In a report published on the site Scidev.net, a city-based specialized in bringing science to development through news and analysis, the authors highlight how this strategy of vaccination with safe and effective immunogens could face situations of this type in environments with resource-poor, low-income countries, and in the developing world.

At the same time, they demand the reduction of the barriers that block global access to biotechnological innovations from that country.

Last June, the team of US researchers, together with colleagues from Africa and the Caribbean, made an official visit to Cuba, the first high-level visit in five years, to exchange with colleagues from the island on the production of vaccines against covid-19 from the country.

The delegation was led by co-chair Michael Osterholm, PhD, MPH, director of the Center for Infectious Disease Research and Policy at the University of Minnesota.

Along with the scientist came Cristina Rabadán-Diehl, PharmD, PhD, MPH, who for 25 years led international work at the National Institutes of Health and the US Department of Health and Human Services, before becoming Director Westat Clinical Trials Associate.

For Osterholm, what he learned about Cuba’s extraordinary work with the covid-19 vaccine made it clear that it can be an important actor in increasing global access to life-saving advances.

He considered that although the policies are complex, “they must face the barriers that prevent their impressive group of scientists and public health experts from doing it.”

The report further explains that the purpose of the fact-finding mission was threefold: first, to learn how and why a small country of some 11 million people, and facing considerable economic hardship, had developed, manufactured, and deployed its own vaccines, It was shown to be more than 95% effective in preventing disease, severity, and death.

Second, understand the launch of the vaccine in Cuba, strategy and preliminary results and third, explore Cuba’s approach to science in the context of public health.

The vaccine development effort and the immunization model could reveal opportunities to reduce global inequalities in access to vaccines and other health innovations, the scientists insist in their study.

They also highlight that the delegation was aware of predictions that the world is dangerously close to the next pandemic, with cross-zoonotic infections, which already account for 75% of emerging infectious diseases, on the rise amid climate change.

They were also alarmed by the unequal access to vaccines that has prolonged the pandemic so far, and how it highlights a broader failure in the current surge in biomedical innovation to reach billions of people in low- and low-middle-income countries.

The visit to Havana was organized by Medicc (Medical Education Cooperation with Cuba), a US-based non-profit organization that promotes health-related dialogue and collaboration.

Since 1997, Medicc has facilitated exchanges between Cuban and US health professionals, academics, policymakers, foundations, students, and leaders of medically underserved communities.

(With information from PL)

In severe cases of degenerative aortic stenosis—or what is the same, the narrowing of the valve in the large blood vessel that originates from the heart (aorta) and does not allow the valve to open completely, which reduces blood supply and makes it much harder for the heart to function—the option is to operate for the purpose of repairing or replacing the valve.

The heart of patients with this condition can weaken and cause chest pain, fatigue, and shortness of breath; and also, stop beating.

Dr. Leonardo López Ferrero, interventional cardiologist and head of the ICCC’s Cardiology and Hemodynamics service, knows this. He is in charge of the team of specialists who this Monday implanted the first minimal access percutaneous aortic valve in Cuba.

The procedure, novel in the country and performed on two patients, places Cuban interventional cardiology in a valuable line of development for the treatment and quality of life of people with this condition, and who cannot be beneficiaries of conventional surgery.

Why is it a beneficial procedure?

According to the specialized literature, degenerative aortic stenosis has an estimated prevalence of between 4% and 7% in the population over 65 years of age. Around 30% of cases do not undergo surgery, due to contraindications to surgical treatment and associated comorbidities. Meanwhile, the global mortality of patients with this condition is 50% to 60%, between the first two and three years after diagnosis, if no intervention is performed.

Through two femoral arteries and a radial artery, the entire minimally invasive procedure is performed, Dr. López Ferrero highlighted.

“Greater advantages for the patient’s recovery, a less aggressive approach, a shorter hospital stay and the possibility of returning more quickly to family and work life, are some of the benefits it offers,” he said.

The interventional cardiologist explained that the two valves that were implanted today are percutaneous, that is, they are transported in a catheter to the aortic valve, a catheter is taken to the narrow aortic valve and the new valve (from bovine pericardium) that is assembled over a stent replaces the patient without the need for open surgery.

For López Ferrero, introducing this new technique in interventional cardiology in the country has a great impact: “In Cuba, more than 30% of our population is already over 75 years old and this is a disease that appears in advanced ages of life,” he specified.

