Cuban President Fidel Castro, who handed over power provisionally to his younger brother after undergoing surgery, has thumbed his nose for four decades at the US government just 90 miles away across the Florida Straits.
On the verge of turning 80, the left-wing leader has enjoyed a revival in international support that has allowed him to pull Cuba out of a post-Soviet meltdown and has worked to ensure that the West's sole communist society survives him.
"I'm really happy to reach 80. I never expected it, not least having a neighbor -- the greatest power in the world -- trying to kill me every day," he said on July 21 at a summit of South American presidents in Argentina.
In his old age, Castro has set about trying to grapple with some of Cuba's glaring failures -- decrepit housing, poor transport, power outages and corruption -- while denying his critics a voice. Cheap oil and money from Venezuelan President Hugo Chavez and credit from China has kept Cuba afloat.
Vilified by opponents as a totalitarian dictator, Castro is admired in many Third World nations for standing up to the United States and providing free education and health care.
He has won friends by sending 20,000 Cuban doctors abroad to treat the poor, mainly in Venezuela, but some as far afield as Pakistan, Indonesia and East Timor.
Some 260,000 patients from Latin America and the Caribbean have undergone free eye surgery in Cuba since 2005 in a joint program with Venezuela.
Castro was greeted by crowds like a rock star in Argentina this month. Anti-globalisation youths see him as a hero, along with revolutionary Che Guevara.
"Fidel and Che are symbols of socialist ideals, equality and solidarity, lost in today's capitalist world," said Jose Fierro, a teacher from Latronquiere in Southern France
"Young people want to believe it is possible," he said, while visiting earlier this month Castro's hide-out atop the Sierra Maestra mountains, from where his guerrillas swept down to overthrow U.S. backed dictator Fulgencio Batista in 1959.
Cubans form lines every day outside foreign embassies to request visas, but then require government permission to leave. Families lose all their belongings if they go for good.
Leading dissident Oswaldo Paya says low wages force many to resort to illegal black-market activities to get by and always look over their shoulders to see if they are being overheard, while the ruling party elite is a privileged caste.
"Cubans don't want to live like this anymore," said Paya.
Castro, who says he has survived 600 assassination plots by the CIA and US-based exiles, is the world's third longest-serving head of state after Britain's Queen Elizabeth II and Thailand's King Bhumibol Adulyadej. He turns 80 on August 13.
His pace has slowed and he appears frail since fracturing a knee and an arm in a fall after a speech in October 2004 seen live on television.
But he has still retained the stamina for speeches lasting 3-4 hours, delivered standing, to denounce his foes and micromanage Cuban affairs, often reeling off pages of statistics on every detail of the country's life.
Doubts about his health, first raised when he fainted during a speech in 2001, have stoked speculation about the political deluge that Cuba might face when he is gone.
Castro's designated successor is his younger brother Raul, who is 75 and is thought to lack the charisma that made Fidel an icon and may be the glue that has held his socialist revolution together.
Cuba's relations with Latin America have rarely been so close, despite US efforts to isolate Havana that date back to the Cold War when the whole region except Mexico broke off diplomatic ties and complied with a US trade embargo.
"Cuba feels much stronger. We survived the big crisis of the early 1990s," Ricardo Alarcon, president of Cuba's National Assembly, said earlier this month. "You can say what you like about Cuba, except that it is isolated."
Yet old timers like Mario Bruqueta, who fought with Castro in the Sierra Maestra, worry about the future without their "irreplaceable" leader.
"The Cuban people are more Fidelista than Comunista," he said.