Cuba's exemplary 'revolution'

Punching way above its weight, the tiny nation has developed five vaccines, and offers hope of vaccine equity across the world

Cubas exemplary revolution

This is possibly the quietest and most stunning of Cuba's revolutions since Fidel Castro overthrew Batista's military dictatorship in 1958.

There have been other revolutions in the tiny nation over the decades — in public health, in medical internationalism (where doctors were sent to countries in need) and most impressively in its biotechnology sector.

Even so, the development of five vaccines to fight the SARS-CoV-2 virus that causes COVID-19, three of which have been deployed to vaccinate 93 per cent of its population, is an unparalleled feat.

This has been largely unnoticed by the global media, which was focused almost entirely on the new-fangled and expensive mRNA vaccines brought out by the likes of Pfizer Inc and upstart company Moderna Inc, and was writing paeans about their bosses.

Science journal Nature was one of the earliest to spot the breakthroughs made by Cuba's Centre for Genetic Engineering and Biotechnology and Finlay Institute of Vaccines. Towards the middle of 2021, a couple of news agencies began to report on the good news emanating from Havana, piquing interest as Cuba sent vaccines to some countries.

When the COVID-19 pandemic hit the Caribbean Island, the Cuban spirit of independence, honed by six decades of trade sanctions imposed by the Americans, once again came to the fore. Depending on the rich world to send vaccines would in all likelihood mean a long and possibly futile wait — which it indeed has for a host of low-income countries in Latin America, Africa and Asia.

Cuba's decision to fight the pandemic on its own holds many lessons for other countries — especially India, which has 10 times the scientific humanpower of Cuba apart from more resources and a much freer access to the inputs required for its research.

The fundamental difference is the depth of Cuba's education and science as well as the clear alignment of its research and development (R&D) with the social and economic priorities of its people. This is how Cuba built an outstanding health biotechnology sector that is globally respected.

Havana's decision to channel its resources and formidable research talent into developing its own vaccines indicated a determination to brush aside its acute economic crisis. It also entailed the shelving of some important research projects, but the heavy caseload of COVID-19 cases called for urgent action.

The results of the year-long effort have been spectacular. Cuba, with a population of 11.3 million, has developed five vaccines and says four of them provide over 90 per cent protection against COVID-19 when administered in three doses. This has allowed the country to vaccinate a massive percentage of its population, more than any other country barring the oil-rich United Arab Emirates — a Gulf state that has a lower population than Cuba — and Portugal, which is a fraction ahead.

As of January 20, 2022, some 86.54 per cent of Cubans are fully vaccinated (three doses) and another 7 per cent have been partly inoculated, according to the dashboard of scientific website Our World in Data.

Glasgow University academic and Cuba expert Helen Yaffe describes this as an "incredible feat" while John Kirk of Dalhousie University in Nova Scotia, another Latin American specialist, was equally laudatory:

Just the sheer audacity of this tiny little country to produce its own vaccines and vaccinating (sic) over 90 per cent of its population is an extraordinary thing.

Both were speaking to news business news outlet CNBC. But given Cuba's track record, this should not come as a great surprise.

In the 1980s when Castro sensed the potential of biotechnology — at a time when even the most advanced rich nations had not yet grasped the possibilities of this nascent field — he invested an unbelievable $1 billion in the sector. He also sent his scientists to the pioneering researchers in the US, Finland and Canada who were ready to share the fruits of their R&D without putting up intellectual property barriers, along with those in the former Soviet Union.

As a result, bio-pharma innovation has been a hallmark of the Cuban system since the 1980s, an endeavour dedicated to finding low-cost drugs to combat life-threatening diseases such as hepatitis, polio and meningitis B.

But this is not what makes Cuba special; rather, it is its readiness to share its discoveries with other Third World countries that puts it in a class of its own. The World Health Organisation (WHO) lauds Cuba as "a global leader in South-South transfer of technology, helping low-income countries develop their own domestic biotech capabilities, providing technical training, and facilitating access to low-cost life-saving drugs to combat diseases such as meningitis B and hepatitis B."

As the world grapples with new variants of SARS-CoV-2, Cuba's discovery that its three-dose regimen of the vaccines — the Abdala vaccine is protein-based while the others, collectively called the Soberana series, use a "conjugate" design along the lines of meningitis or typhoid vaccines — spells hope for countries that have been scrambling for doses.

Political allies may probably get priority, since emergency shipments have already been sent to Venezuela, Nicaragua, Iran and Vietnam while waiting for WHO's approval of the vaccines. This would help make the vaccines more widely available.

In a significant tie-up, the Finlay Institute has joined with the Pasteur Institute in Tehran to run a massive 24,000-person clinical trial in Iran. The results are expected to be published shortly. The only problem for wider access to these vaccines is the limited production in Cuba. The Finlay Institute can produce 10 million doses of Soberana 2 per month, but the world needs more, especially in Africa, where vaccine inequity is stark.

Cuba-watchers like Yaffe believe its vaccines are their best hope for facilitating inoculation in the coming years. Health experts are talking less and less about the Covaxin jab produced by India's Bharat Biotech International Ltd. Not only is its efficacy in taking on the new variants of teh novel coronavirus yet to be proven, its production has also not increased significantly. Nor have there been any licensing agreements with other companies, possibly because the ownership of the technology remains murky or because it is not viewed as a viable project.

So, it is Viva Cuba, with the hope that its latest revolution spreads far and wide. DTE

Views expressed are personal

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