Cuba: A sign of hope for impoverished countries

Just a few days before commercial flights with Cuba were reestablished, in the middle of November, the Swiss physician and professor Franco Cavalli traveled to that Caribbean nation. He is president of MediCuba Europe, an important network of healthcare NGOs with a presence in 13 countries. He is also one of the first European scientists to be able to visit Cuba after the severe restrictions were relaxed.

As he explains: “I found myself in a model country in the fight against COVID-19. It’s a country that, nevertheless, is today confronting a profound economic crisis due to the pandemic and the blockade.”

Between March and November 30, on Monday, the official figures, verified by the World Health Organization itself, reflect an extraordinary healthcare reality: “Cuba accounts for 50 times fewer deaths than Switzerland and almost 120 times fewer than Belgium,” according to Franco Cavalli. He is a prestigious oncologist who between 2006 and 2008 served as president of the International Union against Cancer (UICC). (and who “in 2006 … was voted Switzerland’s “Person of the Year” for his contributions to society, largely due to his work in cancer and palliative care in the developing world.”)

In the last 10 months, the Caribbean nation registered 8,233 infections and only 134 deaths in a population of around 12 million people – which represents an impact of 1.18 deaths per 100,000 inhabitants. At the same time, the Dominican Republic, Cuba’s neighbor, accounts for 21.92 deaths; Germany – Europe’s best example for controlling the pandemic – 19.68 deaths; Switzerland 55.53 deaths now; and Belgium 144.73 deaths – all per 100,000 inhabitants.

Successful healthcare effort

Cavalli pointed out that the island’s public healthcare system, totally free, and prevailing concept of community medicine “has permitted [Cuba] to successfully control the pandemic that otherwise might have wrought havoc as happened in many Latin American and Caribbean countries.”

He highlighted the “extreme discipline of citizens,” adding that “I never saw anyone without a mask while I was in Cuba. Sanitary controls are systematic. On entering whatever institution or public space, they measure your body temperature and require that you disinfect your hands, and in many places your shoes too.”

One objective of his trip was to gain information about progress toward a vaccine. Sovereign 1 has finished its first phase. They tested it in two age groups, one, people who are more than 60 years of age, and the other, people who are much younger. Now phase 2, in which they measure efficiency especially at the level of cellular response and antibodies, is on the way. They hope to begin phase three toward the end of the year. They expect to have the vaccine ready at the end of March and plan on using it during mid-2021. There is a second vaccine project, Sovereign 2. It’s also being tested.

For many years Cuba has invested in biomedical research. Its researchers have enormous experience in this area. For example, they made the first vaccine in the world against meningococcus, explains the Swiss professor. The Finlay Institute, with which he was in close touch during his recent stay, is one of the 32 centers making up that part of the scientific epicenter in Havana that is called BioCubaFarma; 20,000 people are working there.

One of the characteristics of these specialized entities in Cuba is that research and industrial production have developed in the same space. Bio-technical exports constitute an important source of resources for the country, Dr. Cavalli reminds us. One example: Cuba is committed to supplying a large part of the Latin American market with erythropoietin (EPO), a Cuban product that is essential for treating chronic anemias, kidney failure, and treatments that follow chemotherapy cycles,

“In this specific case of a vaccine against SARS-CoV-2, I am not sure if Cuba’s productive capacity is going to be sufficient in case it reaches the point of entering the world market or part of it. Nevertheless, inasmuch as BioCubaFarma can rely on three affiliates in China, my impression would be that some of the production, in this situation, could take place there,” Cavalli observed.

The Swiss doctor recalls having heard in Havana a summarizing expression that he regarded as significant: “We will not be the first to have a vaccine, but we look forward to being the first country that guarantees vaccination for all its people.” This is a challenge, but in consideration of Cuba’s research advances, it could be a reality in the near future.

The Cuban vaccine, added the Swiss scientist, may reach the point of crossing borders. Speaking with several officials of the WHO/OPS (Pan-American Health Organization) in the Cuban capital, he “arrived at the conclusion that there’s hope for the Cuban vaccine being distributed in low-income countries at prices that make it accessible. It would be adapted for high temperatures, which is different from others being developed, and so doesn’t require sophisticated low-temperature supply chains. This could constitute a real alternative to what the big pharmacological laboratories are producing.”

Complex situation

The economic consequences of the pandemic cannot be underestimated. The effects may be dramatic. “If to the severe impact of the blockade, we add, for example, the recent decision of Donald Trump to block remittances from families in the United States to the island, the situation is doubly worrisome,” he insists.

One perceives, he adds, daily problems that are similar to the crisis the Caribbean nation experienced during the “special period” at the beginning of the 1990s. Perhaps one difference “is that now the scarcity of gasoline is less than back then.” Hardship is quite evident in the noticeable efforts people employ to save what they are using in all that they do.

Tourism, one of the essential sectors of the economy, that now accounts for 10% of the GDP, has suffered a significant impact in these last ten months of self-confinement in the island. “Tourist activity has resumed recently but with lots of precautions,” explains Franco Cavalli. Havana’s international airport was just reopened for scheduled flights from November 15 on, and they’ve reactivated some tourist areas like Veradero.

That complex situation does not permit indifference on the part of international solidarity, affirms the president of MediCuba Europe. That network succeeded in putting aside 600,000 euros during the first months of the pandemic and, having done so, were able to assure access to the materials required for preparing tests, and access also to 25 pulmonary ventilation devices.

The Finley Institute now presents Dr. Cavalli with a project of almost half a million euros for buying instruments that can’t be obtained on the market due to the U. S. blockade. What’s involved is equipment that allows for measurement, after immunization, of changes in the white blood cells that produce antibodies that directly fight the virus.

Closing in on 80 years of age, Franco Cavalli every day for 40 years has regarded international solidarity as one of his militant commitments. Cuban and Central American represent priorities on his horizon, but there are others.

Therefore, as he mentioned in an earlier interview, solidarity is much more than the idea of “help for development.” As he said at that time, without abandoning his critical analysis, “That concept is false. I don’t reject the idea of help. We have to keep on working together and in solidarity. Without this little contribution surely people in those countries would be even worse off. But what we should not say is that we are fostering development. The philosophy behind the concept of “help for development” is mistaken. We must promote, above all else, political change of the international rules that are in play.”

And those new rules require horizontal North-South, South-North relationships, not top-down. Starting with that, the president of MediCuba Europe has this hope: in the future, to confront the devastating impact of the pandemic, a vaccine discovered and produced in the Caribbean could be a ray of hope for all of those excluded by the giant multinational pharmaceutical industry.

Translated by W. T. Whitney Jr.

Original in Spanish at Rebelión, shared under Creative Commons.