Havana Bets All on Cuba’s Own Vaccine

Gustavo Figueroa, 90, has been living in Miami for more than 60 years. Born in Cuba in 1930, Gustavo is the eldest of 17 siblings. His brother Carlos Manuel Figueroa, aged 85 and still in Cuba, is next in line. 

Although they have not seen each other for years, their experience of lockdown in recent months was very similar. Living on different sides of the Florida Strait, they had both been confined to their homes, afraid of getting Covid-19.

But as vaccination programmes were rolled out around the world, their stories began to diverge. 

Gustavo soon had access to several vaccines. In the US, people were being immunised with the Pfizer/BioNTech, Moderna and Janssen vaccines.  

All three had passed phase III trials that have proven their high efficacy, and all were accepted under the strict regulatory systems of the US and the EU. The World Health Organization (WHO) also approved their global distribution.  

However his brother Carlos Manuel, who lives in Colón, in the province of Matanzas, can do nothing but wait. So far, no one in Cuba has received a vaccine that has been approved and endorsed by any other countries’ regulatory bodies. 

Havana has instead devoted all its resources towards becoming the first country in Latin America to develop and use its own vaccine.  

The government has pressed ahead with this plan even though Cuba has been experiencing its worst wave of Covid-19 since the pandemic began. According to official statistics, from January to May 2021 there were seven times more cases detected than in the whole of last year. The pandemic has also killed three times as many people as in all of 2020. 

Five variants of the original coronavirus strain, including the so-called British, South African and Californian types, have been detected in Cuba.  

Even so, Cuba and Haiti are the only two countries in the region that have not provided their populations with at least one dose of any of the vaccines proven to be effective. Cuba is also the only country in Latin America that does not belong to Covax, an international programme to help economically deprived nations immunize their citizens with WHO-approved vaccines.

Cuba is also experiencing a crippling economic crisis that has severely restricted its ability to purchase even basic supplies abroad. Reserves in international banks are at an all-time low, according to the Bank of International Settlements, and imports dropped 34 per cent in 2020, the International Monetary Fund (IMF).

Nonetheless, the authorities are looking at developing vaccines that could be sold to like-minded countries such as Venezuela and Bolivia, or used as an incentive for tourists to return to the island. In September last year, Cuba registered the patent of the Soberana brand in Europe. 

GOING IT ALONE

Since last August, Cuba has announced five candidate vaccines: Soberana 01, Soberana 02, Mambisa, Abdala and Soberana Plus. 

In recent months, Soberana 02 and Abdala have been tested in about 80,000 people in Cuba’s two main cities of Havana and Santiago.

The phase III trials are slow because they involve not only administering the three dose vaccines but waiting for a certain number of patients to be infected with the virus and develop the disease. 

Cuba is only collaborating with Iran to test the effectiveness of the vaccine.

The vaccine's effectiveness varies depending on the proportion of those who developed the disease received the placebo, and how many received the treatment.   

To accelerate the process, many phase III trials were carried out in several countries at the same time. Pfizer/BionNTech, for example, trialled its vaccine in 162 different locations in the US, Brazil, Germany, South Africa and Turkey. 

Cuba, on the other hand, is only collaborating with Iran to test the effectiveness of the vaccine Soberana 02 - and in the case of Abdala, it is doing it alone.

At the same time, the authorities do not seem willing to wait until these two trials finish to see if the Cuban candidates reduce the risk of people falling seriously ill with Covid-19. 

According to information published by the Cuban Registry of Clinical Trials, Abdala research studies will finish in July and Soberana 02 in November. However, since the end of March some 270,000 people have received the two vaccines in what the authorities have called “intervention studies”. 

At the end of April, it was announced that almost the entire Havana population – 1.7 million people – would also be inoculated with Soberana 02 and Abdala. 

Other countries with authoritarian regimes such as China and Russia have implemented similar strategies in their vaccination programmes, rolling out the jabs even before the three phase clinical trials concluded.