The donation of the devices by the European company Iberhospitex S.A. and coming from India, allowed this very expensive intervention to be carried out, the specialist pointed out.

“These valves are priced at around 20,000 euros and, if you add the necessary equipment and consumables, the cost can rise to 60,000 euros,” he said.

According to the expert, the placement of these devices is the first step for the gradual start of a transcatheter aortic valve implantation (TAVI) program, for which the ICCC is committed, although the institution has For many years, he has operated patients of this type and performed surgical replacement of the valve, by conventional approach.

It would benefit people who meet the established criteria (electrocardiographic, echocardiographic, angiographic and tomographic established and who have cardiac surgery contraindicated due to the high risk it entails).

Dr. Carmen Rosa Martínez Fernández, director of the Institute of Cardiology and Cardiovascular Surgery, stressed to the press that the medical act goes beyond performing a procedure, since it is part of a practical training workshop that follows the continuous training received by cardiologists center interventionists, and that can be extended to professionals from the rest of the country.

A multidisciplinary team made up of cardiologists from the Institute and the William Soler Cardiocenter, cardiovascular surgeons, sonographers, imaging specialists, anesthesiology specialists and nursing staff, were present at the intervention, which was accompanied by the Spanish doctor Ignacio Amat Santos, head of Hemodynamics and Interventional Cardiology at the University Clinical Hospital of Valladolid.

Martínez Fernández pointed out that Dr. López, head of the institute’s Cardiology and Hemodynamics service, has been trained in Barcelona hospitals on several occasions to perform this procedure. The presence here of Spanish teachers today is also part of a continuous process of training and collaboration.

“The Cuban population is aging and there is a degeneration of the aortic valve as a result of this demographic phenomenon,” said the specialist who insisted on the advantages of the patient’s quality of life.

“Relatives and patients have given informed consent for this to be done with a high degree of gratitude, convinced that it is a developmental step for the better,” she added.

This is also the opinion of Professor Pedro Nodal, head of Anesthesiology, Resuscitation and Surgical Unit of the ICCC and Dr. Luis Leonel Martínez Clavel, anesthesiologist in charge of the new procedure.

“This is the first time we are going to do it here. We chose general anesthesia as a protocol because it is the safest way for the patient and also for us to be able to provide that security. Despite the fact that other techniques are performed in the world, even with local anesthesia and sedation, we cannot run before crawling”, explains Martínez Clavel.

Professor Nodal ratifies it, all the support in surgery, anesthesiology, perfusionists in charge of operating the extracorporeal circulation machine is guaranteed to assume any eventuality.

The Spanish doctor Ignacio Amat Santos, head of Hemodynamics and Interventional Cardiology at the University Clinical Hospital of Valladolid, expresses his satisfaction “for carrying out, together with my colleagues from the Institute of Cardiology and Cardiovascular Surgery, the first minimally invasive aortic prosthesis implant interventions, without the need to open patients, only aided by a small catheter”, he said.

He explained that these valves were developed in the early 2000s. “Some patients had complications from such a major procedure as opening the chest to change a heart valve. So an attempt was made to develop something less aggressive, that the patient tolerated better, that they could go home earlier, that they would recover faster. And the implantation of a valve inside a stent was developed that folds and is inserted through a very fine tube from the groin to the heart, and then inside the diseased valve and correct its malfunction, ”he pointed out.

Amat Santos pointed out that, although the initial experiences were complex, enough experience has already been acquired to generalize its use little by little in the population “and we are working on developing this technique in Havana.”

In Spain, he said, between 4,000 and 5,000 procedures are performed annually in various hospitals. Some countries like Germany or the United States have carried out many interventions of this type and already number in the hundreds of thousands.

But, he added, it was only two years ago that research showed that in patients at low risk for open surgery that option was better. “This means that we have to try to generalize it to all patients who need an intervention of this type in the heart,” he pointed out.

On the socialization of science and medical advances, the Spanish expert believed that it is fundamental, while the entire learning curve that has taken place over the last two decades, since this therapy began with the first patients, is shared. the most complex.

Added to this is the importance of professionals being trained and specialized, “because technology is essential but skill is something that must be learned,” he said, and highlighted the link that has been established with Cuba in this regard.

“I am convinced that the center will soon be performing these interventions almost routinely,” said the specialist.

The first step has already been taken, and two Cubans —one from Havana and the other from Mayabeque— are now evolving stable and satisfactorily, with the hope of returning to a full life a little closer.

