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New health order

We have entered the age of pandemics. Covid-19 dominates the headlines, and rightly so; January has seen a record-high number of cases worldwide. But that is not all. The AIDS pandemic rages on – 34 percent of people with HIV did not receive a viral suppressant in 2020. Meanwhile, a rapidly changing climate is set to turbocharge malaria as warmer temperatures aid the spread of disease-carrying mosquitoes. The World Bank estimates that 5.2 billion people will contract the disease by 2050.

Yet we have no plan to end the pandemics of today – or stop the ones of tomorrow. On the contrary, like the AIDS crisis, the Covid-19 pandemic has seen empty pledges and paltry donations, overshadowed by panicked responses from governments, stigmatisation of marginalised communities, and unchecked profiteering by pharmaceutical companies.

If there is one thing I have learned from my work combating the AIDS pandemic, it is that we simply cannot rely on the wisdom of pharmaceutical executives or the generosity of the Global North where they live. To end the pandemic, we need a radical break, a transformative shift away from the short-termist and profit-captive model of global health governance. But what would a new model look like?

Enter Cuba. While global leaders have been delaying decisive action, Cuba has developed its own Covid-19 vaccines, successfully immunised most of its population, and is now set to help vaccinate the world. Its approach rests on two principles: investment in public health and internationalism.

In the summer of 2021, Cuba’s regulatory agency CECMED approved two home-grown vaccines, Soberana and Abdala, stated to be more than 90-percent effective – vaulting Cuba to the top of the list of countries by vaccination rates within months. With 86 percent of the island’s population now inoculated, Cuba’s vaccines are being touted as the ‘best hope for low-income countries’ – in particular because they are reportedly cheap to produce, can be manufactured at scale and do not require deep freezing.

Cuba’s vaccines have been accessed in medical journals and the country has sought emergency-use approval for its vaccines from the World Health Organization. Vicente Verez, head of Cuba’s Finlay Vaccine Institute has said that all necessary documents and data would be submitted to the WHO in the first quarter of 2022.

How could Cuba achieve this feat? The country has a long history of prioritising public health and investing in pharmaceutical production. This focus has been partly driven by the need for domestically produced goods to overcome the scarcities caused by the gruelling US embargo, imposed after the Cuban socialist revolution, but also driven by a strong commitment to public health over private profit.

Between 1990 and 1996 alone, Cuba invested $1 billion, about 1.5 percent of its GNP, into a cluster of biotechnology institutions where any money earned was reinvested. Today, 517 of the 800 or so medicines consumed in Cuba are produced domestically, boosting the country’s public healthcare capacity. The benefit of Cuba’s substantial state investment in medical science means the benefits accrue to the Cuban people, not Big Pharma. By contrast, governments of countries like the United States and the United Kingdom gave away the rights to vaccines produced using enormous public funding. As a result, pharmaceutical companies hold vaccine recipes under lock-and-key.

Zackie Achmat, "New health order," The News. 2022-01-26.
Keywords: Health sciences , Public health , Global health , Health organization , Healthcare , Pandemic , Covid-19 , Vicente Verez , Cuba , United States , GNP , CECMED