The governments argued that this was necessary due to the emergency posed by the pandemic, with the rationale that the risks associated with coronavirus were far greater than those posed by the vaccines.

Nevertheless, the Cuban case stands out due to the mystery surrounding any information about the two candidates in phase III of the trials. Nothing has been published on the safety and efficacy in humans of Soberana 02, with only one scientific article about its efficacy in mice.  

The only scientific publication on Soberana Plus deals with its impact on a group of 30 patients who had already recovered from Covid-19. As for the candidate vaccine Abdala, simply nothing is known about it.

In contrast, Chinese laboratories had five-phase III candidates by mid-April, with the government already providing three of those to the general population, according to the WHO vaccine database. There were already publications about each of the five Chinese candidates and their use in humans under evaluation. 

Tests involving three of the Chinese drugs were published in The Lancet, one of the world's most prestigious scientific journals, and another in the Journal of the American Academy of Medical Sciences (JAMA).

One of the candidates developed by the Chinese pharmaceutical company Clover which began its phase III in March has already had preliminary results of its phase I trials published in The Lancet. 

Worldwide, of the 20 candidates that were in phase III of the clinical trials by mid-April, only six had not published their results; two of these were Cuban. 

In the Central Asian state of Kazakstan, there is also very little information about its vaccine candidate in phase III of the trials, which the government has already announced will be provided to citizens.

However, the Kazak government has not denied its population scientifically-proven vaccines, rolling out Chinese and Russian doses too.

Cuba is betting exclusively on its own vaccines, and doing so virtually alone.

PROPAGANDA PUSH

While companies and institutions around the world are collaborating to progress faster in the development and large-scale production of vaccines, Cuban laboratories, despite their limitations, have not integrated themselves into any of these international initiatives. 

The Cuban Center for Genetic Engineering and Biotechnology (CIGB) is responsible for the development of Abdala, while the Finlay Vaccine Institute created Soberana 02. 

Both are prestigious institutions within Cuba, and as government propaganda emphasises, have in the past participated in the development of various vaccines. However, this overlooks the fact that previous vaccines were developed over long periods, often in collaboration with other countries or international institutions.   

There is little indication as to whether the eventual vaccines will actually work. 

For instance, the vaccine against meningitis B and C, in the 1980s - one of the great successes of Cuban medicine - took nine years to develop. 

The WHO and the Center for Disease Control (CDC) in the US lent their assistance for final trials, and subsequently the vaccine was commercialised on a large scale in Africa with the collaboration of Brazil. 

Another successful Cuban vaccine was the one against Hepatitis B, commercialised thanks to a partnership with French pharmaceutical company Abivax that made phase III trials possible in several countries. The Cuban vaccine against bacterial meningitis was also developed in collaboration with Canada’s University of Ottawa.  

Despite the lack of information about Soberana 02 or Abdala, the vaccines have been heavily promoted by government propaganda. 

State media outlets have repeatedly announced that Cuba is the first country in Latin America and the Caribbean to develop its vaccines to an advanced stage. 

On January 20, Joe Biden was sworn in as US president and promised to have 100 million people inoculated against Covid-19 in his first 100 days in office.

Cuba immediately launched its own version of Biden´s challenge with the slogan “Cuba is enlisting 100 million doses of Covid-19 vaccine.”  

The Finlay Institute, leader of the project, later clarified that Cuba was “creating the capacity to be able to produce 100 million doses of the Soberana 02 vaccine”. 

But the truth is that there is little indication as to whether the eventual vaccines will actually work. 

For the Cuban brothers, Gustavo and Carlos Manuel Figueroa, their experience of the pandemic could not now be more different.

In March, with the US offering a range of vaccines, Gustavo chose to have the Janssen vaccine as it involved only a single shot rather than two doses.  

Back in Cuba, Carlos Manuel can only trust that the vaccines his own government is investing so much effort in developing will be effective, waiting and hoping that he will eventually be protected