Cuba's Dream: Come For A Vacation, Get A Homegrown COVID Vaccine

Mar 25, 2021
Originally published on March 28, 2021 12:03 pm

Cuba has a dream — to have so much COVID-19 vaccine that not only could everyone on the island get immunized but Cuba would give it away to friends and allies around the world. There would be so many doses, Cuban officials would even offer free inoculations to tourists on arrival at the airport in Havana.

And that's not just wishful thinking. Even as the island nation faces a devastating economic crisis, with people lining up for basic food necessities, scientists are developing multiple vaccine candidates. And at least one of them looks like a winner. If successful, Cuba would be the first Latin American country to make its own vaccine — and it's not a farfetched scenario. The island has a history of vaccine development, including a lung cancer vaccine now in trials at a U.S. cancer center.

This odd situation is a reflection of how much Cuba is an outlier — one of the last Communist countries in the post-Soviet era. And it's been an outlier in the COVID pandemic as well.

For much of 2020, Cuba kept COVID numbers at incredibly low levels, some days reporting only 1 or 2 cases. The virus only took off when Cuba reopened to tourists in November. Now in need of COVID immunizations like every other country in the world, Cuba is attempting to develop and manufacture a homegrown vaccine.

Earlier this month, Dagmar Garcia Rivera, the research director at the Finlay Vaccine Institute in Havana, announced that one of Cuba's five vaccine candidates, the Soberana 2, appears to be highly effective and is entering the final stage of clinical trials.

"This is the first Cuban and Latin American vaccine to advance to phase 3 trials," Garcia declared proudly at a news conference. The phase 3 clinical trial will involve 44,000 people and is the last test of the vaccine before it's sent to Cuba's national regulatory agency, the Center for State Control of Medicines, Equipment and Medical Devices (CECMED) for approval.

A second Cuban candidate called Abdala has also entered a phase 3 study. The names of the vaccine candidates say a lot about what this effort means to Cuba. "Soberana" is Spanish for sovereign. "Abdala" is the protagonist in a dramatic poem by the hero of the Cuban revolution Jose Marti. "Mambisa," a vaccine administered as a nasal spray, is named after anti-colonialist Cuban guerillas who fought Spain in the late 1800s.

In that same revolutionary spirit Cuba isn't even attempting to buy COVID vaccines from multinational pharmaceutical companies. Nor has it bothered to sign up for the WHO-led COVAX dose sharing initiative, providing free or reduced cost vaccines to low resource countries. There hasn't been a clear explanation for this decision.

Technician Mayelin Mejias works at the Vaccine Aseptic and Packaging Processing Plant at the Finlay Vaccine Institute in Havana.
Yamil Lage / AFP via Getty Images

Developing a new vaccine usually takes a decade or more, but Eduardo Ojito, the head of the Cuban Center for Molecular Immunology, says the country should have enough doses of Soberana 2 to immunize the whole country by the end of summer. This is assuming the vaccine candidate sails through phase 3 trials and wins regulatory authorization.

"We are preparing to produce between one and two million doses each month," Ojito says. Despite being in the midst of a foreign currency crisis that's limited imports of vital raw materials for vaccine production, he says the country is on track to have 1 million doses available in April.

Cuba's government is already talking about distributing the vaccine in Iran, Mexico and Venezuela. Officials say they hope to produce enough of the vaccine to be able to distribute in other parts of the world, too.

The big question: Does this island nation of 11 million people have the capacity to pull this off?

"Yes," Helen Yaffe says definitively, "Cuba has the capacity." Yaffe is a Cuba specialist at the University of Glasgow. She has written about the country's pharmaceutical sector and its previous success developing its own vaccines.

Yaffe was in Cuba most recently in December and January. She says there's great excitement and pride about the potential to soon offer a domestically produced vaccine. If Soberana 2 proceeds on schedule, Cuba would have vaccine to spare before many countries have even gotten started with mass immunizations. And Yaffe says there's talk about offering immunizations on arrival at the airport in Havana.

"They have said clearly they will offer them to tourists," she says. "We don't know whether they will sell them or offer them free as part of a package holiday — sun, sea, sand and Soberana 2!"

This incredibly rapid development of a COVID vaccine in Cuba is happening in the midst of one of the worst economic crises to hit the communist nation in decades.

"In many ways this is similar to what we lived after the collapse of the Soviet Union," says Pavel Vidal, a Cuban economist. During that so-called "Special Period" in the 1990s, the island ran out of food, fertilizer and fuel.

Vidal used to work for the Central Bank of Cuba before emigrating to Colombia ten years ago. He says Cuba's often-troubled economy is right now facing serious shortages of many consumer goods including food, cleaning products and even medicines. Vidal says ordinary Cubans spend much of their day queuing in lines for basic necessities and searching for chicken meat. "So we are trying to develop sophisticated vaccines, but people don't have painkillers. That's the paradox," he says.