(By: Lisandra Farinas Acosta/Cubadebate)

Consumer price growth in the 19 countries that share the European currency accelerated to 10.7% in October from 9.9% the previous month, Eurostat data showed on Monday.

This increase would be driven by an astronomical 41.9% growth in energy costs, compared to last year, according to the EU statistical office.

Likewise, the value of food, which increased by 13.1%, and that of imported industrial goods pushed prices up.

The European Central Bank has raised interest rates a total of 200 basis points (2%) in the last 3 months and has already promised a further tightening for December.

The ECB deposit rate, now at 1.5%, is seen to peak at just under 2.9% in 2023, a big jump from expectations around 2.6%. after the body’s meeting last Thursday.
(Taken from RT in Spanish)

When the first cases of covid-19 were detected in Cuba in March 2020 and the pandemic began to spread throughout the national territory, 243 measures were already weighing on the Cuban economy and people, which to date hit sources of income, operations as well as exports and tourism.

At the same time, unilateral decisions by Washington fractured relations between families in Cuba and abroad.

Although they were activated during the Trump administration, Biden has kept them unchanged. A demonstration that, in the United States, the Democratic Party and the Republican Party embody the same hegemonic strategy of imperial domination.

In the case of Cuba, in line with the speech enunciated from the White House, which sought to present the country as a failed state, on digital networks the media financed by the United States government tried to conceal the criminal nature of the system of coercive measures against the island.
Through the analysis of experts, testimonies and documents, this chapter of the audiovisual series Archivo.cu reveals why this unilateral policy denies rights to Cubans.

(By: Daily Perez Guillen)

Caffeine, the same stimulant that helps millions of people start their day, also saves lives in hospitals. If a premature baby is unable to breathe at birth, called primary apnea, caffeine citrate gets its immature lungs going. It is an old drug, well known and cheap to produce. But it has an important uncertainty: only two companies manufacture it and some presentations have only one alternative on the market. If there were to be a problem in the drug’s long supply chain, many newborns’ chances of surviving would be compromised.

The vials of 20 milligrams of caffeine citrate are one of the 508 medicines —made with 264 active ingredients— that the Spanish Agency for Medicines and Health Products (AEMPS), dependent on the Ministry of Health, has included in a new list of strategic medicines for the health system, a category that seeks to shield the supply of drugs so that they are never lacking in hospitals and pharmacies. “They are essential drugs, but they have also been on the market for many years and whose price has been falling over time. This makes them less attractive for the pharmaceutical sector. In many cases there are only one or two manufacturers in the market, which makes them vulnerable”, explains the director of the agency, María Jesús Llamas.

Drug supply problems, more frequent in those cheaper presentations, have become entrenched in recent years throughout the world. A recent report from the AEMPS highlights that in the last year they have grown by 38% in Spain and affect one in every 30 presentations on the market. In the vast majority of cases, these difficulties have little impact on the patient, since there are several identical alternatives for the drugs involved. “But this does not always happen and sometimes the problem affects a drug with no alternatives on the market and we have serious difficulties administering it to the patient who needs it,” explains Olga Delgado, president of the Spanish Society of Hospital Pharmacy (SEFH) and head of this area in the Son Espases Hospital (Palma de Mallorca).

An example is mitomycin, a key drug in the fight against bladder cancer. Others are cytarabine (against some types of leukemia and lymphoma) and methotexate (an immunosuppressant also used against cancer and rheumatoid arthritis). “Several of the drugs to be protected are oncological, but there are almost all specialties, such as some presentations of hydrocortisone [anti-inflammatory and immunosuppressant] and amiodarone, used against serious arrhythmias,” adds Olga Delgado.

Managing deficiencies in some specialties is not always easy. “It takes a lot of work and a lot of planning to buy the affected medicines abroad, where it is still available. It also forces us to restrict its use only to those patients for whom there is no other alternative and to look for others for those who do have it…”, illustrates this specialist.

If a drug is only produced by one company, the risk of a problem occurring in the production plant or during transport skyrockets, with serious consequences for the health of the patients who need it. But it can also give rise to bad practices, if a pharmaceutical company decides to take advantage of the de facto monopoly that it enjoys. This was what happened with Aspen Pharma in 2018, when the company maneuvered to multiply the price of five anticancer drugs, four of which have now been included in the AEMPS list.

