FBIS-LAT-93-236 Daily Report 10 December 1993 CARIBBEAN Cuba

Castro Inaugurates Finlay Vaccine Plant FL1012005093 Havana Cuba Vision Network in Spanish 0235 GMT 7 Dec 93 FL1012005093 Havana Cuba Vision Network Spanish BFN [Speech by President Fidel Castro inaugurating the Carlos Finlay Institute vaccine plant during a ceremony held at the Convention Center in Havana on 3 December -- recorded] [Text] Distinguished prominent guests visiting us from the spheres of the world pharmaceutical industry and science, guests, and ladies and gentlemen, comrades: The same thing always happens to me! Perhaps I insist because I am a persevering person. I mean, I insist on not speaking. I don't know what for! How many times have I asked Maria de los Angeles to make the closing speech? How many times have I argued with the organizers of the ceremonies? But now I realize the only alternative left to me is to either attend or not attend! And really, what can I say here, where such estimable, capable comrades have spoken? What can I say about Finlay that his biographer, Dr. Lopez Sanchez, has not said? We have the privilege of being able to count on a man such as he, who has gone so deeply into Finlay's life, who knows Finlay's work and his life in such great detail! He talked about what Finlay's discovery has meant to mankind. One could say that sooner or later somebody would have discovered it. That happens in everything. But who could calculate the number of lives he saved by coming up with that theory when he did, and by making its application possible when the circumstances under which it was possible to do so arose? How many more years might mankind not have taken to discover this vector? And not just against yellow fever! The same theory served to find the vectors for other diseases, such as malaria. We should not forget that! I could ask you, Lopez Sanchez, if people already knew back then that the mosquito -- another mosquito -- was the vector for malaria? [response unintelligble] [Castro enters into dialog with Lopez] It was after Finlay. In what year? [Lopez] [Words indistinct] already back in 1902. [Castro] 1902. [Lopez] (?So), 20 years. [Castro] Had the influence of the Aedes Aegypti [mosquito] already been discovered? [Lopez] [Words indistinct] in 1903. [Words indistinct] he had solved the problem of transmission via vector. [Castro] You see? So, he had solved the problem in theory in 1881? [Lopez] In theory. [Castro] Those tests you said they carried out: When did they effect them? In what year? [Lopez] Well, he says [words indistinct]. [Castro, interrupting] But I mean the first ones, after he applied the [word indistinct]. [Lopez] (?Around) 1881. [Castro] In 1881, the first test of transmission? [Lopez] [Passage indistinct] [Castro] And did not the brave man who allowed himself to be stung by the mosquito get a prize? [laughter] [Lopez] Well, I don't think that.... [Castro, interrupting] You said here that he survived. All that was very interesting to us all. [Lopez] [Passage indistinct] [Castro] But I must say that, among our scientists, I have known many people who gave themselves a vaccine, so as to test it on themselves. Let us say that the Finlay group that worked on the anti-meningitis vaccine used it on themselves. They later tested it on relatives and all that. This was after having reached quite a high level of certainty, of course. I mean, you can see that anyone back then who lent himself for testing a theory regarding such a dangerous disease, and one for which there was no treatment, has great merit. And as you spoke, I was thinking that, from the moment the theory came into existence, the simple use of a mosquito net on people ill with the disease became an important preventive element. I also was remembering other diseases: dengue fever, for example. One must note that the influence of that theory touches even dengue fever. It was later learned that dengue too was transmitted by the same variety of mosquito. And we, here, had the hemorraghic dengue epidemic, and, well, [words indisinct]. We found ourselves deeply involved in a very serious struggle. And Finlay's theory and thought were present in this struggle. The battle was against the mosquito, in other words, against the carrier. For this, we used effective therapeutic methods. It was very important to know what needed to be done. We had over 300,000 cases of hemorraghic dengue. The treatment given reduced mortality to about 150 cases. That is a high figure, but I am convinced that under any other circumstance or in many countries of the world an epidemic like this one would have taken thousands of lives. In other words, we can say that the therapeutic method and the treatment given to the sick reduced mortality to a minimum. The struggle against the carrier was the key to eradicating the sickness. In the final phase of the treatment the patients were hospitalized to avoid contact with the mosquito. If you know the carrier the struggle becomes more practical and feasible. We continued like that until no more cases of hemorrhagic dengue were reported. Since then our struggle has been to keep the carrier at the lowest level possible. It is very sad to know that Finlay's merits have been questioned. It is not chauvinism on our part, but the authorship of his discovery and his theories have been completely established. I recently read that for many years he had been considered for the Nobel Prize, but due to the opposition of certain interests he was never given that Nobel Prize. Therefore, even in this Finlay was unjustly treated. To this day....