Cuban socialism shows the way for biotech and pharma

With far fewer resources, socialist planning has achieved results to match those of the biggest capitalist powers and has, in some instances, even exceeded them. Without prior expertise, and beginning in the 1961-1965 period, Cuba began to develop a pharmaceutical and biotechnological industry that now rivals those of the advanced industrial capitalist countries. This is the result of the priorities and planning to meet society’s needs. Charles Chinweizu reports.

This industry has been developed despite the US blockade, with the support of the socialist bloc, and with the prime objective of enabling Cuba to develop its socioeconomic prospects and improve the health of its population. Cuba has also helped to develop the biotechnological industries of India (prime manufacturer of generics for the ‘third world’), China and Malaysia, boosting the sovereignty of these underdeveloped countries via ‘south south’ technology transfer.

Health crisis

A health crisis is engulfing the underdeveloped countries of the world. Ten million children under five died in 2006; two million die within the first 24 hours, four million within the first month of life.

Despite the hysteria over the Influenza A(H1N1) virus, vastly more people die every week from seasonal influenza (9,600) than have died from swine flu (800 deaths by 24 July 2009).

90% of deaths from infectious disease are caused by six infections – tuberculosis, pneumonia, diarrhoea, measles, malaria and AIDS – which are most prevalent in less developed countries. The number living with HIV/AIDS grew to 33 million in 2007; 70% get no antiretroviral drug (ARV) therapy. Despite the relatively low cost, only 8% of HIV-positive children and 11% of women in ‘low and middle income’ countries were receiving ARV medication in 2005. Sub-Saharan Africa accounts for 67% of all people living with HIV and for 72% of AIDS deaths in 2007. There were 2.5 million AIDS-related deaths in 2007. Measles kills 0.9 million people and malaria 2.7 million annually. Bacterial pneumonia kills more children under five (two million) than any other disease – more than HIV, malaria and measles combined. 73% of the 151 million cases of childhood pneumonia each year are concentrated in 15 countries, mainly in Africa.

1.7 million people die annually from TB, a curable disease. XDR-TB (Extensive Drug Resistant TB), a new particularly virulent strain, is so dangerous that patients die even before doctors receive results of tests and leaves patients, including those living with HIV, virtually untreatable using current anti-TB drugs. Southern Africa is the epicentre of the HIV/AIDS and TB pandemic. XDR-TB has now developed in 37 countries since 2003.

Cancer rates will double between 2002 and 2020 with 60% of new cases in underdeveloped countries. Diabetes has risen from 30 million to 230 million cases between 1986 and 2006, again with most new cases in underdeveloped countries. Vaccination provides one of the best means for preventing, rather than treating, infectious disease. Lack of access to health care, especially medicines and vaccinations, is the main cause of these easily preventable deaths, but medicines are kept out of the reach of the poor by high drug prices, intellectual property rights and all the other schemes of imperialism, hidden behind a bogus philanthropy egged on by exasperatingly vacuous liberals.

Structure of Cuban biotech industry

In stark contrast, in another underdeveloped nation, Cuba, health care provision for all its citizens is among the best in the world, as reflected in its infant mortality rates and life expectancies. Cuba has developed a pharmaceutical and biotechnological industry that has provided its national health care system with over 160 products. Cuba’s biotech industry is wholly state owned (funding is determined by national need and peer review – a defining feature of Cuban biotechnology). There are no private hospitals and no private profit; all pharmaceuticals are publicly owned and all investment comes from the state. Cuba earns at least $400 million a year from its total pharmaceutical and biotechnology exports, possibly its fourth biggest export earner. All profits are reinvested in the biotechnology sector. Cuba produces approximately 80% of the drugs and medicines used by its 11 million people – the strategy is straightforward: the government develops the drugs and vaccines according to the demands of Cubans. It then tests them and dispenses them across the population through a network of neighbourhood family doctors, polyclinics and hospitals.

Cuba’s extensive commitment to biotechnology began soon after the start of the revolution. Like the Soviet Union, the Cuban government believed that science would benefit the health and socioeconomic prospects of the people. In 1960, Fidel Castro said ‘the future of our homeland must be that of men of science’. But the blockade of Cuba by the US made it impossible for Cuba to import the drugs its impoverished citizens needed, especially as Cuba was not rich in oil and mineral resources. At Castro’s insistence, Cuba therefore decided to establish a National Centre for Scientific Research (CNIC), which opened in 1965, followed by the Centre for Molecular Immunology (CIM), the Finlay Institute and finally by the Centre for Genetic Engineering and Biotechnology (CIGB), which are now a part of the ‘Scientific Cluster’ of western Havana – a complex of 53 applied research centres and their industrial offshoots – that makes up the bulk of Cuba’s biotechnology industry. There are 14 such ‘scientific clusters’. In total, the country has more than 120 scientific research centres, employing about 30,000 people. Hence biotech is not concentrated in the capital Havana, avoiding the creation of inequalities in Cuban society.

Most research and development (R&D) centres also have their own production plants and marketing arms for both domestic distribution and export. However, the R&D centres consult and collaborate with each other and share resources. Interdisciplinary cooperation by Cuban scientists is encouraged and establishing links with foreign research centres is a policy of the Cuban government. Scientific research, innovation and product development, production and marketing are all integrated under the same roof, or at least in the same institution, preventing unnecessary waste of time and duplication of work a common feature of science in capitalist countries. This is only possible due to state monopoly of industry in Cuba and control of the R&D centres whose projects and priorities are not determined by short-term profits.

