Promise and contradictions emerge from celebration of Cuba’s Latin American School of Medicine / By W. T. Whitney Jr

_{^{Photo credit: Prensa Latina}}

_{South Paris, Maine}

The Latin American School of Medicine (ELAM for its Spanish language initials) is a masterpiece of Cuba’s remarkable healthcare system. A conference of ELAM graduates took place in Havana from November 11 to November 15; two sets of them attended. The gathering marked the 25^th anniversary of ELAM’s founding in 1999.

What happened and what was said reflect Cuba’s healthcare achievements and ELAM’s special contribution. A focus on ELAM demonstrates for us the paradox, cruelty, and injustice of U.S. aggression against a people capable of producing such an unprecedented achievement as ELAM.

To be aware that ELAM exists and that its creation falls within the range of human capacity is to be reassured that, in fact, possibilities do exist other than U.S. warmaking, militarization, and complicity in anti-Palestine genocide.

ELAM evolved out of Cuba’s response in 1999 to the ravages of Hurricanes George and Mitch in the Caribbean area and in parts of Central America. Cuban physicians carrying out rescue missions discovered that local healthcare workers were overwhelmed by the catastrophe. Within weeks, Cuba’s political leaders opted to prepare young people to be physicians in their own countries and be ready for future disasters and much more

Soon prospective medical students were heading to ELAM from hurricane-affected regions. Later they came from throughout Latin America, and eventually from Africa and farther afield, including from the United States. They were motivated by idealism – enrollees dedicate themselves to serving the underserved – and the fact that no personal outlay is required.

ELAM has now prepared 31,180 physicians for service in 120 countries. Some 1800 medical students from many countries are presently studying there. ELAM provides the first two years of pre-clinical courses at a converted naval base immediately to the west of Havana. Clinical training over the next four years takes place at teaching hospitals throughout Cuba.

On hand in Havana 25 years after ELAM’s initiation were more than 300 ELAM graduates and students plus 250 guests, physicians and students, from 30 countries. The occasion combined the 1^st International Congress of ELAM graduates and the 2^nd International Assembly of the International Medical Society of Graduates of ELAM (SMI-ELAM).

Organizers assigned the theme “Guardians of life, creators of a better world.” They projected the assembly as “a space for scientific interchange … and a concrete step toward creation of an international medical and scientific organization whose members [are] ELAM graduates.”

The gathering featured plenary sessions, round tables, panels, and presentations by clinical and research specialists. These took place in Havana’s teaching hospitals and Conventions Center. Topics were: primary health care, medical care during emergencies and natural disasters, postgraduate medical training, and higher education in the medical sciences. Presenters linked medical education, social impact, and international solidarity. Experts from abroad and from international organizations were participating.

Welcoming the delegates, ELAM’s rector Yoandra Muro insisted that, “Commander Fidel is here, standing up, fighting with the example he instilled in his children, the graduates of this project of love.” Here, “we have a space for [ELAM] graduates to continue strengthening our kind of work and projecting training programs for the guardians of the present and future.” She identified graduates as “invincible standard-bearers in the field of health, who from their quality preparation are steeped in the work of solidarity.”

Luther Castillo Harry, currently minister of science, technology, and innovation in the Honduran government, graduated from ELAM in 2007. He declared at the conference that, “We are looking at the possibility of building the greatest scientific organization in the world … Each one of us has to be an ambassador of the Cuban Revolution.” And, “We will only gain the possible, through struggle against the impossible.”

Cuban President Miguel Díaz-Canel sent a message welcoming graduates back to their “second homeland.” He indicated he would not attend the sessions because of duties with post-hurricane recovery efforts. Díaz-Canel cited Fidel Castro’s “deep conviction that a better world is possible if we fight tirelessly for that ideal.” He speculated on “Fidel’s happiness had he been able to see you become guardians of the life and health of your people.”

Presiding over a plenary session, public health minister José Ángel Portal Miranda discussed healthcare in Cuba. The report has him outlining a system based on primary care that involves 69 medical specialties and three levels of care. Cuba’s medical network, he explained, consists of 451 polyclinics, 11,315 community health centers, 149 hospitals, and a work force of 400,000 people. There are eight physicians serving each cohort of 1000 Cubans, 80,000 in all. Maternity homes and homes for elders are part of the system.

The minister indicated that 40 different faculties or their affiliates are responsible for training physicians; medical sciences are taught in 13 universities. He identified “the development of science and technology as the fundamental pillar of the health system.” Presently 2,767 research projects and 82 clinical trials are underway.

Portal highlighted Cuba’s international medical solidarity, mentioning the Comprehensive Health Program mediated through international missions, the Barrio Adentro program for Venezuela, Operation Miracle (for eye care), and the Henry Reeve Brigades. He cited some 600,000 Cuban health workers having cared for people in more than 160 countries over many years.

