Power, Politics and Population Health: The Strength of Collaboration

Rudolf Virchow, the father of public health, as far back as the late nineteenth century said, “Medicine is a social science, and politics nothing else but medicine on a large scale.”

His point is well taken. Articles in this issue of MEDICC Review explore the often turbulent relationship between science and those with the power to use it. Eventually, it is they who can wield science for their benefit alone or to improve population and planetary health. They can pay attention to science, they can ignore science, or, in the worst cases, they can bend it to serve their own narrow interests.

As illustrated in several articles, breaking the decision-making monopoly of powerful forces requires that scientists and their allies come together to demand their place at the table. Of course, first must come the opportunity for scientists themselves to collaborate, to reach conclusions based on open, transparent and rigorous debate. This is driven home by Luis Velázquez-Pérez, President of the Cuban Academy of Sciences. Through his article, Cuban scientists call for a global scientific meeting to review the case of Havana-posted US diplomats’ health complaints. Complementing his piece is an interview with Mitchell Valdés, director of the Cuban Neuroscience Center, who emphasizes the critical importance of information sharing as part of proper scientific process for investigating this or any other medical mystery.

In Blanco’s paper on skyrocketing cancer drug prices worldwide, he and colleagues urge collaboration beyond the scientific community to establish a multinational force involving, first and foremost, the less-developed countries, to confront the major pharmaceutical manufacturers. Much is at stake in this peoplevs.-profits struggle: unless drug prices for cancer patients come down, argues the paper, the world’s health systems, even in richer countries, will simply go broke.

From Nigeria, comes Aregbeshola’s Perspective proposing a path towards universal health care. It’s a path that, once again, depends on those in power heeding the results of health and economic research to marshall the political will for change— in a country where less than 5% of the population has health coverage.

Collaboration in Latin America is brought into focus by two articles in this issue, the first an interview with outgoing PAHO/WHO representative in Cuba, Cristian Morales, who talks about PAHO’s and Cuba’s shared values of solidarity and health as a human right. In particular, he refers to the triangular collaboration among Brazil, Cuba and PAHO, responsible for over 11,000 Cuban physicians serving some 45 million people in Brazil’s indigenous and otherwise underserved populations, as part of the Mais Médicos program.

The second is a research paper by Méndez-Rosado examining results of genetic testing in four Latin American countries, including Cuba. He and his colleagues detected hitherto unobserved genomic breakpoints related to de novo balanced structural chromosomal rearrangements. Far from being an esoteric exercise, the results will be useful in prenatal genetic counseling for pregnant women in Latin America and in long-term postnatal followup of patients with such abnormalities.

Perhaps there is no better illustration of the ability of collaboration in health and science to break through barriers than the joint venture between Roswell Park Comprehensive Cancer Center and Cuba’s Molecular Immunology Center. This represents an important step to making Cuba’s cancer-fighting biotech therapies available to US patients, given the encouraging early results (released in September) of early-phase clinical trials of CIMAvax-EGF in US lung cancer patients.[11 Roswell Park Comprehensive Cancer Center. Media release: Roswell Park Lung Cancer Expert Shares Initial Findings From First North American Study of CIMAvax [Internet]. 2018 Sep 26 [cited 2018 Oct 18]. Available from: https:// www.roswellpark.org/media/news/roswell-park-lung-cancer-expert-shares -initial-findings-first-north-american-study
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Cuban scientists call for a global scientific meeting to review the case of Havana-posted US diplomats’ health complaints

CIMAvax’s emergence on the global market is indicative of two major developments. First is the vindication of Cuba’s persistence in researching cancer immunotherapy, a line of research at one point almost discounted, but this year the object of the Nobel Prize for Physiology and Medicine. Second, CIMAvax has benefited from the consolidation of Cuba’s regulatory and clinical trials infrastructure. María Amparo Pascual, founding director of the National Clinical Trials Coordinating Center, is featured in the Interview section of this issue, as part of our series on outstanding Cuban women in science, technology and medicine (STEM).

Another outstanding woman scholar and practitioner who would certainly have been included in the women-in-STEM series, but for her untimely death a year ago September, was renowned educator Emelia Ycart Pereira, a longtime member of MEDICC Review’s editorial board. Dr Ycart dedicated her five-decade career to improving the lives of people with disabilities, among her many activities, directing Havana’s La Castellana Psychopedagogical Center. We dedicate this issue to her memory.

The Editors

Medical Education Cooperation with Cuba Oakland - California - United States
E-mail: editors@medicc.org