By COHA Editorial Board
From Washington DC

The Council on Hemispheric Affairs (COHA) is pleased to announce its formal nomination of the Henry Reeve Brigade for the Nobel Peace Prize, in a formal submission delivered today January 22 to the Nobel Peace Prize Committee in Stockholm, Sweden. For more than 40 years COHA has provided critical-ethical analysis of US-Latin American relations and has studied the culture, politics, and social programs of Cuba. 

Since its inception, the Henry Reeve International Medical Brigade, sponsored by the government of Cuba, has delivered high quality health care services and medical supplies to hundreds of thousands of underprivileged and underserved populations throughout the world. These services include prevention as well as treatment. Its message is one of human solidarity and peace, building bridges of understanding between different countries, regardless of ideology and cultural background. In that sense, the Henry Reeve Brigade represents the best of international cooperation for the good of humanity.

Established in 2005 to offer Cuba’s medical help to those who suffered the impact of hurricane Katrina in the United States, since the start of the COVID-19 pandemic, the Brigade has distinguished itself as a true leader in both the global North and South, offering emergency assistance. Consequently, COHA believes the nomination is quite timely. Twenty-three countries in Europe, Africa, the United Arab Emirates, Latin America, and the Caribbean requested help amidst this global crisis, and more than 1,500 Cuban health professionals–doctors, specialists, and nurses–have answered the call. Other requests for cooperation are underway, as the Reeve Brigade is today recognized as the only international medical contingent providing a scientific and humanitarian response to the pandemic on a global scale.

COHA also acknowledges the historic role of the Reeve Brigade in taking up the challenge to fight disease under very challenging circumstances, instilling hope in seemingly hopeless situations.  Examples include the medical cooperation provided to Pakistan and Haiti after their devastating earthquakes in 2005 and 2010. The Brigade’s brave role in containing the Ebola epidemic in Liberia and Sierra Leone in 2014-2015 was recognized in 2016 by US ambassador to the United Nations Samantha Power, who mentioned it as an example of the positive outcome that cooperation and engagement between Cuba and the United States can bring to the world.

These operations were successful thanks to the outstanding medical-scientific training of the Cuban health professionals, their organizational skills in confronting  natural disasters and health emergencies, and strongly held values of altruism, solidarity, and advancing the common good. The Henry Reeve Brigade has spread a message of hope throughout the world.

“Its 7,400 volunteer health professionals have treated more than 3.5 million people in 21 countries in the face of the worst disasters and epidemics of the last decade,” said the World Health Organization when it presented the Dr Lee Jong-wook Public Health Award at a ceremony for them in Geneva in May 2017 during the 70th World Health Assembly.

Since early 2020, the Brigade has done even more to promote a message of peace. A Nobel Prize for the Henry Reeve Brigade is not only well-deserved, it would raise the profile of this life saving work and perhaps inspire more such efforts in the future.

Signed by COHA members:

Fred Mills, Co-Director
Patricio Zamorano, Co-Director
Jill Clark-Gollub, Assistant Editor/Translator
Danny Shaw, Senior Research Fellow
Arturo López-Levy, Senior Research Fellow
Alina Duarte, Senior Research Fellow
William Camacaro, Senior Analyst
Dan Kovalik, Senior Research Fellow

By Rubén Sierra
From Los Angeles, California

COVID-19 has spread rapidly throughout the world. The pandemic has severely limited the economic activities of developing countries and has even led to periodic shut downs in the most powerful nations. Globally, an estimated 72,650,979 people have been diagnosed with COVID-19 resulting in 1,619,617 deaths.^[1] The pandemic has affected certain countries at a disproportionate rate. According to the most recent data on the pandemic, Cuba has had 10,900 cases and 9,503 have recovered, with 140 deaths.^[2] The US has had about 19.2 million cases, 11,257,711 have recovered with 300,051 deaths.^[3] Nearly 5% of all U.S. Americans have been diagnosed with COVID-19 while a miniscule 0.08% of the Cuban population has been infected. Nearly 90% of Cubans diagnosed with COVID-19 have recovered.

The significant differences in cases and deaths are attributed to a variety of factors. Cuba is a small island nation; its relative seclusion from the rest of the world has prevented a rapid spread of COVID-19. The United States has a population that is 33 times bigger than Cuba. However, these considerations should not ignore the fact that Cuba’s infection and recovery rate is still the lowest per capita in the world and we may be overlooking a key factor in Cuba. Since the Cuban revolution, Cuba’s medical system has been recognized as one of the best and most advanced in the world despite struggling with the constraints of the U.S. embargo.