Concluding his remarks, he stated that, “Out of ELAM have emerged and will emerge galenos who will save humanity from the barbarism. Or, as leader of the Revolution Fidel Castro said – ‘Doctors, not bombs!’” (Claudius Galen was a Greek physician and researcher in the classical era. Spanish speakers often refer to physicians as “galenos.”)

Here is Castro speaking in Buenos Aires in 2003:

“Our country does not drop bombs on other peoples, nor does it send thousands of planes to bomb cities; Our country has no nuclear, chemical or biological weapons. The tens of thousands of scientists and doctors in our country have been educated in the idea of saving lives. It would be absolutely contradictory to their conception to put a scientist or a doctor to produce substances, bacteria or viruses capable of killing other human beings.”

_{W.T. Whitney Jr. is a political journalist whose focus is on Latin America, health care, and anti-racism. A Cuba solidarity activist, he formerly worked as a pediatrician, lives in rural Maine. W.T. Whitney Jr. es un periodista político cuyo enfoque está en América Latina, la atención médica y el antirracismo. Activista solidario con Cuba, anteriormente trabajó como pediatra, vive en la zona rural de Maine.}

How the Knowledge Economy and Science Bolster Cuba’s Socialist Revolution / By W. T. Whitney

_{^{via Radio Havana Cuba}}

_{South Paris, Maine}

Cuba and Cuban science gained acclaim worldwide for producing their own very effective Covid-19 vaccines. The achievement stood out among nations of the Global South. The feat reflects Cuba’s development over decades of a formidable scientific establishment engaged in the development and marketing of biologic products oriented to healthcare mostly, and food production too.

The planning processes and strategizing involved were unique, and so too the resulting organizational forms. These special characteristics relate directly to Cuba’s version of socialism.

In a speech on January 15, 1960, a year after the Revolution came to power, Fidel Castro remarked that, “The future of Cuba will necessarily be a future of men (sic) of science.” The landscape would change dramatically.

The Cuban Academy of Sciences was reactivated in 1962. In succession came: the National Center for Scientific Research (1965), the Center for Biological Research (1982); the Center of Genetic Engineering and Biotechnology (1986) with its 38 scientific institutions, the Immunoassay Center (1987), the vaccine-manufacturing Finlay Institute (1991), the National Center for Biopreparations (1992), and the Center for Molecular Immunology (1994).

The “Scientific Pole,” formed in the 1980s in Western Havana, now includes over 40 research centers that employ 30,000 workers employed. Established in 2012 to facilitate commercialization, BioCubaFarma exports some 164 products from 65 centers. It operates 19 units abroad, as joint ventures or Cuba-owned entities.

Dr. Agustín Lage-Dávila, longtime head of the Center for Molecular Immunology, writes of “whole cycle institutions” that carry out research, product development, commercialization, and export, all under single management. Export income goes toward funding each institution’s activities and contributes to the national budget.

Exported products have included vaccines against meningitis B, hepatitis B, Hemophilus Influenza type B, Covid-19, lung cancer (CIMAvax-EGF), and many other infectious agents. Other products are: interferons, erythropoietin, streptokinase, Heberprot-P (used to treat diabetic foot ulcers), diagnostic test kits, and six non-vaccine treatment modalities for Covid-19.

Lage’s book on the origins, development, and upkeep of Cuba’s immense bio-scientific network was published in Cuba in 2013 and again in 2016. Monthly Review Press recently issued a translated version of the book’s second edition titled The Knowledge Economy and Socialism – Science and Society in Cuba. The various chapters represent articles that Lage, an immunologist, biochemist, cancer expert, had written for Cuban journals. An additional chapter consists of Lage’s responses to questions provoked by first edition of the book. The clarity and readability of the book’s English translation is a plus.

The book overflows with information, opinions, analyses, historical references, and optimism balanced by ample recognition of big problems. Lage explains that, after the Revolution, Cuba at once embarked upon developing human capabilities and initiating social advances. There was no waiting for available funding, as is the practice of most nations.

As a result, circumstances were in place for the building of what Lage calls a knowledge economy. It would feature the export of scientific products, these in place of the natural resources and the industrial base that Cuba lacks. Lage notes that biologic products have to be new and novel in order to sell.

Cuba’s bio-technical industries function “without sterile fragmentation …[and] within inter-institution borders … [K]nowledge is captured and incorporated into negotiable assets.” Cooperation, according to Lage, works better than competition. Elimination of institutional boundaries promotes integration of knowledge. The system favors autonomy over centralized decision-making; it features “layered” decision-making, “crosspollination,” and a shared sense of responsibility.

