Latin American Network Information Center - LANIC
FBIS-LAT-94-141 Daily Report 17 Jul 1994 CARIBBEAN Cuba

Castro Addresses Neuropathy Workshop

FL2107002294 Havana Cuba Vision Network in Spanish 2257 GMT 17 Jul 94 FL2107002294 Havana Cuba Vision Network Spanish BFN [Address by President Fidel Castro at the closing session of the International Neuropathy Epidemic Workshop at the Convention Center in Havana on 15 July; monitored in progress -- recorded]

[Text] conclude with the outstanding address by our minister -- brief, to the point, precise, and heartfelt. However, I bend to duty and fulfill this request since the least I can do is to truly express recognition of and gratitude for your efforts during these past days and we could add, your year-long efforts.

I had the opportunity for close follow-up in the beginning and during the development of this monster that in the end was christened epidemic neuritis. This monster has had two names. In the beginning it was called epidemic neuritis when diverse types of cases were noticed, and in the end it was going to get a second name. Finally, I convinced the comrades from the task force not to change the name anymore since there was enough confusion already and people would lose trust in us if we came up with a third name for this epidemic.

The initial theory, as first reported by the media, was the toxic nutrition theory. This was the result of the first analyses conducted. It was very tentative. It explained the possible causes and was accompanied by a strong campaign against smoking and alcohol. We were very concerned at the time by the fact that many people were manufacturing liquor at home and would use anything to do this.

Truly, there was a great lack of knowledge. We confronted this monster without information of any kind. We researched the bibliography. Although I am not a doctor, which is something I truly regret, I read books, requested reading material, and found myself in the same situation as my comrades: I could find no precedence to this epidemic. There was reference to a somewhat similar case in Japan. Later on, a specific medicine was blamed. It was said that the epidemic would stop once that product was off the market. Numerous syndromes, which I do not care to list, were mentioned, including what happened in Jamaica or during World War II, as well as all their various characteristics.

However, we noticed that our case was unlike any other. We began to seriously worry, first of all, about the scope of the epidemic. It had surpassed every level known to date. Japan had a few hundred cases, 8,000 or 10,000 cases at most. The number of cases of this epidemic was surpassing the numbers anywhere else. We were seriously worried because the toxic nutrition theory did not explain why Cuba alone was experiencing this epidemic since we were aware that there are many countries with a much more dire, even truly critical, extreme nutritional situation. We were wondering: If nutritional problems are the main cause of this epidemic, the Third World will end up disappearing, in addition to a good part of the developed world because there are many cases of people who smoke, drink too much, and do not eat right.

Yesterday, we listened to Dr. Borrajeros [not further identified], who stated that there are people who eat well, but do not get the right nutrients. Therefore, millions of people in the world would fall prey to epidemic neuritis. If our problem really was an abrupt decline in nutritional levels, there are countless cases in the world, in temperate and cold climates as well as in the tropics, of abrupt drops in nutritional levels. We wondered: Why is this happening here? Is this a new disease? If it is truly a new disease, then this is a problem of interest not only to Cuba, but to the entire world. I do not know if in the end we are going to discover a Cuban-specific gene that makes us susceptible to this illness. No foreigner in Cuba has developed the illness. There are thousands of foreign students on the Isle of Youth, and so far as I know, there are no cases among them. All this was very strange. We analyzed every case: Which group had the most cases? Which had the least? Were there groups with good nutritional levels and yet an increased number of cases? I mentioned earlier the thesis about people who eat well but do not get the right nutrients.

I say this because we faced many unanswered questions. The literature worldwide said that the treatment was vitamin-based and that that was the traditional and known method for this type of neurological, and other such illnesses caused by nutritional deficits.

That is what we did. It became necessary to obtain large amounts of vitamins to treat the patients because this epidemic mushroomed suddenly, and it became necessary to find solutions in terms of medicines in a matter of hours, of days.

