Cuba’s national mission to produce a COVID-19 vaccine

There were a few eyebrows raised when Cuba this month announced that it was entering the advanced stage of clinical trials in the development of its coronavirus disease (COVID-19) vaccine, Soberana 02. The most common response was: How come a country that is regarded as poor (as some put it bluntly) has successfully developed a vaccine and in such a short time, whereas so many more affluent countries have failed to do so or have not even bothered to try? After many years of following the mysterious ways in which Cuban society moves, I was less surprised; in fact, I almost expected it to be at the forefront of fighting the coronavirus pandemic.

Investing in health is one of the Cuban revolution’s articles of faith. It is engraved in its ideological DNA and there are a number of precedents for its proactiveness in eradicating outbreaks of disease both at home and internationally. For the Cuban revolution, education and public health have been two interwoven issues that have become a national mission of the highest order.

What I find peculiar about those who expected that Cuba would join the queue with other countries of its size and comparable resources and wait its turn to receive vaccines, is that the very same people are less amazed, for instance, that a country on the verge of starvation like North Korea has developed nuclear weapon capability, which exhausts whatever little resources it has and by doing so risks bringing catastrophe on itself. When a country like Cuba creates a very impressive health system and biotechnology sector, for its own sake and for other countries’ benefit, this becomes a source of bemusement.

Small countries, if they are to be successful, must choose their targets carefully and purposefully and play to their strengths. Cuba, as a country with very limited natural resources, has put its trust and hope in its most significant resource — humans, through investing in health and education. The Cuban revolution has subscribed to this principle since it came to power in 1959 and has stuck to it despite being under a US embargo from almost Day 1, and even when it was abandoned by Russia after the Soviet Union collapsed. Cubans have constantly adjusted to changing circumstances at home and abroad. In more than 60 years, including some extremely turbulent ones, the country has never lost sight of the fact that investment in education and health consolidated the revolution at home. And, by sharing its benefits internationally, Cuba has both increased its prestige, especially in the developing world, and acquired a major source of hard currency.

There is nothing accidental or mysterious about Cuba’s place at the forefront of tackling the spread of disease at home and abroad. While Fidel Castro was incarcerated on the Isle of Youth (then the Isle of Pines) in 1953, he expressed concerns over Cuban healthcare in letters smuggled out of prison. When he came to power in 1959, one of the first services to be completely nationalized was healthcare — but this is not the full story. Necessity played an important part too. In the immediate aftermath of the revolution, medical doctors, mainly from the more privileged class of Cuban society, fled the island, mostly to the US in search of a more comfortable life. This created a push to train doctors from among the urban and rural poor, who were also taught about the universal values of mutual responsibility.

The current pandemic is playing into the strengths of the Cuban healthcare system, which has always focused on preventive healthcare and working within the community. This has proved to be crucial over the last 12 months of testing and tracing, especially as there is massive trust in local medical staff. Moreover, since the 1980s, the country has built an impressive biotechnology industry, also to confront shortages derived from the US embargo. For visitors to Cuba, especially those from the more affluent parts of the world, who are used to clinics and hospitals equipped with state-of-the-art technologies and conveniences, the country’s hospitals feel as if they belong to a different era altogether, and in need of a complete overhaul. However, as in many walks of life and especially in healthcare, the emphasis is not on luxury but on the quality of prevention, treatment and rehabilitation, and a holistic approach is taken, of which pharmaceutical research and development is an integral part.

Like other revolutions, Cuba’s drive for autonomy in most areas of human activity has been the consequence of constant external pressure attempting to strangle it economically and bring about regime change. Being subjected to one of the most severe and cruel sanctions regimes in history, imposed and sustained by successive US administrations, gave a strong impetus for the emergence of an innovative society that is capable of improvisation in response to an unfolding crisis, with an element of defiance in the face of Washington’s uncompromising approach. One of the major beneficiaries of that approach has been the biotechnology sector, which since the 1980s has enjoyed a substantial injection of resources, with high priority given to projects concentrating on finding remedies for diseases directly affecting the Cuban population, and later also the developing world. The country has proved that it can combine medicine and humanitarianism, while also making it a source of income.

Leasing healthcare professionals to foreign countries has, in recent years, yielded Cuba about $11 billion annually, making it a bigger source of income than tourism. Meanwhile, eight of the 13 vaccines that are regularly administered to children on this Caribbean island are produced locally, while Cuba also exports vaccines to more than 30 other countries. Beyond vaccines, Cuban researchers have, for example, developed an advanced and innovative treatment for foot ulcers in patients with diabetes that prevents amputations, as well as a vaccine for lung cancer that causes the immune system to attack the disease.

The development of the Soberana 02 COVID-19 vaccine again highlights Cuba’s medical and biotechnological prowess. In light of the new administration in Washington, which is highly likely to return to Barack Obama’s rapprochement with Havana, and the reforms that have just been introduced by the Cuban government, there is an opportunity for this sector to grow exponentially if both countries cooperate. This will not only benefit Washington and Havana, but it will also maintain Cuba’s ethos of solidarity with citizens of the poorer countries of the world.

• Yossi Mekelberg is professor of international relations and an associate fellow of the MENA Program at Chatham House. He is a regular contributor to the international written and electronic media. Twitter: @YMekelberg