As the pandemic appears to be uncontrollable and has no end in sight, a U.S.-Cuba medical partnership could benefit the global community let alone both countries. During this uncertain time, countries should prioritize partnerships in order to confront this deadly pandemic. More than ever, this may be the time for the U.S. to put aside an outdated embargo and unite medical resources with Cuba to effectively confront the COVID-19 virus. A medical partnership is not something new in their historical relationship.

A Brief History of US-Cuba Medical Partnerships

The United States and Cuba have found some common ground through medical partnerships. As professor Helen Yaffe points out, “since the 1960s, many U. S. scientists have forged scientific links with revolutionary Cuba” to gain access to Cuba’s medical research on the oral polio vaccine, interferon, which signals proteins to be made and released within the body in response to the presence of several viruses.  Moreover, both medical communities have engaged in the North American Scientific Exchange.^[4] Although conflict remains between both governments, their medical communities have identified the benefits of working together in order to advance our understanding of medical treatment.

Most recently, medical researchers and doctors from both countries have reached historic medical agreements. A joint partnership has been solidified related to Ebola treatment in Liberia and research on a lung cancer vaccine in New York. In 2014, “Cuban doctors and nurses staff[ed] a USAID-funded Ebola treatment unit in Monrovia, Liberia.”^[5] This medical venture was a rare opportunity for Cuban medical professionals to work on U.S.-funded projects. In addition, on September 26, 2018, a United States and Cuban biotech joint venture was established to conduct a trial and deliver CIMAvax-EGF, an innovative Cuban lung cancer immunotherapy treatment, to patients in the United States. Innovative Immunotherapy Alliance SA was set up by Buffalo-based Roswell Park Comprehensive Cancer Center and Havana’s Centre for Molecular Immunology (CIM).^[6] Since the introduction of the joint project, Cuba’s medical innovation has constructively contributed to mainstream medical understanding of immunology.

Medical researchers at Roswell Park were astonished by Cuba’s medical breakthroughs. They found that Cuba’s medical progress has the potential to advance cancer treatment in the field of immunology. For example, Roswell Park President and CEO Dr. Candance Johnson said, “this is a momentous step forward […] we are entering a critical new phase of Roswell Park’s collaboration with […] innovative Cuban scientists. Our goal is to develop these promising cancer therapies as quickly and effectively as possible” to “benefit the greatest number of U.S. patients.”^[7] Despite the political tensions between Cuba and the United States, which is mainly rooted in Washington DC, the U.S. medical and scientific community has recognized Cuba’s medical advances. Cuba’s ongoing history of medical breakthroughs has also been recognized by the global community which has resulted in medical partnerships with over 67 countries.

Cuba’s Health Partnerships in the Developing World

Cuba has been a leader in global health partnerships since the Cuban revolution. “Cuba currently has over 50,000 health professionals working in 67 different countries”^[8] which in 2014 was “a greater number of health professionals than Médecins Sans Frontières (MSF), the Red Cross and Unicef combined.”^[9] Cuba leads the world in medical diplomacy as many countries have welcomed Cuba’s exceptional medical professionals. Cuba has made a significant medical impact on every continent. For example, Cuba “has a large presence in 30 different countries in the African continent,” the Middle East, Asia and Portugal and their efforts have been recognized by the World Health Organization (WHO).^[10]

In 2017, “the Henry Reeve International Medical Brigade (HRIMB) of Cuba was awarded the prestigious […] Dr. Lee Jong-wook Memorial Prize for Public Health” by WHO “at a World Health Assembly ceremony […] for its emergency medical assistance to more than 3.5 million people in 21 countries affected by disasters and epidemics since the founding of the Brigade in September 2005.”^[11] Cuba’s medical personnel are more active in countries that need it the most. For example, Cuba sends more medical personnel annually to the developing world than all the G8 countries combined.^[12] Despite Cuba’s limited resources and the never-ending U.S. embargo, Cuba continues to export its vital resource – medical care. Developed countries in Europe are now reaching out to Cuba to partner on a biotechnology response to the COVID-19 pandemic.

European Union-Cuba Political Dialogue and Cooperation Agreement (PDCA)

During the latter part of 2020, Cuba and the European Union (EU) have engaged in a cooperation agreement focused on accomplishing sustainable development goals. Three complex issues have been given priority focus: “(i) climate change, (ii) the path towards an inclusive, knowledge-based economy, and (iii) health systems and the development biotechnology in the context of the COVID-19 pandemic.”^[13] Cuba and the EU are partnering to tackle some of the most pressing global issues.

