Cuba: The Sur­prise Med­i­cal In­no­va­tor

Trillions - - In This Issue -

In the shadow of the world's largest, most ex­pen­sive and most deadly med­i­cal in­dus­try is one of the most ad­vanced and ef­fec­tive med­i­cal ser­vices that has been qui­etly sav­ing lives and heal­ing the sick for decades.

There is no ques­tion that Cuba is a de­vel­op­ing coun­try lack­ing many mod­ern con­ve­niences that far more de­vel­oped na­tions have had for many years. De­spite that, un­like the sit­u­a­tion in the United States, life ex­pectancy is high in Cuba and its cit­i­zens are un­der­stood to be among the health­i­est in the world.

Part of the rea­son for this is that Cuba, again un­like the United States, con­sid­ers med­i­cal care as a fun­da­men­tal right. It also sees pre­ven­tive med­i­cal care as a crit­i­cal part of that care rather than a fi­nan­cial bur­den that in­sur­ance com­pa­nies should find a way to min­i­mize in or­der to be more prof­itable.

Be­sides this, Cuba’s cen­tral gov­ern­ment has made it a pri­or­ity to keep med­i­cal re­search and re­lated sci­en­tific in­vest­ments high, at least rel­a­tive to the size of the gov­ern­ment. It has also done so de­spite not hav­ing ac­cess to crit­i­cal phar­ma­ceu­ti­cals and equip­ment that might have made such re­search more ef­fi­cient. Like those on many projects con­sid­ered a pri­or­ity and crit­i­cal to all, the coun­try’s med­i­cal pro­fes­sion­als have found ways to work around such con­straints. In Cuba’s case, that in­ge­nu­ity, bril­liance and per­sis­tence have pro­duced four ma­jor in­no­va­tions that many out­side the coun­try may not be aware of.

Cancer Vac­cines, Any­one?

One of the dreams in the med­i­cal world for decades has been to come up with a vac­cine that might pro­vide a broad-based means of prevent­ing cancer. Cuba’s med­i­cal teams at the Cen­ter of Molec­u­lar Im­munol­ogy (CIM) in Ha­vana may have done just that with their CIMAVAX-EGF vac­cine.

This unique vac­cine tracks how cancer cells are grow­ing and acts as an ac­tive block­ing agent in keep­ing the dis­ease from spread­ing. It has gone through ex­ten­sive drug trial eval­u­a­tion not just in Cuba but also in Peru, Paraguay and Colom­bia. This par­tic­u­lar ver­sion of the vac­cine was crafted for lung cancer pa­tients, and more than 5,000 have al­ready been treated with it.

The vac­cine also costs only $1 per dose to man­u­fac­ture.

The good news about this par­tic­u­lar cre­ation is that U.S. drug tri­als, long since blocked un­der em­bar­goes, ap­pear to be go­ing for­ward at full speed. In 2016, the U.S. Food and Drug Ad­min­is­tra­tion (FDA) au­tho­rized the first clin­i­cal tri­als for the drug af­ter ac­tive lob­by­ing by the Roswell Park Cancer In­sti­tute. The in­sti­tute will also be in­volved in the tri­als.

Be­sides CIMAVAX-EGF, the CIM also has two other cancer med­i­ca­tions the world may want to take note of.

The first vac­cine, VSSP, is a drug orig­i­nally de­signed to boost the body’s im­mune re­sponse to ex­ist­ing vac­cines. While that in it­self was ex­tremely im­por­tant as a break­through, fur­ther tests have re­vealed that VSSP can help stim­u­late the body’s own de­fense re­sponses to ac­tual cancer cells. It may there­fore turn out to be a very im­por­tant al­ter­nate cancer treat­ment. It is now in the ear­li­est stages of clin­i­cal tri­als.

The other vac­cine is Ra­co­tu­momab, a drug that tar­gets one spe­cific mol­e­cule found on all cancer cells. If suc­cess­ful, it could be used to help fight solid tu­mors such as breast, prostate, colon, lung and even some blood cancer tu­mors. It is cur­rently in the sec­ond phase of clin­i­cal tri­als.

A fourth po­ten­tial anti-cancer phar­ma­ceu­ti­cal de­vel­oped by Cuban re­searchers is Vida­tox. It was de­rived from the venom of a blue scor­pion by a com­pany by the name of Labio­fam. Although still in the very early stages of eval­u­a­tion, it al­ready looks promis­ing in help­ing to treat cer­tain types of cancer.

Re­vers­ing Di­a­betic Foot Ul­cers

One of the most dan­ger­ous com­pli­ca­tions from pa­tients with un­con­trolled di­a­betes is the po­ten­tial loss of toes, feet or whole legs to am­pu­ta­tion. Be­cause di­a­betes causes blood ves­sel and nerve dam­age in the foot, pa­tients can de­velop foot ul­cers, caus­ing the all­too-com­mon red sores that can some­times pen­e­trate bone. Gan­grene of­ten re­sults, with am­pu­ta­tion be­ing one of the few ef­fec­tive treat­ments – so far – to pre­vent fur­ther spread­ing of the ul­cers.

