Four months after Cuba the world鈥檚 highest number of daily covid-19 infections per capita, and more than 9000 cases a day, it has driven the incidence of new cases down to double digits with its own vaccines.
The island reported 61 new daily infections on 21 December 鈥� 0.54 for every 100,000 people 鈥� as cases declined for the fourth consecutive month.
Experts had predicted that Cuba鈥檚 economic crisis would make it fertile ground for the coronavirus because basic medical products, such as covid-19 tests and face masks are often unavailable or prohibitively expensive, and many hospitals lack antibiotics and oxygen.
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Hospitals collapsed in August and September, when daily infections exceeded 9000 a day. But the country now seems to have emerged from the health crisis in an enviable position. Cuba has developed and approved two covid-19 vaccines, with which 84 per cent of its 11 million people have been vaccinated. The country is also rolling out booster shots, and has a vaccine specifically for the omicron variant in the pipeline.
鈥淎ll this has been made possible thanks to Cuba鈥檚 autonomy in the development of its own vaccines, otherwise we would not be in the privileged place we are in the world today,鈥� says at the Finlay Institute of Vaccines in Havana, Cuba.
Cuba鈥檚 government didn鈥檛 negotiate with foreign pharmaceutical companies because foreign vaccines would be unaffordable or arrive too late. It also didn鈥檛 in COVAX, the World Health Organization鈥檚 scheme to provide jabs to lower-income countries.
Instead, the country relied on its state-run biotech industry to develop a covid-19 vaccine 鈥� so far, the country has produced two covid-19 vaccines. is 92.3 per cent effective against symptomatic infection after three doses, and is 92.4 per cent effective after two doses and an additional dose of Soberana Plus, another vaccine, according to studies that haven鈥檛 been peer-reviewed. Cuba has other vaccine candidates in trials, including Mambisa, which is delivered using nasal drops.
Cuba鈥檚 covid-19 turnaround is in part due to the country鈥檚 speedy vaccine roll-out. The government started vaccinating at-risk populations with Abdala in May 2021, before the vaccine was approved for emergency use, and Cuba in the world to vaccinate children as young as 2 in September. Some 1.8 million children between the ages of 2 and 10 have been vaccinated in Cuba, to 97 per cent of all children in the country.
There has also been little opposition to the vaccines. Although confidence in the government has waned during the pandemic due to economic and supply-chain failures, the Cuban public has retained trust in its biotech industry.
鈥淰accine resistance, as we know it in the US or the UK, is really not a thing [in Cuba],鈥� says at the University of Miami in Florida.
Cuba鈥檚 biotech industry produces most of the island鈥檚 drugs, as well as 300 for more than 50 countries. The institutes that make up the Cuban state-run biotechnology conglomerate, BioCubaFarma, worked independently to develop covid-19 vaccines. This meant that the government didn鈥檛 put all its vaccine eggs in one basket and it resulted in an arsenal of vaccines with different strengths and weaknesses, says at S茫o Paulo State University in Brazil.
Soberana 2 is more costly and slower to produce than Abdala, but has fewer side effects and so is preferred for use in children.
Now, the focus in Cuba has turned to the omicron variant, which is surging across the world and was in the island nation on 8 December. Boosters, which have already reached high-risk groups, are being vaccinated more than six months ago.
BioCubaFarma is evaluating the effectiveness of its existing vaccines against omicron and is developing others targeting omicron鈥檚 spike protein in case they need to be updated, says Garc铆a聽Rivera. If a new vaccine is necessary, the head of the Finlay Institute of Vaccines to have one ready by the end of the year. In the meantime, 鈥渢he application of booster doses is the most cost-effective tool we have right now,鈥� Garc铆a Rivera says.
The country鈥檚 widespread vaccine coverage and low infection rates suggest it may be well-placed to try to eliminate covid-19 rather than dampen transmission. 鈥淏ut that option is not on the table,鈥� says Perez Riverol. The island reopened its borders to tourists on 15 November in the hope of reviving its economy.
Cuba鈥檚 public health experts blame the reopening of borders to Cubans in November 2020 for the spread of the delta variant, which culminated in August鈥檚 deadly wave. 鈥淲e don鈥檛 know how well strategies to control infections at the border will work but I am not expecting a massive surge, as the last one with Delta was only three months ago and along with mass vaccination should provide strong immunity,鈥� says Perez Riverol.
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