2019, Number 4
<< Back Next >>
MEDICC Review 2019; 21 (4)
Science and challenges for cuban public health in the 21st century
Lage-Dávila A
Language: English
References: 45
Page: 7-14
PDF size: 162.87 Kb.
ABSTRACT
Cuba’s public health outcomes are rooted in political and social phenomena that have favored achievement of health indicators well above expectations for an economy of its size. A less studied causal component of Cuba’s development in health is the creation, from early in the 1960s, of scientific research capacity throughout the health system, including use of science to launch a domestic industry for manufacturing high-tech products. This component should play an even greater role in meeting Cuba’s 21st century health challenges, especially the demographic and epidemiological transitions, increasing prevalence of chronic diseases, rapid emergence of a complex-product biotechnology pharmacopoeia, greater molecular stratification of diseases, rising health costs, and the need to maintain communicable diseases under control in a global context of climate change and more population mobility.
Tackling these challenges will demand greater scientific influence in the health system, application of a scientific approach in all activities and at all levels, and integration with scientific endeavors of other sectors such as agriculture, industry and education.
REFERENCES
National Health Statistics and Medical Records Division (CU). Anuario Estadístico de Salud 2017 [Internet]. Havana: Ministry of Public Health (CU); 2018 [cited 2019 Feb 16]. 206 p. Available from: http:// les.sld.cu/dne/ les/2018/04/Anuario -Electronico-Espa%C3%B1ol-2017-ed-2018. pdf. Spanish.
Save the Children. Women on the Front Lines of Health Care. State of the World’s Mothers 2010 [Internet]. Connecticut: Save The Children; 2010 May [cited 2019 Feb 16]. [Table], 2010 Mother’s Index Rankings; p. 36. Available from: https://www.savethechildren.org/content/ dam/usa/reports/advocacy/sowm/sowm-2010 .pdf?vanityurl=publications/state-of-the-worlds -mothers-report
World Bank [Internet]. New York: World Bank; c2019. Datos. Prevalencia de VIH (% de la población entre 15 y 24 años de edad). Todos los países y economías; [updated 2019 Jan; cited 2019 Feb 16]. Available from: https://datos.banco mundial.org/indicador/sh.dyn.aids.zs. Spanish.
Santana Espinosa MC, Esquivel Lauzurique M, Herrera Alcázar VR, Castro Pacheco BL, Machado Lubián MC, Cintra Cala D, et al. Atención a la salud materno-infantil en Cuba: logros y desafíos. Rev Panam Salud Pública [Internet]. 2018 [cited 2019 Feb 16];42:2230. Available from: https://scielosp.org/pdf/rpsp/2018 .v42/e27/. Spanish.
Miller LJ, Lu W. These Are the Worlds Healthiest Nations. New York: Bloomberg [Internet]. 2019 Feb 24 [cited 2019 Mar 2]; Economics. Available from: https://www.bloomberg.com/news/ articles/2019-02-24/spain-tops-italy-as-world -s-healthiest-nation-while-u-s-slips
Datosmacro.com [Internet]. Datosmacro.com; c2019. Expansión. Cuba – Esperanza de vida al nacer; [cited 2019 Feb 16]. Available from: https://datosmacro.expansion.com/demogra a/ esperanza-vida/cuba?anio=1960. Spanish.
Castro Pacheco BL, Cuéllar Álvarez R, Ibargollen Negrín L, Esquivel Lauzurique M, Machado Lubián MC, Martínez Corredera V. Cuban experience in child health care. 1959–2006 [Internet]. Havana: Editora Política; 2010 [cited 2019 Mar 2]. p. 9. Available from: https://ipa-world.org/ uploadedbyfck/Report%20on%20Child%20 Health%20in%20Cuba%20by%20Jose%20 Martines_EXPERIENCIA%20CUBANA%20 PARA%20EDITORA%20POLITICA%20(EN GLISH%20VERSION).pdf.
Keck CW, Reed GA. The curious case of Cuba. Am J Pub Health. 2012 Aug;102(8):e1322.
Drain PK, Barry M. Fifty years of U.S. embargo: Cuba’s health outcomes and lessons. Science. 2010 Apr 30;328(5978):5723.
