DESPITE the global economic-financial crisis and the cruel and unjust blockade imposed for more than 50 years by successive U.S. administrations, Cuba is continuing to develop innovative biotechnology products to improve the quality of life of its population and other nations.

Dr. Gerardo Guillén Nieto, director of biomedical research at Havana’s Genetic Engineering and Biotechnology Center (CIGB) in Havana, told Granma International that the center currently has around 70 research-development projects centering on important medical issues such as infectious disease, cardiovascular disease, and cancer.

Reports from the World Health Organization indicate that 45% of deaths in poor countries are due to infectious diseases.

The situation in Cuba changed after 1959 and these diseases ceased to be a health problem thanks to the epidemiological vigilance directed by the prestigious Pedro Kourí Institute of Tropical Medicine (IPK), which has four centers of cooperation with global and Pan-American health organizations, including one dedicated to dengue and its vector.

The most predominant health problems for Cubans are now chronic non-transferable diseases, with an increase in the number of cases of cancer and cardiovascular disease, among the most common causes of death in First World countries.

CIGB’s portfolio of projects is very impressive, Dr. Guillén stated, explaining that it contains innovative products, some which have been recently developed and others which are still in the development process.

Among those recently registered, he mentioned the combined Heberpenta vaccine and Heberprot-P, an injectable solution of epidermal growth factor.

In just one shot, Heberpenta protects infants against diphtheria, tetanus, whopping cough, hepatitis B, and diseases caused by the bacterium Haemophilus influenzae type B.

CIGB, the Finlay Institute, and the Reactive Chemical Laboratory at the University of Havana contributed to its invention.

Second of its type in the world, this liquid vaccine has achieved the same level of effectiveness as the one produced by the transnational GlaxoSmithKline.

The Cuban pentavalent vaccine is part of the massive and free National Vaccine Program that protects the infant population against 13 preventable diseases and has allowed the country to prevent the resurgence of diseases that have been eliminated, including polio (eradicated in 1962 – Cuba was the first country on the continent to eradicate this disease), Neonatal tetanus (since 1972), diphtheria, whooping cough, measles, rubella, and tubercular meningitis in children of under 12 months.

Heberprot-P is the only product in the world that helps heal complicated ulcers, like diabetic foot ulcers (UPD), and reduces the risk of amputation of the inferior members of these patients, thereby increasing their quality of life.

There are 285 million diabetics in the world today, a figure that is predicted to rise to 438 million in 2030, according to estimates by international agencies.

In Cuba, the number of diabetics could reach 624,000 by 2010, according to Dr. Oscar Díaz Díaz, director of the National Institute of Endocrinology, on a 2007 Cuban Television "Roundtable" program on this disease and its treatment.

However, the island has the lowest mortality rate for diabetes (12.3 per 1,000 inhabitants) of the entire American continent, as noted in a report from the Pan-American Health Organization.

Developed by CIGB in conjunction with the National Institute of Angiology and Vascular Surgery, Heberprot-P was registered in Cuba in June 2006 and, in April 2007, was included within the basic spectrum of 866 medications, 537 of which are produced nationally.

Available in angiology services Cuban hospitals, work is ongoing to extend its use to the primary healthcare sector since last year," Ernesto López Mola, CIGB head of business development, informed Granma International in an interview in 2008.

The medication is patented in the United States, European Union, Australia, Hong Kong, Singapore, South Korea, South Africa, the Russian Federation, China, India, and Ukraine. Its use has been authorized in Venezuela and Algeria.

However, American citizens cannot benefit from this medicine due to the U.S. blockade of Cuba.

In the United States, there are almost 20 million diabetics. More than 70,000 amputations related to UPD and diabetic wounds are reported each year and cost the health care system around $11.3 billion per annum.

Heberpenta and Heberprot-P are the most recent acquisitions of Heber Biotec S., an agency that exclusively markets biotechnology and pharmaceutical products, technological services, and research-development products from CIGB and other important Cuban laboratories and institutions to 45-plus countries in Latin America, Asia, Africa, and Eastern Europe.

Heber Biotec S.A. has more than 200 approved health registries in 52 countries and signed distribution agreements with companies all over the world.

Madaisy Cueto Sánchez, the organization’s promotion and publicity manager, explained to GI that both products are marketed under the Heberfarma product line, the pentavalent in the vaccine sector and Heberprot-P in the biological pharmaceutical sector.