Yesterday, I told you some of the anecdotes, things that happened, and about doctors who began using their own medication in certain parts of the country. It was not easy to come and simply give an order after the entire medical establishment of a province had reached a specific conclusion on treatment. They were fully convinced of their diagnosis and the treatment to follow.

Anyhow, the vitamin treatment was used from the beginning, as well as other medicines recommended for similar situations. Vitamins were the core from the beginning. It was the only thing we had. However, since diverse neurological problems had responded to diverse treatments, a series of protocols were put together. Even interferon was used after the first indicatons of the viral nature of the illness appeared. Intaglobin was also used. This product which we are producing in Cuba, is fairly efficient in fighting certain infections. We used ozone. We used magnetic therapy. The list of clinical protocols goes on. Of course, we used the most recommended treatment in every case, vitamins. That is why all these protocols were created on the basis of vitamins.

We followed, almost day to day, the results of these protocols. Five days into treatment, the information was analyzed for each. The protocols were conducted at different hospitals. Results were studied on day seven and day 14 in order to note improvements, if any, and find which protocol was most effective.

We can say that this epidemic became a veritable nightmare. It had to be when we saw the daily reports and cases piling by the hundreds, 200's, 300's. If memory serves me right, one day there were approximately 800 reported cases. It was logical for us to be concerned since this was a problem that affected eyesight and the central nervous system. There were also symptoms of deafness, ataxia, and all kinds of phenomena. We wondered where it would all end.

Of course, there was a moment when there was a great leap in the number of cases as a result of the active search for cases, and when every family doctor -- we did not have as many then, but each year we add between 3,000 and 4,000 family doctors -- began actively searching for affected people. This was done because one of the things discovered right away was the importance of early diagnosis. This is why we launched a program to seek out cases and, of course, overdiagnosis took place. It was unavoidable. Doctors were not that experienced.

In optical terms particularly, we had more specific elements to ensure precise diagnoses. Peripheral eyesight symptoms were very generic and all kinds of symptoms and false diagnoses took place. It became necessary to inform every doctor about progress made, and to find resources of every type in order to make the right diagnosis.

We had previously tackled other diseases. We have had all kinds of diseases -- diseases that affect plants, and more than once, we experienced diseases affecting livestock. There have been those who have internationally admitted that certain diseases have been introduced to Cuba, such as African porcine fever. We have had to tackle certain human diseases as well. One of the worst was dengue, which was also extensive in scope. Dengue resulted in 152 deaths, mainly children. At one point, it affected over 300,00 people. I remember that there were 11,000 reported cases in one day. That was the record day. It forced us to wage a great battle against the carrier, the infamous Aedes Aegypti. We had to engage in a nationwide door-to-door mosquito hunt. Fortunately, it was a domestic type that can grow in bottles or containers, or any small puddle. We had to find products to halt its reproductive cycle, fumigation, and all that. It was a great effort but it was known that if we managed to reduce the mosquito population, we would overcome the illness. There was a moment when we practically hospitalized every dengue patient, and keep all areas mosquito-free. The Aedes Aegypti was almost eliminated in Cuba. Yet, dengue was a cruel, dangerous illness. Some think that if we had not taken those measures, the deaths would have been in the thousands. We used interferon successfully. Coincidentally, our laboratories were already producing interferon at that time.

It was a difficult disease. However, no disease or epidemic was as difficult as this one, as cruel as this one, not because it caused fatalities, but because it made people useless by affecting their eyesight and movement.

We can state that this is the cruelest of all the epidemics we have confronted. There was very little written about it. We had no experience. We had to improvise everything on the go to confront this epidemic and its aftermath. It hurt us a great deal to acknowledge that there was a percentage of cases that did not fully recover, or were severe. In other words, we are still suffering from what happened.

