Cuba is a West Indies country, the largest and most influential in the Caribbean region. The country is dominated by Arawakan speaking people and famous for raw sugar production. The country has overtime progressed in systems, institutions and people-based policies since it was claimed for Spain in 1492. The island of archipelago has a functional education structure and well systemized medical education which is not only leading in the Caribbean region but globally recognized.
Since inception of its medical education in 1999, Cuba has developed medical institutions with state of the heart infrastructure, medical resources and teaching-learning medical luminaries. Cuba tops among most sought after medical schools in the world and has earned a high badge in global ranking with Universidad de La Habana, Ciudad Universitaria Jose Antonio Encheverria, Universidad de Oriente Santiago de Cuba, Universidad de Cienfuegos Carlos Rafael Rodriguez, Escuela Latinoamericana de Medicina, Universidad de Ciencias Medicas de Villa Clara and Universidad de Ciencias Medicas de Cienfuegos leading in medical education. Cuba has an age long excellent record in medicine education and the 285 years of medical teaching has birthed over 100,000 professionally trained medical experts from 80 countries in the world.
The integrity and globally respected medical ingenuity in Cuba are demonstrated in the production of COVID-19 vaccines and its thorough administration in the island country. The Caribbean island produced Abdala, Soberana and Mambisa to prevent the prevalence of coronavirus. Cuba’s production of the vaccines becomes a testament to the high-flying medical experts and research ongoing on the island. The vaccine successful production helped Cuban authorities achieve low death rate at the full-blown virality of COVID-19; recording 146 deaths in 11.2 million country population.
Cuban medical schools are making high strides in cutting-edge research and result-focused learning because the country prioritizes education and authorities support intensive research especially in medical fronts. The freedom for scalable medical research in Cuba has been a consistent handling of epidemic and pandemic in the country which has gained worldwide recognition including endorsement from World Health Organization (WHO). Medical education in Cuba is practical-oriented and involves the integration of research-backed medical theories and principles into real-time and practice-supported medical teaching and learning.
Doctor of Medicine in Cuba
Training for the Doctor of Medicine in Cuba comes with attaining a Spanish proficiency for non-Spanish speakers. Students can take a proficiency test in Spanish to meet the language requirement. Spanish learning is foundational in Cuban medical school and useful for teaching, learning, interaction purposes at the medical school and graduate practice. The training for Doctor of Medicine in Cuba takes 6 years plus a one-year Spanish training for non-Spanish speakers. A bachelor degree in medicine prepares students for medical profession that is cherished beyond the Caribbean island. Cuba boasts of doctors in their hundreds who are on exchange programs in different countries including helping to widen medical reach in Brazil and Venezuela—the well-trained medical doctors from Cuba excel at these exchange programs mostly international. Cuba’s record of high-ranked medical education and schooling resources are traceable to the revolution of Fidel Castro which has remained a game changer in the history of the most influential country in the Caribbean region.
In noting the legacy of excellence in Cuba’s doctor of medicine program, a study conducted on Cuba-trained South African doctors showed that, the students turning doctors were exposed to the core of medicine and they had practical medical experiences in the program. Cuba’s medical education is considered useful for South Africa especially in rural health care, community medical reach, tuberculosis and HIV diagnosis and care.
Doctor of Medicine Curriculum in Cuba
The doctor of medicine program in Cuba progresses from the Family Doctor Programme dominated between 1980 and 1990 to the modern medical education curriculum. The Family Doctor Programme was centered around using individuals and members of the community to support medical teams. This idea of collective medicine was targeted at preventing diseases and responding to the growing medical demands in Cuba. Primary health care was at the fore of the educational design and a community-based medical structure was adopted. The implementation of neighborhood-centered medical system initiated the use of hubs for medical consultation attending to 20 to 40 patients. Social institutions were targets of the medical system and doctors were trained mainly for epidemic prevention and need-based treatment. Cuban’s medical system was overstretched and meeting the public medical demand was difficult.
To attend to the overbearing nature of medicinal need in Cuba, doctor of medicine curriculum was revised to cater more for the public and strengthen health institutions, facilitators and students in medical industry. The revised curriculum births the University Polyclinic Project.
The University Polyclinic Project began in 2003 and has transcended in achievement, the medical records of the prior ‘what and how’ of medical education in the country. PPU is a 6-year program that integrates general medicine into surgeries, primary health care, hospital management, basic sciences, clinical sciences, and morpho physiology. Morpho physiology is a combination of biomedical sciences which include molecular biology, physiology, anatomy, histology, embryology, and pathology among others. PPU has created a medical education that allows students move from one learning level to another; combining theories and practical, and practicing classroom knowledge on the field. Medical students are placed under medical tutors who supervise them as they practice medicinal skills in hospitals and health care centers; this has fast-tracked access to doctors in Cuba and grossly improved health and medical sustainability in Cuba. Updated and modern medical resources are utilized by seasoned medical teachers to bring medical students to real-time and globally-demanded medical skills. Students are trained with research intensive resources and tools including audios, videos, seminars, workshops, independent analysis and group studies. Pedagogic and language training are included in the final level of Cuba medical education; targeted at effective patient-doctor communication in practice.
