Friday, December 09, 2016

Yet Another View of Cuba's Medical Experience

"In Cuba, products were developed to solve pressing health problems, unlike in other countries, where commercial interests prevailed."
World Health Organization report

"The data is intriguing, but we need to do more definitive studies."
Justin F. Gainor, oncologist, Massachusetts General Hospital

"Since I have been taking Cimavax, it [lung cancer] hasn't come back."
"There's no doubt that without this medicine [Cimavax], I would be dead."
Mick Phillips, 69, Appleton, Wisconsin

Mick Phillips's doctor credits a lung cancer vaccine from Cuba with sustaining the Wisconsin man's remission from a disease he learned he had more than five years ago.
Mick Phillips's doctor credits a lung cancer vaccine from Cuba with sustaining the Wisconsin man's remission from a disease he learned he had more than five years ago. (CBC)

Cancer patients from Canada and the United States have been travelling to Cuba for the promise held out by a vaccine that appears to be able to halt the progress of the cancer they're suffering from, even those who have been diagnosed with late-stage cancer that is seen to be incurable by any methods currently practised in North America. Cuba's vaunted biotechnology industry is known to have produced a cancer vaccine that appears effective, but is not approved for use in the United States.

So, 78-year-old Zuby Malik, just incidentally a retired obstetrician-gynecologist, who was diagnosed with Stage 4 non-small-cell lung cancer a year earlier, and who has undergone and exhausted treatments available to her in the United States to little avail, determined to travel to Cuba to bring back with her the cancer vaccine that many other Americans have been successfully using to treat their cancer where all other optional treatments have been tried and found lacking.

New York Governor Andrew Cuomo, in recognition of the medical tourism undertaken by Americans, has given public notice that the Roswell Park Cancer Institute in Buffalo has received the requisite authorization to enable it to conduct a clinical trial of Cimavax, the Cuban vaccine for lung cancer. This would be the first time in sixty years that Cuban and American institutions have partnered scientifically in a joint venture.

Cimavax was developed initially in a bid to halt the growth of cancer and to block cancer from recurring in people diagnosed with non-small-cell lung cancer. The drug is geared to stimulate the immune system of the body in the production of antibodies to bind to a protein called epidermal growth factor (E.G.F.), preventing the protein from further feeding the cancer's growth. The drug is available in Peru, Paraguay, Colombia and Bosnia and Herzegovia.

Although trials undertaken in Cuba have manifested a modest benefit where, in the most recent trial, patients given the vaccine after chemotherapy treatment lived only about three to five months longer than those who did not receive the vaccine, it continues to hold out hope in the minds of those patients with nothing left to lose but their lives. The Cuban study was published in the journal Clinical Cancer Research. It found that patients who were vaccinated with Cimavax who had a high concentration of E.G.F. in their blood lived longer than the others.

Foreign medical tourists are exposed to an initial round of four injections at an international health center, La Pradera, catering for the most part to foreign patients in Havana. Thereafter, patients continue to administer themselves their periodic injections at home, for up to several months on the Cimavax protocol. Cuba, famously known for its superb cigar production favoured the world over, was plagued by a high rate of lung cancer.

Which led Cuban researchers to work on Cimavax, and it was produced in the 1990s. Patients began receiving the vaccine free of charge, in 2011. It has since been administered to over four thousand patients worldwide, according to Roswell Park Cancer Institute in Buffalo, set to begin their own trials on the promising new treatment. The Roswell Park trial plans to combine the vaccine with a form of immunotherapy named a checkpoint inhibitor that restrains the cancer from turning off a patient's immune system.

In Cuba, a four-shot dose of Cimavax has a price tag of up to $100 to manufacture, according to Dr. Kelvin Lee, chairman of immunology at Roswell Park. Mr. Phillips, a lifelong smoker whose diagnosis came in 2009, estimates that he pays $9,000 for his yearly supply of Cimavax; roughly $1,500 each dose. In some patients' experience the price has dropped to $850 each dose. The entire cost of the trip to Cuba can amount to over $15,000 taking into account airfare, lodging at La Pradera and a few months' worth of the vaccine.

For Mr. Phillips, the vaccine has been a godsend, extending his life far longer than he was given hope for. For Ms. Malik, the experience has been less than stellar. The fluid in her lungs initially diminished with the first injection of the vaccine, but since then fluid has once again filled her right lung. She has become weak and short of breath, and her son said she is now considering dropping Cimavax. "It's not panning out as we'd hoped It's really like the Wild West trying to know what is best to do", he stated.

Say what one will of the countless negatives of Cuba's loyalty to the communist ideal, its health system presents as a model of true health-care benevolence within a rigidly authoritarian regime. Its rigorous bioscientific research is undertaken with the health of its population uppermost in mind. And its pharmaceutical production is not primarily greed-inspired, profit-motivated, marketing its products at astronomical pricing as reflected in the free-market system of capitalism. It is instead modestly priced, to make it available to those in dire need.

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