Student blog: The role of global health in U.S.-Cuba relations

In December 2014, President Barack Obama officially announced the intention to re-establish diplomatic ties with Cuba, replacing half a century’s worth of hostility with policies of détente. While the declaration to politically engage Cuba and the establishment of embassies is monumental, political divisiveness and bureaucracy have slowed the pace of progress and raised questions about the best way to move forward in opening ties with Cuba. Given the countries’ mutual interest in being global leaders in health, neglected tropical diseases (NTDs) offer a unique opportunity for the United States and Cuba to engage in scientific collaboration to further the effort to normalize relations.

In 2014, the American Association for the Advancement of Science and the Cuban Academy of Science identified public health areas of mutual interest and signed an agreement to advance scientific cooperation on these issues. However, because the U.S. embargo with Cuba is still in place, there are significant restrictions on collaboration between the two countries. Conducting business in Cuba is still difficult, preventing biotechnology companies in the U.S. from selling important research equipment to Cuba’s medical sector. Additionally, federal research funds in the U.S. cannot be used to support U.S.-Cuba joint research efforts, creating a significant barrier to collaboration. While the complete lifting of the embargo with Cuba will take time, enacting health diplomacy policies that enable U.S. scientists to work in Cuba as well as allowing federal research funds to be used toward joint research projects are steps that can be taken to foster research partnerships between the U.S. and Cuba. Given Cuba’s long history of medical diplomacy and authority in Latin America, engaging in global health diplomacy with Cuba can also be a mechanism for the U.S. to increase its strategic influence in the region.

Global health diplomacy, or foreign policy that focuses on strengthening public health and scientific relationships, can be used to overcome traditional diplomatic challenges. As a bipartisan vehicle, global health diplomacy can encourage bilateral cooperation and facilitate political relations diplomacy between the two countries. A U.S.-Cuba global health partnership would be advantageous for both countries by capitalizing on their complementary strengths. Cuba’s proficiency in preventative medicine and epidemiological surveillance coupled with U.S. medical technology and financial resources will build the capacity of both countries with respect to innovative research and development. More importantly, both the U.S. and Cuba have shown significant accomplishments in achieving medical breakthroughs, with Cuba developing vaccines for lung cancer, meningitis B and hepatitis B. If the two countries were to share knowledge, significant progress could be made in the public health arena.

Focusing on a global health issue of importance to both countries would be the most effective way to initiate a working relationship between the U.S. and Cuba. NTDs, which include infectious diseases of emerging importance like dengue, chikungunya and Zika, provide an important opportunity for U.S.-Cuba scientific collaboration. These diseases are mosquito-borne viruses, and during the last few decades, climate change and urbanization have led to the expansion of geographic areas where the disease is transmitted, increasing concerns about the potential for outbreaks in the U.S. and in Cuba. The symptoms of these illnesses can be severely disabling, creating major public health concerns. The shared expertise between both countries will be vital in controlling and monitoring outbreaks. There are currently several candidate vaccines for dengue, including one that has recently been approved for use in Mexico, Brazil and the Philippines. Both the U.S. and Cuba have yet to approve a vaccine for use in their respective countries, creating an opportunity for cooperation. Currently there are no pharmaceuticals available to prevent or treat chikungunya or Zika virus, presenting yet another area for joint research and the development of therapies. Exchanging lessons learned, clinical trial results and implementation best practices will increase the efficiency of the development process for future vaccine candidates.

Global health needs to become a priority as Cuba and the U.S. continue to shift their policies to establish diplomatic relations. A focus on NTDs will not only yield benefits for both countries, but also provide advancements of global importance in reducing the burden of NTDs. This is an opportune time for global health diplomacy between the U.S. and Cuba to improve security and help both countries project regional influence, thus supporting traditional foreign policy objectives through the pursuit of scientific collaboration.

Anjali Bhatla is a junior at Rice University majoring in health sciences and policy studies. She is an intern in the Disease and Poverty Program at the Baker Institute.

James A. Baker III Institute for Public Policy, Baker Institute Blog Chron

January 20, 2016

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