We believe it was correct to request international cooperation from the very beginning. There were two reasons for that: First, we could not rely on our knowledge and experience alone, and on our scientific centers; Secondly, we believed this would be of interest to the entire international community. That is why we opened the doors to our country and invited, through the World Health Organization and the Pan-American Health Organization, all the countries that wished to cooperate with us in the investigation of the sickness.

We also discovered that we had many weak spots. In general, we felt satisfied with our research centers and with the scientific accomplishments that Cuba had made, but we realized that we were not as strong in some areas. We realized that in the branch of toxicology, we were weak. We discovered that there were gaps in our knowledge of epidemiology. We realized that we were weak and inexperienced with regard to our laboratories' analyses of determined elements, vitamins, and microelements. We did not have all the technology and equipment necessary. The epidemic was a lesson to us and we were able to discover our weak spots in the field of research.

In that way, we developed open cooperation with the entire world, with all the research centers that were interested. We have provided them with all the information. As you have been able to see, we have not held back a single piece of information or detail on the situation we had regarding nutrition and other aspects, or our levels of determined vitamins in the blood, even though we did not have an historic series that would allow us to make a comparison.

I should add that we were unable to make an analysis after we began supplying vitamins -- because the vitamin supplement was given to the population immediately. In the provinces where we had not yet begun supplying the vitamin, we collected blood samples, more than 1,000 blood samples for later examination, which was not easy because of what I mentioned before: the lack of all the necessary equipment and experience to determine the levels of vitamins that the population had in their blood.

We were able to use some data from tests that the haematology institute had carried out for other purposes a long time ago. That is why there are some facts that we do not have -- because we were [chuckles] not going to do blood tests after distributing the vitamins. That was a matter of days and weeks. When the decision was made to take this preventive measure, we had to obtain the components, bring them by plane, put some plants into operation around the clock, mobilize the entire country to begin distributing the vitamin, the only resource we had at that moment as a preventive measure.

It was truly an enormous effort, but it is my belief, as a witness to this entire process, that regardless of the causes, the vitamins played an important role. At this moment, we must say that the vitamins played a very important role in the therapy. We discovered that in milder cases they recovered more quickly, but all types of cases responded to the treatment: mild, moderate, and severe cases. Therefore, the vitamin became the preferred treatment regardless of the cause. This could be seen by all.

As I was saying, it was the only solution we had. There are other remedies if you apply the toxic-nutrition thesis. If we only had the Argentine Pampas, and the hundreds of thousands of heads of cattle and other animals, much of which is sometimes wasted, then we would have been able to take the preventive measure of improving the population's nutrition as a primary step. That is easy to say, but it was not a resource we had at hand.

I should add that the food programs were prioritized programs of the Revolution before the epidemic and way before the special period. You cannot imagine the number of poultry farms we were building to increase an egg production that was already pretty high; the hundreds of new dairy farms we were building to increase milk consumption, which was already high, in addition to the milk that was imported. The hundreds of pork farms that we were building in addition to those we already with already relatively high production. This was all before the special period and before any epidemic.

It was a rational program to improve the population's nutrition, which was already pretty good. It was also quite good in the sense that it was well distributed. Everyone received food. When we said 3,000 calories per capita, it was 3,000 calories for all our citizens, as a norm. When we said 70, 75, or 80 grams of animal and vegetable protein, most of which was animal protein, it was 70 to 80 grams that the entire population received, not including what the peasant population consumed. We were trying to increase all this.

When the special period began, for the reasons already explained here, the food program continued to be the most important program. It was prioritized by the country. Many were the efforts made in food production. But we used to import millions of tons of grains, for human consumption as well as for animal consumption. We used to import millions of tons of fertilizer. We used to consume close to 14 million tons of fuel. We were developing the irrigation projects just as the factors that instituted the special period appeared.

Food production, among other things, requires fuel to prepare the vast caballerias of soil in a climate such as ours. During the rainy season, the soil cannot be properly prepared. Because of our climate, our soil is hard. Our soil is not the soft soil that they have in Europe. It is like cement. One cannot use just any steel. One must use special steel on the equipment to prepare the soil.

