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6 South-South Cooperation in Biotechnology Medicine for the Masses It gives me great pride to inaugurate this Center, right in the middle of the Special Period. It represents a promise of health and well-being for our people, as well as the potential for our economy since it has a great production capacity. It also constitutes the possibility of coordinating with all the other research centers here. That is why we have created these scientific complexes in the polo científico. The idea is for every center in science research to work together in close coordination, and not act independently, ignoring the others. Fidel Castro at the inauguration of the Center for Molecular Immunology, December 5, 1994 International interest in Cuba’s biotechnology potential was aroused in May 2002 when U.S. undersecretary of state John Bolton condemned what he alleged to be Cuba’s offensive biological warfare program. This claim was strongly rejected, including by former president Jimmy Carter, since Bolton’s objective was clearly political. Nevertheless, the incident caused many to examine Cuba’s increasing role in biotechnology. It soon became clear to Western media that Cuba had in fact developed a sprawling complex of biotechnology research and development facilities in the west of Havana known as the polo científico. This consisted of dozens of well-designed new buildings, equipped with modern technology, in which thousands of engineers, technicians, and doctors were producing a wide array of medicines, vaccines, and related products, primarily for the Cuban population , but also increasingly for foreign markets. It was obvious, too, that Fidel Castro was the prime mover behind this initiative, a fact confirmed through several interviews with leading scientists in 2013 and 2014. This poses many questions. Why and how did applied interdisciplinary research in biotechnology evolve so early and so readily in Cuba in the 1990s? Why were preventive medications and vaccines prioritized? How could a small country like Cuba produce such an array of medications and vaccines and indeed most of the medications consumed domestically? Why 140 · Healthcare without Borders was it being praised by international bodies such as the World Health Organization (WHO) and the Pan American Health Organization (PAHO) for its exportation of massive amounts of low-cost drugs to the developing world? Apart from the occasional flurry of reporting on events such as Bolton’s claims, and infrequent articles in professional journals, remarkably little has been reported in mainstream media. In recent years Cuban medicines have been increasingly used throughout the developing world and sold at a fraction of the cost of drugs produced by multinational pharmaceutical companies in the industrialized world. A 2009 editorial in Nature emphasized its leading position in the Global South, as well as its distinctive model, calling it “the developing world’s most established biotechnology industry which has grown rapidly even though it eschewed the venture-capital funding model that rich countries consider a requisite.”1 This recognition came belatedly, however, since Cuba had started this research initiative several decades earlier, and the origins of Cuba’s impressive biotechnology growth may well be traced back to the statement in January 1960 by Fidel Castro that “the future of Cuba has to be of necessity a future made by people of science, of thought.”2 This chapter offers some observations to show how South-South cooperation in biotechnology constitutes a significant support to Cuba’s medical internationalism program. At first glance it might appear odd that a book examining MI, which in essence revolves around the contribution of doctors , nurses, and medical technicians in developing countries, would explore the role of biotechnology. Yet this is an important complement to the work being done by medical personnel in the field. In sub-Saharan Africa, for example, the role of Cuban physicians working in the most distant rural communities to treat patients suffering from malaria and dengue is clearly strengthened by the application of Cuban biolarvicides to kill mosquito larvae. Likewise, in Venezuela the use by Cuban physicians of Heberprot P, which has reduced drastically the need for amputations among diabetics, also assists doctors treating diabetes.3 In the state of Mérida, for example, of 1,091 diabetic patients who received this treatment, only 5 went on to need an amputation.4 Recent Cuban data show that since 2007 more than 29,000 Cubans with diabetes have received this treatment and that the risk of amputation has been reduced 80 percent.5 This integrated approach to the care of public health...


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