HIV care in Cuba opens doors to possible South-South Cooperation initiatives

She speaks slowly, as if making sure she is understood in detail by her Cuban interlocutors. Ask about challenges, results, status of research in the country on HIV and other diseases.

In just over 72 hours of an intense visit to Cuba, Winnie Byanyima, executive director of UNAIDS, did not stop interviewing national authorities, scientists, journalists and health promotion activists. He praised the production of Cuban vaccines against COVID-19, spoke passionately about the possibility of finding a definitive cure against AIDS and defended a response to HIV that leaves no one behind.

“It is a very deceptive virus“, says one of the experts from the Pedro Kourí Institute of Tropical Medicine, a pioneering institution in AIDS studies in Cuba.

Certainly, the characteristics of the virus itself (highly replicable, variable and efficient in evading the immune response) have obstructed efforts to have a vaccine, but neither the international scientific community nor the Joint United Nations Program on HIV/AIDS (UNAIDS), they give up.

By 2030, the organization plans to fulfill its 95-95-95 strategy: that 95% of people with HIV are diagnosed; Of these, 95% have antiretroviral treatment; and of these, 95% have a suppressed or undetectable viral load, that is, they prevent the virus from being transmitted, a goal that Cuba shares with the accompaniment of the United Nations.

He United Nations Development Program (UNDP), the Pan American Health Organization (OPS), He Population Fund (UNFPA) and UNICEF are part of the team of UN Agencies in Cuba that have supported prevention programs for young people and key populations, facilitating access to diagnoses and treatments, the supply of contraceptives, and advocacy work aimed at overcoming stigma and discrimination.

Since 2003, contributions from the Global Fund against HIV, tuberculosis and malaria, implemented by UNDP, have additionally allowed the purchase of laboratory equipment and primary health care institutions, reagents, and supplies, in order to provide virological follow-up to HIV-positive people.

The participation of civil society in finding hidden populations and actively influencing those most exposed to contagion complements the efforts of the National HIV Program and the Cuban health system to maintain favorable indicators in the Response to the virus, compared to others. countries in the region.

Lights over the darkness

No one can tell Elsi Cabrera about HIV more than what she has learned on her own. She was infected in 1998, when antiretroviral treatments and the inclusive vision that came later regarding people living with the virus were still far away.

“There was a lot of ignorance, even among health personnel. I felt people’s rejection and that hurt as much as the infection itself.“, remember.

The delicate state of her illness forced her to enter the Pedro Kourí Institute of Tropical Medicine (IPK) for almost a year, where she was “emotionally and psychologically affected, and seeing around me how other sick people were transformed, losing more and more weight. I swore that if she got out of that quagmire I would dedicate my life to working so that others would not suffer the same as me.”

So it was. Elsi joined the health promotion work among key populations such as trans networks and those of men who have sex with men (MSM).

Promoting healthy behaviors is one of the components of the call “combined prevention strategy” of Cubawhich articulates actions in favor of responsible sexuality, with a legal and rights dimension, and another biomedical dimension (diagnostic tests, use of PrEP, viral load monitoring, sexual and reproductive health interventions and provision of antiretrovirals).

Education and communication have been key tools to counteract risky behaviors from an early age. In 2023 alone, UNICEF reached almost 900,000 adolescents and young people, studying their lifestyles and implementing counseling spaces on healthy behaviors in several provinces of the country.

For UNAIDS, eliminating the disease is a goal that depends greatly on community action. Community organizations living with HIV, at risk of becoming infected or affected by the virus are the front line of progress in the response to the virus, promoting people-centred public health services, building trust, innovating and monitoring the efficient implementation of policies and services.

From Cuba to the world: bridges of south-south cooperation

For Winnie Byanyima, Cuba’s scientific potential could inspire South-South cooperation projects, con transfer of capabilities and technologies to other developing countriesand the possibility of finding joint solutions to common health challenges.

“Cuba prepares medical students and health professionals who are deployed throughout the planetincluding developed countries, with more than 20,000 on the five continents,” said Winnie Byanyima during her visit to the Latin American School of Medicine.

“This makes it one of the largest contributors to global health, which is a key principle for the world to achieve the goal of ending AIDS and meeting the Sustainable Development Goals by 2030.”

In a meeting with scientists from the Biocubarma Biotechnology and Pharmaceutical Industries Group, the UN Undersecretary General said she was impressed by Cuba’s biotechnological capacity to respond to pandemics using its own resources.

With 47 companies and 164 production lines, Biocubafarma was responsible for the production of Cuban vaccines against COVID 19 and, at the same time, manufactures biopharmaceuticals for the treatment of cancer such as monoclonal antibodies and therapeutic vaccines, products for the prevention and treatment of diseases. cardiovascular, as well as systems for early diagnosis and prevention of malignant tumors, among other results.

“We want to support Cuba in cooperation with other developing countriesespecially in Africa, promoting the transfer of technologies that can, in turn, bring a return to the country,” Byanyima stated.

For the executive director of UNAIDS, the world has a lot to learn from Cuba, which is why she hopes to support the country in sharing its experiences with other nations.

“The challenges of fundraising are there, and I have seen with my own eyes how the sanctions against Cuba and other challenges that the country faces impact the response to HIV.” But Cuba has much to offer global health. “We will use our convening power and our voice to advocate for those opportunities to become a reality.”