Deaths averted, doctors trained, clinics staffed, communities reached, minds changed, lives touched: the metrics for measuring the impact of the late Dr Paul Farmer (1959-2022) are impressive in themselves. As a physician, medical anthropologist, professor, author and public health activist, Dr Farmer’s commitment to advancing health equity is felt from Boston to Peru, Rwanda to […]
Ileana Morales Suárez MD MS July–October 2022, Vol 24, No 3–4
It was just before New Year’s Eve, 2019 when an emerging virus in China caught the attention of Dr Ileana Morales, director of Science and Technological Innovation in Cuba’s Ministry of Public Health. She had already participated in implementing Cuban protocols to prevent Ebola and address diseases such as Zika and dengue. But this was […]
Cuba’s decision in September 2021 to launch a massive vaccination campaign against COVID-19 for children as young as two years old turned heads around the world—of clinicians, immunologists, public health experts, governments and regulatory authorities alike. Since then—and just as pediatric COVID-19 hospitalizations reached record numbers globally—some two million Cuban children and adolescents have received the Cuban Soberana vaccines (1.7 million, or 81.3% of that population through December 16, 2021).[1]
Why did Cuban health authorities decide to vaccinate children? What clinical trials provided the evidence for such a course of action, especially for the youngest? And what have been the results thus far?
To answer these and other questions, MEDICC Review spoke with Dr Rinaldo Puga, principal investigator for the completed phase 1/2 clinical trials of the Finlay Vaccine Institute’s Soberana 02 and Soberana Plus vaccines in pediatric ages. Dr Puga’s 30 years as a practicing pediatrician have been accompanied by teaching and research, the latter earning him awards from the Cuban Academy of Sciences, among others. He is currently chief of pediatrics and chair of the Scientific Council at the Cira García Clinic in Havana, which granted him leave to lead the pediatric vaccine trials.
As 2021 drew to a close, Cuba struggled to contain the highly transmissible omicron variant of SARS-CoV-2, braced for a new wave of infections and kept a close eye on other variants of concern popping up around the world—a common experience to countries everywhere as we head into the second year of the pandemic. In Cuba, however, there is one marked difference making all the difference: by early January, 87% of the population was fully vaccinated using a three-dose schedule of vaccines developed and produced on the island.[1] This massive vaccination campaign is complemented by a rapid booster rollout—also using Cuban vaccines—that began in December 2021 and was ongoing as we finalized this issue.
The island nation was able to achieve the third highest COVID-19 vaccination rate in the world[2] after decades of scientific investment, research, discovery and innovation; regulatory oversight and compliance; professional training; and increased production capacity. But a vaccine is only as effective as the health system charged with administering it—in a safe and timely manner, to as many people as possible. Here too, Cuba has decades of experience, including a national pediatric immunization program where 98% of children under 5 are immunized against 13 diseases,[3] an annual polio vaccination campaign (both launched in 1962 and uninterrupted since) and campaigns to contain epidemics such as H1N1.
When the first COVID-19 cases were detected on the island in March 2020, Cuba harnessed this vaccine experience, making a hard tack towards developing its own vaccines. Two of the main protagonists in the country’s biotechnology development, the Finlay Vaccine Institute (IFV) and the Genetic Engineering and Biotechnology Center (CIGB), both with several groundbreaking preventive and therapeutic vaccines in their portfolios, led the search for a vaccine. Today, Cuba has three vaccines authorized for emergency use—Soberana 02 and Soberana Plus developed by IFV, and Abdala, developed by CIGB. Schedules with these vaccines have demonstrated more than 90% efficacy in clinical trials,[4] and after regulatory approval for emergency use, became the backbone of Cuban COVID-19 vaccination efforts. A fourth vaccine, Mambisa (CIGB), administered nasally, and a fifth, Soberana 01 (IFV) are still in clinical trials.
