IN these times of the Covid-19 pandemic wherein it is difficult, uncertain, for countries like T&T to even know where it can source approved vaccines to fully inoculate its population, we see Cuba, a country with the US kneeling on its neck for decades in a blockade, is on the verge of receiving approval for one of its own home grown vaccines with a production that exceeds its local demands and awaiting approval for others. One of these is simply a nasal spray. Indeed, Cuba is the only Latin American country that is producing its own vaccines, even for export, while many are calling for the blockade to be lifted.
But this is not a flash in the pan. In 1999 Cuba developed the first commercial vaccine against meningitis and pneumonia in infants. Also, Cuba has developed a cancer vaccine called ClimaVAX, which is being tested in the US, Japan and some EU countries. The obvious question is how was Cuba, a developing country, able to build such a world class innovation facility even as it struggled under the yoke of the US blockade?
After the 1958 Cuban revolution, its socialist government (despite its alleged human rights repression) developed a strategic plan that was also implemented through the restructuring of the national drug industry. The health sector was among six key strategic areas that were reformed– these were made possible through centralisation of economic policy and by good trade relations with the Eastern European socialist countries.
The Cuban government invested heavily in its human resources as the main asset for national growth and development. Free education was the policy that resulted in the increase in the number of teachers, professional staff and institutions. Special attention was paid to the medical sciences sector, which was tailored to the public health needs, so fostering a close relationship between students and the health system from both the theoretical and practical stand point.
Its bio-tech sector experienced a boom in the 1980s wherein Cuba established a critical mass of qualified experts. Huge investments were made in R&D institutions and technology developments were geared to being accessible to the public and increasing health care. Incentives were made available in order to promote innovation and development of health technologies in the government owned innovation system, including adjustment to patent law based on TRIPPS flexibilities. Also, the government established institutions to design and facilitate manufacturing of the respective products, not only to meet the local health needs but also to target the export markets– reminiscent of Michael Porter’s test market at home.
Recently the Cuban government created BioCubaPharma as a corporate entity integrating the country’s biotech and pharmaceutical sectors as part of the Cuban economic model. Hence this entity saw the emergence of different business units that include technology transfer, contract manufacturing and joint ventures with foreign institutions. By the end of 2013 BioCubaPharma had 2,100 employees, 618 of whom were university graduates, 270 were PhDs and 1,079 MSc.
Cuba has been very successful in its R&D and local manufacturing given the many deals it has secured with, e.g. Algeria, India, Brazil, China, Africa, Mexico, Argentina and Malaysia. Since 1989 nine Cuban inventions have received WIPO gold medals, also four WIPO trophies have been awarded to Cuban centres. (Reference WHO 2015 Report Cuban in medicine…)
The Cuban innovation system follows the Triple Helix with the twist that all of the three elements are government owned. There are no local private sector entities in the Cuban pharmaceutical industry. Local drug production has contributed to 65 per cent of the local health needs in variety, and drug prices are generally low to the population. Further, the Cuban human development index is comparable to that of the developed world. Cuba has also used its production of medical staff to export their services to the developing world so earning foreign exchange or directly for, say, petroleum products. Even in this pandemic Cuba has sent specialist nurses to the Caribbean including T&T.
If a careful look is taken at the Cuban export market for health care it is seen that the strategy employed by its government is one of disruptive innovation, where the products exported are cheaper but as good or even unique, as existing ones but geared to less affluent markets, moving upscale as the innovations take hold.
T&T on the other hand has endeavoured to make its education system available to all (free primary and secondary, GATE and scholarships) and has succeeded in even over producing graduates in some areas. However, what it did not do was to pre-allocate and support strategic economic areas in which these graduates were to go. Hence, many simply emigrated. Unlike Cuba, a foresighting exercise was not done and the hope by T&T appeared to be that with no specific plans as to what on-shore industries should be developed, the private sector left to its own devices, even with trivial general incentives, would innovate and export- this has not yet taken place.
Still, T&T was at a structural disadvantage compared with Cuba since it had no control over its private sector, an innovation partner, and it did/could not direct the R&D of its institutions. Moreso, its lifeblood, petroleum until now bubbled up out of the ground, fuelling the onshore demand for foreign exchange.