Re­searchers from the Cen­ter for Ge­netic En­gi­neer­ing and Biotech­nol­ogy in Cuba, op­er­at­ing un­der the di­rec­tion of Biocuba­farma, have come up with a po­ten­tial treat­ment that could avoid all of this. The drug in ques­tion, Her­ber­prot-p, stim­u­lates the skin’s own nat­u­ral heal­ing pro­cesses for both neu­ro­pathic and is­chemic ul­cers. When the drug is in­jected near the gan­grene-af­fected ar­eas, tis­sue has been seen to heal and dis­eased ar­eas to clear out within about three months.

Her­ber­prot-p also has a well-estab­lished track record. It has al­ready been used in 26 dif­fer­ent coun­tries on more than 165,000 pa­tients.

Block­ing the Trans­mis­sion of HIV and Syphilis from Mother to Child

De­spite ex­ten­sive work in the same re­search field around the globe, Cuba has the dis­tinc­tion of be­ing the first coun­try to find a means to keep both HIV and syphilis in moth­ers from be­ing trans­mit­ted to their un­born chil­dren.

The so­lu­tion is a sys­temic one rather than just one “magic bul­let.” It in­cludes early pre­na­tal care ac­cess, test­ing with re­spect to HIV and syphilis on both par­ents when a woman be­comes preg­nant, ag­gres­sive treat­ment of HIV with an­tiretro­vi­ral drugs, sim­i­larly in­tense treat­ment to deal with syphilis in the mother and track­ing of any po­ten­tial for fur­ther in­fec­tion of the un­born child.

The re­sults are so sig­nif­i­cant that the direc­tor gen­eral of the World Health Or­ga­ni­za­tion (WHO), Mar­garet Chan, called them “one of the great­est pub­lic health achieve­ments pos­si­ble.” It may also help to put an end to the con­tin­u­ing cy­cle of the spread of AIDS in other de­vel­op­ing coun­tries such as those in Africa, where un­pro­tected sex has led to ex­tremely high per­cent­ages of in­fec­tion in new­borns.

Amaz­ing Re­sults in Eye Care

Another im­por­tant area for those look­ing into what Cuba has done with its med­i­cal pro­grams in­volves its re­search and track record in deal­ing with se­ri­ous eye care prob­lems.

The coun­try has long been a leader in treat­ing ex­ist­ing eye prob­lems such as cataracts, re­tini­tis pig­men­tosa and glau­coma. There are cur­rently more than 25 cen­ters in Cuba fo­cused on treat­ments for these ill­nesses and for the ap­pli­ca­tion of pre­ven­tive pro­to­cols to keep them from be­com­ing big­ger prob­lems in the fu­ture.

One of the larger cen­ters for such eye care re­search is the In­sti­tuto Cubano de Of­tal­mología Ramón Pando Fer­rer (Cuban In­sti­tute of Oph­thal­mol­ogy). It has an ex­ten­sive back­ground in the ar­eas of corneal and re­frac­tive surgery, di­ag­no­sis and man­age­ment of clin­i­cal con­di­tions there, ad­vanced corneal treat­ments and ex­cimer laser corneal re­frac­tive surgery.

An im­por­tant mile­stone in Cuba’s history in this dis­ci­pline in­volves a joint op­er­a­tion that Cuba and Venezuela part­nered on start­ing in July 2004. By work­ing closely on di­ag­nos­tic tech­niques and the ap­pli­ca­tion of of­ten sim­ple eye surg­eries, Cuban med­i­cal pro­fes­sion­als were able to pro­vide sig­nif­i­cantly im­proved and/or re­stored vi­sion to be­tween 2.2 and 3.4 mil­lion in­di­vid­u­als in the area. The pro­gram has been so suc­cess­ful that it has been mir­rored in the form of spe­cial oph­thal­mo­log­i­cal treat­ment cen­ters plus 55 sur­gi­cal cen­ters. These have been de­ployed in 31 coun­tries, in Latin Amer­ica and the Caribbean for the most part, and are now spread­ing out into Africa and Asia. They have all been built on the Cuban model, which has been so suc­cess­ful since its be­gin­ning in 2004.

Time for the World to Pay At­ten­tion

Cuba’s ex­per­tise and in­no­va­tive ap­proaches to med­i­cal re­search and med­i­cal treat­ments are set­ting stan­dards that even the big­gest and most well-funded uni­ver­si­ties and phar­ma­ceu­ti­cal cor­po­ra­tions have not been able to match. It is about time the United States opened up much closer med­i­cal co­op­er­a­tion agree­ments with Cuba. It is also about time the world as a whole paid far more at­ten­tion to what Cuba is do­ing in the med­i­cal com­mu­nity and how this might in­form mod­els for tar­geted treat­ments as well as univer­sal health care ev­ery­where.

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