What next for Cuba’s biopharma industry?

In late 2021, Cuban scientists were celebrating. Not only had the country developed effective vaccines against the COVID-19—the smallest country in the world to do so—it had also inoculated 90% of its 11 million citizens, more than any other major nation on Earth.

Cuba had pulled off this feat of public health despite US sanctions that had plunged the country into an economic crisis and left its vaccine research teams with only one spectrometer between them.

Thanks to robust state funding and built-in institutional collaboration, Cuba’s “juggernaut” biopharma industry has punched above its weight for decades, producing 60% of the country’s essential medicines, while selling medicine and vaccines to 77 countries. The sector was long a major source of income for the cash-strapped country.

But now, as a US-led fuel blockade stretches into its seventh month, researchers and economists say Cuba’s biopharma industry is faltering.

“Production has slowed down,” says Mitchell Valdés-Sosa, the director of the Cuban Neuroscience Center in Havana. “We are having power cuts that last up to 20 h a day, and there’s not enough currency to buy all the raw materials we need. For a time, the pharmacies were full of medicine, but now the supply is patchy.”

Cuba produces only about 40% of the crude oil it needs. To supplement this, the Communist country has long relied on imports from Venezuela and Mexico. But after the US military captured Venezuelan president Nicolás Maduro in January, oil tankers from Venezuela stopped arriving.

Mexico, under pressure from the US government, suspended its shipments a few weeks later. On Jan. 29, the US threatened tariffs against any country that supplied oil to Cuba. By mid-May, the island had depleted its diesel and fuel-oil reserves.

The resulting humanitarian crisis has stymied research and demoralized scientists who long ago learned to make do with limited resources.

“The conditions we’re operating underneath have a long history,” Valdés-Sosa says, “but now the noose has tightened.”

Cuba as a pharmaceutical powerhouse

While the mention of Cuba might call to mind images of midcentury US cars and colonial architecture in Easter-egg pastels, the country’s biopharmaceutical industry is decidedly modern.

After a mass exodus of doctors during the 1959 revolution that brought Fidel Castro to power, Cuba was left with just half of its 6,300 physicians and one medical school, staffed by 22 professors of medicine. In response, the new government poured investment into tuition-free medical education and a nationalized health-care system.

Cuba also integrated scientific research into its health-care system so that researchers who developed medicines worked in tandem with the doctors prescribing them. This closed-loop structure allowed for the rapid development, testing, and dissemination of new medicines and treatments. Starting in the early 1980s, the government invested $1 billion in biotechnology, launching the Western Havana Bio-Cluster, a state-funded network of 52 interconnected biotech, research, and health-care institutions, with the goal of bolstering domestic supply of pharmaceuticals while creating new exports for revenue.

“It’s very much a collaborative model,” says Emily Morris, an economist and research fellow at University College London’s Institute of the Americas. “They get together from all the different disciplines and hammer at a problem until they find an answer.”

This kind of cooperation is a necessity in Cuba, where money for salaries and raw materials is scarce, thanks to 6 decades of US sanctions and very few trade partners. Doctors and researchers get by with paltry pay, and Soviet-era equipment is often MacGyvered with salvaged parts.

“They’re always looking for ways around this problem,” Morris says. “It’s not really a can-do attitude; it’s a must-do attitude on the part of the scientists.”

This “must-do attitude” has at times produced remarkable results. In 1989 Cuban scientists developed the world’s first meningitis B vaccine. In 2016 the lung-cancer vaccine CIMAvax became the first Cuban treatment to enter clinical trials in the US.

The country manufactures 8 of the 11 vaccines in its immunization program, and vaccination rates (PDF) before the fuel blockade hovered above 95%.

A Cuban health-care system under strain

Without fuel, the closed-loop health-care system that enabled Cuba’s biotechnology industry has become the country’s downfall. The result is a “polycrisis,” Arachu Castro, the Samuel Z. Stone Endowed Chair of Public Health in Latin America at Tulane University, writes in an article from May. The crisis is “producing cascading harm across every health domain,” she writes.

Power outages can last as long as 72 h, disrupting the 84% of water-pumping stations that rely on electricity. Many researchers have lost access to reliable refrigeration and are struggling to keep their lab animals alive. While some clinical trials are moving forward, others have been delayed indefinitely.

“Scientists are trying to do research at home because they don’t have the power to keep the laboratories going,” Morris says. “It’s very damaging for the research program.”

With no fuel for garbage trucks, streets are littered with growing piles of waste swarming with rodents and insects.

“We go to work with the heat and the mosquitoes,” Valdés-Sosa says. “It’s very difficult to keep things running.”

The other problem, Valdés-Sosa says, is transportation. Researchers can’t drive to work, containers carrying supplies are stranded at ports, and “without oil and gas, it can take weeks to get medicines to the pharmacy.”

According to the United Nations, up to 60% of essential medicines are in short supply in Cuba, creating a black market with prices that many residents can’t afford. The Cuban minister of health claims that without cold storage, more than 30,000 Cuban children have experienced delays in their scheduled vaccines.

According to Morris, the nations that relied on the now-suspended exports of vaccines and medicines from Cuba will likely find new countries to buy them from. What will be harder to replace will be the more than 24,000 Cuban doctors who are currently working in 56 countries, often serving the world’s poorest, more remote communities, “places where people have never seen doctors before,” Morris says.

Cuba’s earnings from these medical missions are one of its largest sources of income, used to finance the health-care system and, at times, to trade for resources like oil. The US, which has long characterized Cuba’s medical diplomacy as a form of human trafficking, is now pressuring recipient countries to cut ties or face their own sanctions. Cuban doctors recently left Guyana and Jamaica after more than 5 decades of providing service there.

Waves of physicians are returning to the struggling island nation to find a medical and scientific system in crisis, and colleagues still working despite the difficulties.

“They feel a vocation, almost like a religious order,” Morris says. “But a lot of scientists well above retirement age are keeping the ship afloat. They are working hard, and they are tired.”

An uncertain future for Cuba’s medical and scientific communities

Only time will reveal the long-lasting impact of the current crisis on Cuba’s medical and scientific communities. Tulane’s Castro worries that the longer the crisis goes on, “the less reversible the damage becomes,” especially for citizens who need urgent medical treatment. But efforts are underway to harden the country’s research institutions against future political and economic shocks.

For one thing, researchers are looking for new academic and scientific partners around the world. Valdés-Sosa recently visited India, where he was working to foster new avenues for collaboration among the two countries’ scientists. Cuba has also strengthened its partnerships with Russia and China.

China has been a pivotal partner in Cuba’s goal to run on 100% renewable energy by 2050. The Chinese government has pledged to help Cuba built 92 solar parks by 2028, providing both materials and labor. More than half are already online. Renewable energy provides about 10% of the island’s electricity, up from 3.6% in 2024.

According to Valdés-Sosa, two of the leading state biopharmaceutical research institutes, the Finlay Vaccine Institute and the Center for Molecular Immunology, have installed solar panels on their facilities. These firms “have a substantial share of their electricity demand covered by green energy,” he says. “But it’s still a low percentage of what we need.”

Yet Valdés-Sosa says the must-do attitude prevails. “Some people are feeling very pessimistic, but they keep on working,” he says.

Ashley Stimpson is a freelance journalist based in Maryland.