The available fuel was reduced to 40 percent of that received in the past. Cuba was left without feed for its poultry, pork, cattle, and dairy farms, for the production milk and for the nutrition of the animals themselves.

Our climate is not the mild climate where beans, a good source of protein, grow easily. Here the most common legume is a weed: the marabu. The cattle will not eat it. It becomes an obstacle [chuckles] to our agriculture.

We do not have the climate of the Netherlands or France, of Europe or the United States, where one can obtain 15, 16, or 17 liters of milk per cow by feeding them legumes instead of grain. We were left with pulse, nonfertilized pulse. We have been able to produce some cultivated crops, such as lettuce and alfalfa, up to 28 liters of milk per cow and the cow would gain weight. We do not have such advantages for milk production. But without fuel, fertilizers, feed, and left as we were in an almost abrupt way, immediate, voluminous food production is very difficult.

We have taken many other measures. Every piece of land available has been offered to the population to create gardens. They have set up gardens and organic gardens in the city. All this has been done for that pupose.

I wanted to add that we are aware that the first thing we need to do is improve nutritional conditions. We have made extraordinary efforts in that sense. Also in the production of fish. Nowadays, it is not easy. We used to have fleets that would fish in open seas. Nowadays it is very difficult to fish in open seas. We even backed the extension of the 200 miles even though it was not in our country's best interests. But it was good for many Third World countries.

Today it is not easy to send the fleet to fish within 200 miles of any country. The obstacles are great. But we have made an effort to increase the production of freshwater fish in all the country's dams and reservoirs.

That is the real, objective situation. Food must be brought from thousands of kms away. Transportation is much more expensive. In addition to this, to purchase food one must have resources and foreign exchange, at least in the amounts that we need. We have had to seek new markets for our products. We do not have international organizations that give us credit and facilities. We are excluded from all that. The deals that Cuba tries to make in the economic sphere are constantly being sabotaged in an attempt to make Cuba's economic life more difficult, as a strategy get us to surrender through starvation, sickness, or any other means. If hunger can initiate illness, then it is truly a cruel attempt to bend our people.

I do not want to talk about this, but I believe it is important that I explain this to you. I feel it is my duty to explain that when we talk about preventive measures, we are not forgetting the fact that we need to improve the nutritional conditions of the population. We are working toward that and we are facing enormous obstacles. That is why we were open to the possiblity of giving a dosage of vitamins to the entire population, and we have followed the path of finding sources of calcium and supplying the population with these products under these circumstances.

We have had good development in the pharmaceutical industry. We are obtaining elements needed [words indistinct] and pay for it. We had no other resources and that is why we insisted that this vitamin dose needed to be improved and supplemented.

We have noticed that the issue of vitamins does not pertain to Third World countries only. It was mentioned here, and this morning I was given a packet that contains who knows what. I believe it even has selenium in small amounts. As someone said yesterday, there could be problems if one were to consume larger quantities of some of these elements. It had carotene and beta-carotene and I do not know if it includes... What is it called? [Unidentified person says: Lecithin] I do not know if it includes lecithin or something that produces lecithin.

These vitamins are from Sweden. As far as I know there, is no special period in Sweden. There is no toxic-nutrition phenomenon in Sweden. There is no neuropathy in that country, yet they are selling large bottles of vitamin and mineral supplements. They use it as a measure to prevent health problems such as heart attcks, cancer, or to reach the potential 120 years that many say man can live.

Therefore, the very rich and developed countries are also seeking vitamin supplements.

Linus Pauling said that we are lacking three or four grams of Vitamin C. Three or four grams. I do not know if even Japan, Sweden, or Switzerland could purchase it because as many know, Vitamin C is not cheap. Of course, it can be obtained from citrus fruits, guavas, and fruits in the quantities considered necessary. But for a super quantity of vitamins, like three or four grams, one cannot imagine the production costs for even a developed country.

