Cuba’s strategies to combat COVID-19

By Niyi Akinnaso

As Nigeria spends billions of Naira to purchase drugs, PPEs, establish new labs for PCR tests, and supplement coronavirus vaccines donated by COVAX to combat COVID-19, the small island nation of Cuba has been swimming in self-sufficiency, by producing its own drugs, PPEs, and vaccines. It has commenced the vaccination of health workers with its own homegrown vaccine, the Soberana (Sovereign) 02. It is one of five vaccine candidates being developed in various laboratories in Cuba.

The feat did not just come overnight. It is a result of decades of investment in biotech and biopharmaceutical industries, leading to over 30 years of vaccine development by the island nation.

However, vaccine production is only one of Cuba’s major strategies to combat the scourge of COVID-19 in the country. In addition to the non-pharmaceutical measures adopted universally, particularly mask wearing, hand washing, and physical distancing, Cuba developed two key strategies to combat COVID-19.

The first strategy is the manufacture of drugs and medical equipment specifically to treat COVID-19 infections. Accordingly, the National Center of Biopreparations (Biocen) immediately focused on the manufacture of several of the main drugs used to treat COVID-19 infections.

Similarly, PPEs were produced and distributed to healthcare workers and then to all citizens to protect themselves. To this end, the Cuban government repurposed a school uniform factory to produce masks instead. Finally, a prototype ventilator was quickly produced and, once found effective, was later mass produced to treat COVID-19 patients. These efforts resulted from collaborations by the Neurosciences Center; the Grito de Baire Enterprise, affiliated with the Military Industries Union; the Center for the State Control of Medicines and Equipment and Medical Devices (CECMED); and the National Design Office.

Simultaneously, the government went full force into vaccine research, drawing upon its decades of experience in vaccine production and freely available literature on COVID-19 vaccines. Two preeminent labs in the country were deployed to this purpose. The Finlay Vaccine Institute focused on three vaccine candidates: Soberana 01, Soberana 02, and Soberana Plus.

The Center for Genetic Engineering and Biotechnology produced the other two vaccines, namely, Abdala and Manbisa. Soberana 02 and Abdala. All five vaccines benefitted from preliminary work by the Center for Molecular Immunology, which “fermented” mammalian cells that directly produced the RBD antigen used in producing the COVID-19 vaccines. It is this method of vaccine production that made it possible for these vaccines to have little or no effect on their recipients.

Another interesting feature of Cuba’s vaccines is storage. Unlike other vaccines that require special temperatures for storage, the Cuban vaccines can be stored and transported at regular refrigeration temperature. This makes it very attractive to countries, which have difficulty with vaccines kept in unusually cold temperatures.

Of Cuba’s five vaccine candidates, Soberana 02 and Abdala have reached the most advanced stage of Phase III clinical trials, the former being a little ahead of the latter. Both have proved to be safe and effective in clinical trials, with little or no side effects. Even the World Health Organization has also confirmed that the two vaccine candidates in Phase III clinical trials were effective and safe in previous clinical trials. However, how effective on a large scale remains to be seen.

Nevertheless, many countries have already expressed interest in the Cuban VOVID-19 vaccines. They include Venezuela, Mexico, Vietnam, Pakistan, India, and Iran. Cuba is still open to partnerships with other countries in order to be able to ramp up production. Nevertheless, it hopes to vaccinate all of Havana, the main island, by the end of June and the rest of the country by the end of the year by which time it is hoped that 100 million doses would have been produced.

There are two unique features of the Cuban vaccine production technology. First, a nasally administered vaccine is added to its array of intramuscular vaccines. This nasal vaccine is Mambisa, now in Phase II Clinical Trial.

A second unique feature is the production of a vaccine specifically for convalescent patients, recuperating from treatment for COVID-19. This is supplemented with follow-up assistance from medical institutions through a Basic Work Group, consisting of specialist doctors, epidemiologists, and rehabilitation specialists. Cuba is so far the only country to have included this type of vaccine in its array of vaccines. Besides, no other country is pursuing as many as five vaccines simultaneously.

The Cuban effort should be understood against the backdrop of over 60 years of pernicious trade embargo imposed on the island nation by the United States, intensified recently by the regime of former President Donald Trump. The social, political, and economic sufferings resulting from the embargo were intensified by the COVID-19 pandemic, which limited Cuba’s exports and shut down the tourism industry, one of the mainstays of the Cuban economy.

In the face of the American trade embargo and the withdrawal of support by the Soviet Union, following its collapse, Cuba quickly decided to invest in human capital development, focusing on medical education, biotechnology, and the pharmaceutical industry. In Cuba, education is free at all levels, although it has a strong political and ideological emphasis. The fruits of the focus on education are threefold: One, Cuba’s literacy rate is one of the highest in the world, at 99.8 percent. Two, the supply of professionals, especially medical personnel, to other countries is one of Cuba’s major exports. Three, Cuba has developed skilled personnel and expertise in the production of drugs, vaccines, and medical equipment. No wonder then that Cuba has one of the best healthcare systems in the world.

No matter what one thinks about Fidel Castro and communism, one factor that cannot be denied is strong leadership and commitment to development. Until Nigeria has such a visionary leader we may have to continue to beg, even with money in hand, for drugs, medical equipment, and vaccines.

 

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