The 6-year medical education under PPU in Cuba begins from morpho physiology to family medicine to philosophy and health, clinical medicine, internal medicine, pediatrics, public health, traumatology, forensic medicine and surgery. The medical education structure has remained progressively strong and continues to put Cuba on the world map.
Why Cuba is the best Place for Medical Education
Cuban medical education creates space for all students to learn without fear or racial discrimination. The accommodation of all students without preferential treatment has placed Cuban medical schools in the to-go list among schools in the Caribbean region. Fidel Castro’s initiative of free medical education for Afro-indigenous and less privileged Americans has reformed the country’s education system and position it globally. Black and Latino students are admitted to Cuban medical schools on merits and they make up to 6 percent of annual medical graduates in the country. Cuba’s excellence in the doctor of medicine program is reflected in the pluralized access to medical care in the country—shown during the COVID-19 pandemic especially with rapid public enlightenment and vaccination. Cuban authorities delight in the medical system and education of the country because, the island country rivals the United States in life expectancy rate while having a lower child-mortality rate when compared with the US.
Cuba has built a long-standing reputation in strategically turning problems to solutions. Problem to solution repute of Cuba is seen in the authorities turning the US economic restrictions to medicinal and public health advantages. Rather than struggle due to inadequate access to medical facilities, Cuban authorities facilitated strengthened and early diagnosis for medical cases; helping to implement preventive measures in combating ailments. Cuba has a practical and solution-centric medical education system and this was during the pandemic where medical students were deployed for contact tracing and trained for vaccination. Engaging medical students for medical care during the pandemic shows how the country prioritizes hands-on learning in medicinal treatment.
Communities and rural areas in most countries have high record of less medical attention. The case is different in Cuba because rural settlements are centralized locations for medical practice and internships in Cuba. Rather than have students cluster in the urban, medical tutors allow students move from one house to another in specified community to reach out to people—as students gain wider medical experience from human and real practices, Cuban residents get effective and near-free access to medical care.
Dreaming of attaining medical education in a globally recognized institution? Then, Cuba is your right choice. The island country leads in doctor of medicine program that is people-centered and tops among contenders. Less privileged but diligent high performing students are catered for in Cuba with the Latin American Medical School that comes at no cost.
The world was definitely a very different place 60 years ago. Cuba, a small but proud country, was trying to find its position on the world’s map in times of geopolitical conflicts between the East and the West. Having a relatively small population compared to its neighbors, Cuba couldn’t hope to secure its position by investing in the military. Instead, they chose a different national diplomatic strategy and made an army of medical specialists. This approach has given Cuba a leading role in the battle for the world’s health up to this day. For 60 years, Cuba has been educating and deploying doctors all around the world to fight against diseases in underserviced areas. It all started with deploying health professionals in Chile after the devastating earthquake in 1960. Today, there are more than 4,000 Cuban health workers in 32 African countries fighting Ebola, cholera, tuberculosis, AIDS, and malaria.
The Cuban health education and training are based on a holistic approach focusing on a combination of healthcare, profound humanistic values, social justice, and community health. Because of this approach, Cuba has a life expectancy rate on par with the US, at the same time spending on healthcare 20 times less.
In 2014, UN Secretary-General Ban Ki-moon sent a statement to the officials at the Escuela Latinoamericana de Medicina (ELAM) in Havana, hailing Cuba for training medical ‘Miracle Workers’ and being on frontlines of global health. In the statement, Secretary-General pointed out that ELAM did more than training doctors:
“I have seen it for myself. As Secretary-General of the United Nations, I travel to many difficult places; desperate places hit hard by earthquakes, hurricanes, or other natural disasters; remote places of deep deprivation; forgotten places far off many people’s radar of concerns. And so many times in these different communities, I have seen the same thing. Doctors from Cuba — or doctors trained in Cuba — helping and healing. Your doctors are with communities through thick and thin: before disasters strike, throughout crises and long after storms have passed. They are often the first to arrive and the last to leave. For those students who cannot come to Cuba, you are also helping to establish medical schools from Bolivia to Eritrea to Timor-Leste. ELAM has trained tens of thousands of students, but Cuba can teach the entire world about health care. I want to join so many others in saluting Cuba’s healthcare system, rooted in primary health care, which has yielded outstanding results — lower infant mortality, higher life expectancies, universal coverage. This is a model for many countries around the world. Through initiatives such as Operación Milagro, Cuban-trained doctors have saved or improved eyesight for millions of people in dozens of countries. You have helped them to see, but you have also given the world vision; a vision of generosity, solidarity, and global citizenship. I am very proud to see it for myself. And I thank you for sharing it with the world.”