For this installment in MEDICC Review’s series spotlighting leading women of Cuban science, we sat down with Dr Verena Muzio, Director of Clinical Research at CIGB. A pioneer of Cuba’s biotechnology sector, she is an immunologist with a doctorate in biological sciences. Her professional trajectory began researching the genetically engineered hepatitis B surface antigen that led to the development of Cuba’s recombinant hepatitis B vaccine in 1989. The same technological platform used in this vaccine was used to develop CIGB’s Abdala vaccine against SARS-CoV-2—part of the reason Cuba was able to secure a vaccine so quickly. A phase 3 clinical trial determined a 92.28% efficacy rate for Abdala, with results to appear in forthcoming publications.
At the time of this writing, more than 10 million Cubans (nearly 90% of the country’s population), had received at least their first dose of Soberana 02 or Abdala, two of five vaccine candidates for SARS-CoV-2 developed and produced on the island. Late-phase clinical trial data revealed that Abdala is 92.28% effective after the full, […]
Soaring summer temperatures, systematic urban and political violence, unreliable infrastructure—power outages, water shortages, sporadic transportation and interruption of other basic services—plus the illness, death and economic straits wrought by COVID-19, are what Haitians awake to every day. On the morning of August 14, 2021, they also woke to the earth in the throes of violent, […]
Cuba has five COVID-19 vaccines in clinical trials and is on track to receive emergency use authorization from the country’s regulatory agency to begin mass vaccination with two of those candidates: Abdala and SOBERANA 02. Results from phase 1 and 2 trials of these vaccines, the first developed and produced in Latin America, have been […]
The effects and implications of COVID-19 are global, comprehensive and long-term. The pandemic has exposed inequities, the fragility of economic and political systems, and in many cases, skewed priorities. Population health, not to mention planetary health, is suffering as a result. Nevertheless, the global health crisis in which we are embroiled has provided opportunities for […]
Three fourths of the 175 staff at Cuba’s National Medical Genetics Center (CNGM) are women. And women constitute 90% of the research team working on the Center’s largest current project—unlocking the biological secrets of COVID-19 in the Cuban population. They are identifying particularly vulnerable groups and geographies, reviewing therapies applied and long-term sequelae of the […]
On March 23, 2020, Cuba’s Henry Reeve Emergency Medical Contingent began treating COVID-19 patients at Maggiore Hospital in Crema, Lombardy. Within days, the 52-member contingent comprised of 36 doctors and 15 nurses (plus 1 logistics specialist), together with Italian colleagues, were receiving patients in an adjacent field hospital established and equipped for this purpose. At […]
On August 13, 2020, Cuba’s national regulatory agency, the Center for Quality Control of Medicines, Equipment and Medical Devices (CECMED), authorized clinical trials for SOBERANA 01—Cuba’s first vaccine candidate and the first from Latin America and the Caribbean. On August 24, parallel Phase I/II double blind, randomized, controlled clinical trials were launched at clinical sites […]
If all physicians are detectives, using their skills to track down what ails body and mind, then epidemiologists are medicine’s social detectives, using their training to understand the great calamities of population health. For over 30 years, Dr José Moya has worked in the field since his initial position as head of epidemiology in Ayacucho, […]
Virologist Dr María Guadalupe Guzmán is recognized as a global leader in dengue research and heads the Pedro Kourí Tropical Medicine Institute’s work as a WHO/PAHO Collaborating Center for the Study of Dengue and Its Vector. The Institute (IPK) was founded in 1937 and is now Cuba’s national reference center for the diagnosis, treatment, control […]
Belén Gopegui (Madrid, 1963) Licenciada en Derecho en la Universidad Autónoma de Madrid. Novelista y guionista española. Con su ópera prima La escala de los mapas, (1993) recibió varios premios y su tercera obra, La conquista del aire, fue adaptada al cine. Belén Gopegui fue descrita como la mejor de su generación por el escritor […]
Cristian Morales, an economist by training, has dedicated his career to improving health and health equity in the Americas through his work with PAHO/WHO. This has taken him from hurricanes, earthquakes and epidemics in Haiti to PAHO’s Washington DC offices, where he was instrumental in achieving consensus on a resolution aiming for universal health—coverage plus […]
Science journalism was little known in Cuba when Iramis Alonso wrote her thesis on the specialized field in 1990. That year, journalism degree from the University of Havana in hand, she set off to Cuba’s eastern countryside to complete two years of social service reporting for local, regional and national print media. Living in the […]