American Association for World Health. The Impact of the U.S. Embargo on Health & Nutrition in Cuba [Internet]. Washington, D.C.: American Association for World Health; 1997 Mar [cited 2019 Feb 16]. 322 p. Available from: https://medicc.org/ ns/documents/The_impact_of_the_U.S._Embar go_on_Health_&_Nutrition_in_Cuba.pdf 1997
GAPMINDER [Internet]. Stockholm: GAPMINDER; c2019. Updated GAPMINDER World Poster; [cited 2019 Feb 16]. Available from: https://www .gapminderdev.org/tag/chart
Morris E. Unexpected Cuba. New Left Rev. 2014 Jul–Aug;88:545.
Rojo Pérez N, Valenti Pérez C, Martínez Trujillo N, Morales Suárez I, Martínez Torres E, Fleitas Estévez I, et al. Ciencia e innovación tecnológica en la salud en Cuba: resultados en problemas seleccionados. Rev Panam Salud Pública [Internet]. 2018 [cited 2019 Feb16];42:98108. Available from: https://www.scielosp.org/pdf/ rpsp/2018.v42/e32/es. Spanish.
Constitución de la Organización Mundial de la Salud. Documentos Básicos. Supl 45a Edición [Internet]; Geneva: World Health Organization; 2006 [cited 2019 Feb 16]. 20 p. Available from: https://www.who.int/governance/eb/who_consti tution_sp.pdf. Spanish.
Boorse C. A Rebuttal on Health. In: Humber J. and Almeder R, editors. What is Disease? Biomedical Ethics Reviews. New Jersey: Humana Press; 1997. p. 1–134.
Nordenfelt LY. Action, Ability and Health: Essays in the Philosophy of Action and Welfare. Dordrecht: Springer Netherlands; 2000. 173 p.
Lage Dávila C, Álvarez Pérez AG, Luis Gonzálvez IP, Maldonado Cantillo G, Bonet Gorbea MH. Los determinantes sociales de la salud. Actualización. InfoHEM [Internet]. 2015 Jan–Mar [cited 2019 Feb 16];13(1):5775. Available from: https://www.researchgate.net/ publication/305816699_Los_Determinantes_So ciales_de_la_Salud_Actualizacion. Spanish.
World Health Organization. World Conference on Social Determinants of Health. Rio Political Declaration on Social Determinants of Health. Rio de Janeiro, Brazil, 21 October 2011 [Internet]. Geneva: World Health Organization; 2011 [cited 2019 Feb 16]. 7 p. Available from: https:// www.who.int/sdhconference/declaration/Rio_po litical_declaration.pdf?ua=1
Álvarez AG, García A, Bonet MH. Pautas conceptuales y metodológicas para explicar los determinantes de los niveles de salud en Cuba. Rev Cubana Salud Pública [Internet]. 2007 [cited 2019 Feb 16]. Available from: http://scielo.sld.cu/ pdf/rcsp/v33n2/spu13207.pdf. Spanish.
De la Torre Montejo E, López Pardo C, Márquez M, Gutiérrez Muñiz J, Rojas Ochoa F, editors. Salud Para Todos Sí Es Posible. Havana: MercieGroup – ENPSES, CUJAE; 2005. Spanish.
Zajacova A, Lawrence EM. The relationship between education and health: reducing disparities through a contextual approach. Annu Rev Public Health . 2018 April 01;39:273–89. DOI:10.1146/ annurev-publhealth-031816-044628.
Lage A. La Osadía de la Ciencia. Havana: Editorial Academia; 2018. Spanish.
Álvarez JY, De la Osa JA. Apuntes sobre Salud y Ciencia en Cuba. Madrid: Editorial Sangova, S.A.; 2002. Spanish.
Pruna Goodgall PM, Gálvez Sandoval O, Fernández Prieto L, Valero González M, Beldarraín Chaple E, Ramos Guadalupe LE, et al. Historia de la ciencia y la tecnología en Cuba. Havana: Editorial Cientí co-Técnica; 2006. Spanish.
Jordán JR. Desarrollo Humano en Cuba. Havana: Editora Cientí co Técnica; 1979. p. 150. Spanish.
Kohler G, Milstein C. Continuous cultures of fused cells secreting antibodies of prede ned speci city. Nature. 1975 Aug 7; 256:4957.