In 1981, the government stepped up its biotechnology initiative – its scientists developed the leukocyte interferon (for the treatment of several forms of cancer and HIV/AIDS) from human blood in six weeks flat. Cuban scientists first discovered it was far more efficient to produce interferon via genetic engineering than by extracting it from blood, so it was first made this way in Cuba, and is now the common method in the labs of the developed capitalist countries. Even during the worst period of economic crisis after the fall of the Soviet bloc, Cuba invested over $1 billion between 1992 and 1996 (1.5% Gross National Product) in the ‘Scientific Pole’, and sent its scientists to labs in Latin America, Sweden, Spain, and Germany to continue research collaborations. New scientific disciplines, such as bio-informatics and computational sciences are constantly being developed to obtain results that directly impact upon Cuban society (Tirso Pons et al, ‘Computational biology in Cuba’, 2007, ploscompbiol.org).

Concrete accomplishments of Cuban biotech

Cuba can count among its many attainments: a genetically engineered cholera vaccine; a cholesterol-lowering drug derived from sugar cane; bone implants for reconstructive surgery that are made from coral; an extensive array of recombinant proteins (recombinant means material produced when segments of DNA from different sources are joined to give new combinations of genetic material) such as interleukin-2 (for cancer treatment); synthetic peptides; monoclonal antibodies (MAbs, for cancer therapy); alpha and gamma interferon; streptokinase (world’s most advanced anti-coagulant for breaking up blood clots in heart attack victims designed and produced in Cuba); erythropoietin (a hormone that regulates red blood cell production), and several animal and human vaccines. These include:

  • a Hepatitis B vaccine that has virtually eliminated the disease in Cuba (it afflicts an estimated 300 million people worldwide) the world’s only effective Meningitis B vaccine

  • a Hib (Haemophilia influenza type b) vaccine – the first fully synthetic vaccine to succeed in all clinical trials

  • a vaccine against a specific type of cancer that has been licensed for use in the US, despite the blockade.

Cuba developed the first synthetic vaccine for the prevention of pneumonia and meningitis, which is much cheaper than what is offered by Western pharmaceutical companies. The Finlay Institute alone has developed seven vaccines for Cuba’s health system, including against typhoid, diphtheria, tetanus, whooping cough and Meningitis B and C.

Cuba has developed antigens enabling it to routinely screen blood products for HIV and hepatitis viruses, pregnant women for neural tube defects in the foetus, and newborns for certain biochemical birth defects and sickle cell anaemia. Cuba also has in development recombinant vaccines against HIV, Hepatitis C, and Dengue fever.

Most of Cuba’s vaccines are produced using recombinant (genetic engineering) technology. Advantages of recombinant vaccines are that the vector can be chosen to be not only safe but also easy to grow and store, reducing production cost. The only recombinant vaccine for the Hepatitis B virus (HBV) vaccine currently in use in humans is Cuban. Although the US and France also manufacture a Hepatitis B vaccine, according to Baretta, former head of Canadian pharmaceutical firm Aventis Pasteur, ‘What they [Cuba] have done there is truly remarkable. Their work on hepatitis is likely to become the standard for the rest of the industry.’ (Financial Times, 14 June 2002).

Cuba’s record boasts 26 inventions with more than 100 international patents already granted since the Revolution. By 2009 Cuba was also exporting its products to over 58 countries around the world, earning vital foreign currency for the blockaded island; but, as Cuban chemical engineer Sonia Gonzalez said, ‘All the products we produce are applied in the first place in our own country. Our national health care system provides these vaccines free to our people... We believe it is an important programme for the nation.’

But although the US has granted Cuba 26 patents, the blockade has so far prevented Cuba from selling any of its products there. Each year in the US, there are 1,700-3,400 cases of meningococcal meningitis, now increasingly resistant to most common antibiotics. In 1986 a vaccine with proven effectiveness against Serogroup B (and subsequent trials have shown effective against subtypes A and C) was developed in Cuba by the Finlay Institute. Since then, 55 million doses have been administered in Cuba and other countries and it is registered for use in 15 countries, but not the US. From January to March 2009, at least 1,500 people died of the deadly brain disease meningitis in two countries of Africa’s ‘meningitis belt’. There are no vaccines for the strain (Serogroup A) found in Africa.

Traditional vaccines are preventative, but Cuba has also led the way in the production of therapeutic vaccines which produce an immune response to treat patients with pre-existing conditions. According to Cuban government predictions, cancerous diseases in general will become the first cause of death in Cuba by 2010 and it is rapidly developing more advanced therapeutic cancer vaccines. Cuba has developed an asthma vaccine, stem cell treatment for diabetic ulcers on the feet (which usually lead to amputation), the world’s first halal vaccine for meningitis, and there are at least 40 products in development at the CIGB. Cuba’s biotech industry concentrates on the diseases affecting the poorest countries of the world. The US and Britain’s biotech and pharmaceutical industries concentrate on areas of profitability. Setting aside the gutter attacks from Cuba’s enemies on its ‘knock-off drugs’, or Bush’s assertion that Cuba was developing biochemical weapons, there have been more sophisticated attacks on Cuba’s quality management and control, despite the fact that Cuba’s biotech industry and companies have been successfully evaluated by the World Health Organisation and other international bodies up to ISO 9001 quality and GMP (Good Manufacturing Practice) standards.

None of this would be possible without socialism, which is the driving force for these developments since the start of the revolution. Meningitis B now accounts for 90% of cases in Britain; current vaccination protects against Hib meningitis, Meningitis C and pneumococcal meningitis but there is no Meningitis B vaccine in Britain. Cuba has the Meningitis B vaccine – why don’t we? End the blockade of Cuba!

FRFI 210 August / September 2009

 

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