A major focus is pursuing a comprehensive response to COVID-19 in Cuba. For example, “saving lives and mitigating the health impact of the COVID-19 emergency in Cuba” will be “implemented by the Pan-American Health Organization equaling 1.5 million euros to strengthen national capacities to fight the pandemic.”^[14] The idea is that if Cuba is able to significantly reduce their COVID-19 rate then the island nation would be able to focus on assisting with the response in other countries such as the ones in Europe. The European Union recognizes the value of Cuba’s medical personnel. Separate nations within the European Union have already signed agreements to work with Cuba on COVID-19 diagnostics and vaccinations.

Sweden and the United Kingdom Sign Separate Agreements with Cuba

Sweden and the United Kingdom have emerged from the EU to establish independent partnerships related to COVID-19 prevention and response. Sweden has agreed to invest in Cuba’s diagnostic technologies such as SUMA – which enables detection of COVID-19.^[15] The United Kingdom also recognizes the value of cooperating with Cuba on prevention and treatment of COVID-19. Specifically, the United Kingdom is partnering with Cuba on several health projects. The British Embassy is “collaborating with the Cuban Centre for Genetic Engineering and Biotechnology (CIGB) […] related to: the clinical trial of an immune enhancer, the development of diagnostic tests for serological antigen detection and the effect of an existing antiviral in COVID-19 positive patients.”^[16]

British diplomats clearly understand the importance of their partnerships with Cuban medical personnel. British Ambassador to Cuba, Dr. Antony Stokes stated that “the pandemic has impacted our economies” while “putting the world’s health systems under pressure […] Cooperation between countries is essential in responding to the challenges posed by COVID-19.”^[17]

Cuba’s COVID-19 Vaccine Trials

Cuba has become a world leader in clinical trials of a potential COVID-19 vaccine. The country is currently developing two vaccine candidates – known as Sovereign 1 and Sovereign 2, and the Caribbean island could become an important supplier to neighboring countries that may struggle to access vaccine supply, according to Reuters.^[18] If the vaccines prove to be safe and effective, the vaccinations “would become available for purchase in the region through PAHO, the America regional office of the World Health Organization (WHO),” said José Moya, the representative in Cuba for the Pan American Health Organization (PAHO). ^[19]

The potential vaccines are drawing significant interest from Latin American and African countries. Some countries are currently positioning themselves to gain access to it. For example, Mexico and Venezuela along with the ALBA (Bolivarian Alliance for the Peoples of Our America) alliance, which includes 10-member countries such as Nicaragua, Bolivia and Caribbean nations, are interested in importing Cuba’s vaccine.^[20] The government of Ethiopia has also signaled interest in partnering with the island by stating that “Cuba has a good scientific reputation.”^[21]

Conclusion

The COVID-19 pandemic continues to ravage the global community. This infectious virus does not discriminate against poor or wealthy countries. Cases and deaths continue to rise around the world especially in the United States. More than ever, medical communities must come together to seek a comprehensive response to the spread of COVID-19. In response to the growing pandemic, the United States Food and Drug Administration (FDA) has approved the use of COVID-19 vaccines from corporate leaders Pfizer and Moderna. The vaccines are estimated to be 95% effective but many medical experts such as Peter Hotez, virologist and dean of the National School of Tropical Medicine at the Baylor College of Medicine, expects the U.S. to face vaccine shortages and that the country will actually “need four or five different vaccines.”^[22]

Despite historical tensions, clearly manifested in the continued U.S. embargo on Cuba, a medical partnership between the two countries may be essential to overcoming the devastation being caused worldwide by the COVID-19. Both countries have engaged in medical partnerships in the past. Cuba has proven to develop highly effective medical vaccines and treatments that have benefited the United States medical research community such as the oral polio vaccine and now CIMAvax. Currently, countries in Europe, Africa and Latin America are solidifying their partnerships with Cuba regarding a WHO-approved COVID-19 vaccination. It is also acknowledged by U.S. medical professionals at the Baylor College of Medicine that “the Cubans have created two vaccines that sound technologically quite promising.”^[23]

The severity of COVID-19 should make the U.S. embargo obsolete and create the urgency for the U.S. and Cuban medical community to work together for the well-being of our global community.

Ruben Sierra was a 2008 COHA Research Associate. He studied Caribbean Literature and Music at the Casa de las Americas in Havana, Cuba in 2007. He has over 8 years of experience working with labor unions and non-profit organizations in California.

Fred Mills and Patricio Zamorano contributed as editors of this article

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Sources and end notes

^[1] CNN. Tracking Coronavirus’ Global Spread. https://www.cnn.com/interactive/2020/health/coronavirus-maps-and-cases/ (accessed December 14, 2020).

^[2] https://www.worldometers.info/coronavirus/country/cuba/ (accessed on December 26, 2020).

