CubaPLUS Magazine

Dr. Francisco Durán, National Director of Epidemiology of the Cuban Ministry of Public Health (Minsap), is an affable, friendly, slow-spoken man and, above all, with great power of persuasion. He gave an exclusive interview to CubaPLUS Magazine to talk about the pandemic, the subject that has been occupying the world for more than two years.

The country, he pointed out, has managed to overcome COVID-19, thanks to the population’s compliance with sanitary measures and, especially, to the vaccination program, carried out with nationally produced immunogens.

Cuba is the only Latin American nation that has achieved the creation of five vaccine candidates, three of which are already vaccines, an unprecedented fact in an underdeveloped country with scarce resources due to the well-known difficulties imposed on it.

Only with a Revolution, with a scientific hub - as historic leader Fidel Castro, who created and developed the idea in 1991, called it at the time - was it possible for Cuba to have produced our own vaccines," he emphasized.

We are not talking about a country that is just starting to produce vaccines, we must take into account that in Cuba’s vaccination program, of the 11 immunobiologicals that are administered and protect against 13 diseases, eight are nationally produced, managing to eliminate an important group of diseases that plagued the world and Cuba before the triumph of the Revolution, among them: rubella, measles, mumps, diphtheria, whooping cough and polio. Therefore, Cuba has been creating vaccines for years and has been producing them depending on the needs," he said.

Despite the fact that we have the highly contagious Omicron and the even more contagious Omicron BA1 and BA2 subvariants circulating throughout the country, there has been a notable reduction in cases and deaths, which shows that the Cuban vaccine is effective," he said.

The effect of the vaccine, he clarified, does not prevent you from catching the disease, but it makes it possible to develop a much less complicated clinical picture and in the great majority of cases hospitalization is not necessary, the disease produces mild symptoms."

However, he considered the total elimination of the virus to be difficult and, as the Director of the World Health Organization (WHO) Tedros Adhanom Ghebreyes himself has stated, &respiratory viruses are continuously circulating, causing an endemic of acute respiratory infections. For this reason, every year, those that can, Cuba included, vaccinate at- risk groups of children and adults with anti-influenza vaccines. I do not mean that this is the future of the COVID-19. There has been talk of a first booster, a second booster...the scientists will then say how often it will be necessary to vaccinate again."

A piece of information
Epidemiology, explained Dr. Durán, is concerned with the health and disease of human populations and is of tremendous value, because when a certain disease or health problem appears, not necessarily a communicable disease, one must first discover the agent that produces it, the host that has it, the environment that facilitates the transmission of the disease or the health problem, so that emergency measures can be taken to combat the situation.

The actions to be taken in the case of a vector-borne, respiratory-borne or digestive-borne disease are not the same.

It also covers non-communicable diseases, from which we Cubans and a large part of the world are dying. The main causes of death in Cuba, for example, are heart disease, cancer, kidney failure, diabetes mellitus, accidents... however, thanks to our health system we have achieved a high life expectancy," he said.

Something important is that epidemiology is not exclusive to epidemiologists, he explained: &the objective is that any physician, graduate or other health professional should apply the clinical epidemiological method in their work."

When he began his medical studies, Durán intended to become a psychiatrist, just like his father, and even worked as one for a few years. However, in 1981, he switched to epidemiology in his native province, Santiago de Cuba, where the specialty was just beginning to develop. When he finished his specialist training, he was appointed Head of the Aedes Aegypti mosquito Eradication Campaign. That was his first experience as an epidemiologist.

Many other battles awaited him after that: he worked in the fight against dengue, then AIDS arrived on the scene. He was appointed Head of the Acquired Immunodeficiency Syndrome (HIV) Prevention and Control Program in Santiago and when the sanatorium for these patients was inaugurated, he was appointed Director.

Subsequently, he became Rector of the Medical University of Santiago de Cuba, Provincial Director of Health of the region and in 2003 he moved to Havana to serve as Vice-Minister for Teaching and Research.

In 2009, he was appointed Head of Cuba’s medical mission in Angola, where he stayed for three years and, as he said, he learned about diseases he had never seen before, which was very valuable for his training as an epidemiologist.

Upon his return in 2012, he became the First Deputy Director of the &Pedro Kourí" Institute of Tropical Medicine (IPK) and in 2014 the National Directorate of Epidemiology, a responsibility he currently holds.

During all these years, he has had to deal with cholera, dengue, zika and chikungunya epidemics, as well as lead the programs of Prevention and Control of Communicable and Non-communicable Diseases and International Health Control.

We have worked hard. All the officials of the leadership have had to be all over Cuba supporting the work in the provinces and it has been a combat experience, which helped us to confront COVID-19, because as its existence was reported in 2020, before we had the first case -March 11, 2020-, we had already prepared the prevention and control plan, with approval from the country’s top authorities. Of all my experiences facing epidemics, this was unquestionably the toughest," he said.

For this long-standing epidemiologist, this work has been &a beautiful experience, despite the misfortune. It allowed me to prepare myself technically, to connect with many people, to give encouragement and above all to raise awareness of the measures to avoid contagion and to protect their medical care. It was very interesting from the epidemiological point of view for my work team and for me," he concluded.