But he says no one should underestimate the Cuban government's ability to manage its acute fiscal crisis in the midst of a global pandemic while at the same time trying to develop an entirely new vaccine. "The Cuban government has like a Ph.D. in managing this kind of a complex crisis."

He says Cuba has the capacity and more important the political will to develop a COVID vaccine. A vaccine would not only protect Cubans, it would allow the communist nation to fully reopen its international tourism industry, which is one of its largest sources of foreign revenue, and bolster another longstanding revenue source: pharmaceutical exports.

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AUDIE CORNISH, HOST:

As countries scramble to try to acquire enough COVID vaccines for their populations, Cuba is taking a different approach - no contracts with big drugmakers, no support from the WHO's vaccine procurement program. The cash-strapped communist government is attempting to develop and manufacture its own vaccine. If successful, it would be the first COVID vaccine developed in Latin America. NPR's Jason Beaubien has more.

JASON BEAUBIEN, BYLINE: Each morning, Cuba's top epidemiologist, Dr. Francisco Duran Garcia, goes on national television and radio to present the daily COVID update.

(SOUNDBITE OF ARCHIVED RECORDING)

FRANCISCO DURAN GARCIA: (Speaking Spanish).

BEAUBIEN: Dressed in a white lab coat and a white face mask with a small Cuban flag, Dr. Duran, like Anthony Fauci in the U.S., has become the public face of the government's response to the pandemic. He gives the latest statistics on cases and offers advice on hygiene and masks. On this day, a 70-year-old from Old Havana has just passed away.

(SOUNDBITE OF ARCHIVED RECORDING)

DURAN GARCIA: (Speaking Spanish).

BEAUBIEN: Dr. Duran expressed his condolences individually to the families and friends of those who've died. The number of daily COVID cases peaked in Cuba in February at just over 800 a day.

(SOUNDBITE OF ARCHIVED RECORDING)

DURAN GARCIA: (Speaking Spanish).

BEAUBIEN: The COVID numbers have come down slightly from their peak, but Dr. Duran says there's a great risk that they could increase again. Right now Cuba is relying primarily on social distancing and masks to contain the virus. It doesn't have any vaccine yet. It doesn't plan to purchase any and would have trouble coming up with the foreign currency to buy any even if it wanted to. So Cuba is betting everything on its own laboratories. Currently, it has four candidates in late stages of development. Dagmar Garcia-Rivera is the research director of the institute producing the vaccine given the patriotic title Soberana, meaning sovereignty. The version called Soberana 2, she said, is entering the final stage of clinical trials.

(SOUNDBITE OF ARCHIVED RECORDING)

DAGMAR GARCIA-RIVERA: (Speaking Spanish).

BEAUBIEN: Cuba says it could have enough vaccine to immunize the whole country by the end of summer, and they very well might. Even though vaccine development and manufacturing is complicated, Cuba, unlike many other countries, has a robust domestic pharmaceutical industry. It's developed domestic vaccines for yellow fever, meningitis, hepatitis B and even a lung cancer immunization, which is currently in clinical trials in the U.S. But when it comes to producing a COVID vaccine, Cuba is trying to do it at a breakneck speed in the midst of a major economic crisis.

PAUL VIDAL: Many ask if it's similar to what we lived after the collapse of the Soviet Union, what we call the Special Period.

BEAUBIEN: Paul Vidal is a Cuban economist who's been living in Colombia for 10 years. But before emigrating, he worked for the Central Bank of Cuba. He says ordinary Cubans right now are facing serious shortages of food, cleaning products and even painkillers like aspirin.

VIDAL: We are trying to develop sophisticated vaccines, but people don't have painkillers. That is the paradox.

BEAUBIEN: Despite the challenges, he says Cuba is used to adversity. He says it's like Cuba has a Ph.D. in crisis management. The vaccine is hugely important to the government to help them get out of their current crisis. He's confident they'll succeed. Helen Yaffe agrees. She's a Cuba specialist at the University of Glasgow. Yaffe's written about Cuba's pharmaceutical sector and its previous success developing its own vaccines.

HELEN YAFFE: Does Cuba have the capacity? Yes, Cuba has the capacity.

BEAUBIEN: Yaffe was in Cuba most recently in January. She says there's great excitement and pride about a homegrown vaccine. If Soberana 2 proceeds on schedule, Cuba would have vaccine to spare before many countries have even gotten started with mass immunizations. And Yaffe says Cuba could use it to help jumpstart their tourist industry. There's talk about offering immunizations on arrival at the airport in Havana.

YAFFE: They have said clearly they will offer them to tourists. We don't know whether they will sell them or offer them free as part of a, you know, package holiday - sun, sea, sand and Soberana 2.

BEAUBIEN: Or one of the other patriotically named vaccines that the communist government is currently trying to produce.

Jason Beaubien, NPR News.

(SOUNDBITE OF THE CINEMATIC ORCHESTRA'S "THE AWAKENING OF A WOMAN") Transcript provided by NPR, Copyright NPR.