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<font size="1"><a href="https://www.counterpunch.org/2021/03/30/cuba-libre-to-be-covid-libre-five-vaccines-and-counting/">https://www.counterpunch.org/2021/03/30/cuba-libre-to-be-covid-libre-five-vaccines-and-counting/</a>
</font><h1 class="gmail-reader-title">Cuba Libre to be COVID-Libre: Five Vaccines and Counting…<br></h1>
<span class="gmail-post_author_intro">by</span> <span class="gmail-post_author"><a href="https://www.counterpunch.org/author/helyal0912/" rel="nofollow">Helen Yaffe </a></span>- March 30, 2021<br></div>
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<div id="gmail-attachment_134479" class="gmail-wp-caption"><p><img src="https://uziiw38pmyg1ai60732c4011-wpengine.netdna-ssl.com/wp-content/dropzone/2021/03/Ministry_of_the_Interior_of_Cuba_with_flag.jpg" alt="" style="margin-right: 0px;" width="482" height="321"></p><p id="gmail-caption-attachment-134479" class="gmail-wp-caption-text">Photograph Source: Martin Abegglen from Bern, Switzerland – <a href="https://creativecommons.org/licenses/by-sa/2.0/">CC BY-SA 2.0</a></p></div>
<p>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.</p>
<p>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.</p>
<p>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.</p>
<p>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.</p>
<p>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.</p>
<p>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.</p>
<p><strong>What is special about Cuba’s vaccines? </strong></p>
<p>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.</p>
<p>There are five types of Covid-19 vaccines being developed globally:</p>
<blockquote><p>+ Viral vector vaccines, which inject an unrelated
harmless virus modified to deliver SARS-CoV-2 genetic material (Oxford
AstraZeneca, Gamaleya and SputnikV);</p>
<p>+ Genetic vaccines containing a segment of SARS-CoV-2 virus genetic material (Pfizer, Moderna);</p>
<p>+ Inactivated vaccines containing disactivated SARS-CoV-2 virus (Sinovac,/Butantan, SinoPharm, Bharat Biotec);</p>
<p>+ Attenuated vaccines containing weakened SARS-CoV-2 virus (Codagenix);</p>
<p>+ Protein vaccines containing proteins from the virus which trigger an immune response (Novavax, Sanofi/GSK).</p></blockquote>
<p>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.’<a name="_ftnref1">[1]</a></p>
<p>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.’<a name="_ftnref2">[2]</a></p>
<p>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.</p>
<p>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.</p>
<p>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.</p>
<p><strong>Phase III trials and ‘interventional studies’</strong></p>
<p>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.</p>
<p>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.</p>
<p>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.</p>
<p><strong>Cuba and China team up on Pan-Corona </strong></p>
<p>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.</p>
<p><strong>A vaccine for the global south</strong></p>
<p>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 <u>per dose</u>) 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.<a name="_ftnref3">[3]</a></p>
<p>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.</p>
<p>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.</p>
<p><strong>Notes.</strong></p>
<p><a name="_ftn1">[1]</a> ‘<a href="https://www.bmj.com/content/372/bmj.n334/rapid-responses">Rapid response</a>’ letter in <em>The BMJ</em>, 1 March 2021,</p>
<p><a name="_ftn2">[2]</a> Email correspondence, 9 March 2021.</p>
<p><a name="_ftn3">[3]</a> ‘“<a href="http://www.thebureauinvestigates.com/">Held to ransom</a>”: Pfizer demands governments gamble with state assets to secure vaccine deal’, <em>Bureau of Investigative Journalism</em>, 23 February 2021.</p>
<p><em>A version of this essay was published in in Fight Racism! Fight Imperialism! No. 280, April/May 2021.</em></p>
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