in Canada yielded promising results, though Obama administration officials were harassed by individuals they surmised to be Russian intelligence officers. By July 2015, the U.S. and Cuba formally reestablished diplomatic relations and even discussed intelligence cooperation. In March 2016, President Obama visited Cuba, delivering a speech broadcast nationwide on Cuban television. However, by November 2016 President Trump’s election and Fidel Castro’s death upended key assumptions regarding the future of U.S.-Cuban relations and cast future progress in doubt.

The Trump administration initially suspected Cuba was behind the attacks as the government had previously maintained reasonable control of their own territory. This view eroded as cases spread overseas beyond the reach of Cuban intelligence. China was seen as a possible culprit as they had built significant inroads in Latin America over recent years. Some even considered Venezuela and North Korea as possibilities. Yet in every calculation of capability, intent, and opportunity, the balance always fell on Russia as the most likely perpetrator of Havana Syndrome. Russia is one of only a handful of states could develop the technology to carry out such advanced attacks on so many targets around the world. Geopolitically, it was also clear that Russia had the most to lose from improved U.S.-Cuba relations. Notably, the strategic effect of these attacks and subsequent response did strain relations. Washington evacuated officials from Havana, issued a travel warning for Cuba, and expelled Cuban diplomats.

Top officials in the Biden administration have adopted a similar belief that Russia is most likely responsible for these aggressive attacks against U.S. personnel, but concrete evidence remains elusive. However, reasonable assessments suggest a coordinated state effort. Planning operations of this size and duration would require significant operational infrastructure and effort. Some reports allegedly identify known operatives from the GRU, Russia’s military intelligence service, in the vicinity of Americans when they experienced Havana Syndrome. Such evidence is circumstantial, not conclusive, but would nevertheless align with a recent track record of poor tradecraft by GRU personnel. Targeting, surveillance, and attack operations all leave a noticeable footprint to some degree. A weapon that falls on the electromagnetic spectrum could also be detectable. As Adam Entous observed concerning the manhunt for Osama bin Laden, similar operations can turn on a dime once actionable intelligence is discovered.

The U.S. Government Response

Questions regarding the legitimacy of the victims’ claims hampered the U.S. government’s ability to undertake a systematic, interagency investigation of Havana Syndrome. Doctors at the University of Pennsylvania were contacted to examine early victims. Starting with an examination of only the recorded files, doctors initially suspected the symptoms were psychogenic. Once they physically examined the patients, however, they observed indications of traumatic brain injury caused by unknown external impact. Other parts of the government continued the investigation without taking the critical second step of examining the patients’ principal physical ailments, instead relying upon early misplaced assumptions.

Adam Entous discusses the FBI report.

A deeply flawed internal FBI report concluded the illnesses were psychogenic. This report amplified initial skepticism across departments and agencies and hindered a cohesive government response. The FBI’s Criminal Investigative Division first interviewed Havana Syndrome victims as part of their criminal investigation. The Behavioral Analysis Unit reviewed those reports and concluded the symptoms were psychogenic, a medical opinion made without any physical examination of the patients. Unfortunately, this grave misstep provided ammunition to those questioning whether Havana Syndrome had physical markers. Senior officials at the CIA and State Department relied on the FBI report in assessing their employees’ healthcare needs, even as cases increased around the world. As Havana Syndrome was not viewed as a legitimate threat at that time, few resources in the U.S. government were dedicated to solving this ongoing mystery.

An internal assessment found “serious deficiencies” in the State Department’s own response in areas of “accountability, interagency coordination, and communication, at all levels.” The attacks also took on a new dimension as White House staffers became targets. Two staffers in London ahead of President Trump’s state visit in May 2019 reported symptoms of Havana Syndrome. Another staffer later reported experiencing symptoms just outside the White House as he walked to his car. Still, no coordinated effort was formed in the U.S. government. These events raise a series of secondary and tertiary questions of why top leaders across the American intelligence community did not actively raise the alarm in a more proactive way over the last two years of the Trump administration. Or, if they had done so, why did national security policymakers fail to respond to clear evidence of attacks on American personnel?