Statement fully available at: https://www.un.org/press/en/2014/sgsm15619.doc.htm
Counting all medical training programs established by ELAM medical graduates, the Republic of Cuba has the world’s largest medical school. Currently, medical students from more than 100 countries all around the world are doing their medical training in Cuba.
The Cuban Medical Education Program
The program is modeled after the European medical schools. This means it would take a student six years to become a medical doctor in Cuba as opposed to 4 years of training in the US and Canada. In terms of knowledge, this means two extra years of clinical rotations under the supervision of medical professors. The medical school focuses on a wholesome approach: it addresses the biological, psychological, and social aspects of health and disease. Most of the time, a student is at the patient’s bedside and makes house-calls during the training. This way, the students get a unique perspective to healthcare – they learn to recognize and handle all challenges a doctor faces in everyday medical practice from top to bottom of the healthcare system.
The first-year studies involve basic methodology and integrated medicine courses. The second year of medical school is composed of anatomy, pathology, physiology, microbiology, genetics, in addition to psychological and social studies. During this time, a student learns about basic principles of human biology and psychology, fundamentals of healthcare system organization, and disease prevention — all that through the scope of data-driven and evidence-based approach.
In later years of training, students attend clinical rotations and start practicing medicine under the supervision of their professors.
During these six years, no student is left unattended. Professors are available 24/7, group sessions are a commonplace, and students are stimulated to collaborate on various projects during the training. This way, students learn to develop strong professional relationships, a high sense of belonging, and lifelong friendships with their colleagues and professors. In short, Cuban medical school promotes the universal approach where all benefit.
Students who want to pursue a medical career in the US, just like their peers in the US medical schools will have to pass the United States Medical Licensing Exam® (USMLE). In this regard, the Cuban medical graduates perform outstandingly. The US residents who studied medicine in Cuba achieve a match rate of 94%. In other words, sky is the limit for them. Furthermore, the Cuban medical educational institutions are approved by the “California State Medical Licensing Board,” the most stringent in the United States.
Cuban medical school delivers knowledge, and it seems they know how to make students acquire the knowledge. In terms of cost-effectiveness, it is not for free, but the entire medical training comes at a price that’s one-fifteenth of the price in the US. While the cost of the medical program in the US, which includes tuition, fees, books, and interest on loans, reaches up to $1,000,000.00, in Cuba, it is just $73,000. Let’s put it this way- medical training in the US requires about 8-10 annual specialist salaries. In Cuba, it costs 6-8 specialist monthly wages.
The social and cultural life of students during their education flourishes, and its uniqueness is almost unmatched. Cuba possesses rich cultural history adorned by astonishing architecture, but what really makes it stand out is its people, their customs and way of life. In that sense, this place can be described as Heaven on Earth. Cubans focus on what really matters in life – love, friendship, solidarity and unity. These days, there are not many places on the planet left where a person can learn about the values that make us humans. Cuba is one of those few spots for sure!
Since the production of the recombinant human form in the Center for Genetic Engineering and Biotechnology of Havana, Cuba, in 1986 Interferon Alfa 2-B antiviral drug has broken barriers in public health as an active therapy against causal agents of diseases. an antiviral and antineoplastic drug used to treat a myriad of virus-borne infectious diseases. The drug, actin as an immune system booster, is simply a recombinant form of the human protein interferon alpha-2 reproduced outside of the body by recombinant DNA technology, exploiting microorganism fast growth.
The history of Interferon Alfa 2-B, in Cuban health history, remains prominent as it was the groundbreaking technology that led to the end of hemorrhagic dengue fever outbreak in the country in the 1980s, igniting the rise of the biopharmaceutical sector. Till today, Interferon Alpha 2-B remains a prominent tool in the treatment and elimination of several diseases and has been more recently used to fight and combat the worldwide Covid-19 pandemic.
How Interferon Alfa 2-B Works
As earlier indicated, Interferon Alfa 2-B is a recombinant form of a protein in the human body that naturally works to fight off viruses in the body. The drug works as a stimulator of the immune system and is classified under medicine as an immunotherapeutic agent. Since Interferon Alfa 2-B is a copy of a naturally occurring human protein belonging to the cytokines family, it mimics and acts the way the original protein does.