[pauses] Just recently, a book was written in Europe challenging Finlay's merits. This was just recently, that is why we must continue struggling. We believe this with a very deep conviction. We recognize his merits just as many do throughout the world, including Latin America. That is why we have summoned you here and have used the date of his birth to commemorate Latin American Medicine Day. I do not know if all Latin American countries celebrate this date, but I do know that there are some that celebrate Medicine Day on this date. [Castro questions Dr. Lopez Sanchez] Is this date universal? No? [Lopez] There are doctors that take advantage of the date to celebrate Latin American Medicine Day, but it is not celebrated in all places. [Castro] It is not celebrated in all places. Is it celebrated in some countries? [Lopez] In Latin America. [Castro] In some Latin American countries. What do they celebrate, the day of Latin American Medicine Day or Medicine Day? [Lopez] They celebrate Medicine Day or Doctors Day. [Castro] Doctors Day. Was this after Finlay's birth date or is this just a coincidence. [Lopez] It was after his birth. [Castro] Finlay is highly recognized in Latin America. Has your book been published over there or have we lacked the means? You should have gotten together with a publicity transnational to bring your book... [Lopez, interrupting] The book is in the hands of all doctors here in Cuba. [Castro] Yes, but it is not in the hands of the rest of the doctors. [Lopez] That does not depend on me. [Castro] What did it depend on: the publisher, paper? [Lopez] The publisher. [Castro] Maybe something else can be done to distribute your book in the rest of the world. It is needed because accusations are still being written. Just today, I was told by Rosa Elena [Rosa Elena Simeon, president of Cuban Academy of Sciences] that you had conducted an excellent conference defending the authorship....[pauses] You said it would be controversial when I said: Use some of those arguments today. Lopez pointed out: We have foreign visitors with us and I do not want to touch on a controversial subject. This is probably as wise as Finlay's discovery. Another thing I cannot talk about is what the medical developments in Cuba since the triumph the Revolution have represented because Comrade Teja [Public Health Minister Julio Teja] eloquently spoke of this. He gave us some figures that are significant and which could be analyzed. He pointed out that the infant mortality rate has reached 9.4 for every 1,000 live births. This is something that we could not even imagine in the current circumstances of the special period. We struggled to maintain the level we had reached. We struggled to keep it from increasing, not making the rate go below 10, which was one of our goals under normal conditions. You must keep in mind that all these programs were designed during normal periods. The list of all these programs which Teja spoke of, he detailed each one of them, is very long. I believe there were more than 50 programs associated with medicine that were developed and implemented in the last 10 or 12 years: from pediatric cardiovascular surgery to prenatal genetics program, many of these vaccination programs, the development of specialties, intensive pediatric therapy, and intensive prenatal care. Why is it called prenatal? [Lopez] It is perinatal. [Castro] Oh, perinatal. Because prenatal is before birth, right? Then it is perinatal, which means the time around the birth. This intensive care has saved many lives. These programs as a whole have made the reduction of the infant mortality rate possible. Just look at the results of a job so well done that even under such difficult conditions they can continue advancing and progressing. The family doctor is also associated with these achievements. That is another one of these programs, of the approximately 50 programs or measures. The family doctor also is a complete program. The development of specialities also is a complete program. We can say that we have been applying many programs in health care matters to be able to obtain these results. However, when he [Teja] said: 51,000 doctors, I must confess that I also was amazed, as if I had never heard the number of doctors we have. It is something that is frequently mentioned. I frequently talk about it, too, but time has betrayed me. I lost track that in August another.....[pauses] How many graduated? 