Cuban Biopharmaceuticals, Diagnostics and Medical Care Find Growing Interest from U.S. and International Healthcare Sectors

Cuban Biopharmaceuticals, Diagnostics and Medical Care Find Growing Interest from U.S. and International Healthcare Sectors

Remarkably, Cuba, despite near isolation from U.S. medical research, has managed notable advances in medical technology from its own industry. Cuban development of medical products such as cancer therapeutics, in vitro diagnostic (IVD) platforms and vaccines has occurred in the vacuum of U.S.-pioneered medical advances, but often manage only limited visibility internationally due to difficulties in investment. Reconciliation between the United States and Cuba has the potential to improve the distribution of Cuba-innovated medical products; facilitate learning and medical training across two very different healthcare systems; and improve collaboration in medical research to reach shared goals in the hemisphere and worldwide. The following review is not to suggest that Cuban healthcare is not without its weaknesses, there are many, but rather that the Cuban healthcare system and biotechnology industry feature promising resources worthy of investment.

One promising cancer therapeutic developed at Cuba’s Center for Molecular Immunology (CIM) is Cimavax, the first therapeutic vaccine for non-small-cell lung cancer (NSCLC). The low-cost therapeutic slows the progression of NSCLC and extends patient life by stimulating the immune system to produce antibodies against epidermal growth factor (EGF). Other cancer therapeutics used for NSLC use inhibitors against kinases involved in the cancer’s molecular pathways. Cimavax uses two proteins to help the immune system recognize EGF. The Center for Molecular Immunology (CIM) has already registered or initiated clinical testing on 28 biopharmaceuticals, largely therapeutic vaccines and antibodies, including the lung cancer therapeutic vaccine Racotumomab co-developed with Argentine Insud group and the internationally marketed EGFR monoclonal antibody Nimotuzumab.

Cuban authorities related that domestic exports of pharmaceutical and biopharmaceutical products were worth more than $680 million in 2013, representing the largest export group in the state-organized economy. Like its other healthcare industries, Cuba’s biopharmaceutical industry also serves as a diplomatic instrument and manifestation of an ethos to improve the quality of life of underserved populations. Cimavax is reportedly produced at a cost of only $1 per dose and represents a limited, yet palliative, therapy for lung cancer patients. The product is responsive to the needs of the domestic market, where lung cancer mortality is significant. Cimavax has been administered to 5,000 patients worldwide, including 1,000 Cuban patients, and is set to begin testing in the United States with partner Roswell Park Cancer Institute of Buffalo, New York. Researchers at Roswell will explore potential applications for Cimavax technology in the treatment of other forms of cancer as well as preemptive vaccination of patients at risk for lung cancer recurrence.

Other biopharmaceuticals produced by Cuban industry include vaccines against infectious disease. A prophylactic Meningitis B vaccine was developed by CIM in the 1980s and was widely distributed throughout the world, except the United States where deaths of children from the disease persisted until 1999. In that year, an agreement was struck between Cuba’s Finlay Institute for vaccines research and SmithKline for the development of a U.S. version of the vaccine. The U.S. trade embargo against Cuba has unfortunately inhibited the diffusion of medical innovations between the two countries otherwise facilitated only sporadically through agreements such as between Finlay Institute and SmithKline or Roswell Park Cancer Institute and CIM. Opportunistic international companies such as French ABIVAX have won marketing authorizations with partners such as the Cuban Center for Genetic Engineering and Biotechnolgy (CIGB) to introduce Cuba-developed products to international markets. In 2015, ABIVAX secured commercial rights to a therapeutic hepatitis B vaccine known as ABX203 or HeberNasvac for the production of patient antibodies against the viral surface antigen. The vaccine uses recombinant surface (HBsAg) and core (HBcAg) viral proteins. The produced immune response has been shown to suppress viral loads and could become an alternative to more expensive antiviral drugs.

The Center for Immunoassays also counts among Cuba’s numerous medical institutes and serves as a notable regional supplier of micro-ELISA diagnostic systems in Latin America. The Center markets its immunoassay products under Tecnosuma and offers tests for HIV, hepatitis B, hepatitis C, dengue and Chagas among other infectious and non-communicable diseases. The smaller institute could develop as an innovator for immunoassays and other diagnostic tests against neglected and tropical infectious diseases.

Even Cuba’s system of free state-provided healthcare could represent an important resource for international markets. With a leading low doctor-to-patient ratio, Cuba has a prolific medical workforce that has been instrumental to garnering good will internationally and, to date, and providing services abroad in quid-pro-quo deals such as for oil with Venezuela and in exchange for infrastructure investment from Brazil. Cuban doctors are such an integral resource for the Cuban economy and state that they have been targeted by U.S. defection programs. With improved relations, U.S. healthcare providers could also benefit from the Cuban medical workforce through bilingual training programs and immersion in a system that emphasizes preventive and accountable care to keep cost manageable for the country’s limited budget. Poor medical infrastructure in Cuba could also be improved through the expansion or reconfiguration of the two-tiered system that also serves medical tourists.

In part a product of past geopolitics, Cuban medicine is gaining recognition for being uniquely responsive to the healthcare needs in resource-limited countries and the developing world. The relatively high standard of care in Cuba relative to other developing countries reflects strengths cultivated there in the absence of resources available to other leading healthcare systems in the developed world. The potential future rehabilitation of the Cuban economy should leverage Cuba’s strengths in biopharmaceutical therapies, other medical technologies suitable for developing healthcare markets and experience in cost-contained healthcare services.