We have raw material such as sugar to produce Vitamin C, and we tried to purchase very expensive plants, very complex technology, and monopolized technology. Therefore, any country that wants to produce Vitamin C will find out that those who control and monopolize the technology will not sell it or supply it. Furthermore, this equipment is very expensive. The world has many other problems but we in this workshop cannot get involved in all of the world's problems.

But I will say that vitamins are relatively inexpensive. We have been seeking a source of calcium, which we consider essential. A comrade from Matanzas Province spoke of spirulina. We have been developing spirulina for some time now. Spirulina contains Vitamin B-12 and the carotenes. Many have said that it is much older than mankind. I once read that Spirulina has existed for more than 3 or 4 billion years. I believe it was one of the first life forms that existed on earth. It is very good. It is rich in protein; it has approximately 70 percent protein, but there are production costs. Its costs involve electricity and fuel. One would have to construct important installations. We are now building some of them, but it will not be enough to provide spirulina to 11 million people.

If we were to make a cost analysis, we would see that Vitamin B- 12, a vitamin of the B-complex, costs 100 times more than it would cost to provide that same vitamin through spirulina. Spirulina is even good as a business venture because nowadays there is a tendency to consume all these types of products. This is within our reach. We will give everything within our reach, apart from the efforts in agriculture and everything we are doing with the self-sufficiency program.

The self-sufficiency program is a prioritized program throughout the country. More than 400,000 hectares... [pauses] No, not 400,000 -- approximately 4 million hectares of state land has been placed in the hands of work collectives as owners of the production [words indistinct] so they produce not only the commercial crops, which we cannot stop producing, products for exportation, but the products for self sufficiency and consumption by the population.

I believe it is my duty to explain this to you so that there is no doubt as to our awareness of those things that should be prioritized.

Someone mentioned that we are following up on each case. That was one of the first things that we decided. One of the most basic and humane things we could do was to follow up on all these cases. We cannot imagine a single citizen, who had the epidemic and has not yet recovered, being forgotten and abandoned to their own luck. We have not given up, nor will we ever give up.

One way or another, we will overcome. We even worked on development of the nerve growth rate [factor de crecimiento nervioso]. In the future, some possibilities may evolve from this technique. The Center for Genetic Engineering has been working on this for approximately three years because of the influence it could have in the transplanting of nerves. We cannot lose hope that these nerves will recover a portion of their functions, or that medicines might possibly work miracles. If we have to wait for miracles, then we will even wait for a miracle before we give up hope of these citizens recovering all their faculties.

We will not give up that struggle. We do not just follow up on those who have had the epidemic. Our Ministry of Public Health monitors all patients who require special care -- from those who have received kidney transplants, who are many, to those who have received heart transplants, or have any other disease.

Just a few days ago, a Cuban institute donated $50,000 of what they had obtained through the sale of plants. They had the right to keep part of the proceeds, but instead, they donated $50,000. The workers got together and agreed to make the donation. I asked myself what will we could do with that $50,000. Every so often, we receive donations and turn these funds over to the Ministry of Public Health. I asked the minister of public health: How can we invest this $50,000 that these workers have donated? He said: In the purchase of lengthy insulin [insulina de consumo lento] because we have a number of citizens who need this type of insulin, and at the moment, we are short on supplies.

All our heart and diabetes cases and all the cases of sickness that requires follow-up are monitored. Not only patients with neuritis are monitored. All citizens who require follow-up are monitored.

Fortunately, we have an abundant, well-trained human resource. They are well trained and have great compassion and a spirit of solidarity with other people. We already have 50,000 doctors. We must not forget that with the triumph of the Revolution, only 3,000 of the 6,000 doctors who there here, stayed. There was a policy of leaving us without doctors. We were left with only 3,000. Today we have at least 17 doctors for every doctor who stayed behind, and our universities continue to graduate thousands of doctors each year.

