[News] Cuba Libre to be COVID-Libre: Five Vaccines and Counting…

[Anti-Imperialist News]

https://www.counterpunch.org/2021/03/30/cuba-libre-to-be-covid-libre-five-vaccines-and-counting/
Cuba
Libre to be COVID-Libre: Five Vaccines and Counting…
by Helen Yaffe <https://www.counterpunch.org/author/helyal0912/>- March 30,
2021
------------------------------

Photograph Source: Martin Abegglen from Bern, Switzerland – CC BY-SA 2.0
<https://creativecommons.org/licenses/by-sa/2.0/>

On 23 March 2021, British Prime Minister Boris Johnson told a group of
Conservative Party backbenchers: ‘The reason we have the vaccine success is
because of capitalism, because of greed, my friends.’ Johnson was
articulating the dogma that the pursuit of private profit through
capitalist free markets leads to efficient outcomes. In reality, however,
Britain’s accomplishments in developing the Oxford AstraZeneca vaccine and
in the national vaccination rollout have more to do with state investments
than the market mechanism. Government money subsidised the vaccine
development at the University of Oxford, and it is the state-funded
National Health Service that has carried out the vaccination programme.
Johnson did not admit that it is due to capitalism and greed that Britain
now has the fifth worst Covid-19 mortality rate in the world with over
126,500 deaths (almost 1,857 per million people in the population) and
counting.

The British government, like most neoliberal regimes, refused to take the
measures necessary to slow and halt community transmission, it failed early
on to provide health care and social care workers with adequate PPE and
other resources which could have saved the lives of hundreds of frontline
staff who died as a result. It contracted private businesses to carry out
essential activities, most with little or no relevant experience, for
example, instead of equipping the community-based GP system of the National
Health Service to take charge of ‘track and trace’, the government dished
out £37 billion to Serco to manage part of the system. In public health
terms it has been disastrous; but measured by Boris Johnson’s celebrated
standards of capitalism and greed it is has indeed excelled. The greatest
beneficiaries of Britain’s response to the pandemic have been the private
corporations making huge profits. Around 2,500 Accenture, Deloitte and
McKinsey consultants are on an average daily rate of £1,000, with some paid
£6,624 a day.

Johnson has now laid out a road map for reopening the economy. As a result,
even the most optimistic scenario predicts a third wave between September
2021 and January 2022 resulting in at least 30,000 additional deaths in
Britain. These deaths are preventable. But it precisely because the British
government is driven by the capitalism and greed that it insists that we
have to learn to ‘live with the virus’ so that the business of business can
continue.

Contrary to Johnson’s claims, this pandemic has affirmed that public
healthcare needs cannot be adequately met under a profit-based system.
Indeed, it is the absence of the capitalist profit motive which underlies
the outstanding domestic and international response to Covid-19 by
socialist Cuba, which now has five vaccines in clinical trials and is set
to be among the first nations to vaccinate its entire population.

By reacting quickly and decisively, by mobilising its public healthcare
system and world-leading biotech sector, Cuba has kept contagion and
fatalities low. In 2020 Cuba confirmed a total of 12,225 coronavirus cases
and 146 deaths in a population of 11.2 million, among the lowest rates in
the Western Hemisphere. In November 2020, the airports were opened, leading
to a surge with more infections in January 2021 than the whole of the
previous year. By 24 March 2021, Cuba had registered fewer than 70,000
cases and 408 deaths. The death rate was 35 per million and the fatality
rate was just 0.59% (2.2% worldwide; 2.9% in Britain). Within one year, 57
brigades of medical specialists from Cuba’s Henry Reeve International
Contingent had treated 1.26 million Covid-19 patients in 40 countries; they
joined 28,000 Cuban healthcare professionals already working in 66
countries. Cuba’s accomplishments are more extraordinary given that from
2017 onwards, the Trump administration punitively unleashed 240 new
sanctions, actions and measures to tighten the 60-year blockade of Cuba,
including nearly 50 additional measures during the pandemic which cost the
health sector alone over $200 million.

Cuba has gone on the offensive against Covid-19, mobilising the
prevention-focussed, community based public healthcare system to carry out
daily house visits to actively detect and treat cases and channelling the
medical science sector to adapt and produce new treatments for patients and
Covid-19 specific vaccines. These advances bring hope not just for Cuba,
but for the world.