As the Ministry of Health did not agree to pay up to 30 times more for any of them, Aspen Pharma left the Spanish market without supplies, forcing hospitals to buy drugs that were much more expensive. The conflict was not resolved until 2021, when the European Commission became involved in the case and its Competition authorities threatened the company with a multi-million dollar fine for abusing its dominant position. Finally, Aspen Pharma relented and agreed to lower the price of its drugs by 73%.

“A medicine that is not attractive to produce for the pharmaceutical sector is a problem for the health system,” summarizes Emili Esteve, the director of the technical department of the Farmaindustria employers’ association. “We must find a way to resolve this situation and the creation by the AEMPS of the list of strategic medicines is a step in the right direction. The objective is for more manufacturers to be interested and, to achieve this, protecting them from the erosion caused by the current reference price system (which limits price increases or drives them down to save on pharmaceutical bills) is essential”, he adds.

The AEMPS initiative is the culmination of years of effort, also in the international arena, to identify the most important medicines for health systems and find the formula to guarantee their supply. The World Health Organization (WHO) has been publishing a list of essential medicines for years and the European Commission has also developed its own strategy with member states “to make supply chains more resilient and stronger,” according to the agency. .

These policies also have a scientific and industrial component, with the aim of contributing to the consolidation of a strong and innovative European pharmaceutical sector. The Profarma Plan is the translation at the Spanish level promoted by the Ministry of Industry and in which those of Health and Science also participate.

“Spain has a very good manufacturing capacity, both for the synthesis of active ingredients and for finished medicines, and we hope that this will be a stimulus. The general objective of the plan, which provides for aid, is to collaborate so that it is more innovative and competitive and, in this case, it also includes incentives for more companies to commit to the production of strategic medicines”, explains María Jesús Lamas.

Diversion to other countries
A recurring complaint from the sector in recent years has been that Spain is one of the European countries with the lowest drug prices, which would be behind some cases of shortages, since distributors – pharmaceutical companies usually have production quotas fixed for each country—in some cases obtain higher profits by diverting them to countries where prices are higher.

The AEMPS, which admits the need to guarantee the economic viability of strategic drugs, describes these cases as anecdotal and cites its latest shortage report as an example, in which only 2.4% of the 1,105 presentations with problems explained the reason. alleged by the owner of the drug was the lack of “commercial interest”. 25.3% of incidents were due to “non-quality manufacturing issues”, 24.6% due to lack of “plant capacity”, 22% due to “increased demand” that was not able to be met. cover, 8% to problems in “the supply of active ingredients” and 7.5% were related to “quality” problems, among other reasons.

“The problem of the supply chain is global and as such we are facing it with our European and international partners. There are active ingredients that are only produced in one or two places in the world. A problem in that factory or in the means of transport that distributes them to the whole world affects all countries. That is why it is so important to review each of the links in the chain, to identify at which points there may be a vulnerability and to have specific measures for each of them: have contingency stocks, increase the number of suppliers, plan the maintenance of production plants and planning any shutdown, among many others”, concludes the director of the agency.

(Taken from Therapeutic Arsenal)

This was announced on Tuesday -as part of the 15th health for all fair, which takes place at the Pabexpo exhibition center-, engineer Alejandro César González Urquiza, member of the team that developed the ‘device, which clarified that the license It was awarded after a rigorous validation process.

Previously, he explained, two satisfactory experimental tests were carried out on pigs, which were ventilated under the supervision of the regulatory authority. Subsequently, a stability diagnosis of the equipment was approved, which was put into service for a long continuous period, without showing any failures.

After all the validation process carried out with Cecmed, where tests were carried out on the software, the pneumatic system and the electronics of the equipment, the entity granted the authorization for use in humans, in order to testing it in patients with ventilatory needs. .

Professor Alberto Martínez Sardiñas, anesthesiologist, intensivist and project manager, indicated that two of these devices are already located at the Calixto García Hospital and the Neurology Institute, respectively, while the third, which is now on display at the Fair, He will be transferred to the Hospital Miguel Enríquez, also in Havana.

He specified that within ten days clinical trials should begin in ventilated patients of these hospitals, with medical personnel previously trained and advised by the developers of the device.

Martínez Sardiñas pointed out that this equipment represents a possible solution to provide all forms of ventilation to severe and critical patients in Cuba. It was born from the difficulties of importing these devices, which during the covid-19 acquired a high cost.

