The Cuban president’s challenge to the Trump administration came during a tour of central Cuba last week, where CNN was given rare access to the Cuban head of state. The focus of the trip was officially the local economy, but the 2020 US election appeared to be very much on Diaz-Canel’s mind.

“It’s ridiculous how the United States practically every week sanctions Cuba and then uses manipulative language to say this is ‘helping’ the Cuban people.” Diaz-Canel said. “We are not going to surrender nor dishonor ourselves nor get on our knees whatever price we have to pay,” he said.

The price could be very high. Few countries have as much at stake as Cuba does in the November election. All the top Democratic candidates have declared they are in favor of the policy of engagement and lifting the nearly six decades old US economic embargo on the communist-run island.

President Trump on the other hand dismantled the history-making Obama opening with Cuba and has placed some of the most punishing sanctions on the island in decades, which Cuba blames for shortages of fuel, food and even gas for cooking.

While Republican presidents have historically supported the claim by conservative Cuban-Americans, most of whom live in swing state Florida, that Cuba needs to hold multi-party elections and make repatriations for property seized after the 1959 revolution, Trump has hit the island especially hard.

How to improve the island’s struggling economy in the face of tougher sanctions is the most pressing challenge for Cuba’s new president, who was born in 1960, the same year the US economic embargo went into place.

CNN was one of three international outlets invited to accompany Diaz-Canel on parts of his trip to the colonial-era city of Sancti Spiritus, which has a population of just over 140,000 people. At least six government ministers, Cuba’s newly named Prime Minister and a small army of plain clothes security flanking Diaz-Canel descended on the city.

In the early years of the revolution, Fidel Castro traveled widely throughout Cuba to interact directly with the populace, often with the international media in tow. After his brother Raul Castro succeeded him in 2008, the practice –and media access— all but died out.

Diaz-Canel, Raul Castro’s handpicked successor, recently reinstated the highly visible trips across the island, perhaps to show a more responsive government in times of economic crisis. During his two-day visit to Central Cuba last week, he shot hoops with a local basketball team, chatted with university students and shook hands with passengers waiting at a local bus station.

Despite the change in leadership, Trump administration officials have made no serious effort to reach out to Diaz-Canel and have insinuated that the Cuban president is not really in charge as Raul Castro remains head of the Cuban Communist Party until 2021, when he says he will retire.

Instead the Trump administration has embarked on a policy of sanctions as water torture, slowly but steadily issuing penalties that make it harder to visit or do business with the island.

Last year, the Trump administration terminated a deal with Major League Baseball that would have allowed Cuban players to compete in the US, ordered American cruise lines out of Cuba and cancelled US airline flights to everywhere but Havana, nine destinations in all. The measures hurt Americans as well as Cubans, the Cuban government says.

US officials say the sanctions are depriving the Cuban government of badly needed funds and will force them to rethink Cuba’s support for the Maduro regime in Venezuela and their record on human rights.

But two and half years into Trump’s Cuba policy there are few signs the US is getting its way. Cuba all but ignores US criticism on human rights; it recently jailed and began criminal proceedings against one of the island’s best-known dissidents. Venezuelan President Nicolas Maduro remains in power and last week he declared to Cubans they can “count on Venezuela for everything, today and always.”

Venezuelan oil is still flowing to Cuba and the partnership is strong, perhaps even stronger, in spite of Washington’s efforts — and US officials’ threats of more sanctions.

Diaz-Canel says Cuba is willing to negotiate with the US, but not under the threats of more economic arm twisting.

“They have to treat us equals,” he said.

The future of US-Cuban relations could come down to the upcoming US election. If a Democrat were to win, US visitors, which have dwindled under the Trump administrations sanctions, would likely come roaring back to fill the mostly empty new hotels built during the Obama boom.

Many would also stay in rental homes and eat in private restaurants the government has allowed Cubans to open. And with more engagement and trade would come more influence.

If Trump wins a second term, some Cuba watchers wonder if the businessman who at one point tried to open up a hotel on the island might change tact and decide to pursue his own détente. But Diaz-Canel doesn’t think so.

“The way Trump has behaved towards Cuba doesn’t just have to do with the election,” he said.

He added, “Cuba is ready. For us, these situations aren’t new. Cuba is ready to confront difficult moments with or without his reelection.”