Cuban Vaccines Cross Borders, but Barriers Remain

Patricia Grogg interviews scientist Concepcion Campa, director of Cuba’s Finlay Institute

HAVANA TIMES, Sept. 7 (IPS) — Even today, many years after it was proved effective, the Cuban vaccine against meningitis B is still ignored by industrialized countries, whose medical literature usually states there is no immunization against that strain of the disease.

“There are many regulatory barriers, obstacles that sometimes the transnational laboratories themselves impose,” says Cuban scientist Concepcion Campa, who headed a research team in the 1980s that discovered and developed the vaccine that has potentially saved millions of children.

VA-MENGOC-BC is the only vaccine available in the world against the disease caused by meningococcus B and has been included since 1991 in Cuba’s national infant immunization program. Meningitis has not been a public health problem on this socialist-run island since then.

“It has also been used successfully in other countries of Latin America, including Brazil, Argentina, Uruguay, Colombia and some Central American countries. The vaccine is undeniably more accepted now than it was in the beginning, but it has yet to enter Europe,” Campa, president and director-general of Cuba’s Finlay Institute, told IPS.

Half of the staff at Finlay are women. The Institute’s range of research, development and production of vaccines and serums also includes protection against meningitis A and C, leptospirosis, diphtheria, tetanus, typhoid fever and whooping cough.

Q: I did a random search on the Internet and found European medical literature that says a vaccine against meningitis type B does not exist, when you have had it since the early 1990s. How is that possible?

A: That vaccine has to compete with transnational pharmaceutical laboratories that have very expensive marketing programs and are elaborated with a great deal of business intelligence.

We have spoken with some companies, but from the beginning they make it clear: “we are a for-profit firm and our main reason for existing is the profit percentages. Of course, we also work to improve health.”

That principle puts us at a disadvantage. Above all, we are working for the good of human health, not for profits, and we don’t have the great volumes of money needed for marketing and for informing the public. The anti-meningococcal B vaccine has suffered a great deal because of this.

Q: But Cuba needs to increase its revenues. Isn’t biotechnology a good way to do that?

A: Yes, but our profits will never be comparable to those of the transnationals. It isn’t that we are working at a loss — we couldn’t — because we need to research and develop new products. But we can’t compare the profits of the transnationals with what we earn here.

Q: Cuba has opted to work jointly with other countries in the biotechnology field. Is that the case of the Finlay Institute as well?

A: The first agreement was signed with Brazil, precisely based on the anti-meningococcal B vaccine, back in 1990 or 1991. They needed huge volumes of the vaccine and we had the capacity to provide the active ingredients, but not for the final industrial process of packaging the vaccine.

We collaborated to send them the preparation in big bottles, which brought down the cost of the vaccine for them, and for us it facilitated the industrial process. That is how the partnership with Brazil came about, and it has been very strong.

Q: It sounds like a good precedent for the partnership between the Finlay Institute and the Brazilian governmental Bio-Manguinhos (Institute of Technology in Immunobiologicals), in order to produce vaccines for the so-called “meningitis belt” in Africa.

A: Indeed it was. In 2006 we received a request from the World Health Organization (WHO) to produce the anti-meningococcal A-C vaccine that was needed to confront the epidemic outbreaks in Africa. We partnered with Brazil and together passed the WHO qualification. It is a South-South collaboration that functions very well.

We built a plant solely with Cuban investment to manufacture those vaccines, which was inaugurated in December 2008. Now we are working also on the anti-meningococcal W-134, one of the strains with the greatest impact in Africa. It is also a response to a WHO emergency.

Under the agreement, Cuba sells the vaccine’s active ingredient to Brazil, which carries out the final process, including filling, lyophilization (freeze-drying), packaging, labeling, and quality control, to be sold to the international organizations or directly to African countries.

Q: With what other countries do you have partnership agreements?

A: We have research projects with Malaysia and some countries in Europe, like Britain, Sweden, Switzerland and Italy. In Latin America, with Chile, Mexico, Argentina, and again with Brazil in basic research. In production, the strongest collaboration has always been with that South American giant.

There have been other attempts, such as conversations and negotiations for cooperative production with Vietnam, India, Egypt and China, among others.  We have also tried this type of collaboration with South Africa. The first step would be production, and later the transfer of technology.

Q: What is the secret for developing such a complex industry under the conditions of a developing country?

A: Cuba has many strengths. The first is the priority that the government has given biotech, investing millions to build the industry we have today. The second is our human resources, the result of a revolutionary process that elevated education to first place.

Another strength is the collaboration amongst all of the research centers.  We are not competing against each other; we help each other. Right now, the vaccine against pneumococcus is something we are working on as two scientific institutions. Each has its economic and organizational independence, but in the work we are truly a loving and understanding family.

Q: Is the vaccine against pneumococcus a reality yet?

A: We are working in collaboration with the Biomolecular Chemistry Centre because pneumococcus has become one of the leading causes of infectious diseases, not only for children in Cuba, but in other parts of the world. It is a vaccine that does exist, but still needs to be adjusted in its composition, effectiveness and price. It is quite advanced and we hope to begin the first clinical trials soon.

These bacteria cause pneumonia, meningitis and ear infections. It is a seven-valence vaccine, meaning it protects against the seven most common pneumococcus types in Cuba and Latin America. Each development is aimed to meet the health needs of this and other countries of the South.

Q: What other projects is your institution involved in now?

A: The most immediate development is the anti-meningococcus W-134, which is nearly complete and the clinical trials will take place in January 2011. When it comes to a product that is already on the market, international regulations allow us to demonstrate that it is equal or superior to what already exists.