The contrast with capitalist modes of bio-technical production is striking, he suggests. There, funding rests on venture capitalism. Products and their value end up in private hands through patents, intellectual-property protection, and regulatory barriers. Planning is for the short-term. Scientific creation is divorced from ownership of the results.

Lage repeatedly returns to the necessity of overcoming a contradiction pointed out by Karl Marx, that of the social character of production and the private character of appropriation of both the product’s value and the means of production. He refers to the “private appropriation of accumulated science and knowledge,” and to the appropriation of people in the form of brain drain.

As a socialist country, Cuba defends social ownership of the means of production and the accumulated value of products. Socialism is a prerequisite, he suggests, for science to be propelling a nation’s economy.

Lage emphasizes the contribution of Cuban culture and notions of sovereignty in bolstering the project. Culture shows in ethical values, motivation, solidarity, and inclination toward unity. There is an “indissoluble link between sovereignty and socialism” through which “our daily tasks are part of a larger historical task.”

He adds that, “We are getting closer … to the knowledge economy …[and] approaching Marti’s ideal of ‘whole justice’ daily through every social program we successfully implement … Thus we construct not only the spiritual and material well-being of our people but also the defense of national sovereignty.”

Lage discusses the knowledge economy as it manifests at the local level, specifically in Yaguajay, near Sancti Spiritus, the municipality he represents in Cuba’s National Assembly. He cites a “municipal socioeconomic developmental strategy” that, enlisting nearby universities and research centers in “knowledge management,” has led to “qualitative changes” in healthcare, tourism development, computing, housing promotion and agriculture.

The “levers of socialism” are helpful, in particular: massive state investment in creating human capital, integration among institutions, linkages with social programs, exports connected to Cuba’s international agreements and solidarity programs, the capacity to innovate in managing institutions, and workers’ “political and social motivation.”

He recognizes risks. Time is one; “building a knowledge economy … is today’s task, not tomorrow’s.” Rich countries use “their accumulated economic advantages … to enlarge those advantages and erect new development barriers in poor countries.” He cites residual damage from the Special Period, old habits of “centralized business management,” brain drain, and pressures exerted “by the most powerful empire that has ever existed.”

As regards U.S. aggression: “They know … the potential of socialism. A country that makes its material wealth grow based on the education and spiritual wealth of its people and on the equity that derives from the social ownership of the means of production and distributive justice would be too clear evidence that the solutions to the problems facing humanity today are not on the path of capitalism nor in the subordination to the interests of the developed capitalist countries. Thus, they need to show that our system ‘does not work,’ hence the blockade.”

A cautionary note: a report from Columbia Law School in 2021, eight years after Lage’s book was first published, cites Cuban statistics showing “a drop of almost 40% in exports of chemical products and related products between 2015 and 2019 … [And] medicinal and pharmaceutical products make up around 90% of the total exports of chemical products.” It seems that income derived from bio-technology exports is down.

Agustín Lage Dávila, The Knowledge Economy and Socialism: Science and Society in Cuba, (Monthly Review Press, NY, 03/31/2024), www.monthlyreview.org, pp320, $29.00 (PB) Paperback ISBN: 978-1-68590-042-7

Mexico Leads in Opposing the Cuba Blockade and US Imperialism / by W.T. Whitney, Jr.

_{^{Photograph Source: Eneas De Troya – CC BY 2.0}}

Mexican president Andrés Manuel López Obrador (AMLO) visited Cuba on May 8-9. He began by highlighting regional unity as good for equal promotion of economic development for all states. AMLO addressed themes he had discussed previously when Cuban president visited Mexico City in 2021.

At that time AMLO, by virtue of Mexico serving as president pro tempore, presided over a summit meeting of the Community of Latin American and Caribbean states (CELAC). He proposed building “in the Western Hemisphere something similar to what was the economic community that gave rise to the current European Union.”

Two days later, AMLO included Diaz-Canel in a celebration of the 200^th anniversary of Mexican independence. Praising Cuba’s dignity in resisting U.S. aggression, he called for an end to the blockade.

Months later in Havana, on May 8, 2022, AMLO, speaking before Cuban leaders and others, recalled “times when the United States wanted to own the continent …. They were at their peak in annexations, deciding on independence wherever, creating new countries, freely associated states, protectorates, military bases, and … invasions.”

U.S. leaders, he declared, need to be convinced “that a new relationship among the peoples of America … is possible.” He called for “replacing the OAS with a truly autonomous organism.” CELAC presumably would be that alternative alliance. Formed in 2011, CELAC includes all Western Hemisphere nations except for the United States and Canada.

The United States in 1948 established the Organization of American States (OAS) for Cold War purposes. When the OAS expelled Cuba in 1962, only Mexico’s government opposed that action and later Mexico was one of two nations rejecting an OAS demand to break off diplomatic relations with Cuba.

