By Paul Guzzo, The Tampa Tribute, August 1, 2015
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Cuban biotech researchers work in a clinic in Havana. Photo: MEDDIC
TAMPA — As relations with Cuba improve, many people in Tampa are hoping for easier access to one export item the island nation has made famous — premium cigars.
But there’s far more at stake with another product developed in Cuba — a treatment for lung cancer, the disease most commonly caused by tobacco smoking.
The H. Lee Moffitt Cancer Center & Research Institute in Tampa is one American institution that has expressed interest in the Cuban drug CimaVax, recently sending representatives to the island nation.
In addition, an unnamed Tampa medical center is said to be interested in bringing doctors here from Cuba. And local cancer survivors and their families are traveling to Cuba to learn more from their counterparts there.
“As the doors open wider between our countries, there will be other medical benefits,” said Candace Johnson, CEO of Roswell Park Cancer Institute in Buffalo, New York, which is seeking FDA approval to run a clinical trial on CimaVax.
Evaluations could begin within six months. In the coming years, Roswell may test other Cuban pharmaceuticals.
“I am optimistic that a field like health can open the way for real positive relations between these two countries,” said Gail Reed, founder of the Oakland, California-based nonprofit Medical Education Cooperation with Cuba, MEDICC.
It may sound improbable that a nation isolated for decades by the U.S. embargo, a land of old cars and crumbling ruins in the minds of many Americans, might have scored such a sought-after medical breakthrough. Lung cancer is the leading cause of death from cancer in the U.S., according to the National Cancer Institute, and women are dying from the disease in rising numbers even as cigarette smoking declines.
But in Cuba, the field of medicine belies that Third World image.
The United Nations reports that Cuba’s infant mortality rate is less than five deaths per 1,000 births compared to six in the U.S. Cubans also have the same life expectancy as people in the U.S. — 79 years, according to the U.N. report.
What’s more, Cuba trains almost seven doctors for every 1,000 citizens compared with just under three in the U.S., the World Health Organization reports.
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Those medical professionals have become one of Cuba’s most sought-after exports. The Cuban government says it has sent nearly 40,000 health care workers to work temporarily in 77 countries — most recently, helping treat Ebola patients in West Africa — and generated $8 billion a year in foreign exchange.
One of Cuba’s biggest health care partners is Venezuela, which provides much-needed oil in return.
Bringing Cuban doctors to Florida to study and practice on a temporary basis was the subject of a recent meeting at a Tampa medical center, said Jonathan Edelheit, CEO of the nonprofit Medical Tourism Association in Palm Beach Gardens, which advocates for international health care options.
“I can’t say more right now,” Edelheit told the Tribune. “But there were some stakeholders from Tampa’s government at the meetings.”
Representatives from Moffitt Cancer Center were part of a Greater Tampa Chamber of Commerce trip to Cuba in May and toured its National Institute of Oncology and Radiology in Havana.
Moffitt Vice President David de La Parte had little to say about the prospects of working with the institute.
“Similar to Moffitt, the cancer hospital is focused on patient care, research and education,” de La Parte said in an email. “That resulted in a discussion about potential opportunities down the road in the areas of training, education and collaboration. We look forward to continuing our discussions.”
Reed, who edits the MEDICC medical journal in Havana, said Tampa medical centers have good reason to study Cuba’s health care system.
The country has developed systems for vaccination that are among the best in the developing world, Reed said, because the communist government has made it a financial priority.
Cuba produced a vaccine for meningitis B in 1989, she said, while it took until 2014 for the U.S. to approve one.
Cuba also has a vaccine for diabetic foot ulcers, which is the reason behind some 80,000 amputations a year in the U.S., Reed said.
In Cuba, the vaccine has reduced amputations by 70 percent. It is available in 26 countries but not in the U.S.
Cuba is currently working on a vaccine for cholera, Reed said.
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Researchers in the U.S. hope Cuba’s CimaVax can also be administered as a cancer prevention, said Johnson, the Roswell Park CEO.
CimaVax targets a protein that cancer cells attract and use to multiply, Johnson said. The vaccine may work as an immunization for patients at risk of cancer.
“Cuba did a randomized trial with 4,000 late-stage lung cancer patients,” Reed said. “Standard therapy did not work for them. Those given the vaccine once a month through an injection in the arm lived twice as long as the others. And their quality of life was good. Some even went back to work.”