According to data provided to GI, more than 335 million people in the world have benefited from the vaccines that Heber Biotec S.A. exports.

In addition to the pentavalent vaccine, the company markets Trivac HB (against dipheria, whooping cough, tetanus, and Hepatitis B), the Heberbiovac HB recombinant (against Hepatitis B) and the combined

Quimi-Hib (against the bacterium Haemophilus influenzae type b).

Heber Biotec S.A. and CIGB together form a complex of research-development, production, and marketing.

Inaugurated on July 1, 1986, CIGB is a vanguard institution in Cuban Biosciences. The institution’s principal value is in its personnel, who are highly qualified and committed to the development of new products to improve the quality of life of millions of people around the world, as well as other applications for agriculture and livestock.

It has laboratories endowed with the state-of-the-art equipment needed for high level modern biotechnology research and has production facilities that meet the highest international standards.

CIGB is part of the Scientific Complex to the west of Havana established in 1991 in order to accelerate the development of biotechnology and medical-pharmaceutical products via the systematic coordination of research, teaching, and specialized production among different institutions. The original idea came from a speech given by Fidel Castro in the 1980s.

At the recently concluded 2009 Havana Biotechnology Conference, Dr. Luis Herrera, director of CIGB, acknowledged the role played by the leader of the Cuban Revolution as the precursor to the country’s biotechnological development. In the 1980s, this sector received an initial government investment of more than $1.5 billion, which allowed the undeveloped and blockaded nation to place itself alongside the most developed countries in this field in the world.

Of the products being developed by CIGB, Dr. Guillén emphasized Proctokinasa, which is nothing more than the application of the Estreptoquinasa recombinant via the rectum in the form of a suppository, which helps break up clots. This product is the next to be registered.

He stated that an Alpha Interferon 2b Human Recombinant gel (Hebergel), indicated for low-grade cervical lesions, is currently in phase three of clinical trials. In addition, HeberPAG, a combination of Gamma Interferon human recombinant and Alpha 2b Human Recombinant, indicated for brain cancer, is currently in the advanced stages of development.

He noted that the therapeutic vaccine against Hepatitis C (Heberterap C) is currently in phase 2 of clinical trials in chronic patients and added that studies are underway for its prophylactic application.

In relation to the therapeutic vaccine against prostate cancer (Heberprovac) he stated that phase one of clinical trials has now concluded. Projects currently in the preclinical research stage include a prophylactic vaccine against the four strains of the dengue virus (Cuba is one of three countries in the Americas where this disease is not endemic), and drugs against diseases like rheumatoid arthritis.

Some of these projects were presented by Cuba at the 2009 Havana Biotechnology Conference, dedicated this year to medical applications in that branch of knowledge. Prominent researchers, including the 2008 Nobel Prize Winner in Physiology and Medicine Harald zur Hausen, and 1988 Nobel Prize Winner in Chemistry Robert Huber, attended the event.

During the conference, close to 500 specialists from more than 30 countries were informed about Cuban biotechnology products, which contribute to the diagnosis, prevention, and treatment of 26 diseases.

In 2007, Cuban pharmaceutical and biotechnology products were the country’s second highest export item, only exceeded by nickel. The income generated from the sale of pharmaceuticals was valued at $350 million.

TEN years ago a former military installation – the Granma Naval Academy – was converted, in an action of solidarity on the part of a little country criminally besieged and blockaded by a contemporary Goliath, into a Latin American medical university, with the idea that thousands of disadvantaged young people could make a reality of their dreams, subsequently to promote health, prevent disease, cure and save the lives of thousands of their own of their own compatriots in need.

In order to have a palpable sense of that historic event I talked at that time with Nora Karina of Guatemala, Lesver Miguel of Nicaragua, Nelson Menocal of Honduras and many more of that huge group of young people from our America who began that journey into the future.

I was deeply impressed by the story of a petite and communicative young woman, Igni Estrada Moncada, with vivid memories of poverty, doubtless similar to those of many students studying free of charge at the Latin American School of Medicine, and who received her doctor’s degree, as confirmed by the University’s General Secretariat, during the first ELAM graduation in 2005.

I remember that Igni said she liked the rain but, paradoxically, suffered when she heard it falling, because a few steps away from her home in Ilopango municipality, El Salvador, many people were living in corrugated shacks, “and then I think that the children will be getting wet inside their own homes, getting sick, and the people who most need it are the ones who receive the least medical attention.”