AMLO predicted that “by 2051, China will exert domination over 64.8% of the world market and the United States only 25%, or even 10%.” He suggested that, “Washington, finding this unacceptable,” would be tempted “to resolve that disparity through force.”

AMLO rejected “growing competition and disunity that will inevitably lead to decline in all the Americas.” He called for “Integration with respect to sovereignties and forms of government and effective application of a treaty of economic-commercial development suiting everybody.” The “first step” would be for the United States “to lift its blockade of this sister nation.”

AMLO’s visit prompted agreements on practicalities. The two presidents determined that Cuba would supply Mexico with medications and vaccines – particularly Cuba’s anti-Covid-19 Abdala vaccine for children. Mexico’s government will send almost 200 Mexican youths to Cuba to study medicine; 500 Cuban physicians will go to Mexico to work in underserved areas. The two presidents signed a general agreement providing for expanded cooperation in other areas.

Before arriving in Cuba, AMLO had visited Guatemala, El Salvador, Honduras, and Belize. Along the way he reportedly complained that, “The United States may have awarded $40 billion in aid to Ukraine but doesn’t fulfill its promise of years ago of helping out Central America.”

The two presidents’ encounter in Havana raises the question of a long-term Mexican role in mobilizing collective resistance to U.S. domination and the U.S. blockade of Cuba. Mexico is well-positioned to lead that effort, what with strong economic and commercial connections with the United States. The United States, leaning on Mexico as an economic partner, may well be receptive to certain demands.

According to the White House-based Office of the U.S. Trade Representative, “Mexico is currently our largest goods trading partner with $614.5 billion in total (two way) goods trade during 2019.”

Beyond that, and in relation to Cuba, Mexico has its own revolutionary tradition and longstanding ties with Cuba. She is well-placed to lead a strong international campaign to undo the U.S. blockade.

In his major speech, AMLO cited support from Mexico in Cuba’s first War for Independence. He mentioned Cubans’ collaboration with Mexico’s much-admired president Benito Juárez and pointed out that Mexico in1956 hosted Cuban revolutionaries led by Fidel Castro as they prepared for their uprising against Batista. AMLO cited former Mexican President ,’s solidarity visit to Cuba in 1961 after the CIA -organized Bay of Pigs invasion. In token of cultural ties between the two peoples, Mexico was the guest of honor at Havana’s recently concluded International Book Fair.

José Martí warrants special attention. In exile, Martí lived, taught and wrote in Mexico City from 1875 to 1875. Afterwards he stayed connected with Mexican friends. Martí would later write admiringly about the liberal reforms of Indian-descended president Juarez, whom he regarded as the “impenetrable guardian of America.”

That “America” would be “Our America,” which became the title of a Martí essay with deep meaning for unity and for separation from the United States. “Our America” proclaimed that the culture and history of lands south of the Rio Bravo (Rio Grande) originated autonomously, quite apart from European and U.S. influences. The essay appeared first in January 1891, in two journals simultaneously. One was El Partido Liberal, published in Mexico, the other being a New York periodical.

Unity among Latin American and Caribbean nations appears to be precarious as the U.S. government prepares to host the 9^th Summit of the Americas in Los Angeles, on June 6-10. The Summit is an offshoot of the OAS which, according to its website, “serves as the technical secretariat of the Summits process.”

The United States has indicated that the leftist governments of Cuba, Venezuela, and Nicaragua won’t be receiving invitations. AMLO, speaking in Havana, reiterated his objection and once more stated that if nations are left out, he will not attend. Nor will the presidents of Bolivia and Honduras, Luis Arce and Xiomara Castro, respectively.

The presidents of several Caribbean nations will also be staying away. They point to the hypocrisy of U.S.-appointed Venezuelan president Juan Guaidó being invited, but not Cuban president Miguel Díaz-Canel. Unhappy with U.S. advice on transparency of elections and Russia-Brazil relations, Brazilian president Jair Bolsonaro will not attend.

The conclusion here is that the old system of regional alliances is unstable and that the timing may be right for renewed resistance to U.S domination and the blockade. Now would be the occasion for U.S. anti-imperialists and blockade opponents to align their strategizing and efforts with actions, trends, and flux in Latin America and the Caribbean. And, most certainly, they would be paying attention to actions and policies of Mexico’s government.

Martí had often corresponded with his Mexican friend Manuel Mercado. His letter of May 18, 1895, the day before he died in battle, stated that, “The Cuban war … has come to America in time to prevent Cuba’s annexation to the United States. … And Mexico, will it not find a wise, effective and immediate way of helping, in due time, its own defender?”

_{Counterpunch, May 19, 2022, https://www.counterpunch.org/}