*What is special about Cuba’s vaccines? *

Some 200 Covid vaccines are being developed worldwide; by 25 March 2021, 23
candidates had advanced to phase III clinical trials. Two of those were
Cuban (Soberana 2 and Abdala). No other Latin American country has
developed its own vaccine at this stage. Cuba has three more vaccine
candidates in earlier stage trials (Soberana 1, Soberana Plus and an
intranasal, needle-free vaccine called Mambisa). How do we explain this
accomplishment? Cuba’s biotech sector is unique; entirely state-funded and
owned, free from private interests, profits are not sought domestically,
and innovation is channelled to meet public health needs. Dozens of
research and development institutions collaborate, sharing resources and
knowledge, instead of competing, which facilitates a fast track from
research and innovation to trials and application. Cuba has the capacity to
produce 60-70% of the medicines it consumes domestically, an imperative due
to the US blockade and the cost of medicines in the international market.
There is also fluidity between universities, research centres, and the
public health system. These elements have proven vital in the development
of Cuba’s Covid-19 vaccines.

There are five types of Covid-19 vaccines being developed globally:

+ Viral vector vaccines, which inject an unrelated harmless virus modified
to deliver SARS-CoV-2 genetic material (Oxford AstraZeneca, Gamaleya and
SputnikV);

+ Genetic vaccines containing a segment of SARS-CoV-2 virus genetic
material (Pfizer, Moderna);

+ Inactivated vaccines containing disactivated SARS-CoV-2 virus
(Sinovac,/Butantan, SinoPharm, Bharat Biotec);

+ Attenuated vaccines containing weakened SARS-CoV-2 virus (Codagenix);

+ Protein vaccines containing proteins from the virus which trigger an
immune response (Novavax, Sanofi/GSK).

The five Cuban vaccines under clinical trials are all protein vaccines;
they carry the portion of the virus spike protein which binds to human
cells; it generates neutralising antibodies to block the binding process.
Dr Marlene Ramirez Gonzalez explains that they are, ‘subunit vaccines, one
of the most economical approaches and the type for which Cuba has the
greatest know-how and infrastructure. From protein S – the antigen or part
of the SARS-CoV2 virus that all Covid vaccines target because it induces
the strongest immune response in humans – Cuban candidates are based only
on the part that is involved in contact with the cell’s receptor: the RBD
(receptor-binding domain) which is also the one that induces the greatest
amount of neutralizing antibodies. This strategy is not exclusive to Cuban
vaccines. But Soberana 02 does distinguish itself from the rest of the
world’s candidates as the only “conjugate vaccine”. Currently in phase III
clinical trials, it combines RBD with tetanus toxoid, which enhances the
immune response…Cuba had already developed another vaccine with this
principle. It is Quimi-Hib, “the first of its kind to be approved in Latin
America and the second in the world”, against Haemophilus influenzae type
b, coccobacilli responsible for diseases such as meningitis, pneumonia and
epiglottitis.’[1]

Idania Caballero, a pharmaceutical scientist at BioCubaFarma points out
that the vaccines build on decades of medical science and work on
infectious diseases. ‘The mortality rate in Cuba due to infectious
diseases, even in times of Covid, is less than 1%. Cuba today vaccinates
against 13 diseases with 11 vaccines, eight of which are produced in Cuba.
Six diseases have been eliminated as a result of vaccination schedules. The
vaccines produced with these technologies have been administered even to
children in the first months of life.’[2]

The Soberana vaccines are produced by the Finlay Institute in partnership
with the Centre for Molecular Immunology (CIM) and the Centre of
Biopreparados. Soberana means ‘sovereign’, reflecting its economic and
political importance; without a domestic product, Cuba would struggle to
access foreign vaccines either due to the US blockade or to the cost.
Soberana vaccines insert genetic information into superior mammalian cells.
Soberana Plus is a the world’s first vaccine for Covid-19 convalescent
patients to reach clinical trials.

The other vaccines, Abdala and Mambisa, names which also pay tribute to
Cuba’s struggle for independence, are produced by the Centre of Genetic
Engineering and Biotechnology (CIGB). These vaccines insert genetic
information in a less evolved organism, a unicellular microorganism (the
yeast Pichia Pastoris). They build on the CIGB’s extraordinary record,
including its Hepatitis B vaccines, used in Cuba for 25 years.

By developing different vaccine platforms, those institutions avoid
competing for resources. Caballero explains that: ‘Cuba has the capacity to
produce two independent vaccine chains, with over 90 million vaccines
annually, while maintaining the required production of other products for
the domestic market and for export.’ The Cuban vaccines require three doses
and, because they are stable at temperatures of between 2 and 8 degrees, do
not require costly special refrigeration equipment.

