Cuba: South-South solidarity saves lives

Cuban Doctors arriving in South Africa during the covid-19 pandemic.

At the height of the Covid crisis, I saw African hospitals struggle without vaccines, and heard African presidents plead in vain for the big Western pharmaceutical companies to share technology so that developing countries could make their own medicines and end their pandemic. 

The huge suffering that hoarding of technology brought led me to co-found the People’s Vaccine Alliance to call for the sharing of health technologies, a call which even now major pharmaceutical companies continue to obstruct. 

Meanwhile, a small Caribbean island was hard at work developing three vaccines of its own. Cuba began a mass vaccination programme in 2021, becoming, in 2022, the country with the second highest vaccination rate in the world. Today, Cuba remains one of the world’s most vaccinated countries against Covid-19. But Cuba did not only act to help its own people, it also produced and provided vaccines for other countries. 

At a time when many other low- and middle-income nations were struggling to get the vaccines, Cuba was exporting it to Mexico, Vietnam, Iran, Venezuela and Nicaragua. Unlike the Western-based pharmaceutical industry, Cuba, although it does get a financial return on its investments, does not put profit before lives. 

As I have seen for myself on my visit to Cuba this month, just as Cuba played an important role in support of African countries’ political liberation, so now Cuba-Africa collaboration can help empower Africa to break free from the chains of pharmaceutical companies’ monopolies. 

I was able to discuss with President Miguel Díaz-Canel, doctors, scientists, researchers, people living with HIV, health advocates and others opportunities for strengthening cooperation between Global South countries in the face of current and future global pandemics. Over the past 60 years, Cuba has sent more than 600,000 doctors to assist people in 164 countries, including during the Covid-19 pandemic, with more than 20,000 health workers working in 56 countries today. Cuba has consistently shared the fruits of its well-developed biotechnical industry with Global South countries, exporting hundreds of millions of vaccines overseas every year to more than 40 countries. It developed the world’s first meningitis-B vaccine, manufactures eight of the 11 vaccinations used in its national immunisation programme and has eliminated polio, diphtheria, measles, rubella, and whooping cough. Cuba was also the world’s first country to virtually eliminate mother-to-child transmission of HIV and its public health model has resulted in the world’s best doctor-patient ratio. 

How did this Caribbean island nation, stymied by external economic restraints, achieve such impressive results? The importance that Cuba has placed on public health, and its significant public investment in biopharmaceutical technology, have been crucial. Cuba’s success is testament to what can be achieved, even on the strictest of budgets and in fiscal distress, when governments prioritise public health.

I had the privilege to meet many of the experts at the forefront of Cuba’s health system, including scientists, researchers, and specialists at the prestigious Institute of Tropical Medicine Pedro Kouri. At the Abelardo Ramirez polyclinic in Havana, I witnessed how HIV can be fully integrated into primary health care services in ways that protect the rights to health and bodily autonomy of people living with and at risk of HIV. I saw how HIV services are also connected to other levels of health care and how community groups like Prosalud reach marginalised communities with critical health messages. 

Across the world there is a pressing need to overcome the barriers to equitable access to lifesaving health technology for millions of people around the world that are caused by pharmaceutical monopolies who put their billions of profits before lives. As we prepare for the next pandemic, countries of the Global South need to strengthen collaboration with each other to protect and save their people. 

Brazil has tabled in the G20 a bold proposal that builds off its own remarkable success in building a public-health-focused pharmaceutical complex. The idea is to launch a global effort to ensure that the innovation and manufacturing capacity needed to address diseases that kill the marginalised — from HIV and TB to Dengue — exists in all regions. Through facilitating technology transfer and building capacity and markets, a bold effort could help close the yawning gaps in access to new medicines and make us more prepared to make diagnostics, medicines, and vaccines when the next pandemic hits. We can ensure health for all — together. 

Strengthening South-South solidarity will save lives. Harnessing Cuba’s biopharmaceutical expertise can play an important role in protecting the health of people across the Global South, who deserve the same chance at survival as people in the Global North. 

Winnie Byanyima is the executive director of UNAids.