By Gail Reed

AIDS Deaths Down in Cuba

By November 2001— five months after the Cuban public health system introduced domestically manufactured anti-retrovirals for all the country’s AIDS patients—deaths from AIDS and the incidence of opportunistic infections among HIV-AIDS patients were registering a drop from the same period one year before.  The wards of the Pedro Kourí Tropical Medicine Institute, where seriously ill AIDS patients are hospitalized, are practically empty.  According to Dr. Jorge Pérez, some 90 patients were usually hospitalized there each month from around the country, but by November that rate had dropped to a dozen. 

Cuba now produces AZT (zidovudine), D4T (stavudine), 3TC (lamivudine), DDI (didanoside) and crixivan (indinavir).  Combined treatment is begun once patients’ viral load and lymphocytes reach internationally-established levels, or if particular opportunistic infections appear.  The analysis of which combination therapy will be applied to each patient and when is carried out by a team of specialists from the Tropical Medicine Institute, epidemiologists from across the country, pharmacologists, and internists, and a group of HIV-positive persons.  Patients are urged to stick to the treatment recommended, since abandoning the medications will most certainly shorten their life expectancy.  Special emphasis is placed on their use of condoms during sexual relations, since infecting another person with a strain of HIV under treatment may hasten the spread of drug-resistant HIV.

Cuba is now preparing to produce nevirapine, amprenavir and nelfinavir.

Prevalence of HIV in Cuba is 17 times lower than the average for the rest of Latin America, where one of every 200 adults is infected with the virus, and also considerably lower than the rate for the Caribbean, which is one for each 50 adults.

Latest HIV-AIDS Statistics for Cuba

As of October 31, 2001, a total of 3,750 persons had been diagnosed as HIV-positive in Cuba, a cumulative number representing total cases since the epidemic was first found in the country in 1986.  Of these cases, 2,923 are men (77.94%) and 827 women (22.05%).  Of the 1,464 HIV-positive persons who have developed full-blown AIDS, 940 have died, and 584 are today living with AIDS.

Cuban Scientists to Test New AIDS Vaccine Candidate

In November, a team of Cuban scientists from Havana’s Center for Genetic Engineering and Biotechnology (CIGB) announced they plan to test a new AIDS vaccine candidate in HIV-positive volunteers.  Dr. Carlos Duarte, head of the AIDS Research Team at the Center, told Juventud Rebelde newspaper that the team will inoculate volunteers with an immunogen which stimulates cytotoxic T-cells.  Dr. Duarte stressed that the group has concentrated its efforts in the search for vaccines based on cellular defense responses, which they believe is the most promising line of research. “We are developing two technologies,” said Dr. Duarte, “immunization with naked DNA and another with live vectors, in this case the so-called pox virus.”  The vaccine candidate will be evaluated in combination with tri-retroviral therapy.  “The strategy is to apply tri-therapy in a group of patients to reduce their viral load to a minimum, and in the course of treatment incorporate two to three doses of the vaccine to increase their immunological response against certain regions of the virus.”  While not eliminating the virus altogether, the person’s immune system would improve control of viral levels, and significantly reduce the drug dependency of infected individuals.

Dr. Duarte warned, however, that a preventive vaccine against HIV-AIDS is still some time away, even for the companies most advanced in their research.  “But even if these companies develop a vaccine,” he commented, “a product developed by Cuba will still be important for the countries of the Third World, those which in fact a most affected by the disease, and least able to pay for treatment.”

Former U.S. Surgeon General Praises Cuban Health Care,
Raps U.S. Embargo

Dr. Joycelyn Elders, former U.S. Surgeon General, says that Cuba’s health care system is better at keeping people healthy than the U.S. system.  Her remarks came at the end of a visit to Cuba last September.  She said she was impressed with Cuba’s preventive, primary health care.  “Cuba’s is better,” she said.  “They work at keeping people healthy.”

She said the U.S. does better at caring for the sick, and the delegation of five physicians who made the trip stressed that the island lacks important medicines and equipment.  They blamed the U.S. embargo on Cuba as one of the reasons for the shortages.  Medical sales to Cuba by U.S. firms still require a special license from the U.S. Treasury or the U.S. Commerce Department, and neither agency is required to grant permission.

The delegation to Cuba included former Surgeon General Dr. Julius Richmond;  President of the National Medical Association, Dr. Rodney Hood; former President of the American College of Physicians, Dr. Whitney Addington; and noted neurosurgeon Dr. Robert White.

Two Caribbean  Ministers of Health are Cuban Alumns

Newly appointed Minister of Health of St. Vincent and the Grenadines, Dr. Douglas Slater, visited Cuba last fall to sign a series of collaborative agreements in public health.  But the trip was also a reunion with former medical school classmates, since 15 years ago, Dr. Slater received his M.D. in Havana.  “I have Cuba to thank for my professional education and also a humanist vision of medicine,” he told reporters in the Cuban capital.

In the Caribbean, Dr. Slater is joined by Dr. Clarice Modeste, Grenada’s Minister of Health and the Environment, who also received her medical degree in Cuba.

Cuban Health Professionals Serving Abroad

By the end of 2001, some 3,800 Cuban health professionals were service in 56 countries, most of them in Latin America and Africa.