Participating in the closing ceremony of the event -which began on October 17- was Jorge Luis Broche Lorenzo, member of the Secretariat and head of the Department of Attention to the Social Sector of the Central Committee of the Party; the Deputy Prime Minister of the Republic Inés María Chapman Waugh; the Minister of Public Health José Ángel Portal Miranda; ministers and deputy ministers from other nations; directors of the MINSAP; representatives of international organizations and organizations and several of the delegates who participated in the event.

During the report, Dr. Ileana Morales Suárez, director of Science and Innovation of the MINSAP, made reference to the fairs that were part of Cuba-Health 2022: the Health for All Trade Fair, the Third Fair of Scientific Editorials and the First Fair of Medical Tourism and Wellness.

“Cuba-Salud 2022 had more than 3,000 face-to-face participants. Of them, 947 delegates from all Cuban provinces and 452 participants from 64 countries on all continents, who were joined by exhibitors, guests and members of the logistics and scientific insurance commissions”, reported Morales Suárez.

The doctor acknowledged the participation in the event of the leadership of PAHO and the United Nations Population Fund, as well as 44 high-level delegations, which represented ministries and secretariats of health from countries around the world.

The scientific program of Cuba-Health 2022 exceeded 350 face-to-face activities, where various topics were addressed, such as the safety and quality of medical care, confronting emerging and reemerging diseases, the impact of climate change on health, the organization and operation of health systems to make them more efficient and sustainable, antimicrobial resistance, new forms of international cooperation in health, research and innovation, among other issues.

The foregoing is of special importance, if one takes into account that “Cuba-Salud 2022 was celebrated in a complex international context, where the commitment of governments to achieve the goal of health for all faces the multiple challenges posed by epidemics, conflicts and disasters of natural or technological origin”, commented Morales Suárez.

Regarding the contributions of the event, Dr. Christopher Tufton, Minister of Health and Welfare of Jamaica, pointed out that “it has shown us that it is vital to share knowledge, to increase the capacities of the world’s health systems.” In addition, he referred that these conferences have been an example of what can be done in the face of global needs.

For his part, Dr. Armindo Daniel Tiago, Minister of Health of Mozambique, recognized Cuba’s collaboration with countries around the world and congratulated the government of the largest of the Antilles for the level of organization of the event and its scientific quality. “Cuba-Salud 2022 exceeded our expectations and will contribute to strengthening our health systems and our friendly relations,” he said.

Closure of Cuba-Health 2022. Photo: Cubadebate.

The central words of the closing were given by Tania Margarita Cruz Hernández, first deputy minister of the MINSAP, who appreciated the debates held at the event on economic, legal and regulatory issues related to health; as well as the exchanges that positioned the quality of life as a fundamental determinant of social development.

“In Cuba, despite the intensification of the blockade, the media war and the impact of the epidemiological situation caused by covid-19, the activities of the health system have not stopped and the altruistic, human and ethical behavior that characterizes Cuba has prevailed. to our professionals, for which we have maintained a service based on justice, equity and professionalism, whose premise is the development of primary health care”, reflected the deputy minister and explained that the development of promotion, prevention, medical care and rehabilitation.

He also made reference to the medical missions in other countries, which continue to be a fundamental pillar of the Cuban health system, in correspondence with the principles of solidarity of the largest of the Antilles.

Cruz Hernández thanked the participation in Cuba-Health 2022 of prestigious national and international organizations that, together with the Ministry of Public Health, made the development of the convention possible; She expressed her gratitude to the foreign delegations and the attending Cuban professionals and opened the call for the fifth International Convention and the Health Exhibition Fair, which should be held in 2025.

“Let’s continue working so that health is not a privilege, but a right for all. Count on Cuba to achieve this better world that Commander-in-Chief Fidel Castro Ruz always aspired to,” she concluded.

(By: Lisandra Fariñas Acosta, Yilena Héctor Rodríguez)

The event will bring together the most innovative scientific and health literature that is developed in Cuba, as well as updated research by prestigious authors, both national and foreign.

In the opening remarks of the exhibition event, Dr. Jorge González Pérez, general director of Medical Teaching of the Ministry of Public Health (MINSAP), maintained that it is of vital importance that health professionals have the necessary tools to face the current world reality, in order to reaffirm the need to improve the health of the population as a determinant of social development.