Months into the Biden administration, the U.S. government response has changed. Congress unanimously passed the HAVANA Act, a bill authorizing additional support for those suffering from Havana Syndrome. In October 2021, President Biden signed the bill into law. CIA Director William Burns has also made investigating Havana Syndrome a top priority and signaled that urgency by placing the officer that led the manhunt for Osama bin Laden at the head of the task force. In many respects, the Havana Syndrome investigation should resemble a standard counterterrorism operation—a clear mandate from the top, coordination across agencies, and dedicated resources to monitor adversaries for any potential missteps.

New Policy Responses Needed

In formulating a comprehensive response, national leaders must consider the way ahead and how to approach the challenge of crafting a purposeful response. A counterintelligence mindset can aid the effort as new intelligence on the intentions, plans, and capabilities of organizations responsible for these incidents are a core priority. Clear attribution remains an elusive puzzle piece that would drive well-coordinated policy across the national security enterprise. Definitive answers will require the right combination of sources and methods, but only as a first step in a comprehensive approach. Crafting a policy response that deters and defends in this gray area presents a significant challenge for the president and the intelligence community.

Marc Polymeropoulos on potential policy responses.

Reports of Havana Syndrome closely fit the model of asymmetric warfare—the attacks have a seemingly low cost to create and reproduce around the world but are also extremely disruptive and deniable. Havana Syndrome could be the result of intelligence collection operations, perhaps an effort to eavesdrop or extract information from electronic devices. Nevertheless, there is a possibility Washington may uncover attributable evidence that Havana Syndrome is a result of deliberate, state-sponsored attacks against U.S. personnel. Any such discovery would require an unambiguous response signaling American resolve at home and around the world.

The record thus far has been mixed. Pentagon officials in the Trump administration informally discussed enacting more severe measures against GRU officers, but many were wary of escalating or provoking without a high-confidence assessment. The Biden administration implemented an up-tempo systematic process with more resources, but increased resources alone does not equate to positive outcomes. Although it is unlikely intelligence officials will be able to issue high-confidence assessments about Havana Syndrome to the level policymakers would prefer, much like the raid on Osama bin Laden, they will have to decide what to do. The continued debate over response options will require leaders to balance organizational priorities in pursuit of national interests while intelligence officials continue to meet rigorous standards and reduce uncertainty in support of the decision-making process.

Policymakers need a suite of options beyond the traditional responses of targeted sanctions and the designation of foreign officials as persona non grata. At minimum, responses should be proportional in effect and could target those directly responsible for attacking American personnel. Perhaps even more importantly, actions must hold organizers and decision-makers accountable for their actions. A less than comprehensive response that appeases those leaders will only encourage continuation and increased aggression. Inadequate responses risk failing to deter continued attacks on not just Americans, but also potentially on allies around the world and would irreparably harm long-standing norms in the intelligence space.


Even as the Biden administration ramps up its efforts to uncover the source of Havana Syndrome, new events continue to proliferate around the world. Incidents reported by staffers associated with high-level officials are particularly concerning. In August 2021, Vice President Kamala Harris’s trip to Vietnam was delayed after multiple officials in Hanoi were treated for symptoms of Havana Syndrome just before her arrival. The next month, a staffer traveling with Director Burns in India was treated for the Havana Syndrome.

Policymakers cannot wait for unquestionable, definitive evidence before developing new response options. In the face of escalating attacks on America’s frontline, the consequences are too great to indefinitely ponder alternative scenarios. Recent steps to collect better data, define clear guidance to personnel, and provide medical care are all important. But it is time to consider actions which will end these incidents now and in the future. U.S. diplomats and intelligence officials have unselfishly put themselves in harm’s way to support and defend the Constitution of the United States. Part of that selfless service comes from the confidence and knowledge that America will protect and care for them in the field and at home. Washington needs to make a clear commitment to fulfilling that duty on all fronts including foreign and domestic.

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For more information on this publication: Belfer Communications Office
For Academic Citation: Power, Sean and Michael Miner . “Report – Havana Syndrome: American Officials Under Attack.” Belfer Center for Science and International Affairs, Harvard Kennedy School, November 4, 2021.