That’s a question Americans should ask themselves, especially those Americans that have cancer, know someone who has cancer, or have lost someone to cancer. That is because Cimavax is a Cuban drug that has been extending the lives of cancer patients since the 1990s. Cimavax, has been shown in Cuban trials to extend the lives of lung cancer patients by months, and sometimes years, but cannot be found in the US due to the embargo against Cuba that has been in place for more than five decades.
Cimavax fights cancer by stimulating an immune response against a protein in the blood that triggers the growth of lung cancer. After an induction period, patients receive a monthly dose by injection. It’s a product of Cuba’s biotechnology industry, nurtured by former President Fidel Castro since the early 1980s.
Due to the embargo placed on Cuba by the United States, that country had to produce the drugs it could not access or afford. And medications like Cimavax – low-tech products that could be administered in a rural setting – were developed to fit the Cuban context. Although the Cubans will not reveal the cost of producing Cimavax, it is cheaper than other treatments.
For Cuba’s residents, all health care is free. One beneficiary is Lucrecia de Jesus Rubillo, 65, who lives on the fifth floor of a block of flats in the east of Havana. Last September she was given two or three months to live. What began as pain in Lucrecia’s leg, was diagnosed as stage-four lung cancer that had spread. She had chemotherapy. “That was really very hard,” she says. “It gave me nausea, and it hurt. But my kids asked me to fight, so I did.”
After radiotherapy, Lucrecia began Cimavax injections. Now she is strong enough to walk up the five flights of stairs to her home, and her persistent cough has diminished. She feels better, more hopeful, and is thinking about what to do next. Her doctor is Elia Neninger, an oncologist at the Hermanos Ameijeiras Hospital in Havana. Neninger is one of the principal clinicians to trial Cimavax on patients since the 1990s.
“Lucrecia arrived incapacitated by her disease in a wheelchair,” Neninger remembers. “Now the tumour on her lung has disappeared, and the lesions on her liver aren’t there either. With Cimavax, she’s in a maintenance phase.” Neninger, who has treated hundreds of patients with Cimavax says she has treated stage-four lung cancer patients who are still alive 10 years after their diagnosis.
Yes, Cimavax is mostly proven to extend life for months, not years, does not help everyone, and in trials, around 20% of patients haven’t responded, but that’s often because the disease is very advanced, or they have associated illnesses that make treatment more difficult according to Dr Neninger. Still, it has worked miracles in more patients than not, and American cancer patients deserve to be exposed to the chance that it might work for them.
There might be hope on the horizon because American trials of Cimavax are already taking place at the Roswell Park Cancer Institute in Buffalo, New York. It is the first time a Cuban medication has been trialled in the US, and required special permission because the embargo prohibits most collaboration and trade. It was able to be arranged due to the improved relations with Cuba under President Obama.
Nonetheless, Dr Kelvin Lee, the Chair of Immunology at the Roswell Park Cancer Institute is impressed. Cancer immunotherapy is getting more expensive in the US, Lee says. A cheap vaccine that can be administered at primary care level is very attractive. And he thinks it is possible that Cimavax could be used to prevent lung cancer, too.
“If we could vaccinate the high-risk smokers to prevent them from developing lung cancer, that would have an enormous public health impact both in the United States and worldwide.” This has not been proven, however, and the initial US trials of Cimavax only began in January.
There is political uncertainty, too. On the campaign trail before his election, President Trump said he would reverse the thaw with Cuba that began under the Obama administration, unless there was change on the island, which is governed as a one-party state.
“Our demands will include religious and political freedom for the Cuban people, and the freeing of political prisoners,” Trump said on the campaign trail in Miami. So far, Cuba has not made it to the top of his in-tray.
There is a large constituency of Americans who believe that Cuba does not deserve the kind of recognition and status the association with the Roswell Park Cancer Institute brings. This means that the battle to bring this life saver to Americans who need it is still largely ahead, but it’s one worth fighting.