HAVANA, Sept.16 CUBA has a unique relationship with tobacco. Cigars are the country’s national product and tobacco generates an annual income of between $400 and $500 million. If you’ve ever walked down the Malecón of an evening, Havana’s iconic waterfront promenade, you can’t fail to have noticed the scores of young people pulling on cheap cigarettes in the sea breeze.
It still strikes me as odd when I see people smoking inside public buildings, and it isn’t frowned upon to light up at your desk in most Cuban workplaces.
And therein lies the problem.Cancer is the second biggest cause of death in Cuba, after cardiovascular disease, andlung cancer rates are among the highest in the region, according to the World Heath Organization.
But Cuban researchers are helping lead the fight against the disease. They recently added a new weapon to the arsenal against lung cancer: Cimavax. This vaccine – designed to be given to people with cancer – encourages the immune system to attack a protein that fuels tumour growth, slowing the disease’s spread.
“The basic idea is to mobilise the immune system so the components which typically defend you are able to fight the cancer cells growing inside the body,” says Kaleb Leon, director of investigation and research at the Center of Molecular Immunology (CIM) in Havana, where the drug was developed.
There is one key reason why Cuba punches above its weight in the medical research arena: research and treatment are tightly connected in the Cuban healthcare system. Writing in the journal PNAS earlier this year, a group of US neuroscientists including Mark Cohen of the University of California, Los Angeles, noted the benefits of this “two-way communication between the lay public and research scientists in the cause of public health” (doi.org/7qc). They cited large-scale population studies which “routinely achieve more than 95 per cent enrolment success”.
Partly because of this connection, the team at CIM has made significant progress with clinical trials of Cimavax.Pooled results from phase I and II clinical trials showed that those vaccinated survived for 11 months on average, while the survival rate in a control group was four to five months (Human Vaccines, doi.org/dbgtw9).
And the work has attracted international interest. On his recent trade visit to the island, Andrew Cuomo, Governor of New York, brought representatives from Roswell Park Cancer Institute in Buffalo. They have now signed an agreement with CIM to further test and develop Cimavax in the US.
“An agreement has been signed to further test and develop Cuba’s cancer vaccine in the US”
Leon is clearly proud of his team’s achievements as he guides me around the national immunology lab, housed in a modernist building on the outskirts of Havana.
“Roswell Park has been in touch with us for about three years now,” he says. “The plan is to start a phase I clinical trial there at the end of this year.”
But he admits it hasn’t been easy. For over five decades, the US government has maintained an economic and diplomatic embargo on communist-run Cuba, which has made it almost impossible for researchers in the two nations to work together.
This year’s PNAS article emphasised the benefits to the US of closer cooperation. Scientists in Havana, too, are aware that they would benefit from further detente.
“In many different senses this weird relationship we have with the US has caused problems for us,” says Leon. The US forbids third nations from selling equipment containing US-made components to Cuba, for example.
But 2015 has seen quite a turnaround for these cold war enemies, including a face-to-face meeting between presidents Obama and Castro, diplomatic ties re-established and embassies reopened.
If the thaw is to last, however, it must take hold in arenas beyond diplomacy. Cancer patients on both sides of the Straits of Florida will hope biomedical research can benefit from this new-found spirit of cooperation.