José Ramón Machado was born in San Antonio de las Vueltas, in the former province of Las Villas, and was schooled in Camajuaní and Remedios. He is a medical doctor by profession, graduating from the University of Havana in 1953. Machado joined the revolutionary movement immediately following Fulgencio Batista's coup d'état of 10 March 1952, while still a medical student, and was an early member of the 26th of July Movement opposing the dictatorship. Later, under the command first of Ernesto "Che" Guevara and subsequently of Fidel Castro, he was one the original revolutionaries who fought the guerrilla war in the Sierra Maestra. In 1958, promoted to the rank of captain, he was sent to the province of Oriente under the command of Raúl Castro as part of the rebels' bid to open up a second front. There he was placed in charge of the guerrillas' medical service, establishing a network of hospitals and dispensaries, and was promoted to the rank of major "comandante".
After the Cuban Revolution
Following the revolutionaries' victory on 1 January 1959, he was appointed the director of medical services in Havana and later served as the national Minister of Health from 1960 to 1967, during which time he was responsible for the development of the country's health sector. In January 1968, reportedly in the aftermath of a personal conflict with Fidel Castro over the running of the health sector, he was appointed to serve as the Politburo's delegate in the province of Matanzas. He remained in Matanzas until mid-1971; his administration of the province's economy and health sector was successful, particularly in terms of crop outputs, public transport and reduced infant mortality. Upon leaving Matanzas in 1971, he was appointed first secretary of the Cuban Communist Party in the province of Havana and was elected to the Politburo in December 1975. He is a member of the National Assembly of People's Power, representing the municipality of Guantánamo. Since 2006, he has been responsible for overseeing Cuba's international education programs. José Ramón Machado has been described as "a hardline communist ideologue and old guard revolutionary." On 10 January 2007, he represented Cuba at the inauguration of Nicaraguan President Daniel Ortega. Machado was elected by the National Assembly of People's Power as First Vice-President of the Council of State on 24 February 2008, at the same time as Raúl Castro's election as President; he received 601 out of 609 votes.