The function of Interferon Alfa 2-B when administered is to boost the immune system and assist it in fighting off foreign harmful agents. It is a communicator offering assistance to the immune system for an elongated period due to the presence of polyethylene glycol, bound to it. This act of immunotherapy as an immunotherapy treatment is what makes it useful in the treatment of cancer.
Uses of Interferon Alfa 2-B
Interferon Alfa 2-B is used in various ways to fight off several illnesses. With viral diseases, the therapeutic agent has so far been successful in the treatment of chronic hepatitis C and B. It is a popular drug in the treatment of cancer and found useful in fighting and eliminating AIDS-related Kaposi sarcoma, leukaemia, melanoma (cancerous tumours), some genital warts, and hairy cell leukaemia, amongst others.
The drug aids and upregulates the action of antibody stimulation proteins and presenting cells to act against viral proteins and improve health. It can stay in the body longer than typical interferon alfa-b. It enhances the target specificity of macrophages to trap and eliminate viral genetic material and enhances the immune system to act properly. The natural nature of the drug’s mechanism of action makes it very useful in medicine with little possibility of toxicity at the right dosage.
Interferon Alfa 2-B in Treating Covid-19
As the world battled with Covid-19, scientists from all over the world struggled to find a therapeutic solution to reduce the effect of the deadly virus in claiming lives. In Cuba, Interferon Alpha 2-B was a solution which showed considerable promise. During premilinary cohort studies of the efficacy of interferon alfa 2-B on individuals infected with Covid-19, it was discovered that recovery in patients who had received the drug was significantly better than in patients that didn’t receive it as part of their treatment.
As a natural antiviral drug and immune booster, Interferon Alfa 2-B was a lifesaver to the public health sector of Cuba and nations around the world that adopted the drug. Although improvements were seen and experienced, its use in treating coronavirus was not without controversy and criticism.
Critics remained skeptical and indicated that very minimal studies have been conducted on the efficacy of Interferon Alfa 2-B towards eliminating Covid-19. There was also little evidence that long term use of the drug did not pose a future threat to the health of people. The critics even argued that the side effects of the treatment were quite similar to the background symptoms of the Coronavirus infection. However, with China and several other countries purchasing with no news of adverse effects and recorded toxicity, Interferon Alfa 2-B became the wonder drug that mitigated the virus to an extent as research studies for a vaccine progressed.
How Interferon Alfa 2-B Is Administered
Usually, Interferon Alfa 2-B is not advised to be taken without a prescription from a qualified and certified medical practitioner. The antiviral agent is administered intramuscularly or intravenously through injections into the muscle or skin. Shots are usually given in hospitals and medical centres by doctors or medical practitioners. However, with technology and multi-dose pens present for chronic infected sickly patients, it could be used in the home too. But it must be noted that the directions of the manufacturer and prescription by a doctor must be followed judiciously to avoid overdose and errors leading to medical complications.
Is Interferon Alfa 2-B Toxic
Generally, Interferon Alfa 2-B is not toxic to use, neither has there been reports of the adverse effects of the drug. Nonetheless, like every other drug, Immunotherapy has its side effects and specifications for use. It has been noted that sometimes, there could be swellings in the site of injection which should naturally reduce. But if the swelling gets worse, it is advised to see a doctor.
Some of its major side effects include flu-like symptoms including fatigue, fever, headache, nausea, dizziness, dry mouth, and even upset stomach upset. The side effects should last about 24hours after use. If after 24 hours, the side effects persist, patients are advised to see their doctor. Taking Interferon Alfa 2-B must be supplemented with the intake of fluids to boost immunity and strength.
Can Everyone Use Interferon Alfa 2-B?
It is very important for medical purposes to know that although everyone can use Interferon Alfa 2-B, some predisposing factors like the health status of a patient must be considered before using the drug. Typically, pregnant women, partners whose partners are pregnant, individuals with kidney disease and patients allergic to ribavirin are advised not to use it. Therefore, when on a visit to the doctor, it is of essence that you provide the right information to avoid complications with immunotherapy use.
Interferon Alfa 2-B remains an active antiviral and antineoplastic therapeutic drug in fighting against viral diseases and cancer, improving the public health sector. The immunotherapeutic agent is excellent at boosting the immune system and eliminating viral proteins and attachment mechanism, improving the health of users and sickly individuals. Nonetheless, indiscriminate use without a prescription must be avoided.
