On October 23, 2020, at the Melia Varadero International Hotel in Matanzas Province, a man is standing near a Cuban national flag. Varadero, Cuba's main seaside resort, is reopening to international tourism amid the coronavirus pandemic.
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Cuba's most advanced Covid-19 vaccine candidate is set to enter late-stage clinical trials next week, bringing the tiny island nation ever closer to an exceptional medical performance that analysts believe will have far-reaching ramifications across the global south.
Cuba's most promising vaccine candidate of the four under development is Soberana 02. The vaccine name translates from Spanish to "Sovereign", an alleged allusion to Cuba's national pride in its world-famous healthcare system.
Soberana 02 is scheduled to enter phase 3 studies from March 1. According to official figures, up to 150,000 volunteers will take part in the tests within weeks. Phase 3 trials represent the final phase before a vaccine is generally approved by national regulatory authorities.
It comes at a time when many people in Cuba are forced to stand in line for hours to buy basic goods and the authorities continue to adhere to a decade-old U.S. trade embargo – with sanctions that former President Donald Trump has in recent years Years.
"It's just this incredible dichotomy," Helen Yaffe, a Cuba expert and lecturer in economic and social history at the University of Glasgow, Scotland, told CNBC over the phone.
"On one hand, you have this high-tech biotech sector that brings a lot of hope to the global south because there is the possibility of an affordable vaccine – (and) vaccinating the global south will be the priority," said Yaffe.
"And at the same time, Cubans get up at four or five in the morning to join the queue because there is a real shortage of really basic food and even medicine."
What do we know about Soberana 02?
The Cuban Finlay Institute, the country's leading biopharma institution, is overseeing the development of Soberana 02. Vicente Verez, director of the institute, has indicated that the vaccine could be available as an option to tourists later this year.
If Soberana 02 is found to be safe and effective, the development of a domestically manufactured vaccine will likely be hailed as an astounding scientific breakthrough and major political triumph. Cuba would also be the first Latin American country to immunize its population with a domestically manufactured vaccine.
Technician Mayelin Mejias will work in the vaccine aseptic and packaging processing facility at the Finlay Vaccine Institute in Havana on January 20, 2021.
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The government has not yet outlined any concrete plans for vaccinating tourists, but analysts say it is possible for foreigners traveling to Cuba to receive their first dose of vaccine on the island before subsequent doses to take home can take.
Although public data are limited, it is believed that up to three doses of the vaccine could be given at two-week intervals.
People are already talking about sun, sea, sand and Soberana 02. So I wouldn't be surprised if people went to Cuba to look for the vaccine and I'm sure the Cubans will offer it.
Lecturer in Economic and Social History at the University of Glasgow
Yaffe, who is also the author of We Are Cuba !: How a Revolutionary People Survived in a Post-Soviet World, said Cuba's sophisticated health system would help the country introduce the vaccine "extremely" quickly.
"I can guarantee that. And if they have a vaccine every two weeks, people could be vaccinated within a month of starting," Yaffe said.
"By the summer, people will be pretty desperate to go on vacation, and I think Cuba, which is nominating itself as the ideal travel destination. People are already talking about sun, sea, sand and Soberana 02. So I wouldn't be surprised if Die People go to Cuba to find the vaccine and I'm sure the Cubans will offer it. "
How does it work?
The Soberana 02 vaccine is a conjugated vaccine. This is a type of vaccine that contains a portion of the spike protein that binds or conjugates to human cells to increase its stability and effectiveness.
Unlike other coronavirus vaccine candidates like Pfizer-BioNTech, Soberana 02 doesn't require any additional cooling requirements. This should ease the logistical and administrative challenges associated with vaccination programs in low-income countries.
People line up in Havana to buy groceries on Feb.2, 2021 as Covid-19 cases emerge in the island nation.
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At a virtual session led by the Pan American Health Organization on February 5, Dr. Verez, Soberana 02 returned "encouraging results" in the early test phases. He added that the vaccination has not yet produced any significant side effects.
The Cuban government has announced that it will produce 100 million cans of Soberana 02 this year to meet the needs of its own citizens as well as those in other countries. It is said to be one of the first countries in the world to vaccinate its entire population in 2021, though many advanced nations started administering bumps almost two months ago.
Several countries have expressed an interest in purchasing the vaccine, including Vietnam, Iran, Venezuela and the African Union, which represents all 55 countries in Africa.
Cuba, which has seen relatively few Covid cases compared to other countries in the region, has seen a sharp rise in infections and deaths in recent weeks. To date, Cuba has recorded 45,361 cases of the coronavirus and 300 deaths, according to Johns Hopkins University.
"One of the world's best kept secrets"
Cuba has long been known for its medical diplomacy. Thousands of professionals have been sent abroad to help countries cope with short-term crises, natural disasters and medical emergencies.
Human rights groups have raised concerns that the Cuban government is imposing repressive rules on doctors working abroad and invoking the right to privacy, freedom, expression and association.
At the start of the Covid-19 outbreak, Cuba had an estimated 24,500 medical workers in 58 countries. Another 4,000 members of the Cuban Henry Reeve Brigade, a group of highly respected health professionals, have worked in countries from Kuwait to Mexico, Italy to South Africa.
Cuban doctors during a welcoming ceremony for Cuban health workers deployed in Cape Town, South Africa, in the Western Cape on May 24, 2020 to support efforts in the fight against COVID-19.
Mischa Jordaan | Gallo Images via Getty Images
It's a deeply rooted tradition that the country, with just over 11 million, has more medical staff working overseas than all of the G7 countries combined.
"This is an extraordinary recording, largely unknown to the mainstream media – one of the best-kept secrets in the world," said John Kirk, a professor in the Latin America program at Dalhousie University in Nova Scotia, Canada, via email to CNBC.
"Medical internationalism is in Cuban DNA, and the preamble to the Cuban Constitution mentions the obligation that Cuba must share its medical talent with developing countries," he added.