On 6 January, news agencies announced that Cuba has signed a treaty with Iran to conduct clinical trials of the new COVID-19 vaccine not only on the island, but also in those in the Asian country. The agreement included two news stories: one, that Cuba is not only able to produce vaccines but also to export these biotechnological products; and two, that on the island there are very few people contaminated with coronavirus – for their happiness – to be able to carry out fully phase 3 of the clinical tests of vaccines on the island.

A few days earlier, at the end of December, Lehendakari Miguel Díez-Canel visited the researchers of the Finlay Vaccine Institute in Havana to publicly express the recognition of Cubans for their work “The only country in the Third World that has carried out the production of such a vaccine”. Not only that: it will be the only nation to fund and produce the vaccine to 100% of the population with public resources.

According to the World Health Organization, in early January 2021, of the 237 vaccine projects that are in the process of preparation around the world, 6 had already been approved by some government and began to be applied to the public, 6 were already in the process of approval and 64 more in clinical trials. Among the 12 included in phases 2 and 3 of the latter is the Sovereign of Cuba 02.

In addition to the two vaccines cited by the Finlay Institute, the Center for Genetic Engineering and Biotechnology of Cuba works in two other vaccines, overcoming the clinical tests of phase 1, Abdala and Mambisa, carried out on January 18. A great feat for a poor island, with four inhabitants like the Basque Country (11 million people), with a Gross Domestic Product more or less our own: Cuba’s GDP has risen from $100 billion in 2018 to $90 billion in 2016, plus that of the Basque Country and Navarre without Iparralde.

It is no coincidence that Cuba is at the front end of vaccines, as this type of technology is not improvised in two days. Italian immunologist Fabrizio Chiodo recently offered an interview to Ana Iglesias Mialareti, of the Pompeu Fabra University of Barcelona, in which he analyzed the subject. Chiodo, who is supposed to have done a PhD in San Sebastian, besides being a professor at the University of Havana, is also at the Superior Council of Scientific Research of Italy and has participated in the studies and clinical trials of vaccines Soberana 01 and Soberana 02.

Chiodo has explained that at the technological level Cuban vaccines are equal to those of the generation based on the latest technologies for the multinationals of old vaccines. Since vaccines were made until a few years ago to produce an immune response in the receptor using deactivated viruses, today they are based on genetic manipulations the last generations, such as those that have worked Pfizer and Moderna, and inject genetic components of the viruses to teach the recipient's cells to create proteins from the viruses and to awaken immunity. It is estimated that between the two generations the producers of Cuba and one third of the COVID-19 vaccines that have so far reached clinical trials, called Subunit Protein Vaccines: Novamax Vaccines, Vector Institute of Russia, etc.

Cuban researchers have used the viral proteins of other vaccines produced on the island earlier to develop vaccines against COVID-19. In Soberana 01 they use the meningococcal B vaccine, which in the last 20 years has been exported to other countries to immunize the children of the island. In the case of Soberana 02, a tetanus virus protein has been used, as has already been done with other vaccines, such as influenza B, between otras.Segun Chiodo, these two new vaccines can be stored in ordinary fridges, without the need for special freezes (the first one they have brought to the market, that of Pfizer-BioNTech is at -70ºC). The authorities of Havana hope that by April phase 3 of the clinical tests will be passed and that by July the entire population of the island will be vaccinated.

Chiodo has underlined the importance of public ownership, but not of the pharmaceutical multinationals. He started working with Cubans because the vaccines of these are the only ones in the world that are 100% public: “I always thought I’d like to work one day helping a country where everything related to pharmacy is public. They told us that he was a student and that it was impossible to do a clinical trial if it wasn't with a pharmaceutical company in the world. There was only one exception: Cuba.”

TRYING TO BE SELF-SUFFICIENT IN PHARMACIES

“Pfizer and sovereignty: Cuba's COVID-19 vaccine provides a very interesting counterpoint to the one developed by Pfizer in the United States. In an interesting article, the American anthropologist Naomi Schoenfeld has explained the context of the issue in the journal Medical Anthropology Quarterly.

For starters, it is no coincidence that the institute where the Soberana vaccines come from has the name Finlay: Carlos J. The Cuban scientist Finlay demonstrated in the 19th century that Yellow Fever disease is introduced by the Aedes aegypti mosquito. Finlay is an institute that since 1934 has been manufacturing vaccines against smallpox, typhus, tuberculosis, rabies and tetanus… In the 1970s, with the birth of biotechnology, there was a radical change in vaccine production, in collaboration with the Finnish scientist Kari Cantell. Cantell invented how to create Interferon, which today remains one of the stars of Cuban pharmaceutical companies, from human leukocytes, but he preferred to share the knowledge acquired in research rather than to patent… a generous scientist!

Chance wanted Denge's disease, found immediately on the same island to produce interferon in Cuba, to give a new outbreak, moving 116,000 patients to hospitals. People engaged in biotechnology offered the health system – both from the State – to test interferon against dengue, and hence the close integration between research and health care, which remains one of the island’s hallmarks.