^[3] https://www.worldometers.info/coronavirus/country/us/ (accessed on December 26, 2020).

^[4] Yaffe, Helen. We Are Cuba!: How A Revolutionary People have Survived in a Post-Soviet World. Yale University Press, 2020.

^[5] Gannon, Seth, and Morrison, Stephen. Health Cooperation in the New U.S.-Cuban Relationship. Health Affairs Blog: Global Health Policy, https://www.healthaffairs.org/do/10.1377/hblog20150429.047389/full/ (accessed December 11, 2020).

^[6] Deck-Miller, Annie. Governor Cuomo Announces First-Ever Biotech Venture Between U.S. and Cuba to Research and Develop New Cancer Treatments. Roswell Park Newsroom, September 26, 2018, https://www.roswellpark.org/newsroom/201809-governor-cuomo-announces-first-ever-biotech-venture-between-us-cuba-research (accessed December 26, 2020).

^[7]Ibid.

^[8] Gonzalez, Mauro, et al. International Medical Collaboration: Lessons from Cuba. US National Library of Medicine, National Institute of Health, December 2016, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5184795/

^[9] Huish, Robert. Why Does Cuba ‘Care’ so Much? Understanding the Epistemology of Solidarity in Global Health Outreach. International Development Studies, Public Health Ethics, Dalhousie University, 2014.

^[10] Gonzalez, Maura, et al. International Medical Collaboration: Lessons from Cuba. United States Library of Medicine, National Institute of Health, 2016.

^[11] PAHO/WHO. Cuba’s Henry Reeve International Medical Brigade Received Prestigious Award. May 26, 2017, https://www.paho.org/hq/index.php?option=com_content&view=article&id=13375:cubas-henry-reeve-international-medical-brigade-receives-prestigious-award&Itemid=42353&lang=en (accessed December 26, 2020).

^[12] Huish, Robert, and Kirk, John. Cuban Medical Internationalism and the Development of the Latin American School of Medicine. Latin American Perspectives, Vol. 34, No. 6, Aggressive Capital and Democratic Resistance (Nov 2007), New York, 2007.

^[13] European Union External Action Service. EU and Cuba Hold Second Dialogue on Sustainable Development Goals. Press Release, April 12, 2020, https://eeas.europa.eu/headquarters/headquarters-homepage/89326/node/89326_en (accessed on December 13, 2020).

^[14] European Union External Action Service. EU and Cuba Hold Second Dialogue on Sustainable Development Goals. Press Release, April 12, 2020, https://eeas.europa.eu/headquarters/headquarters-homepage/89326/node/89326_en (accessed on December 13, 2020).

^[15] World Health Organization. Cuba: Health Authorities and International Partners Exchange Ideas on Opportunities for Cooperation, while Sweden invests in COVID-19 Diagnostic Technologies. (http://stream.nbcsports.com/nfl/watch-sunday-night-football, (accessed on October 13, 2020).

^[16] Government of the United Kingdom. The UK in Cuba: Creating Alliances in Response to COVID-19. British Embassy in Havana, October 2, 2020, https://www.gov.uk/government/news/the-uk-in-cuba-creating-alliances-in-response-to-covid-19  (accessed on December 13, 2020).

^[17] Government of United Kingdom. The UK in Cuba: Creating Alliances in Response to COVID-19. British Embassy in Havana, October 2, 2020, https://www.gov.uk/government/news/the-uk-in-cuba-creating-alliances-in-response-to-covid-19  (accessed on December 13, 2020).

^[18] Marsh, Sarah. Cuba Leads Race for Latin American Coronavirus Vaccine. Reuters, November 12, 2020, https://www.reuters.com/article/us-health-coronavirus-vaccine-cuba-focus-idINKBN27S1OX (accessed on December 14, 2020).

^[19] Marsh, Sarah. Cuba Leads Race for Latin American Coronavirus Vaccine. Reuters, November 12, 2020, https://www.reuters.com/article/us-health-coronavirus-vaccine-cuba-focus-idINKBN27S1OX (accessed on December 14, 2020).

^[20] Ibid.

^[21] Ibid.

^[22] Owermohle, Sarah. U.S. Could Face Months of Vaccine Shortages Amid Global Competition. Politico, December 8, 2020, https://www.politico.com/news/2020/12/08/coronavirus-vaccine-shortage-443839 (accessed December 26, 2020).

^[23] Marsh, Sarah. Cuba Leads Race for Latin American Coronavirus Vaccine. Reuters, November 12, 2020, https://www.reuters.com/article/us-health-coronavirus-vaccine-cuba-focus-idINKBN27S1OX (accessed on December 14, 2020).