The fact that Cuba's response to the COVID-19 has been far more effective than most countries in the region, including the United States and also several European nations, is a reality that is becoming evident. A health system based on prevention, with a presence in all communities of medical offices, organized by neighborhood and linked to polyclinics, as well as general and specialized hospitals in all provincial capitals and some of the most important cities, as well as medical schools, along with advanced centers for biomedical research, have made possible active monitoring and surveying to identify asymptomatic patients, to isolate them and provide early treatment with national protocols and medicines, in addition to the creation of our own technology to test patients, requiring a minimum costly reagents in pre-existing laboratories in all the country's municipalities.
Cuba lost half of its doctors to the United States in the years immediately following the triumph of the 1959 Revolution, leaving barely 3,000, but today has 95,000, with the highest rate of doctors per inhabitant on the planet.
While the majority of therapeutic clinical trials underway around the world are being conducted to identify treatments to contain the so-called cytokine storm in COVID-19 patients, the inflammatory hyper-response triggered by the disease, Cuba has successfully achieved this with a medicine of its own (CIGB-258). Cuba is working urgently, as are great powers like the United States, Germany, China, Russia and the United Kingdom, to produce a vaccine for the prevention of the disease, and has developed its prototype of a pulmonary ventilator for intensive care patients.
The above, as well as the creation of world-class biotechnology research centers, the training of thousands of highly qualified scientists committed to the health of their people - who have remained in Cuba, facing shortages and scarcity, despite systematic “brain drain” policies of northern countries to attract talent from the South, which the U.S. blockade intensifies in the Cuban case - came as the result of Fidel’s vision which, beginning in the early 1980s, encouraged the national production of medicines such as interferon; innovative vaccines against diseases, such as Hepatitis B and meningococcal meningitis; monoclonal antibodies for the treatment of different types of cancer, and remedies that are unique in the world, including one that has prevented innumerable amputations for patients with diabetic foot syndrome, among many other achievements.
To be added to all this are innovative brain research and our own diagnostic tools that allow pre-partum detection of congenital defects, diseases present in the blood such as HIV and others, now including COVID-19. All these treatments are available, free or at a symbolic cost, to Cubans at the community level, along with vaccinations against 13 diseases for children.
It was also in the mid-1980s when Fidel began to speak out, as Cuba's medical schools were multiplying and the number of students in health-related specialties growing. Despite the doubts of more than few skeptics and taunts from his enemies, he insisted that the country would be a world power in medicine.
When, a few years later, the disappearance of the USSR triggered the deepest economic crisis in Cuban history, scientific research centers remained open, while the Comandante en jefe repeated: "This country will live with the creations of our intelligence." The export of medical services is today the main source of foreign exchange for the Cuban economy, despite U.S. government persecution, while the development of innovative biomedical products has also made an important contribution.
Cuba is a world leader in health solidarity, present in the most remote regions of poor countries and offering thousands of scholarships for medical students, in addition to the work of the Henry Reeve internationalist contingent for disaster situations.
It is not far-fetched to emphasize Fidel’s role in all of the above. Cubans watched him explain the efforts on television in well-argued presentations, opening doctors' offices, hospitals, polyclinics and scientific centers, and listened to his speeches at med school graduations, not with the demagogy of a capitalist politician who takes advantage of these occasions for some public relations campaign, but with the knowledge of a person who conceived the project and promoted it down to the last detail; someone who knew the “why and what for” of everything, always thinking of how the most humble citizen would benefit.
If this were not enough, there is the availability of university institutions throughout the country, with accommodations to house students from distant locations free of charge, which have served as isolation centers during the epidemic, among them a University of Computer Sciences, conceived by Fidel, where thousands of professionals have been trained and applications have been developed for cell phones, including the recently launched app allowing individuals to self-report any COVID symptoms or provide information to health authorities.
Likewise, it was Fidel who promoted the creation of educational television with the needed facilities, which today has allowed general and art education students to continue their learning at home.
What about after the pandemic?
All that is very well, an observer could say, Cuba will undoubtedly overcome the health crisis before others, but what will happen after that, when the impact of intensified U.S. sanctions which have battered the Cuban economy is compounded by the global economic crisis, aggravated by the pandemic with its negative impact on activities such as tourism, which play a key role in generating hard currency for the nation. The economic damage caused by the virus has created enormous challenges for all countries and even more so for one facing from the longest economic blockade in history.
As has been stated by the country's leadership, it is essential to make decisive progress in the implementation of economic transformations agreed upon at the VII Congress of the Communist Party here, despite the new, unfavorable conditions,
The Cuban government has indicated that current economic priorities include national production of food, with the goal of producing most of our food on the island, along with fuel savings; limiting imports given our dwindling reserves of foreign exchange; the promotion of exports of all kinds; and the safe opening of tourism when conditions allow. Here too, Fidel's ideas could play a very important role.
The intensive cultivation of high-protein crops, to which the Comandante dedicated his efforts in the last years of his life, has great potential to provide animal feed, according to the UN’s Food and Agriculture Organization. Beginning in 2011, alongside Cuban scientists and farmers, Fidel worked on research with moringa, mulberry and tithonia as food for monogastric (chicken, pig) and polygastric (cattle and sheep) livestock. As occurred with his vision for Cuban medicine and biotechnology, some mocked these projects, but scientific research indicates that the three crops exhibit greater productivity per hectare than soybeans, sunflower and alfalfa, allow up to eight harvests a year, and support high density cultivation.
The extensive, innovative, unique knowledge accumulated by Cuba in this field could be very attractive for foreign investment, both associated with supplying the domestic market and for export. Local development projects, facilitated by authorities granted to municipalities in the new Constitution, could find opportunities in this field, especially with the support of the Sierra Maestra Science, Technology and Innovation Institute, founded in 2018 by the Cuban government, to give continuity to this work initiated by Fidel.
It was also the Comandante who conceived developing the keys off Cuba’s coastline for tourism, accessible via roads built over the water during the difficult 1990's, which today have solid infrastructure, including airports. Practically virgin beaches on islets north of the big island, without resident populations, could provide the initial opening to international visitors, after the epidemic is fully controlled, without putting population centers at risk. Hotel companies such as Meliá and Iberostar are already incorporating health sustainability as a fundamental value in their post-pandemic strategy, and few tourist destinations in the world can compete with what Cuba is able to offer when guarantees and assurances are in place to reopen our borders.
This is not a panacea, which do not exist in economic affairs, more so in times of uncertainty and crisis at a global level, but it is evident that Fidel is far from being "the one responsible for the economic disaster," as some “Cubanologists” affirm, but rather the contributor of very important ideas for sources of income for a non-oil producing country, without great natural resources or much fertile land, requiring irrigation and fertilization. A country that has not only survived in conditions created by economic siege, but has also developed a project of social justice that provides basic services for all its citizens, that many countries lack, without the problems that are endemic elsewhere, like organized crime and child labor.
In addition to the massive training of highly skilled human resources, clearly an incentive for foreign investment and the export of professional services, as well as globally unique, value added products, which he promoted, Fidel Castro's tireless work for his people has been not only a decisive factor in ensuring that the humanitarian disaster evident in many other nations, with governments that have opposed his model, has not occurred here. The example he provided of tenacity, service to the people, eagerness for knowledge and scientific rigor, contributes to the development of solutions here that allow Cuba to once again dash the right wing dream of returning our island to the status of "hybrid casino-whorehouse" that some believe possible, in light of the "perfect storm" created by the combination of a tightened economic blockade and the arrival of a virus, which, if anything, has laid bare the unviable nature of the economic, political and social system the Comandante devoted his life to fighting.