The Center for Genetic Engineering and Biotechnology of Cuba and the Finlay Institute have patented and produced more than a thousand molecules that want to modulate the immune system, following the path opened by interferon: various interferons, the hepatitis B vaccine, the meningitis vaccine B… The latter became famous in the 1980s when it helped control the outbreak of meningitis Brazil Uruguay

Naomi Schoenfeld considers that, referring to the book “Vaccination Policy: Global History”, the power of a government to produce its own vaccines strengthens national sovereignty and therefore the success or failure of this national remedy for those involved in the vaccination campaign influences the popular conscience of the people.

VACCINE, THE MOST POLICY OF MEDICINES

In the words of Schoenfeld and generically, vaccines are truly political pharmaceutical beings, “they impact far beyond the objectives that have been imposed scientifically. From the name, they suggest protection. They express techno-scientific knowledge, hygiene, medical command. Populations, politics, privileges and even violence are a management tool. They are a kind of insurance against possible risks. (…) The vaccine generates major changes in populations, in the economy, in politics, in society and even in immunity.”

This vaccine policy entails great contradictions. Because as a backdrop to the benefits and promises listed below, it can also trigger anti-vaccine behaviors in many people, as these drugs work more than us through ourselves, provoking and implementing our immune system. In addition to people who rely on arguments of health, ethics, ecology or policy against vaccines, the anthropologist stands out – from the case of EE.UU. who are well aware of this – those of racially motivated minorities: “Black people distrust vaccines, which have been used throughout history for unethical medical experiments, for those who represent state violence.”

The Cuban population has a very different experience from vaccines. “Here vaccines have been created in the country’s ‘closed ecosystem’ of state biopharmaceuticals, from research to the universal national health system. In this respect, it is essential to have integrated policy and science, so that it is clear that the interests of citizens and not the interests of companies dominate. This integration of science and policy has succeeded in Cuba in tackling the virus and implementing two vaccines. When the island’s economy is ruined, the socialist State continues to do its job as a guardian, and that is why it is so important that these sovereign vaccines also develop in these difficult times. In this sense, we can say that these Sovereigns are the socialist vaccines against COVID-19.”

Even though it sounds like a lie in its wealth, the anthropologist, who lives in California, sees it in exactly the opposite situation in the United States. Here the success of the vaccination campaign will be related to the ability to buy doses. The relations between science and politics are built backwards of Cuban women, above all the interests and benefits are more important than the health of the people. Despite the fact that US multinationals have managed to get the world’s largest share of supply through their flagship vaccines, the United States does not have a universal health system or regional coordination, millions of people live without regularizing insurance and surveillance, which means mass vaccination is going to become a real headache.

“Knowing the history of Cuba -- Schoenfeld says -- in vaccination, everyone knows that Sovereign vaccines are ready and the work to do so will be simple: business as usual. On the contrary, in the United States business as usual means that ‘people who believe in science’ will be able to access the vaccine and that many will have to obtain through the best available substitution if they do not have a national health program: they will have to get it in our Walgreen and Walmart hypermarkets (‘until vaccines are exhausted’, ‘useless supply in 50 states’, ‘see conditions’, ‘not being compatible with other deals’…).

WHO REMEMBERS THE HEALTH OF THE POOR

COVID-19 also surprised Cubans like other researchers around the world, according to the Telesur chain, director of the Finlay Institute, Vicente Vérez Bencomo. Health authorities, with strict measures controlling the first outbreak of the virus on the island in May, realized that they had to prepare it for the next wave. For the happiness of biotechnology professionals, thousands of scientists around the world had been involved in COVID-19 research and largely made public the knowledge acquired about the components and characteristics of the pandemic.

In May, President Díaz-Canel called the researchers and asked them to speed up their search, as Cuba needed their vaccine. They were able to reduce the usual deadlines thanks, to a large extent, to the information freely disseminated by scientists around the world, and by August they had already prepared two doses of the selected formulation. These first doses were taken into their bodies by the two main investigators. “With this we sought to achieve two goals,” says Verez Bencomo- on the one hand, to demonstrate that those responsible had confidence in that result and on the other hand, to become ourselves in order to make a leap in a process that requires strict scientific and ethical conditions that the first two were able to test the vaccine and that would allow us to access clinical trials faster.”

By August they knew that the first vaccine to be registered in the world would not be that of Cubans – the big multinationals had announced that the first vaccinations could start at the end of the year… – but Verez Bencomo pointed out as an objective that this country would be the first to incorporate all its citizens, all and gratis.Pensaban also in many other people in the world: “When vaccines appear, the first to immunize populations will be the rich countries of the world. For both the price of these vaccines and the fact that we are 8,000 million citizens in the world, you cannot think that they will all be vaccinated in 2021. Solidarity with Cubans is not to offer what is left of you, but to share what you have with what you have, but it would be a dream to share with us at the end of the year the world, and especially that of Latin America”.