During the decades of very rigorous sanctions brought by the United States, Cuba has managed to develop one of the biggest machineries for drug research and development. Due to the embargo, Cuba was practically forced to invest a substantial amount of funds into the medical research, in order to address the issue of the overall health of the population. Today, Cuba possesses a strong and sophisticated system for the production of state-of-art medicinal products. A large biotech and pharmaceutical group called BioCubaFarma gathers over 30 enterprises that are focused on investigating, developing and producing high-quality medicinal products intended for supplying domestic and international markets. Cuba currently markets the products 49 countries worldwide. A very resilient approach of Cuban experts in the field of drug research and development provides impressive results and continues to surprise the international scientific community with innovations and ideas.
Vaccination represents one of the public health medical interventions that has shown tremendous benefits in prevention, eradication and significant reduction of incidence of severe and debilitating infectious diseases worldwide. Due to the significance of vaccination for the public health, several leading organizations in the field of vaccination including the World Health Organization (WHO), Global Alliance for Vaccines and Immunization (GAVI) and the United Nations Children’s Fund (UNICEF) developed strategies to increase the immunization rate worldwide and disseminate the new technologies in the field of vaccination globally. All three organizations advocated for the research and development of polyvalent vaccines covering multiple diseases in order to make the process of vaccination more simplified and to cover more pathogens with only a single vaccine administration. In order to respond to the recommendations given by the leading organizations in the field of immunization, Cuba started with the challenging research and development program of vaccines.
Trivac HB is a polyvalent (combined) vaccine containing diphtheria anatoxin, tetanus anatoxin, B. pertussis whole cells and hepatitis B surface antigen. It provides protection against all the above-mentioned pathogens and represents the second ever produced tetravalent vaccine worldwide. Several years of sophisticated research regarding vaccine formulation, potency, safety and tolerability resulted in the successful registration of this medicinal product in 2004. Since then, Trivac HB has been successfully administered in children for the purposes of prevention of the aforementioned infections. This vaccine represents a state-of-art medicinal product due to several reasons. The tetravalent formulation allows the protection against the multiple pathogens, decreasing the need for multiple vaccinations resulting in the better acceptance of the immunization program both by the families and the sanitary personnel.
A careful process of selection of each component’s formulation resulted in inadequate protection in 97% of tested children, which is an impressive result. Safety of the vaccine was vigilantly monitored during the clinical trial process in each child. Less than half of the children experienced an adverse effect following administration of the vaccine. All reactions were mild in nature, with reversible fever being one of the most frequently reported systemic side effects. The vaccine was very well tolerated in children and the overall safety profile of the vaccine was assessed as non-toxic. Administration of the vaccine resulted in the production of high concentrations of antibodies against each pathogen conferring the high protection to the immunized children.
Haemophilus influenzae type b represented one of the main causes of severe bacterial meningitis in plenty of the countries worldwide until the introduction of a vaccine against this pathogen. The vaccine production includes the expensive process of extracting the capsular antigen prior to conjugation. Cuba has made an effort to develop a less costly method of vaccine production that would keep the vaccine potency. Cuban experts proposed the model of production of a synthetic bacterial antigen that would exhibit the same efficacy and would have an acceptable safety profile.
The safety, tolerability and preliminary efficacy of Quimi-Hib were investigated in two major Phase I clinical trials that were double-blinded and randomized in order to produce the highest level of evidence for obtained results. Populations investigated were adults and children (4-5 years old). Studies were conducted on healthy volunteers. The primary endpoints were safety and tolerability of the vaccine. The occurrence of local and systemic adverse events was monitored following the administration of the vaccine during 72h post-administration. The safety profile of the vaccine included the anticipated risks that were mild to moderate in nature and completely reversible. Vaccine efficacy was monitored using the contemporary methods of immunology for the screening of vaccine immunogenicity. The results obtained demonstrated high immunogenicity of the vaccine, meaning that the efficacy of the Quimi-Hib was comparable and equivalent to the traditional vaccine. With this vaccine, Cuba has successfully resolved the issue of high complexity and costs that was the main issue of the traditional vaccine. Quimi-Hib represents the innovative approach to vaccine development. Excellent results resulted in the registration of the vaccine in Cuba. This particular vaccine is now the part of the countries’ National Immunization Program.
The incidence of tick-born diseases is increasing worldwide in both humans and domestic animals. It has been estimated that approximately half of all ticks are Boophilus species. Therefore, an effective prevention of tick-borne diseases should target the control of infestation by this specific species. Cuba has developed an efficient method for the protection against tock-borne diseases, which directly resulted in significant reduction of tick-related infestations. This vaccine offers the cost-effective method for the prevention of tick-born diseases that is benevolent for the environment. The development of the so called Bm86 gut antigen, which is the active ingredient of the Gavac vaccine, has brought the feasible solution to control the tick infestations. The investment of knowledge, expertise, and funds to develop such a sophisticated method of prevention in Cuba will also contribute to further research and development of other molecular technologies towards the discovery of new methods for inhibition of tick infestation.