Ministry of Public Health (CU). Registro Nacional de Cáncer [Internet]. Havana: Ministry of Public Health (CU); 2019 [cited 2019 Feb 16]. Available from: http://www.rnc.sld.cu/. Spanish.
Ministry of Public Health (CU). Programa integral para el control del cáncer en Cuba. Estrategia nacional para el control del cáncer [Internet]. Havana: Editorial Ciencias Médicas; 2012 [cited 2019 Feb 16]. 25 p. Available from: https://www .iccp-portal.org/system/files/plans/CUB_B5 _CUB_Estrategia_cancer.pdf. Spanish.
Urra P. Cuba & ICTs: real crisis leads to virtual innovation. MEDICC Rev. 2008 Winter;10(1):52.
World Health Organization. Cuban experience with local production of medicines, technology transfer and improving access to health [Internet]. Geneva: World Health Organization; 2015 [cited 2019 Feb 16]. Available from: http://www.who.int/ phi/publications/cuban_experience_local_prod _medstech_transfer/en/
Grupo de las Industrias Biotecnológica y Farmacéutica de Cuba. BioCubaFarma [Internet]. Havana: BioCubaFarma; c2019 [cited 2019 Feb 16]. Available from: https://www.biocubafarma .cu. Spanish.
Reed G. Thirty years of technology at work for health: Niurka Carlos, Director, Immunoassay Center, Havana. MEDICC Rev. 2017 Oct;19(4):68.
Fulop T, Larbi A, Dupuis G, Le Page A, Frost EH, Cohen AA, et al. Immunosenescence and In amm- Aging as two sides of the same coin: Friends or Foes? Front Immunol [Internet]. 2018 Jan 107 [cited 2019 Feb 16];8:1960. Available from: https:// www.ncbi.nlm.nih.gov/pmc/articles/PMC5767595/
Saavedra D, García B, Lage A. T-Cell subpopulations in healthy elderly and lung cancer patients: insights from Cuban studies. Front Immunol. 2017 Feb 14;8:146.
Bacallao J, Alerm A, Ferrer M. Paradigma del curso de la vida. Sus implicaciones en la clínica, la epidemiología y la salud pública. Havana: ECIMED; 2016. Spanish.
US Drug & Food Administration [Internet]. Washington, D.C.: US Drug & Food Administration; c2019. Drugs Databases. Drugs@FDA: FDA Approved Drug Products. Insulin recombinant human; [cited 2019 Feb 16]. Available from: https:// www.accessdata.fda.gov/scripts/cder/daf/index .cfm?event=overview.process&ApplNo=018780
Evaluate Pharma World Preview 2016. Outlook to 2022 [Internet]. London: Evaluate Pharma; 2016 Sep [cited 2019 Mar 2]. 49 p. Available from: https://info.evaluategroup.com/rs/607-YGS -364/images/wp16.pdf
Couzin-Frankel J. Breakthrough of the year 2013: cancer immunotherapy. Science. 2013 Dec 20;342(6165):14323.
Booth CM, Cescon DW,Wang L, Tannock IF, Krzyzanowska MK. Evolution of the randomized clinical trials in oncology over three decades. J Clin Oncol. 2008 Nov 20;26(33):545864.
Lage A. Global pharmaceutical development and access: critical issues of ethics and equity. MEDICC Rev. 2011 Jul;13(3):1622.
Blanco-García E, Ledón N, Lage-Dávila A. Rising cancer drug prices: what can low- and middleincome countries do? MEDICC Rev. 2018 Oct;20(4):359.
The National Institute for Health and Care Excellence (NICE) [Internet]. London: National Institute for Health Care Excellence (NICE); c2019 [cited 2019 Feb 16]. Available from: https://www .nice.org.uk
Wolfe RM, Sharpe LK. Anti-vaccinationists past and present. BMJ. 2002 Aug 24;325(7361):430–2.
World Health Organization [Internet]. Geneva: World Health Organization; c2019. Diseases. Emergencies preparedness, response. Smallpox; [cited 2019 Feb 16]. Available from: https:// www.who.int/csr/disease/smallpox/en/
World Health Organization. Polio. Eradication [Internet]. Geneva: World Health Organization; 2018 Nov 26 [cited 2019 Feb 16]. 7 p. Available from: http://polioeradication.org/wp-content/up loads/2016/07/B144_9-en.pdf