“Information and knowledge management, the efficient use of information technologies and resources, constitute key elements, and cannot be seen in isolation, but rather as part of this process of evaluating and renewing strategies for organization and policies on health issues,” he said.

Dr. Jorge González Pérez, general director of Medical Teaching of the Ministry of Public Health (Minsap), argued that it is vitally important that health professionals have the necessary tools for their training. Photo: Cubadebate.

The Cuba-Health 2022 International Convention has, as its main purposes, to promote reflection and exchange about the current and future challenges of health at a global level, emphasizing the actions of the countries in the face of the needs that the world faces today, in aspects such as the safety and quality of medical care, emerging and re-emerging diseases, efficient and sustainable health systems, international cooperation in health, which includes medical education, as well as evaluating access and universal health coverage, Gonzalez Perez said.

He said that several scientific publishers, companies, societies and institutions linked to health participate in the Editorial Fair, which will have the opportunity to exhibit their scientific production, information resources or products that they represent, in the field of medicine and health sciences. general health.

According to the Fund’s representation on the island, during his visit, which will last until next Wednesday, he will exchange with national authorities, tour the projects developed by UNFPA in Cuba and participate in the 2022 Cuba-Health International Convention, inaugurated this Monday.

The senior official has a history of more than 30 years of strategic leadership in the fields of medicine, public and reproductive health, social justice and philanthropy.

Her academic career began at Johns Hopkins University School of Medicine and Columbia University School of Public Health.

From 2014 to 2016, Kanem represented UNFPA in the United Republic of Tanzania, and in July of that year she was appointed UNFPA Deputy Executive Director with responsibility for programmes.

In addition, she was the founding president of ELMA Philanthropies Inc., a private institution whose work primarily targets children and youth in Africa, and she held the position of senior associate of the Lloyd Best Institute of the West Indies.

She has a medical degree from Columbia University (New York) and a master’s degree in Public Health from the University of Washington (Seattle), specializing in Epidemiology and Preventive Medicine. Likewise, she graduated with honors from Harvard University, where she studied History and Science.

Natalia Kanem is the fifth Executive Director of UNFPA since the Fund began operations in 1969.

(With information from Cubaminrex)

The voices of the three audios are similar. Will it be the same COVID biologist? asked Barbara Betancourt, recently released from rest forced by dengue fever aggravated by numerous cormobilities and chose to tell her experiences as a patient, highlighting the way in which the early warning and protection system works for people that distinguish the work of MINSAP, in a strategy that already includes television ads during prime time.

If anything has been transparently monitored in the country, it is epidemiological issues. Every day a meeting of the working groups created to deal with COVID, which have remained activated (one for the epidemic and another for experts) in the face of the growth in dengue cases, for example. In Cuba, many resources and medicines may be and are lacking, but information and primary care are guaranteed. But to be up-to-date, you really have to search for and contrast the information in the Cuban public media.

A last alarmist audio, not related to health, but to the state of mind of the population, served as the closing of the analysis.

Created as soon as the country’s presidency and the directors of MINEM reported how they had decided to face the problem of energy generation, there the elements that seek to give credibility to the hoax, make the lie seem like the truth, are heard again. It is an old but very functional technique, even more so in the stormy sea of ​​the internet, where anything goes and almost everything is believed. By identifying the voice as that of someone expert, giving apparently real locations, a degree of credibility is obtained in which to support the main message: “don’t believe what you have been told. There is no solution”.

In reality, we live in hard times of uncertainty and the objectivity of the problems, specifically the blackout, create the conditions for anyone to believe in anything. But there is a job, a serious, consecrated and professional job, that expects and deserves trust.

I have seen some post in the last few hours, stating that the changes in the direction of the UNE and the MINEM will solve everything at a stroke. Beware of over-enthusiasm. The official notes on the changes are clear in terms of recognizing the merits of the substituted teammates and those that those who assume these tasks will have to face. We should not expect miracles. Perhaps we should wait for a change in strategy, tactics, innovations.

The pressures under which you have worked so far have an impact on the valued colleagues who will take on other tasks. But we must not forget that the problem is not only Cuban. Many other countries, without a blockade and with unfenced finances, are also suffering from energy crises.

As was said when announcing the changes, work continues under tension, but the purpose of overcoming the current deficits as soon as possible remains. There is no exact date yet. There is a commitment. And the few resources available based on those efforts.

(By: Arleen Rodríguez Derivet/Cubadebate)