against cancer Julian Borger in Havana Clinical trials of a cancer therapy genetically engineered by the Cuban biotechnology industry are due to begin in London next month. It may prove to be a landmark both for medicine’s struggle with the disease and Fidel Castro’s attempts to break out of Cuba’s United States-imposed
isolation.
Despite a lack of resources, laboratories in Havana have made startling strides in developing revolutionary vaccines and antibodies against meningitis, hepatitis and lung, breast, head and neck cancers. But their use in other parts of the world has been hindered by the Helms-Burton Act – the US measure which penalises foreign companies for dealing with Cuba. That wall is beginning to crumble in the more general thaw in US-Cuba relations, and Western investors have found that Cuban scientists are ahead in some fields in the race to produce genetically engineered medicines. British pharmaceutical company Smith Kline Beecham succeeded a year ago in persuading Washington to give it an exemption from the Act, allowing it to develop and market a Cuban vaccine against meningitis B. It is the only such vaccine in the world. Canadian firm York Medical has secured funds for trials of Cuban cancer vaccines and antibodies. Company director David Allan said that trials of a cancer vaccine would begin in Britain “in the next few weeks”. The vaccine does not prevent cancer in a healthy person, but it prevents existing tumours from spreading. It works by provoking the immune system into making antibodies against epidermal growth factor (EGF), a naturally occurring protein which plays an important role in childhood development but seems to have no function in adults other than nourishing tumours.
The problem in reducing its supply was to find a way to provoke the immune system into fighting a substance normally found in the body. The Cubans bonded EGF with a bacterial protein known as P64k, which promotes an immune response to both and thus mops up the supply of EGF.
York Medical says that the vaccine has produced impressive results in Cuban tests, increasing the average survival time by 200%. The Cubans have also developed an antibody which could provide a second line of attack against certain tumours. It works by blocking EGF receptors on cancer cells and prevents them connecting with and being nourished by the protein. This not only stops the tumour growing but weakens the cancer, making it far more vulnerable to chemo- and radiotherapy.
To Cuba the success of these trials is essential. In the past 10 years Castro has ploughed about $1- billion into its cluster of biotech institutes, capitalising on a long-term investment in medical expertise that has given Cuba more doctors per capita than any other country in the world. The investment also represents, in the words of a diplomat in Havana, “Fidel’s moon-shot” – a bid for national greatness and an impudent challenge to the US monolith in the great scientific race of the era. But Jos, Suarez, whose job it is to find foreigners to invest in Cuban scientific discoveries, points out that the country’s achievements save lives. It is not national vanity, he argues, but “a national necessity”.
“The world is not interested in paying to cure the diseases of poor countries,” he said. “The existing cholera vaccine is for tourists. It works for 30 days, but if you live in a poor country there is no vaccine for you. We are testing a cholera vaccine for people who live in the Third World.” The meningitis B vaccine was developed as an emergency response to an epidemic in the 1970s. The government gave 15 researchers the task of finding a solution in a hurry. They tested the prototypes on their own bodies, and came up with a vaccine that was 84% effective. By 1990 meningitis was no longer a threat in Cuba. Allan thinks that if the cancer trials prove successful it will be politically impossible for Washington to suppress the Cuban vaccines. Two months ago York Medical was struggling to find investors, who were wary that the project would be strangled by Washington’s embargo. The funds for trials have come in in the past few weeks. Allan believes that investors have drawn the same conclusion he has: the US embargo is “headed for the ash-can where it belongs”. The measure which is currently before the US Congress does not kill the Helms-Burton legislation but will leave it vulnerable. And it is unthinkable that the US public will continue to tolerate the Act if it becomes a barrier to importing effective cancer treatments.