Heberbiovac HB represents a vaccine developed for the prevention of hepatitis B infection. This vaccine demonstrates also a therapeutic potential and can be used as an adjunctive treatment for patients suffering from hepatitis B infection. This vaccine was developed in Cuba according to the recommendations tailored by the World Health Organization. The vaccine contains hepatitis B surface antigen, an active ingredient responsible for effective prevention of the hepatitis B infection. This vaccine has also shown efficacy in the treatment of both acute and chronic forms of the disease, as well as in the management of hepatocellular carcinoma. Interestingly, when receiving the vaccine, 95% of newborns of infected mothers are protected during life.
Heberviron was developed in Cuba for the treatment of hepatitis C infection. Not only that it has a significant cure rate, but it also exhibits a very good protection against the recurrence of the infection. The treatment duration when using Heberviron lasts for 7 days. This is quite important since the shortened treatment duration reduce the risk of serious side effects that may occur with the use of this drug. The combination of interferon and antiviral drug ribavirin as the active ingredients of Heberviron allow the better treatment outcomes and increase the success rate of treatment against the hepatitis C infection. Heberviron represents the state-of-art product of Cuban drug research and development.
Heberon Alfa R
Cuba has an advanced biotechnology industry. The development of interferon alfa-2b designed for intramuscular, intralesional, intravenous or subcutaneous injection confirms this statement. Heberon Alfa R structure is adapted so that the drug can be used in different modes of administration as stated above. Heberon Alfa R contains anti-tumor and anti-virus properties. It is intended for use in patients suffering from serious diseases such as chronic hepatitis B and C, HIV-induced Kaposi’s Sarcoma, malignant melanoma and many other neoplastic disorders. This drug is also approved for the use in children, where administration of Heberon Alfa R was proven safe and effective in children and adolescents.
Heberkinasa was created using the recombinant technology in order toprovoke a rapid and more effective thrombus degradation. Heberkinasacauses thrombus dissolution and recanalization of the affected vessel. The drug also prevents the tissue affected by ischemia to undergo necrosis. It has been demonstrated in clinical trials that recombinant streptokinase restores the ventricular function of the heart following myocardial infarction. The drug decreases the risk of pulmonary embolism and facilitates the elimination of embolus. The formulation of this drug does not contain immunogenic albumins, which directly reduces the risk of hypersensitivity and immune-mediated reactions, improving the drug’s safety profile.
Cuba produces the so-called highly active antiretroviral therapy (HAART). This treatment is intended for those infected with the HIV virus and other less common retroviruses. The formulation of the drug is specifically designed to reduce the side effects of conventional HAART drugs. This formulation reduces the abnormalities in blood cells and reduces the trend of hemoglobin depletion during treatment, which improves the overall tolerability profile of the drugs. Cuban antiretrovirals also have need shown to increase the number of virus-free CD4 lymphocytes. Decreased mortality and mortality from HIV infection has been also demonstrated in clinical trials.
Hebertrans is a highly sophisticated product containing the extract of leucocytes derived from human leucocytes that are used as the modulator of the defective immune response. The main characteristic of this medicinal product is that Hebertrans produces no side effects. It may be used in patients with defect immune system such as those receiving cytotoxic cancer treatment, those with immune deficiency (both acquired or congenital) or patients with autoimmune and allergic conditions. Hebertrans leads to the effective stabilization and normalization of the immune response.
Heberitro is a recombinant human erythropoietin. It stimulates the natural production and maturation of red blood cells, increasing the mass of red blood cells within the bloodstream. It is effective in various types of anemia caused by iron depletion. Its’ effectivity has been especially demonstrated in patients suffering from chronic kidney failure, those on HAART anti-HIV therapy, as well as in patients undergoing radiotherapy.
The sophisticated technology in Cuba allowed the development of so-called granulocyte colony stimulating factor (GCSF). Hebervital directly increases the production and maturation of granulocytes, especially neutrophils. Neutropenia is a serious risk in a patient receiving chemotherapy and may lead to the development of severe infections, even sepsis. GCSF successfully increases the number of granulocytes necessary for the effective immune response against infections. Hebervital directly decreases the risk profile of chemotherapy by mitigating the risk of severe neutropenia or bone marrow failure.
LeucoCIM is a granulocyte colony-stimulating factor (G-CSF) used for the treatment of neutropenic patients. Drug use has been proven beneficial in patients having myelosuppression following cytotoxic treatment, patients with myeloid leukemia and those with neutropenia caused by HIV/AIDS. The drug also prevents the development of bone marrow suppression in patients undergoing bone marrow transplantation.
