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Science and Technological Innovation in Health in Cuba: Results in Selected Problems*

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Science and Technological Innovation in Health in Cuba: Results in Selected Problems* Pan American Journal Special report of Public Health Science and technological innovation in health in Cuba: results in selected problems* Nereida Rojo Pérez,1 Carmen Valenti Pérez,1 Nelcy Martínez Trujillo,1 Ileana Morales Suárez,2 Eric Martínez Torres,3 Ileana Fleitas Estévez,4 Miriam Portuondo Sao,2 Yisel Torres Rojo2 and V. Gustavo Sierra González5 Suggested citation (original manuscript) 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 Publica. 2018;42:e32. https://doi.org/10.26633/RPSP.2018.32 ABSTRACT In Cuba, health research is based on the priorities of national scientific policy, derived from the health status of the population. The objective of this article is to describe the characteristics of the Science and Technological Innovation System and how the results of its research benefit the health of population groups. To this end, research related to the generation of products and technologies, diabetes, dengue and disability was selected. This system follows a methodology outlined by the Ministry of Science, Technology and the Environment, and has 37 research entities. It is organized into pro grams and projects that support basic and applied research using a multidisciplinary and intersectoral approach; these programs and projects are funded mostly by the State and are organized as a closed-loop system, i.e., the same entity is responsible for the entire process, from research to marketing, including market studies and post-marketing monitoring. The selected research projects demonstrate the alignment between research, gener- alization of results, and their effect in improving the population’s health and universal access to health care. Results were obtained in diagnostic methods, pre ventive and therapeutic vac- cines, warning signs for the prognosis and treatment of dengue, prevention of congenital mal- formations, and policies and programs that have benefited people with disabilities and their families. The State’s commitment to developing and funding scientific research, taking inter- sectoral action, identifying research priorities, and providing systematic training and attention to human resources have been key factors in meeting the system’s objectives. Keywords National science, technology and innovation policy; health sciences, technology and innovation management; biomedical research; health programs and plans; research design; Cuba * Non-official English translation from the original The Science and Technological In- productive and service activities (1). Spanish manuscript. In case of discrepancy, the original version (Spanish) shall prevail. novation System in Cuba is overseen Consequently, the number of research 1 Escuela Nacional de Salud Pública, Havana, by the Ministry of Science, Technolo- programs and structures was re- Cuba. Send correspondence to Nereida Rojo gy and the Environment (CITMA), in duced, and they were renamed and Pérez, [email protected] 2 Ministerio de Salud Pública, Havana, Cuba. accordance with Resolution No. classified according to their mission 3 Instituto de Medicina Tropical Pedro Kourí, 44/2012, which resulted in the reor- as follows (2): Havana, Cuba. ganization of scientific activity based 4 Representative of the Pan American Health • Research centers, when their main ac- on a policy aimed at achieving greater Organization in Havana, Cuba. tivity is scientific research and 5 BioCubaFarma, Dirección de Política Científica, efficiency and closer ties with Havana, Cuba. innovation; This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs 3.0 IGO License, which permits use, distribution, and reproduction in any medium, provided the original work is properly cited. No modifications or commercial use of this article are permitted. In any reproduction of this article there should not be any suggestion that PAHO or this article endorse any specific organization or products. The use of the PAHO logo is not permitted. This notice should be preserved along with the article’s original URL. Rev Panam Salud Publica 42, 2018 1 Special report Rojo Pérez et al. • Science and technological innovation in health in Cuba • Science and technology service cen- In the 2013 World Health Report, the science and set research priorities for ters, in charge of service delivery, Director-General of the World Health Or- 2012–2016 in five national programs, specialized production and research; ganization (WHO) stated, “All countries based on changes in the population’s • Development and innovation units, must be producers as well as consumers health status, availability of resources organized as enterprises,6 budgeted of research. (7). and the need to optimize them (Table 2), units (funded by the State) or other Cuba has systematically worked to- explained as follows (11): types of organization, all of which are ward that goal. The Science and Techno- Program 1: Health determinants, mandated to develop or innovate in logical Innovation System for Health risks and disease prevention in vulner- order to add value to the goods, ser- (SCITS) is singular and all-inclusive, and able groups. Emergence of new econom- vices and processes they offer. guided by two principles: the interdepen- ic actors and income disparities between dence of education, services and research; different social groups—along with a de- Research and development activities and the integration of scientific advances mographic situation marked by low fer- are organized on the basis of programs into social practice (8). This approach en- tility and birth rates, population aging and projects (basic research unit), and are ables the study of health problems and and migration—have imposed a new so- classified as follows (1): needs at the three levels of care (primary, cial/health context on the National • Projects associated with science, tech- secondary and tertiary) with alternative Health System (SNS), in which certain nology and innovation programs de- solutions in accordance with a sectoral, social groups may be affected. signed to study problems of national intersectoral, multidisciplinary perspec- Program 2: Organization, efficiency interest, supervised by CITMA re- tive and adherence to local culture (9). and quality in health systems and ser- gardless of sector; programs group SCITS’ present development is due to vices. Given the constraints imposed on together interrelated projects to fulfill the government’s commitment and pri- Cuba’s access to markets under favor- State priorities; management units in ority attention given to research, innova- able conditions (12) and the global eco- the health sector are responsible for tion and development of products and nomic crisis, the SNS has been obliged to health-related programs services to meet the population’s health prioritize and optimize organizational, • Projects not associated with pro- needs. Consequently, conditions, re- quality and efficiency processes in order grams, aimed at resolving national sources and human capital formation are to maintain the sustainability of current priorities that do not require imple- guaranteed so that actions developed in services, based on their design and mentation of a program SCITS programs and projects contribute realities. • Institutional projects, which conduct to efficiency, equity and the well-being of Program 3: Natural and traditional research on priorities identified by the population (10). medicine. The program attempts to pre- non-entrepreneurial entities for solv- The purpose of this article is to de- serve culture in health care through inte- ing concrete problems scribe the features of SCITS in Cuba and gration of traditional and modern natural • Entrepreneurial projects, which aim present research results that illustrate its medicine techniques. to solve priority problems specific to positive effect on the population’s health. Program 4: Cancer. Cancer is the sec- enterprises or business groups ond-leading cause of death in Cuba. This CUBA’S SCIENCE AND group of diseases causes approximately Approximately 26% of all Cuban scien- TECHNOLOGICAL 18 and 19 years of potential life lost in tific institutions are dedicated to health-re- INNOVATION SYSTEM IN women and men, respectively (13). Re- lated research, development and HEALTH search focuses on improving prevention, innovation, and are part of the Ministry of diagnosis, comprehensive care and Public Health (MINSAP), the Biotechnol- SCITS comprises 37 science and tech- rehabilitation. ogy and Pharmaceutical Industry Group nological innovation institutions: 16 re- Program 5: Aging, longevity and (BioCubaFarma), universities and other search centers, 3 science and technology health. Individuals aged ≥60 years ac- sectors (4). MINSAP sets the sector’s pri- service centers, and 18 development count for 19% of the population, and the orities in accordance with the country’s and innovation units administered by indicator is trending upward (13), signi- economic and social policy guidelines (5). MINSAP with methodological over- fying a greater burden on social and The State provides funding to carry sight by CITMA. Scientific societies con- health services; research should contrib- out research, innovation and develop- tribute to its functioning as do other ute to attainment of healthy aging. ment programs and projects at all levels. organizations
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