*Phase III trials and ‘interventional studies’*

By late March, phase III trials were underway for Soberana 2 and Abdala,
each incorporating over 44,000 volunteers over 19 years old in regions with
high incidence of Covid-19. Soberana 2 is being administered in Havana and
Abdala in Santiago de Cuba and Guantanamo. Analysis and follow-up for phase
III trial patients will continue until January 2022 to investigate whether
they prevent transmission, how long immunity lasts, and other questions
that no vaccine producers can yet answer. However, an additional 150,000
healthcare workers in Havana are receiving Soberana 2 shots, as part of an
‘interventional study’, a form of clinical trial that can be authorised
after drug safety has been demonstrated in phase II. Intervention studies
do not involve double blind testing or placebos. Another 120,000 healthcare
workers in western Cuba will receive Abdala in the next few weeks. Other
interventional studies in the capital will see 1.7 million people in
Havana, most of the adult population, vaccinated by the end of May 2021,
meaning that 2 million Cubans will have been fully vaccinated.

Assuming satisfactory results, in June the real national vaccination
campaign will begin, prioritising groups according to risk factors and
starting with over 60-year-olds. By the end of August 2021, six million
Cubans, over half the population, will have been covered and by the end of
the year, Cuba will be among the world’s first countries to fully vaccinate
its entire population.

Cuban medical scientists are confident that they have the capacity and
experience to adapt their vaccine formulations, technologies and action
protocols to tackle new variants. The next steps are for Soberana 1 and
Soberana Plus to enter phase II trials and a new study involving 5 to 18
year olds will be launched.

*Cuba and China team up on Pan-Corona *

Cuba’s CIGB have teamed up with colleagues in China to work on a new
vaccine called Pan-Corona, designed to be effective on different strains of
the coronavirus. It will use parts of the virus that are conserved, not
exposed to variation, to generate antibodies, combined with parts directed
at cellular responses. The Cubans contribute the experience and personnel,
while the Chinese provide equipment and resources. The research will take
place at the Yongzhou Joint Biotechnology Innovation Center, in China’s
Hunan Province, which was established last year with equipment and
laboratories designed by Cuban specialists. Gerardo Guillen, director of
biomedical science at CIGB said the approach: ‘could protect against
epidemiological emergencies of new strains of coronavirus that may exist in
the future’. The project builds on nearly two decades of medical science
collaboration between Cuba and China, including five joint ventures in the
biotech sector.

*A vaccine for the global south*

Cuban professionals have received ten gold medals from the World
Intellectual Property Organisation (WIPO) over 26 years; their biotech
products were exported to 49 countries prior to the pandemic, including
vaccines used in childhood immunisation programmes in Latin America. Cuba
has stated that its Covid-19 vaccines will be exported to other countries.
This brings hope to low- and middle-income nations that simply cannot
afford to vaccinate their populations at high prices (between $10 and $30 *per
dose*) demanded by big pharma. In February 2021, the Bureau of
Investigative Journalism reported that US company Pfizer has been
‘bullying’ Latin American countries into putting up sovereign assets, such
as embassy buildings and military bases, as guarantees against the cost of
any future legal cases in relation to their Covid-19 vaccines.[3]

Through an agreement with Iran’s Pasteur Institute, 100,000 Iranians will
take part in the phase III clinical trials for Soberana 2 and another
60,000 people will participate in Venezuela. Other countries including
Mexico, Jamaica, Vietnam, Pakistan, and India, have stated their interest
in receiving the Cuban vaccines, as has the African Union, which represents
all 55 nations in Africa. It is likely that Cuba will apply a sliding scale
to its Covid-19 vaccine exports, as it does with the export of medical
professionals, so what it charges reflects the countries’ ability to pay.

What Cuba has achieved is remarkable, but as Caballero states: ‘without the
unjust US blockade, Cuba could have more and better results’. Cuba has
become a world-leader in biotechnology because it has a socialist state
with a centrally planned economy, that has invested in science and
technology and puts human welfare before profit; that is, with the absence
of capitalism and greed that British Prime Minister Johnson celebrates.

*Notes.*

[1] ‘Rapid response
<https://www.bmj.com/content/372/bmj.n334/rapid-responses>’ letter in *The
BMJ*, 1 March 2021,

[2] Email correspondence, 9 March 2021.

[3] ‘“Held to ransom <http://www.thebureauinvestigates.com/>”: Pfizer
demands governments gamble with state assets to secure vaccine deal’, *Bureau
of Investigative Journalism*, 23 February 2021.

*A version of this essay was published in in Fight Racism! Fight
Imperialism! No. 280, April/May 2021.*
-------------- next part --------------
An HTML attachment was scrubbed...
URL: <http://freedomarchives.org/pipermail/news_freedomarchives.org/attachments/20210330/cae83df9/attachment.htm>