Gilda Torano et al. Phase I Clinical Evaluation of a Synthetic Oligosaccharide-Protein Conjugate Vaccine against Haemophilus influenzae Type b in Human Adult Volunteers. Clinical Vaccine and Immunology. September 2006 vol. 13 no. 9 1052-1056.
Dania Bacardí et al. Preclinical safety testing of the Quimi-Hib® vaccine adjuvanted with aluminum phosphate during product development. Biotecnología Aplicada 2013;30:118-124.
Néstor S. Expósito, Daniel Cardoso, Eduardo Martínez, Yanelis Herrera, Karelia Cosme, Pablo A. Díaz4, Yayrí C. Prieto, Zoe Núñez, Mabel Izquierdo, Orestes Mayo, Joel Pérez, Luis C Hidalgo. TrivacHB: A Cuban Polyvalent Vaccine. Biotecnología Aplicada 2006; Vol.23, No.2.
Jose de la Fuente et al. A ten-year review of commercial vaccine performance for control of tick infestations on cattle. Animal Health Research 2007. 8(1):23-8.
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CECMED. Resumen De Las Características Del Producto. Estreptoquinasa recombinante. Last revision: 27 Dec 2013.
Back in 1978, a conference was held in Almaty (formerly Alma-Ata), the city in Kazakhstan where the one of the most significant public health declarations emerged. One of the most significant excerpts of the Declaration was the profound role of primary health care in establishing the concept of „Health for All”According to the World Health Organization (WHO), an adequate availability (adequate supply of healthcare), accessibility (adequate distribution of healthcare) and acceptability (treating all patients with dignity) of a healthcare system is required to ensure the best possible health outcomes in a population. Cuban healthcare system is established to meet the aforementioned standards, and by many criteria, this system is currently unique and one of the most efficient healthcare systems worldwide (1) .
National Healthcare Policy Goals
Back in 1983, Cuba introduced a Public Health Law establishing basic principles of the healthcare organization. The main characteristic of this healthcare system is that healthcare represents a right that is available equally to all and is completely free of charge (2) . One of the major differences between Cuban and American healthcare principles is that in Cuba, healthcare is the responsibility of the state. Additionally, the Law promotes global cooperation of health systems and its professionals.
On the contrary, a profit-driven healthcare system in the United States results in great imbalances of knowledge and quality of health services, and more importantly, creates a population that cannot afford a proper healthcare leading to healthcare quality being unpredictable and dependent on the financial state of each individual (3) .
National Health System of Cuba, that has been founded on a very effective primary health care, is producing impressive results. Rates of immunization are amongst highest in the world. Over 98 percent of children are vaccinated against 13 illnesses by the age of 2 (4) . Antenatal care is provided to 95 percent of pregnant women and mortality rate of infants is 5 per 1000 births. Control of blood pressure at least once per year is available to the entire population (5) . As a result of exceptional healthcare outcomes, Cuba is officially at the top of the list of countries that meet the United Nation’s Millennium Development Goals, focusing on the social components of healthcare services.
The pillar stone of Cuban healthcare system is the primary healthcare institutions. A community-based polyclinic, covering a population of 30000 to 60000 individuals represents a centerpiece of primary health care. These polyclinics serve as a hub for family doctor and nurse practices, where each family doctor covers a population of approximately 600 to 800 individuals. The polyclinics are also centers for education and training of the new physicians, nurses and other healthcare sciences students. Interestingly, Cuba was one of the first countries worldwide which introduced the concept of family care physicians (6) . This model of healthcare organization increased the prevention of chronic conditions such as diabetes, hypertension, heart failure, obstructive pulmonary disorders, and significantly decreased the need for “high-tech“ technologies in diagnosing and treating diseases (7) .
The polyclinics are advancing even today. The goal is to extend the range of health services at the primary healthcare level. Polyclinics are being equipped with ultrasound, X-rays, endoscopy, emergency care, immunization, rehabilitation services and many other (1) . Approximately 800 to 1000 patients use the services daily.
Drug Research and Development
Cuba is investing a significant amount of funds into drug research and development. The approximately US $1 billion investment in pharmaceutical and biotech industry resulted in the production of innovative medicines, vaccines and diagnostic kits that are now being sold internationally (8) . The most significant achievements of drug development will be discussed here.
Serogroup B meningococcal vaccine
Cuba developed and registered this vaccine back in 1989 in order to prevent childhood meningitis. The United States Food and Drug Administration (FDA) registered this exceptional medicinal product only recently, in 2014, when it was manufactured by Pfizer.
