This week, perhaps the most prominent news story about the ongoing reality show unfolding in the White House was related to the content of the US president’s speech to the high-level segment of the United Nations General Assembly, the breakdown of his teleprompter, and the escalator he was using to get to the plenary session.
A comment made by Trump on Monday, September 22, as part of his crusade against vaccines and medicines and their alleged effect on the development of certain diseases, quickly made headlines.
According to several media outlets, the US president said: “… there is a rumor, and I don’t know if it’s true or not, that Cuba doesn’t have Tylenol because they don’t have the money to buy Tylenol. And they virtually don’t have autism (…) tell me something.”
The comment, lacking in rigor like so many others he makes on a daily basis, would have been of no consequence if several journalists interested in keeping their jobs in turbulent times had not sought an explanation for this even more banal phrase and had not tried to create a smokescreen for the real problems, but also for the achievements of Cuban medicine.
Some have placed great emphasis on the Cuban health system’s alleged inability to record all cases of autism in the country, without explaining that it is a difficult condition to diagnose and that it takes time to establish, in addition to a high level of specialization on the part of doctors.
None of the texts published on the subject explained that in the United States there is no single health information system, nor is there a centralized system or a clinical specialty on human ailments as a system.
In other words, health statistics are based on the study of samples, while in Cuba they are based on the study of the entire population. In the United States, private clinics and public health services operate independently and do not share protocols, while on the island they are part of a monolithic system. American universities do not graduate specialists in neurology who are interested in their patients’ heart conditions or intestinal systems, while in Cuba, comprehensive general medicine that interrelates all specialties is expanding.
These differences, and many others, have allowed a country without resources and without access to purchase Tylenol directly from its manufacturers to be much more successful in dealing with major pandemics such as COVID-19 than the country where it is now said that the component known as acetaminophen is not good for pregnant women.
For any observer, the numbers of people affected and killed by the pandemic in the United States were alarming, yet they are well below reality, precisely because of the inconsistent way in which the phenomenon was addressed and with the diversity of records based on different parameters.
The Cuban system, with its characteristics, has made it possible to sound the alarm to warn of the prevalence of atypical diseases or those with a higher than average international percentage, which has enabled the rapid action of specialists who created unique tools. Thanks to one of these alerts, Cuban experts were able, without Tylenol or other resources, to create a tool known as the National Genetic Map, which allows them to know years in advance and with a high degree of accuracy the diseases that will develop in families and territories, based on that information.
And the effort did not stop there. Relatively small groups of Cuban specialists traveled to sister countries such as Nicaragua, Venezuela, and Bolivia, carrying out similar work and providing their authorities with a scientific product that no multinational company is capable of manufacturing.
With very few US brands on the labels of its medicine bottles, Cuba has invested its limited resources in preventive medicine and has established, over decades, a doctor-nurse-patient relationship that long precedes the development of any illness. In the context of Trump attacking the manufacturer of Tylenol for the benefit of other large companies, the business model is based on the prevalence of disease in order to sell more products and services, with prices that are not justified by efficacy or prior research, which increase the wealth of manufacturers to the detriment of society’s living conditions.
If, before making such a statement, Trump had asked the now unemployed specialists at the Center for Disease Control or the National Institutes of Health about the low rates of various diseases in Cuba, they would have explained how many times they traveled to Havana to learn about local procedures and discover the unique concepts of the so-called Cuban school of medicine.
Incidentally, these procedures and concepts are not secret, nor are they used for profit. They are available to anyone who wishes to establish a respectful relationship with local specialists, on equal terms. They are available to the thousands of foreign students who have studied medicine at various faculties on the island, at the Latin American School of Medicine, where young people from more than 110 nationalities, including 245 from the United States, have been trained. All foreign specialists working in the same areas as the approximately 30,000 Cuban health experts who currently offer their experience and knowledge abroad can access this knowledge.
Any Cuban visiting the United States is struck by the number of young Americans, including those from middle and upper income families, who suffer from internal rotation of the calcaneal-tarsal complex with a clubfoot and varus position, which in Caribbean parlance are simply called zambos. The explanation is very simple: the US healthcare system does not provide mass care for newborns to detect such conditions and determine their treatment at an early age, when there is still time to correct the problem without surgery or further complications. Nor is it part of Americans’ human rights to receive a pentavalent vaccine at birth.
The State Department, or what remains of it intellectually, is located just 200 meters in Washington, D.C., from the headquarters of the Pan American Health Organization (PAHO), which in 2016 recognized Cuba as the first country (with or without Tylenol) to successfully prevent the transmission of HIV and syphilis from mother to child.
Most of the experts who participated in this analysis were American. Trump expressed concern about autism in his country and made comparisons with Cuba just days before the 20th anniversary of Hurricane Katrina’s passage through the city of New Orleans, which had and still has a high percentage of African-American population and which the Anglo-Saxon and Aryan president at the time, George W. Bush, was only able to guide them with the phrase “get out of there while you can.” How many lives could have been saved among the thousands who died thanks to an early warning, how many could have been saved after the storm if Cuban doctors had been allowed to travel there to offer assistance?
But the United States faces other storms in health issues for which it has no immediate solutions, even through expensive treatments and costly equipment.
Cuba, with its own resources and innovation, is able to prevent 73% of amputations resulting from diabetic foot. The United States has not been able to register an effective drug against this disease in the last 25 years.
The maternal mortality rate among the African-descendant population in that country is four times higher than in Cuba. Low-income pregnant women visit two doctors in nine months: the one who tells them they are pregnant and the one who delivers their babies.
In Cuba, there is rigorous monitoring of expectant mothers before and after childbirth. Paracetamol (Cuban Tylenol) is often in short supply, but they have a higher life expectancy. Cuba created a vaccine against lung cancer that has extended the life expectancy of terminally ill patients to the point that they die of other conditions.
That vaccine and its possible preventive use are at the heart of the only health agreement still in force between the two countries. It is the same vaccine (Cimavax, not Tylenol) that caused star television commentator Christianne Amanpour to say “wow” on primetime television when she learned of its results and its potential to limit the effect of the disease among Americans.
We do not know, nor is it of interest to us, what medications are consumed or prohibited among members of the U.S. cabinet, but it would be advisable for them to study the effects of Donepezil on memory loss. We say this because, according to the images released alongside the information about Trump’s comments on Tylenol and Cuba, behind him was Secretary of Health and Human Services Robert Jr. Kennedy, who is no stranger to these issues and knows Cuba. Does he not remember what he learned about Cuban medicine during his visits here?
(José Ramón R. Cabañas Rodríguez is Director of the International Policy Research Center (CIPI) in Havana, Cuba)
