The Times They are A-Changin’

President Obama’s Havana visit in March was both product and symbol of improved Cuba–US relations following renewed diplomatic relations and opening of embassies last year. Encouraging too was the first high-level visit to Washington DC by Cuban Ministry of Public Health leaders, headed by First Deputy Minister José Angel Portal (March 28–April 1). All are promising developments that could open the door to bilateral cooperation.

In the field of health, US people may stand to benefit as much as Cubans. As one of our Viewpoints in this issue suggests, Cuban biotech innovations are increasingly in use and in demand world-wide, but have had a hard time overcoming extra hurdles in the USA, erected by the US Department of the Treasury’s Office of Foreign Assets Control (OFAC), not the FDA. One such innovation is Heberprot-P, a medication for diabetic foot ulcers that clinical trials elsewhere have shown reduces relative risk of amputation by 70%, a dramatic figure if you consider the some 73,000 amputations in the United States annually. As diabetes and its costs rise throughout the USA and worldwide—“beat diabetes” the theme of this year’s World Health Day—it seems reasonable to allow such a product access to the normal FDA regulatory process, even to fast-track it.

Climate change, natural and man-made disasters, and other global health threats present formidable challenges, but also opportunities for US and Cuban scientists to work together. One such arena is infectious diseases, particularly the arboviruses that cause Zika, dengue and chikungunya. Perhaps few in the USA are aware that the mosquitoes carrying these diseases are scattered throughout 30 US states and Puerto Rico, not to mention their endemic presence in most of Latin America and the Caribbean. Even fewer may know that Cuba’s Pedro Kourí Tropical Medicine Institute is home to the Americas’ only WHO/PAHO Collaborating Center for Research on Dengue and related viruses. As Gorry’s Feature in this issue of MEDICC Review details, the Institute is hard at work with national and international efforts to stop the spread of these diseases and their tragic and often deadly consequences. Thus, it is heartening to see that during the Cuban health ministry delegation’s trip to the USA, Dr Jorge Pérez, Institute Director, spent two days at the CDC, and President Obama made specific reference to collaboration on Zika during his own visit to Cuba. In this case, collaboration could have meaningful and life-saving results for people everywhere, especially in developing countries.

Readers of this double issue of MEDICC Review will notice some changes in the journal’s look, including both masthead and cover design. We are pleased to welcome issue coordinators Jorge Bacallao, Lila Castellanos, Esther María Fajardo and Pedro López Saura; research associate Annet Sánchez; as well as Aram Alvarez, Silvia García and Jennifer Davis in publishing and marketing.The masthead also includes new indexing of MEDICC Review in the Network of Scientific Journals in Latin America and the Caribbean, Spain and Portugal (Redalyc).

The new cover reveals our decision to forgo central themes for issues in favor of a broader approach, which encourages more authors to submit their work. This also allows us to introduce “Editors’ Choice,” calling reader attention to articles we consider ‘must reads.’

This April, our list is headed by a groundbreaking study on prevalence of kidney damage markers in youngsters residing in Salvadoran farming communities, following up on our special issue of April 2014, Chronic Kidney Disease Hits Agricultural Communities (Vol. 16, No. 2) and our first original research article published in 2011 on chronic kidney disease of uncertain causes (CKDu). The disease, not associated with traditional risk factors such as hypertension and diabetes, has been responsible for at least 20,000 deaths in Central America and Asia. Meanwhile, debates continue on its etiology, mainly narrowed to those who consider a multicausal hypothesis involving nephrotoxic agrochemical exposure coupled with dehydration, and those who argue heat stress and dehydration alone are responsible for renal damage in CKDu patients.

Some changes in MEDICC Review’s content are also in the offing: while we previously welcomed manuscripts from Cuban authors for any issue, limiting other authors to theme-related content, our pages are now open to all international research related to health equity and vulnerable populations. We will continue to prioritize Cuban professionals’ work and reporting on the country’s health system, strategies and results. In this vein, another Editors’ Choice article reviews survival of Cuban patients with pulmonary TB, as the nation makes efforts to eliminate the disease as a health problem.

Finally, a second Feature looks at the legal, ethical, organizational, resource and training complexities involved in solid organ donation and transplantation in Cuba. The article reviews types of donors and transplants, laws and regulations governing the procedures and followup, and reports on the work of the hepatobiliary surgical team at Havana’s William Soler Pediatric University Hospital, the only public pediatric transplant service free to patients in Latin America and the Caribbean.

We close this editorial on a note of sadness: the loss of four Cuban health professionals during this period. Dr Sonia Águila, teacher of generations of OB-GYNs and friend to her hundreds of patients, passed away after our last issue went to press. Dr Águila was a collaborator of MEDICC Review, which benefited from her extraordinary expertise, grace and dedication. She will be missed by all who had the privilege of knowing her.

Just days ago, Cuban physicians Bárbara Caridad Cruz, Leonardo Ortiz and Eric Omar Pérez were among the hundreds who lost their lives in the earthquake in Ecuador. Over 700 Cuban health professionals are serving in that country, including some 50 members of the recently dispatched, specially trained Henry Reeve Emergency Medical Contingent, who will stay “as long as we are needed,” according to the team’s leaders. To the families of all who have lost loved ones—Cubans, Ecuadorans and others—we extend our sincerest condolences.

The Editors

Publication Dates

  • Publication in this collection
    Jan-Apr 2016
Medical Education Cooperation with Cuba Oakland - California - United States
E-mail: editors@medicc.org