The drug has been developed in the CIGB (Center for Genetic Engineering and Biotechnology) of Havana. It is a combination of two interferons. The result of its complex mechanism of action is tumor growth suppression, particularly basal cell carcinoma (CBC) no matter of its size, location and subtype. Although most of the skin carcinomas can efficiently be cured surgically, in some cases, it’s not that simple (face- surgical procedures are often mutilating causing severe reduction of the quality of patient’s life).
The drug was registered in Cuba in 2006 and, since then, 15 more countries registered it, and more than 100.000 patients around the world have received the treatment with incredible results. The target patients are those with chronic diabetic ulcers resistant to other modalities of treatment (high amputation risk). By its structure, Heberprot-P is an epidermal growth factor (EGF), and it’s administered by injection, locally.
According to the clinical research, Nimotuzumab, due its safety profile, is an excellent ad-on therapy for the patients diagnosed with squamous cell carcinoma of the head and neck (SCCHN). The study blished back in 2009, clearly demonstrated that Nimotuzumab, combined with radiotherapy, triples the 30-month survival rate compared to the group of patients who received radiotherapy only.
1994 was the year when Cuban Center for Molecular Immunology started investigating this medicinal product for the purpose of treating non-small cell lung cancer (NSCLC). Studies have shown a significant increase in survival of NSCLC patients. Earlier this year, more than twenty years after the product was developed in Cuba, Roswell Park Cancer Institute in Buffalo, New York, decided to initiate the clinical trial in order to investigate the efficacy and safety of this vaccine for the treatment of patients suffering from NSCLC.
Melagenina Plus (Vitiligo)
The drug is an alcoholic extract from human placenta. The Melagenina Plus lotion is applied once a day to the affected areas. It causes the repigmentation by stimulating melanocytes in a chromic region of the skin (white patches). Available all around the world for more than 20 years, it claimed the title of miraculous vitiligo drug.
This interesting vaccine received approval in Latin American countries back in 2013, following completion of phase II/III study involving patients with advanced and progressive NSCLC. Racotumomab showed a significant increase in survival of patients suffering from end-stage NSCLC. This promising medicinal product is being evaluated in a multinational phase III study aiming to investigate the effects of this vaccine on health outcomes in NSCLC patients (NCT01460472).
In conclusion, it appears from the above that the industry in the United States still does not possess adequate mechanisms in providing innovative medicinal products when compared with Cuba.
HIV/AIDS, Ebola Outbreak
Cuba was the first country in the world recognized by the WHO for eliminating mother-to-child transmission of HIV and syphilis (9) . According to the Center for Disease Control (DCD), up until 2014 in the United States, there were 5419 deaths among the population who acquired HIV through perinatal transmission. Recently, Cuba has sent a large group of physicians in order to fight the Ebola outbreak.
These were just some of the characteristics of Cuban healthcare system that continues to impress and produce enviable results. There are plenty of lessons to learn from Cubans in terms of proper healthcare organization with only one goal: to ensure a healthier future.
1. Cuba’s primary health care revolution: 30 years on. http://www.who.int/bulletin/volumes/86/5/08- 030508/en/. [Online] [Cited: February 24, 2018.] 2. Ley No. 41. Ley de la Salud Pública. http://www.parlamentocubano.cu/index.php option=com_content_iew=article&id=257:ley-no-41- salud ublica&catid=46:leyes&Itemid=79.[Online] [Cited: February 24, 2018.] 3. Gray, Bradford H. For-Profit Enterprise in Health Care. s.l. : Washington (DC): National Academies Press (US), 1986. 4. Eradication of poliomyelitis in Cuba: a historical perspective. P, Más Lago. s.l. : Bull World Health Organ, 1999, Vol. 77(8). 681-7. 5. Caring for Them from Birth to Deat. C, Perez. s.l. : Lanham, MD: Rowman & Littlefield Publishers, 2008. 6. Health for all: a dream realized in Cuba. CW, Keck. s.l. : Medical and Health Annual. Chicago, IL: Encyclopaedia Britannica Inc., 1994. 357–362. 7. he Cuban health system: responsiveness to changing population needs and demands. SM, Santana. s.l. : World Dev, 1987, Vol. 15(1). 113–125. 8. The Curious Case of Cuba. Keck, C. William. s.l. : Am J Public Health, 2012, Vol. 102(8). e13–e22. 9. WHO VALIDATES ELIMINATION OF MOTHER-TO-CHILD TRANSMISSION OF HIV AND SYPHILIS IN CUBA. s.l. : Saudi Med J, 2015, Vol. 36(8). 1018-9.
CubaHeal Medical is a global organization specialized in facilitating medical treatments, medical education, in addition to patient and student care in the Republic of Cuba. CubaHeal is a loyal supporter of the Republic of Cuba, the Cuban people, the Cuban revolution, and the Cuban revolutionary leadership.