Cuba and Taiwan push for homegrown Covid vaccines amid frosty relations with the world’s superpowers

'A different form of vaccine diplomacy': US sanctions and concerns about Chinese influence prompted Cuba and Taiwan to develop jabs at home

High-risk laboratory workers work in Havana, Cuba on the first vaccines in Latin America to start the third and final phase of clinical trials
High-risk laboratory workers work in Havana, Cuba on the first vaccines in Latin America to start the third and final phase of clinical trials Credit: Ernesto Mastrascusa/EPA-EFE/Shutterstock 

At first glance, little beyond their island status links Cuba and Taiwan. But complex relationships with neighbouring superpowers have pushed both countries to bet on home-grown coronavirus vaccines.   

In Cuba, decades of sanctions imposed by the United States have inadvertently created a thriving biotechnology industry. Four vaccine candidates are in development in the communist country, including two which entered phase three trials this month.   

Meanwhile, 9,000 miles away on China’s doorstep, growing fears Beijing could use access to vaccines as a further means of political coercion have raised the stakes for two Taiwanese jabs currently in phase two trials.   

“This is just a different form of vaccine diplomacy,” said Dr Clare Wenham, assistant professor of global health at the London School of Economics.   

“Everyone knows vaccines are a finite pot of gold right now. The approach for places who can’t purchase them, or don’t want to be constrained by superpowers, is to make your own [if you can].”  

Medicine students check door-to-door for people with symptoms of the coronavirus in Havana. Cuba has around 8.4 doctors per 1,000 people - compared to 2.8 per 1,000 in the UK
Medicine students check door-to-door for people with symptoms of the coronavirus in Havana. Cuba has around 8.4 doctors per 1,000 people - compared to 2.8 per 1,000 in the UK Credit: EUTERS/Alexandre Meneghini

In Cuba, domestic capacity dates back to the 1980s, when then-leader Fidel Castro invested heavily in the biotechnology industry to get around a US embargo which made it almost impossible to import medical supplies.   

In the years since, the country’s laboratories have produced drugs including the world’s first meningitis B vaccine and interferons used to treat cancers and viral infections.   

“Before the pandemic Cuba was exporting [biotech products] to around 49 countries… and had the capacity to produce almost 70 per cent of the domestic medicines consumed,” Dr Helen Yaffe, a Cuba expert at Glasgow University and author of 'We Are Cuba', told The Telegraph

“Some have been surprised, even sceptical, that [the country] has four vaccines in development. But this is really just a logical next step in Cuba’s history.”   

This month two coronavirus vaccine candidates became the first developed in Latin America to enter stage three clinical trials: Soberana 2, which means “sovereignty” in Spanish; and Abdala, named after a poem by a Cuban revolutionary icon.  

Laboratory workers in Havana work to develop coronavirus vaccines - Soberana 2, which means “sovereignty” in Spanish; and Abdala, named after a poem by a Cuban revolutionary icon.  
Laboratory workers in Havana work to develop coronavirus vaccines - Soberana 2, which means “sovereignty” in Spanish; and Abdala, named after a poem by a Cuban revolutionary icon.   Credit: Ernesto Mastrascusa/EPA-EFE/Shutterstock 

Both are conventional jabs targeting the coronavirus spike protein. According to Eduardo Martínez, head of state conglomerate BioCubaFarma, which is overseeing the process, the vaccines have shown a “potent immunological response” and no serious side effects in smaller human trials. Two other jabs, including one administered via a nasal spray, are in early testing.   

Initial results are expected for Soberana 2 – which is being tested on roughly 44,000 people in Cuba and other countries including Venezuela and Iran – as soon as May.   

For Cuba, the stakes are high: vaccines are expensive and the US embargo makes importing jabs difficult. 

The economy, which relies heavily on tourism, has also been decimated by Covid – GDP has fallen by 11 per cent. Though overall mortality rates remain low compared to much of Latin America, with 2.8 deaths per 100,000 people, easing stringent border restrictions also triggered a recent uptick in cases.  

“Our plan is to, of course, first immunise our population,” said Dr Vicente Vérez Bencom, director of the Finlay Institute of Vaccines, which is developing Soberana 2. “We’re planning to have in the order of 100 million doses during 2021.”  

The country only needs only around 20 to 30 million doses to vaccinate its population. It expects to export excess jabs at a small profit, to reinvest into the country’s free healthcare system.   

The obstacle now is getting there: the US embargo could also prevent mass production if the medical equipment needed to ramp up cannot reach the country.   

Meanwhile, Taiwan appears to be going it alone out of what its health minister described as the risk of “external forces intervening” in its attempts to buy vaccines for use at home.    

A democratic island of 23 million which is also claimed by the Chinese Communist Party, Taiwan has come under increased pressure recently from Beijing for refusing to bow to its territorial demands. Now some fear Covid-19 could offer another frontier for Chinese influence.  

A man wears a protective mask to prevent the spread of Covid in Taipei ahead of Chinese New Year. The country's successful handling of the pandemic means life has largely returned to some semblance of normality
A man wears a protective mask to prevent the spread of Covid in Taipei ahead of Chinese New Year. The country's successful handling of the pandemic means life has largely returned to some semblance of normality Credit: REUTERS/Ann Wang

Unlike Cuba, the country – which has emerged relatively unscathed from the pandemic after acting fast to shut down outbreaks – has agreed deals with international vaccine producers.

Roughly 117,000 AstraZeneca jabs arrived in early March, of some 10 million expected, and the country is set to receive 4.76 million jabs through the vaccine sharing Covax scheme.   

But the stakes around two conventional, protein-based vaccines produced in Taiwan and in phase two clinical trials – produced by Medigen Vaccine Biologics and United Biomedical Inc Asia V – rose after suspicions China influenced negotiations with pharma giants.  

The health minister, Chen Shih-chung, claimed in a radio interview in February that Taiwan and BioNTech had been on the cusp of signing a deal for five million Pfizer vaccine doses, only for the company to suddenly pull out.  

“I had always worried that there would be external forces intervening,” he added, without naming any country. “We believe there was political pressure.”  

China denied any interference and BioNTech confirmed it was still negotiating a deal with Taiwan.

But Professor James Liao – president of Academia Sinica, the prestigious institution supporting the two local vaccine producers – told The Telegraph geopolitics and international pressure on supply chains have driven Taiwan’s quest to develop its own vaccines.   

“[The protein-based vaccines] take longer to manufacture but they are easier to administer and easier to store,” said Prof Liao, adding that animal testing in the first phase of the vaccine trials has been promising.  “If everything is working as planned, they will get emergency use authorisation around [mid-year] and begin to produce.”  

Like Cuba, Taiwan believes domestic vaccines will offer the country added security. The health minister told the Taiwanese parliament that he hopes the homemade drugs can start to be rolled out as early as July, while the island plans to build manufacturing facilities to produce as many as 20 million doses per month.   

“We know Covid-19 will not be the last pandemic,” said Prof Liao. “So we definitely need to have our own vaccine development capability.” 

Additional reporting from John Liu

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