4,600. This totals 51,000 doctors. The health accomplishments Teja spoke of have to be seen in relation to the presence of the personnel and their abilities. This could be better appreciated if we remember that at the beginning of the Revolution there were 6,000 doctors, and that many were unemployed, and that 3,000 left the country. We were left with 3,000 doctors. Now we have almost 17 doctors for every one we were left with. There are thousands in the medical schools. We have medical schools in the provinces. This was another program. Is it a program or a measure, that of having medicine schools in every province? There are several in Havana. This is why we have about 20 or 21 medical schools. Right now, we are using these schools primarily to train nurses. We have had to reduce the number of new students. However, about 2,500 new students register each year. We have been reducing the number. At a certain point, twice that many were registering. So far, we have not had an excess of doctors. The problem with doctors is that no one can make them retire. A division or army general, or whatever, can be retired but not a doctor. Doctors never retire. This is good of them. Right? You have not retired and that is good. [Castro addresses Lopez] And do not even think about stopping your studies on Finlay, because you would be relinquishing your most sacred duty. All these efforts have been conducive to creating this situation. When Teja spoke about hospitals and large hospital complexes, he mentioned the Hermanos Ameijeiras Clinical Surgical Hospital. Originally, the Hermanos Ameijeiras Hospital was going to be a bank -- I believe a central bank. The facility was completed at the triumph of the Revolution. Later, it underwent a fire. Afterwards, it sat there for years waiting to be rebuilt into a bank or perhaps waiting for money to become a bank. The fact is that we changed the project and turned the building, which already had several stories, into a hospital. Of course, we had to change many things. I thought about it and asked myself: Did we do this right? What should be built first, a bank or a hospital? The fact is that we built the hospital and have yet to build the bank. Banks are, of course, needed. Is it not so Benavides [not further identified]? Banks are needed because money is needed for all these projects. What we have truly done is to....[pauses] We have plenty of money, but in Cuban pesos. We have very little hard currency. However, we have managed to get along with the little we have to maintain these projects, like the special period, for example. I would say that the most extraordinary thing the health minister mentioned is that we attained and have maintained these results in these times. This is what is truly admirable. We could even say having achieved this is miraculous. I also cannot talk, although I am talking, about the significance of this new plant being inaugurated today. I can only say that I was facing a contradiction. I was told that plant No. 3 is being inaugurated, that is the name of that plant of the Finlay Institute. It has the capacity to produce 100 million doses of vaccine per year. I asked where is the inauguration going to take place. They told me: at the Convention Center. I asked myself how is this possible. I have never seen anything like it. They told me: It is impossible to inaugurate it there because of the gardens, what it would entail, and the visitors we have, so that they could be comfortable. I said: Fine, it is impossible inaugurating it there. However: Is it possible to inaugurate it in a convention hall? But it seems it is possible to do so. This is what we are doing so far. What we need is a little bit of imagination. We need to use our imagination and imagine the plant as we speak about it, or imagining how the plant might look. Likewise, we also wanted to imagine what the (Merie) [not further identified] plants might look like. Their founder is here: [Name indistinct] [applause] When we discussed the idea of building this and other plants, we asked ourselves what might the (Merie) plants look like. We saw pamphlets or publicity that the plants undoubtedly look very modern. It makes a great impression. We had to consult the literature and our experience because plant No. 3 is the grandchild of plant No. 1. At plant No. 1 the practical problems of the production of the vaccine were solved once the vaccine was developed and tested. We still needed to produce it. The ideas used in plant No. 1 were very useful when it came time to design plant No. 3. I believe it is fair to praise our scientists, a group from the Finlay, [two indistinct names], and others, our designers, our draftsmen, and engineers who were capable of giving shape to the idea of plant No. 3. -- the production flow, the equipment. When one visits the completed plant now, we see that it is a truly complex project of great quality. It requires, above all, great quality and has been built with great quality. Of course, there we see the processes -- I am not reveling any secrets, the culture and fermentation areas, the main areas, the purification and the aseptic area -- as Conchita [Concepcion Campa, Politburo member and director general of the Finlay Research Institute] called it. I heard her