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FeatureLike a tropical lullaby, the rocking chairs lay down a languid rhythm accompanied by laughter, bits of gossip, and gripes about the heat. Olga Lydia, 39, anemic, and preparing to give birth to her fi rst child, wonders aloud what it will be like to have a son, when in her heart of hearts she wanted a daughter. Meanwhile, Loreta, 18, and expecting twins, rocks quietly alongside, a smile on her fl awless face.Olga Lydia and Loreta are two of the more than 67,000 at-risk expectant mothers[1] served by Cuba's network of over 300 maternity homes, receiving comprehensive care and childbirth education in either live-in or ambulatory modalities. Since the fi rst 15 such homes were founded in 1962 in the eastern part of the country, the system has evolved into a national program employing a uniform practice for women presenting certain risk factors during pregnancy. The strategy has helped the country achieve a nearly 100% in-hospital birth rate[2] and lower infant and maternal mortality rates, and partly explains why Save the Children ranks Cuba as the number one developing country in which to be a mother. [3]
MEDICC Review: Can you synthesize CECMED's role as a national regulatory authority?Olga Lidia Jacobo: Any medicine, device or equipment-Cuban or imported-used in our health system must be approved by CECMED, the country's single regulatory authority. To ensure new products meet global standards of quality, safety and effi cacy, WHO defi nes the six basic functions for NRAs as: medicine regis-tration; lot-by-lot vaccine release; inspections; clinical trial authorization; laboratory access; and post-marketing surveillance. As a WHO Level 4 NRAr, CECMED undergoes regular, independent evaluations and inspections to certify compliance with standardized best practices throughout each aspect of these six functions. By way of background: after Cuban scientists started producing new vaccines and other biotech products in the1990s, CECMED,
MEDICC Review:The recombinant hepatitis B vaccine, Heberbiovac-HB, developed over 30 years ago by CIGB, foreshadowed the potential of Cuba's biotechnology sector.
Can you tell us about that experience?Verena Muzio: Developing the hepatitis B vaccine was a huge challenge, involving a lengthy clinical development and production process which began in 1986 under the direction of Dr Luis Herrera, founder
MEDICC Review: Can you tell us what the situation is like on the ground and if all the members of the Cuban team are accounted for?Luis Orlando Oliveros: We have 253 professionals working here-the majority women-distributed throughout the country. Everyone is okay. The situation is very tense, especially in the southern region most affected by the earthquake [the epicenter was 5 miles from the town of Petit Trou in the Nippes department, 80 miles west of the capital, Eds.]. This was a very strong earthquake, causing the kind of widespread destruction-loss of human life, collapsed buildings, diffi culty in accessing health services-that our team has seen with other natural disasters. It is a very diffi cult situation, made more so by the spread of COVID-19. All of our health professionals staffi ng hospitals in the towns of Aquín, L'Asile and Jérémie, closest to the epicenter, are attending the injured. Patients are being treated in triage areas set up outside, on hospital grounds. MEDICC Review: Are you working with other organizations? Who is coordinating the relief effort?
THE AUTHORConner Gorry MA, journalist with a master's degree in international policy. Senior Editor, MEDICC Review. She reported from inside the Henry Reeve Medical Contingent in the aftermath of the 2010 earthquake; Dispatches from Haiti, 2010 is a collection of articles from that posting.
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