The vaccine has been available to Cubans since 2011. Through a delegation to Cuba led by New York Gov. Andrew Cuomo, Roswell signed an agreement with the Center for Molecular Immunology in Havana to import CimaVax to the U.S.
Still, in many respects, Cuba does resemble a Third World nation when it comes to the nation’s health care system.
With its struggling economy, there are shortages of basic necessities such as bandages.
“You can get a heart transplant but might have to bring your own sheets to the hospital,” said Reed.
Medical supplies are one of the commodities that U.S. citizens can legally sell to Cuba.
Tampa, a center for the manufacture of medical devices, can capitalize on this opportunity, Chamber of Commerce President Bob Rohrlack said before his group’s trip to Cuba in May.
Cuba does not buy much from the U.S. health care industry — just $7.5 million worth since 2003, said John Kavulich, president of U.S.-Cuba Trade and Economic Council in New York.
There are a number of reasons for this, he said.
Some U.S. companies don’t want to go through the Commerce Department licensing process, for example. And Cuba grudgingly pays in cash — the only way many U.S. companies are allowed to do business there now.
The Cuban government believes that buying U.S. health care products would signal acceptance of these U.S. trade restrictions.
What’s more, many U.S. medical products simply cost more than those from other nations, Kavulich said. “However, their doors have always been open to donations without any issues,” he said. “Thus far this year, donated products from the U.S. exceed $1.8 million.”
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Alberto Jones of Palm Coast in Flagler County is among those making the donations, gathering and delivering goods from people in the Tampa area who are working to improve relations with Cuba.
Jones’ wife was diagnosed with breast cancer in 2013 and successfully treated in the U.S.
A native of Guantanamo, Jones kept his family in Cuba informed of her progress. He was shocked to learn that despite the island’s excellent record of cancer treatment, patients lack items taken for granted in the U.S. — creams for dry skin, for example, or slings for lymphedema, both brought on by treatment. Wheelchairs and prosthetics also are in short supply.
With support from Tampa donors, he and his wife have been collecting and delivering such material to Cuba.
On their first visit to Guantanamo in 2013, Jones and his wife found women waiting for them in lines that stretched across town.
“The U.S. and Cuba both have something to offer each other,” Jones said. “We need to continue building bridges between the two. It will only result in benefits for the sick.”
Jones is leading a delegation of cancer survivors, physicians and caregivers to Havana in October.
Called “Pink to Pink,” the group will meet with Cuban counterparts to continue Jones’ push for collaborative efforts.
Among those going is Rayshana Black, who received a graduate studies degree from the University of South Florida in 2010 and was diagnosed with leukemia three years later.
Now 32 and living in Atlanta and with a clean bill of health, she founded the support group Black Girls Survive Cancer and looks forward to meeting with organizations in Cuba to see if she can take away any lessons on helping survivors.
She is also interested in learning more about how Cuban cancer centers deal with their patients.
“In the U.S. we are a little more focused on the disease than the patient,” Black said. “Sometimes we forget the patient is a human trying to survive. That makes us feel like we are the disease rather than a person.”
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Because Cuban doctors are trained to work with low-income patients in other countries, without the “bells and whistles” available in the U.S. health care system, bedside manner is stressed, said Reed.
“They do more hands-on training in community settings starting with their undergrad medical education,” Reed said. “From day one they emphasize that every physician is also their patient’s teacher.”
Cuba’s Latin American School of Medicine has educated more than 200 U.S. citizens through scholarships.
Cuba may also be open to U.S. medical tourists — those visiting another country for health care procedures.
An estimated 750,000 Americans a year travel abroad as medical tourists, said Edelheit, with Medical Tourism Association.
Among the attractions can be affordable prices and the availability of procedures not approved here, such as stem cell therapy.
Today, Cuba is an illegal destination for U.S. medical tourists. They can only travel to the island for educational, research, humanitarian, family or athletic purposes.
If and when U.S. citizens are allowed to undergo medical procedures in Cuba, Edelheit said, it could grow into a popular choice, especially for people in nearby Florida, where Tampa and Miami have ancestral links.
“If a Cuban can benefit from a U.S. drug, wonderful. And if an American can benefit from a Cuban drug, wonderful,” Reed said. “The two communities can be an example of why we should all work together.”
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