use that word here. There also are the finishing and packing areas, the most complex. We can perfectly see how it was designed with great logic and rationality -- as far as I know. I am not an expert on this. I am repeating what Diaz [not further identified] said, that the plant was very good, very well designed. It seemed very rational to me. I have great confidence in the plant's production capabilities, the quality of its production on the basis that it is the third one. As Conchita mentioned, this idea came about not following the commercial criteria Maria de los Angeles [Politburo member Maria de los Angeles Garcia] spoke of. She frankly acknowledged that the plant also has significant economic aspects. Our concern, when work began to produce a vaccine against meningococcal meningitis type b, was due to an epidemic we were experiencing. It was frustrating to see more than 1,000 cases every year and a high mortality rate, and great fear among family members that their children might contract it. We not only have to measure the direct damaged caused by an epidemic or an illness on the people affected or their relatives, but also the fear, the anxiety it provokes in millions of people. A vaccine such as this one prevents another illness, agony, in millions of people and helps them. This is the value of these vaccines, as well as that of all vaccines developed, and the ones being developed. We have truly ambitious plans in this regard. I believe the figures Conchita presented justify it: Millions of children are still dying, while vaccines are available, from illnesses that are predictable or preventable. She [Campa] used the word preventable. We ought to consult a good writer to tell us what word we should use. She [Campa] said there are 2.1 billion or 8 million illnesses for which there are no vaccines [as heard]; there might a treatment, of course, but no prevention. The figure of 900 million children who become ill is impressive. I believe that this gives an idea of the importance of the work in the field of vaccines. I remember, however, that a fairly well known writer, many of you might have read or heard of him, perhaps not so much the younger generations, [George] Bernard Shaw was a sworn enemy of vaccines. I read him as a student but did not internalize his prejudices on vaccines. He said that vaccines were a poison, a toxin being injected into people, etc. I believe that, objectively, that view is not sustainable. Vaccines have saved literally millions and millions of people. We should not forget that currently the human population....[pauses] UNICEF presented me with a watch which records the projected growth of the population of Cuba and the world. I believe that yesterday it read: 5.541 billion people. Can this vary? Well, it does. Every minute there is another mass of people on earth. This piece of equipment is small; it is like a watch. It is programed to show this information. Without vaccines the immense drops in infant mortality would not have been attained. Of course, this is not the result of the vaccines alone. There are treatments, but vaccines have been decisive because Third World countries in general do not have many medical options. However, they have the option of vaccines. The immense demographic growth we are experiencing, the increment of almost 100 million people a year, is closely tied to the development of vaccines. Now: Are vaccines also going to be blamed for hunger in the world? Conchita, one of these days you and the Finlay are going to be partially blamed for solving the problem of how to preserve children's lives but not the problem of how to feed them. This is the great tragedy of our times. However, I do not want to discuss this further because I already said that I had nothing to add following everything you said. [chuckling] I repeat: I had nothing to say following Maria de los Angeles address on historic aspects and strategies, and all those issues that resulted in our health program. I believe that Maria de los Angeles spoke in political terms. She explained it politically and historically. This is not forbidden. Right? I believe history has spoken here twice: spoken through the mouths of Lopez Sanchez and Maria de los Angeles. He told us the history of Finlay, and she gave us the history of medicine in the Revolution. Teja spoke of the processes and Conchita of the vaccine and the plant. I repeat that everyone has been remembered: Finlay, the doctors -- today is Doctors Day, all have been warmly congratulated. I join these congratulations wholeheartedly. Scientists were also congratulated, as well as the workers who built this center. They inaugurate it....