We would rather have a reserve that even allows other doctors to study and to give doctors who want to emigrate the freedom to do so. Approximately 2,500 students register every year; 6,000 have registered at a given moment. We have the country covered with family doctors who work in the communities, schools, daycare centers, and factories. In other words, we have numerous human resources. I believe one day we will truly marvel at the fact that, amid a special period and this epidemic of hallucinations, the country was able to lower the infant mortality rate to less than 10, despite all these problems. How was it possible that the infant mortality rate was lowered to nine-odd? I believe we are now among the top 20 countries regarding infant mortality rates. Some industrialized countries do not have that parameter of infant mortality.

Despite our limitations and needs, which I have explained, and many other needs... [pauses] we not only need food, we also need clothing, soap, and cleaning products. We need fuel for our potable water and sewage treatment plants, we need fuel to keep the cities clean, we need fuel for everything. If our battle was only against the neuritis epidemic -- but we must wage 100 simultaneous battles. We are not discouraged by this. We wage a battle on 100 different fronts, and achieve success in many of them. Not a single school or schoolroom has been closed in our country; not a single hospital or polyclinic has been closed. There are more family doctors every year. We manage the best we can to distribute what we have, but no one knows how many things have been protected amid the most incredibly difficult conditions.

Since you made me come here, I feel free to explain some of these things. They are known by the comrades in our country, but perhaps they are not known by those who come as guests. That is the overall social framework in which we wage this struggle. I can add that our research centers have continued to develop their activities and they have priority status. Our research centers... [pauses] there are new research centers. They will begin to operate this year. We will not abandon research. We have had to use science in everything -- even fer... [pauses] ferli... [pauses] feri... [pauses] ah, to fertilize. We have researched bacteria that helps add nitrogen or other elements to the soil, varieties of plants that are drought resistant -- everything.

I did not tell you we are also in a geographic position that has its drawbacks. Do not think I refer to the fact we are neighbors of a powerful, a very powerful neighbor. I mean the area through which all the hurricanes pass -- those that come from the east during the summer. We are now in hurricane season. They begin in the Atlantic Ocean and blow this way. Hurricanes have also appeared in the west -- the famous Storm of the Century, with winds of up to 200 km per hour, came from the west, and it was not even the hurricane season. The Storm of the Century razed who knows how many plantations. It was actually the storm of the millenium for us. It could have very well come 10,000 years before Christ or 10,000 years after the Revolution, [chuckles] but it decided to come -- and at what time? We were in the middle of this epidemic.

There are also new phenomena [chuckles] because we are also suffering the climatic changes that everyone talks about. This is not a theory or an illusion. We have seen this [chuckles] -- the weather is getting increasingly hot; hurricanes disrupt the weather; hurricanes become more frequent and stronger. The famous Nino, in the Pacific Ocean, also has its repercussions in our country. This results in strange phenomenona. In other words, we even have to face those natural phenomenona. Nevertheless, we do not lose faith, we maintain our combative spirit, we maintain our ideals and our goals. Everything we have achieved we have achieved with the Revolution.

Excuse me if, in the middle of an event... [pauses] if I talk about the Revolution in a scientific workshop, but definitely, this scientific workshop is also a Revolution. When have you seen so many scientists from so many different countries gather like this? I think it is an encouraging sign about the new times -- about the new times and everything. Some signs are not encouraging and others are encouraging, but your reaction, your participation in this event is something we will never forget. I repeat, we bear witness to the process and we are able to ascertain how much progress was achieved since the day we were told about a strange epidemic over in Pinar del Rio. We were told it had such and such characteristics, and our scientific personnel got together.

