[A-List] Cuba: health care advances

["Michael Keaney" <michael.keaney@xxxxxx>]

Cuba seeks to capitalise on biotech
By Patrick Michael Rucker
Financial Times: December 4 2002

After Alessia Spallone severed her spine in an aircraft crash last August,
doctors at one of Switzerland's most renowned clinics said she would never
walk again.

Then her father, himself a neurosurgeon, arranged for treatment in Cuba.

The International Centre for Neurological Restoration (Ciren) on the
outskirts of Havana does not offer the luxurious surroundings Ms Spallone
knew in Switzerland, but she is feeling better. "Their whole approach is
different," she says of the intensive care she is receiving. "The doctors
don't know yet if I will regain use of my legs, but we work as if I will."

Around 900 foreigners a year seek treatment at Ciren and according to Julian
Alvarez Blanco, director of the centre, they would like to treat many more.

"We would welcome more foreign clients, but the truth is we are very little
known," Dr Alvarez admits. "We focus on patient care and find little time to
advertise."

Cuba's education and public health systems, long the pride of Fidel Castro's
revolution, could soon be providing for the island's financial future if a
number of high-tech and medical projects prove that communist tools can be
put to capitalist use.

The collapse of the Soviet Union delivered a devastating economic blow to
Cuba. Guaranteed sales and fixed prices for sugar are no more and many of
Cuba's other industries have had a shock adjusting to the free market.

Tourism has replaced sugar as the island's main source of foreign exchange
and, in past years, has generated nearly $2bn, four times the value of an
average sugar harvest.

With one of the world's most literate citizenry and a doctor to patient
ratio of about one doctor for 200 people - more than three times greater
than Britain's - Cuba is an island rich in human capital. Traditionally
those resources have been used in the service of the state, but a prolonged
economic crisis has Cuban officials trying to convert the island's wealth of
knowledge into hard cash.

Cuba's medical and biotech sectors could be ripe for such a conversion.
Having flourished during twenty years of generous state funding, Cuba's
biotech programme was aimed at meeting domestic pharmaceutical and
agricultural needs. Much of that work infringed upon international patents
but a number of recently- signed protocols will make Cuban products
acceptable to the global market.

"We are not crazy about the patent system, but that is the world we live
in," concedes Carlos Borroto, vice-director of Cuba's Centre for Genetic
Engineering and Biotechnology. "Signing those protocols does show our shift
away from 'me too' research to developing original products for export."

Profits from the sale of Cuban vaccines, notably for hepatitis B and
meningitis, facilitate much research, Dr Borroto explains, although his
institute is courting pharmaceutical companies to inject some risk capital.

Almost all sectors of the economy have been open to foreign investment since
the mid 1990s, but of 400 associations with foreign capital, only sixteen
are in the biotechnology, health and science sectors. Cuba's food industry
has nearly an equal number of such projects.

For some observers, that contrast shows that Cuba continues to neglect
industries most open to foreign involvement and growth.

"The Cubans should worry less about import substitution and focus more on
the capital intensive industries suitable for their labour market," says a
western diplomat in Havana who follows the Cuban economy. "Why make ketchup
and potato chips when your workers are fit for something more
sophisticated?"

Local workers are providing technically-complex products, as demonstrated by
ICC, a company which administers nearly all Cuba's official websites. The
privately-held company's thirty Cuban workers manage web content, develop
software and recently began providing internet commerce and banking
services.

The company has to contend with Cuba's telecommunications shortcomings, says
Anibal Quevedo, ICC's sole Cuban manager, but the island's preparatory
education system creates a reservoir of qualified workers.

"Cuba's future is as a service economy, and in that respect our company
serves as a model," Mr Quevedo says. "We constantly shift our business
according to opportunities in the market and our employees reskill as we do.

"The young employees we have are educated, eager and ready to work, but
those employees could be lacking in another generation if the young are
allowed to grow old without any experience in these fields."