2021 World Health Organization guideline on pharmacological treatment of hypertension: Policy implications for the region of the Americas. Campbell NRC, Paccot Burnens M, Whelton PK, Angell SY, Jaffe MG, Cohn J, et al. Lancet Reg Health Am. 2022 May;9:None. https://doi.org/10.1016/j.lana.2022.100219   Cardiovascular disease (CVD) is the leading cause of death in the Americas and raised […]

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 […]

Wherever you may be reading this: thank science. As you dress your children for school, commute, commune, worship or workout: thank science. As you plan a wedding, year-end celebrations, a trip, surgery, or dental cleaning: thank science. Our very survival is thanks to collaborative research and science that delivered safe, effective COVID-19 vaccines in record […]

Cuba’s public health outcomes are rooted in political and social phenomena that have favored achievement of health indicators well above expectations for an economy of its size. A less studied causal component of Cuba’s development in health is the creation, from early in the 1960s, of scientific research capacity throughout the health system, including use of science to launch a domestic industry for manufacturing high-tech products. This component should play an even greater role in meeting Cuba’s 21st century health challenges, especially the demographic and epidemiological transitions, increasing prevalence of chronic diseases, rapid emergence of a complex-product biotechnology pharmacopoeia, greater molecular stratification of diseases, rising health costs, and the need to maintain communicable diseases under control in a global context of climate change and more population mobility.

Tackling these challenges will demand greater scientific influence in the health system, application of a scientific approach in all activities and at all levels, and integration with scientific endeavors of other sectors such as agriculture, industry and education.

KEYWORDS Public health, science, health care costs, health workforce, chronic disease, biotechnology, immunology, aging, Cuba

She was a country girl from the northeastern Cuban province of Holguín, her father a farmer, her mother a teacher. Fast forward a few decades: Dr Lilliam Álvarez mastered mathematics, physics and nuclear science, finally specializing in numeric solutions to differential equations. She spent 20 years at the Cybernetics and Physics Institute in Havana, half that time as deputy director. For another eight years, she served as director of science in the Ministry of Science, Technology and the Environment. Full professor and senior researcher at the University of Havana, she is a member of the national academic authority that awards doctoral degrees in math and is Cuba´s ambassador to the International Mathematical Union. In 2000, she was inducted into the Caribbean Academy of Sciences, and in 2008, was elected a full member of the Third World Academy of Science (now The World Academy of Sciences).

But over time, her rich bibliography, with titles the likes of A numerical technique to solve linear and non-linear singularly perturbed problems began to be peppered with other provocative gender-informed work: Women doing hard sciences in the Caribbean, Are Women Good for Math? and her 2011 book Ser mujer científica o morir en el intento (Be a Woman Scientist or Die Trying). Her focus on women in science—and their rights to belong in its leadership as well as its ranks—is also reflected in her activist approach internationally and in Cuba.

She is a member of the Organization for Women in Science for the Developing World and heads its Cuban chapter. After her designation as a Distinguished Member of the Cuban Academy of Sciences, she was elected Secretary in 2010 and also chairs its Commission on Women in Science.

The Cuban Academy of Sciences was the right place to hear her story and to explore the way she sees women scientists in today’s Cuba—and the country she would like to see in the future.

After nearly 60 years of universal education and health, coupled with national policies supporting women’s rights and advancement, the results are in: according to recent data, more than half of Cuban scientists and almost 60% of all professionals in Cuba are women. Moreover, women’s representation in government is rising, including at the highest levels such as parliament, where they constitute 53.2% of members. Digging deeper, we find a story richer than national statistics or political representation. It’s the story of the collective achievements of female professionals on the island. For example, the clinical research team responsible for developing CIMAvax-EGF, Cuba’s novel biotech therapy for non-small cell lung cancer, was headed by a woman. Likewise, the lead scientist of the Cuban team that developed the world’s first effective meningitis B vaccine is a woman. And the cofounder of the country’s clinical trials coordinating center and registry is a woman, as is the founder of the National Center for Agricultural Animal Health. Yet, as in any country, there is more to be done to achieve true gender parity and release the full potential of women. To begin our series profiling outstanding Cuban women professionals, MEDICC Review spoke with sociologist Dr Marta Núñez, who has devoted decades to research on gender relations and the role of women in Cuba. She provides an overview and framework for contextualizing the advancement of Cuban women—including the challenges still to overcome.

Gastroenterology, hepatology and liver transplant exchanges between the USA and Cuba have mainly consisted of scientific events and short visits. This has facilitated Cuba’s inclusion in recognized scientific organizations, familiarity with Cuba’s biotech products for treatment of liver disease, and access by Cuban professionals to the highest level of scientific information for clinical practice. It has also given health professionals in the US a more accurate picture of Cuba’s health sector. The results of the Global Alcoholic Liver Disease Survey, which included Cuba and was designed and coordinated in the USA, opened doors to joint research and scientific publications. Until now, there have been no protocols for ongoing cooperation to enable bilateral clinical trials or continuing professional development in diagnostic, therapeutic and surgical techniques for hepatology and liver transplantation. There are many mutually beneficial research prospects in these areas. What has been accomplished to date, described in this article, is encouraging and sets the stage for future collaboration.

KEYWORDS Hepatology, liver transplant, health, medicine, science, Cuba, USA

This roundtable began with world-renowned US and Cuban experts in arboviruses (particularly those transmitted by mosquitoes) but was quickly transformed with the participation of globally recognized scientists in other fields. All have contributed and continue to contribute to the often frustrating efforts to advance bilateral health cooperation, for the benefit of the USA, Cuba and the world. Each from their own vantage point argues why such cooperation can release potential to create scientific synergies capable of addressing some of the most perplexing and urgent global health problems.

INTRODUCTION Cuba’s science policy is grounded in a scientific and technological innovation system applicable to all institutions. In hospitals, the system should influence medical care and administrative and teaching processes, as well as promotion of scientific activity as such.

OBJECTIVE Describe results of the Scientific and Technological Innovation System at the Dr Gustavo Aldereguía Lima University Hospital, the main provincial hospital in Cienfuegos, Cuba.

METHOD This was a key informant survey and document review concerning the hospital’s scientific activity during 2000–2014. A questionnaire was administered to 22 key informants to select key indicators and area. Data on the hospital’s scientific activity related to these indicators were retrieved from hospital, provincial public health and scientific publishing databases. A second group of 35 key informants confirmed linkages between scientific outputs and the innovation system’s main activities.

RESULTS The following were reported over the study period: sustained development of scientific human resources (40% grade II specialists, 30% master’s degree holders and 11.4% accredited academic researchers among the hospital’s professional staff), high scientific output (annual average of 445 studies completed, 118 publications and 203 projects under way) and high visibility (national and international recognition) of the hospital’s achievements in science and innovation. Key informants considered that results related to development of scientific potential were influenced by the following activities of the Scientific and Technological Innovation System: promotion of grade II specialty training, researcher accreditation and awarding of master’s degrees and PhDs in the sciences, development of an extensive continuing education program (for researchers and their mentors), public recognition of professionals with good scientific results, promotion of research and other scientific activities, and the requirement that professional and technical staff participate in national events sponsored by scientific societies.

CONCLUSIONS Implementation of a Scientific and Technological Innovation System can contribute to a hospital’s scientific capacity and productivity.

KEYWORDS Hospitals, health services research, organizational deve-lopment, organizational innovation, technology, research, science, Cuba