Unfortunately, we must say that the public health office's epidemiology section worked on its own when it initially learned about the disease. No one was told; no one was warned. The minute we heard about the existence of this disease... [pauses] it was after some time because there were isolated cases throughout 1992, but there was no official information on the problem. [We heard about it] in the first quarter of 1993; otherwise, we would have done much earlier what we later did. All the research centers' work was coordinated; we organized a group with the authority to handle the problem and conduct an investigation. A certain amount of time was lost, but all those who had the knowledge and experience in one field or another got together and worked systematically on this problem.

In the beginning they worked in the dark. They relied mainly on theory and they desperately sought bibliography. Roman [not further identified] knows about this because he brought us some of the international bibliography on this. We saw it. We analyzed all the possible theories. Was it this? Was it that? They obviously tested the tobacco because the problem began in Pinar del Rio. They wanted to know if there was a product or pesticide that could be used on the tobacco plants -- in case that was the origin of the disease. Time was wasted.

Research work that takes three days took them three months. No one knew anything except the Comrades over there. They felt very confident because we had a good defensive and preventive system against diseases, all of which was prioritized. But time was wasted due to the self-sufficiency that men and institutions sometimes feel. What we know today is truly astonishing compared to what we knew back then -- and we know that we know nothing at all -- that is the worst of all. Despite all we do know, there is so much more that we do not know, but whoever has had the privilege of listening to the reports presented yesterday and today is amazed about all the progress that has been achieved, the logic behind all that is said and explained.

Anyone who attended these lectures is amazed, too. The lectures given by our guests have been the most outstanding. I have noted that their scientific level was very high and they had a very strong ability to synthesize and expound their information. I will not criticize the lectures by the Cubans because they did very well, but I believe they have learned. They have learned a great deal by listening to a great number of your lectures. It would useless to say eminent scientists were here; the important thing is that we have had the opportunity to listen to them, each one in his area or branch of work. I would honestly like to say that I am very impressed. We are more than just friends and associates, we are now comrades in this great struggle for the health of mankind.

Either we discover all there is to discover about this, or mankind will suffer a great deal. We are not just a little island in the world. The world's population is almost six billion. I have recently read an estimate, I believe that there were only 5 million people remaining to complete this figure. In a few more months this figure will be reached -- world population grows by 240,000 people daily. Almost six billion people. I ask myself: Is there any country that can feel free of this phenomenon? We must get to the bottom of the matter, we must solve this problem. This is not poliomyelitis -- we knew about that, it affected a number of people, but the effects of this type of disease are much worse. It has one characteristic above all -- it is widespread.

Is there anyone who can assert there is a country in the world free of a phenomenon such as this? It would be an extraordinary accomplishment if we could get to the bottom of this matter. Some say that certain diseases have lasted 20 years. We cannot wait 20 years in this case. There are still cases. This is not like Japan, where the epidemic ended and, as far as I know, there are no new cases. Other diseases have been mentioned here. The struggle against them has been going on for quite a time -- multiple sclerosis, for example. However, that is a rare disease. The problem with this disease is that it became widespread. Its danger potential is far greater than any other disease. It is too big.

We are dutybound to continue working and it is our hope that we will all continue to work and have others join us, to get to the bottom of this phenomenon. This is how we see you -- as comrades, as brothers in the struggle for a great human cause, in the struggle against a phenomenon that affects not only us. We have learned that we must know how to fight for others. Thousands upon thousands of our doctors, over 10,000 of our doctors, have served abroad. Over 90 percent of them have done this for free. We have fought for good health all over the world. Now that we wage a struggle against this disease, or against any other, with any new discovery or new medicine, we always bear in mind that we are waging a struggle for others as well.

We therefore know how to appreciate the cooperation we receive and the great human and moral merit that this signifies. That is why, as [Public Health Minister Julio] Teja said, we look forward to seeing one another again. We do not say good-bye; we say until we meet again -- not to our friends, but to our brother scientists and comrades in this wonderful and extraordinary battle that we wage. Thank you very much.[applause]