Researchers at Cuba's National Medical Genetics Center: Pioneering Studies on COVID-19.

Three fourths of the 175 staff at Cuba's National Medical Genetics Center (CNGM) are women. And women constitute 90% of the research team working on the Center's largest current project-unlocking the biological secrets of COVID-19 in the Cuban population. They are identifying particularly vulnerable groups and geographies, reviewing therapies applied and long-term sequelae of the disease, and contributing to ongoing vaccine research and trials. Their results are critical to determining effective preventive and treatment strategies as the country moves into the next phases of epidemic control. The national study is the first and only one of its kind in Latin America. Then the first COVID-19 cases were diagnosed in Cuba on March 11, 2020, the Center's role in epidemiological surveillance was activated, based on its experience with the Zika threat in 2015. This involved mobilizing the National Genetics Network anchored in primary healthcare facilities, comprised of 452 genetics counselors, nurses and clinical geneticists, supported by technicians, epidemiologists and family doctors. The Network's role would become key to the ensuing research. As the magnitude of the pandemic became clearer, CNGM investigators approached the Ministry of Public Health and government leaders with a broad-ranging proposal to study biological factors that would help explain differences in vulnerability, symptoms, immune response and severity of the disease, as well as its profile in different Cuban subpopulations. After approval, the studies got underway in June, encompassing Cubans who had been infected through June 11, 2020, and were by now convalescing. The nine main research lines were defined, and principal investigators went to work developing the instruments needed and training personnel across the island on their use. While final results are still being analyzed, CNGM Director Dr Beatriz Marcheco and four lead researchers talked with MEDICC Review about the scope of their work and some of the most intriguing preliminary findings.

We are calling for adoption of universal, redistributive and solidarity-based policies with a rights-oriented approach to leave no one behind.

Serving in her present role since the economic crisis of 2008, Alicia Bárcena is no newcomer to regional and global emergencies, economic or otherwise. She also has extensive experience in the UN system, including as chief of staff to the UN Secretary-General and later, during Ban Ki-moon's tenure in that position, as Under-Secretary General for Management. From 2016 to 2017, she co-chaired the International Resource Panel at the UN Environment Program. A biologist trained in her home country of Mexico, she later received a master's degree in public administra-tion from Harvard University, USA. For decades, Ms Bárcena has devoted her professional career to issues of sustainable development, fi nancing of public policies, and the environment. She has received Doctor Honoris Causa degrees from the University of Oslo, Norway (2014); the University of Havana, Cuba (2016); and the Universidad Autónoma de México (2019). Today, she is a board member of the Global Partnership for Sus-tainable Development Data and a member of the University of Oslo/The Lancet Independent Panel on Global Governance for Health.

We are living in the geologic age when human activities have dramatically affected our planet and its environment.

Dr Barry is incoming Board Chair of the Consortium of Universities for Global Health (CUGH) and past President of the American Society of Tropical Medicine and Hygiene. She is a member of the National Academies of Sciences, Engi-neering, and Medicine, and serves on the National Academy of Medicine's Board of Global Health. She has received the Elizabeth Blackwell Medal for outstand-ing contributions to women in the fi eld of medicine, and is founder of WomenLift Health, a global initiative to transform global health outcomes by unleashing and elevating talented mid-career women to become global health leaders.

In this kind of situation, health as a public good once again becomes paramount...

Dr Jeanette Vega is well known in global health circles for her work in the areas of health equity, social determinants of health and health systems. She has served as Chile's Vice Minister of Health, and as director of the country's National Health Fund (FONASA). For fi ve years, she was also WHO Director of Equity and Social Determinants of Health. She currently sits on the 13-member Global Preparedness Monitoring Board (GPMB), co-chaired by H.E. Gro Harlem Brundt-land, Former Prime Minister of Norway and Former WHO Director-General; and Mr Elhadj As Sy, Chair, Kofi Annan Foun-dation Board, and Former Secretary-General, International Federation of Red Cross and Red Crescent Societies. An independent international monitoring and advocacy body, the GPMB prepared the seminal 2019 report on the state of global preparedness, A World at Risk.

Are increased chronic diseases a potential legacy of Cuba's special period?

Cuba is the only country I know to erect a monument to the egg….and so it should. Located on Havana's Fifth Avenue, the simple sculpture pays homage to the salva vida-literally the life saver of many a Cuban family, particularly in the 1990s. Those were the worst years of what was euphemistically called the "Special Period," when the economy careened ever downward, reeling from the loss of 85% of Cuba's aid and trade in the post-Soviet era.

The curious case of Cuba.

As health professionals in the United States consider how to focus health care and coverage to ensure better, more equitable patient and population health outcomes, the experience of Cuba's National Health System over the last 5 decades may provide useful insights. Although mutual awareness has been limited by long-term political hostilities between the United States and Cuban governments, the history and details of the Cuban health system indicate that their health system merits attention as an example of a national integrated approach resulting in improved health status. More extensive analysis of the principles, practices, and outcomes in Cuba is warranted to inform health system transformation in the United States, despite differences in political-social systems and available resources.