[pauses] Well, they do not inaugurate it. The center is being inaugurated today. Tomorrow they observe Construction Workers Day in the vicinity of the plant, in a street parallel to the plant. The efforts of many people have been required. We also cannot forget the draftsmen, engineers, and technical personnel, those who worked in the acquisition of the equipment in order that it was of the best quality, and they had to overcome many obstacles. You must realize that we have to overcome things in the midst of the blockade. I believe that in this area we are progressing well. I believe that we have been accumulating a great potential in terms of vaccines. We are working on several vaccines. We have not mentioned that we also are trying to make some contribution in finding a vaccine for the Acquired Immune Deficiency Syndrome [AIDS], one of the most terrifying plagues being experienced. It is a growing threat, a threat that grows day to day to the point that data on the situation in certain parts of the world is mindboggling: The fact that there are countries where 30 percent of the population is infected by the Human Immune Deficiency Virus. Imagine a country with 30 percent of the population infected! The importance of treatment as well as prevention of this illness! All measures adopted so far have yielded marginal results. Its spread has not been checked. We adopted unique measures, feasible in Cuba because we began fighting AIDS when the number of cases was still very small. We are perhaps the country in the world where the AIDS epidemic has spread the least, the country in the world where it has spread the least. We have acquired an important body of experience which is being better understood daily, but which is not possible to implement when the spread is massive. Yes, Lopez Sanchez. We have had to use certain traditional methods, certain forms of quarantines together with specialized care -- not a total quarantine or anything like that, it is a flexible quarrantine. This is a system we are still improving but despite this, AIDS cases are growing in Cuba; despite this, it grows. At least we have been able to keep it at reasonably low levels. We also are working on an AIDS vaccine. We also are working on vaccines against parasites. This is very important. I believe this is one of the most important challenges for the medical sciences. We also are working against Hemophilous meningitis, meningococcal meningitis caused by the Hemophilus bacteria. We plan to combine the vaccine for meningococcal meningitis type B and for meningococcal meningitis caused by Hemophilus into one vaccine. [as heard] This is one of the options of the Finlay Institute. In this field we are making progress. We are making progress in many other fields of health research, science, biotechnolgy, and the pharmaceutical industry. We did not mention here another institute we just finished: the Ozone Institute. It works on ozone research. It has proven it can solve very important problems. The Molecular Immunology Center is well into its construction for the development and production of monoclonal antibodies. Perhaps, we did not mention the concept that in this development science and production go hand in hand. The factories are built next to the research center or annexed to it. First we build the research center and then the factory. This helps us to maintain constant and systematic ties between research and development. This is an idea we have tested and that we are implementing at the highest possible number of research centers with very good results. To these tasks we have dedicated efforts and resources. Like medicine, they have not been left unattended in the special period because in addition to the benefits in human terms that this represents for our health and perhaps the rest of the world, it carries the promise of economic rewards for Cuba which we truly need. This field will probably become in the future one of the most important economic fields of Cuba. What else can I say. Conchita thanked all of you. I thank our guests, particularly our foreign guest and also Cuban guests, because some may have had to get here on bicycles or overcame great transportation difficulties. I want to express our admiration for what (Merie) did. We hope to become partners and not competitors. His presence at the inauguration of this plant reflects his great love for medicine and vaccines. He was very busy in his country and Europe and yet he set aside a day to travel to this side of the Atlantic, arrived here at noon and returns tomorrow at 0600. We have to truly thank and admire gestures such as this. We have to thank and admire the gesture of everyone who traveled significant distances. I also want to mention the Argentine guests because they are as distant in terms of flight hours as the French. Mexicans are a little bit closer but this does not mean we appreciate their presence less. [pause] They are also closer in our hearts. This does not mean the others are not close to our hearts because I would become very unpopular and spoil Maria de los Angeles' entire effort. All are close to our hearts, although we have to stress that Mexicans are historically very close. Without further ado, I want to thank you for having shared Medicine Day with us, the success of our researchers, the feat of our builders, and to tell you that we will always be willing to work and cooperate with you. We will always think of you. We will always keep the memory of this day and meeting. Thank you very much. [applause]