And she asked: “What doctor living in Colonia Escalón (a nearby area where wealthy people live) is going to go and attend to a community living ion such poverty?

“I’ve come to Cuba in response to your solidarity, to train in order to serve people in need with out any distinction of class.”

Sometimes she felt afraid, she explained, that the humane and social vision that she felt so deeply could be diverted from its source even if she had had the possibility of being educated in a capitalist country, “and I would come to be impregnated with the philosophy – as I’ve seen – that you take a sick child (to hospital) and if you don’t have the money to pay, you simply don’t get attended to, and that happened to me with one of my little brothers when he was only one day old.”

Studying for this humane career in Cuba, she concluded by saying, “I know that I couldn’t change those ideas, because I am surrounded by doctors who think the same as I do: that, as doctors, we have to be where the people need us.”

The student selection process for entry into ELAM is undertaken in their own countries of origin, fundamentally in response to a Cuban proposal that they should be young people with a vocation for Medicine and with scant or no possibilities of training for this university career in their places of origin.

THE IDEA EMERGES

From the heart of City of Havana, driving toward the west of the capital along Fifth Avenue, you come to the Panamericana highway. Some 25 kilometers further on, at the very limit of the two Havana provinces, lies ELAM, notable for its structure and rural setting and, in the academic sphere, for the integration of its teaching, investigative and welfare components in the education-learning process.

The idea of an Comprehensive Health Program (of free medical aid for the region and other continents) and a Latin American School of Medicine (as the sustainable part of that aid) was born in 1998 after the passing of two hurricanes that inflicted much damage in the Caribbean and Central America, giving rise to a large number of victims and incalculable material damage.

On November 15, 1999, during the 9th Ibero-American Summit of Heads of State in Havana, Fidel officially announced the ELAM project, “as a simple symbol of what, united, we can achieve,” and which aspires to be, he said, “a modest contribution from Cuba to the unity and integration of the peoples that we are representing here.”

He stated that material of a political nature would not be imparted, as is the case with young Cubans in all university centers. “They will learn the history of our hemisphere, especially that of Latin America and the Caribbean… Anyone is free to profess his or her religion, whatever it might be. And he noted: “The most important thing will have to be their total dedication to the most noble and humane of the professions: to saving lives and to preserving health. More than doctors, they will be the jealous guardians of the most precious of human beings, the apostles and creators of a more humane world.

“Doctors prepared to work there where they are needed, in the most remote corners of the world where others are not prepared to set foot. These are the doctors that will be trained in this School.”

“Your example, as the dearly loved young people already studying in this School,” stated Fidel, “will awake consciences and will be followed by the professionals who, in high numbers and with excellent quality, have formed the universities of Latin America. Saving millions of lives, offering secure and optimal healthcare to the 511 million inhabitants of Latin America and the Caribbean, can only be the task of hundreds of thousands of doctors who, in their vast majority, are already technically trained for that.

ACADEMIC TRAINING

Doctor Midalys Castilla Martínez, deputy teaching rector of ELAM, says that the training principles in the School are the same as those implemented with Cuban students, and the same rigorous study plan. In this academic sphere the integration of teaching, investigative and welfare components in the educational-learning process favor the comprehensive training level that these students have to reach on their courses.

Another essential objective of this program is associated with the values that should characterize a medical professional: humanism, solidarity, professional ethics and internationalism, fundamental aspects of the work that will transform them into human beings capable of aiding social and community changes, expressed in improved health indicators, quality of life and well-being, and the ELAM project’s principal goal as a contribution to greater social equality.

The educational training model of these students establishes a direct link with scenarios in which they will undertake their professional work. From the first of the six years of the course, and in their vacation periods, they are inserted in the most remote communities of their countries to take part in promotional and preventative health projects.

This link becomes more intense and diversified as students advance in their courses.

As one example of this integration in the investigative and welfare sphere, a clinical-epidemiological study is being made of kidney disorders among the inhabitants of a remote community in El Salvador, with the participation of ELAM students and graduates, together with specialists from the Nephrology Institute attached to the Cuban Ministry of Public Health and that of El Salvador.

Students complete their courses with a National State Examination, which legally endorses them as professional doctors, in line with regulations established by the Cuban higher education system, and which facilitates the recognition and accreditation of their degrees in their countries of origin.

The teaching deputy rector recognizes that the heterogeneous composition of the ELAM student body in terms of origin and cultural diversity has presented a challenge to the faculty’s professors but, at the same time, is an important pillar in the students’ overall training.