Soberana, or sovereign, is how Cuba baptized its top COVID-19 vaccine, which just completed the last phase of clinical trials. Other shots are called Abdala, named after a poem by independence hero José Martí, and Mambisa, the word for 19th Century insurrectionists in the fight against Spanish rule.
The names reveal a lot about the island's political and economic strategy to focus on a homegrown solution that is presumably cheaper and can ensure a provision of lifesaving shots even amid challenges created by the long-standing U.S. embargo. Cuba's long tradition of vaccine production, a robust biotech industry and critical mass of scientists set it up for success in becoming the first country in Latin America to produce a COVID vaccine.
But as trials linger on and rollout plans keep getting delayed, Cuba's bet on vaccine sovereignty may be coming at a price that's rising by the day: COVID-19 cases, which totaled just over 12,200 in all of last year, surpassed 124,000 so far this year. Since the start of the pandemic Cuba has registered 136,628 cases and 912 deaths, according to the World Health Organization. Though the numbers remain low by Latin American standards, daily case counts soared to about 1,000 in the past two months, as more tourists arrived after the island reopened its borders to tourism in November.
Earlier this month Cuban health authorities began vaccinating people with the Soberana and Abdala vaccines even before the shots were approved by the local drug authority, as fears grew that the arrival of a coronavirus variant first detected in South Africa could lead to new spikes in cases.
"We decided to start vaccinating people where transmission rates are higher because the risks are also increasing," Health Minister José Angel Portal Miranda said this week in a video address to the World Health Assembly. "The benefits of this intervention outweigh the risks," he said, adding that over one million people have received at least one shot of the vaccines. He estimated that about 70% of Cuba's population could be vaccinated by the end of August.
"Once we finish all trials and regulatory approval, we'll be able to vaccinate all our people and also help other nations," he said.
Cuba is rushing to get ahead of the virus, as it needs to jump-start its economy and revive tourism, a key source of revenue for the embattled island that's struggling during its worst crisis since the fall of the Soviet Union. Crushed by the pandemic and the Trump-era tightening of the embargo, Cuba's economy shrank 11% last year and shortages of food and other basic necessities are now part of daily life. And the short-term outlook remains challenging, as the Biden administration hasn't made Cuba a foreign policy priority.
The death earlier this month of Dr. Gustavo Sierra, one of Cuba's most prominent scientists, and deaths of children and pregnant women from COVID-19 in recent weeks heightened concern in the island that for most of last year was able to control transmission through strict lockdown measures and public health monitoring through its vast community health network.
Leaders of Cuba's vaccine project say the slow pace of development was by design, meant to guarantee effective vaccines that will not only immunize most of the nation's 11 million people this year but also protect people in Latin American and African countries that need shots. Cuba hopes to produce 100 million doses of vaccines this year and is already in talks with potential buyers like Argentina and Mexico. It has even flagged the possibility of offering Soberana to tourists. And production can continue over the next few years to supply a likely need of booster shots.
"We have to do it well, even if it takes us longer," Vicente Vélez Bencomo, one of Cuba's top vaccine scientists, said on YouTube during a roundtable on a state TV station earlier this month. "We can't skip any steps; we opted to develop our candidates on conventional platforms that require more testing, more evidence, more clarity in its safety indicators. We had to wait, and that's why we're arriving a little later at a vaccine."
This is as much a test of Cuba's biotech industry as it is of President Miguel Díaz-Canel's performance during a historical transition of power in the authoritarian regime. The 60-year-old civilian became the island's most powerful figure last month when he replaced Raúl Castro as the Communist Party's First Secretary. Now he is working to assert his leadership to implement key reforms Cuba desperately needs to spur economic growth, including measures to expand private businesses.
Selling vaccines to other developing countries could be a boon for Cuba's cash-strapped economy even if its strategy is to sell the shots at affordable prices. Venezuela said it will produce the Abdala vaccine, while Mexico and Argentina have expressed interest in ordering the Soberana vaccine. Iran, which banned U.S. and British vaccines, hosted a Phase 3 trial of Soberana 2 as part of an agreement that includes producing millions of doses there.
Cuba is well-positioned to produce the shots because it has an established biotech industry that produces many vaccines, including eight out of 11 vaccines in the country's childhood immunization program.
"They have quite a few of world's firsts in biotechnology, including the world's first meningitis B vaccine, they have the hepatitis B vaccine, which has been exported all over the world. And we're talking about big numbers. So they have the capacity," said Helen Yaffe, a Latin American Studies professor and Cuba specialist at the University of Glasgow. The island also has a high ratio of science researchers in its population, on par with Europe and the U.S. and above the Latin American average, she said.
Cuba could potentially sell its vaccine to the COVAX platform created by the World Health Organization to ensure fair access to vaccines by helping the world's neediest countries purchase COVID-19 inoculations at a discounted price.
But the shots must first be approved for emergency use by the island's regulatory agency and then approved by the WHO. Cuba's scientists have promised to publish the Soberana details soon in a peer-reviewed publication of the American Chemical Society, Vélez Bencomo said.
"Every vaccine development project in Latin America and the Caribbean is very welcome. It's very important to recognize efforts from many governments and academic institutions in our region that are trying to develop vaccines because maybe we will need vaccines against the coronavirus for many years ahead," said Jarbas Barbosa, assistant director for WHO's Pan American Health Organization. "If we need to have boosters or vaccines against variants in the future, it's important to have more capacity in the region to produce vaccines."
