EXECUTIVE SUMMARY Insights from Cuba’s COVID-19 Vaccine Enterprise: Report from a High Level Fact-Finding Delegation to Cuba

In June 2022 an international delegation of scientists from the United States, the Caribbean and Africa traveled to Havana, Cuba for a threeday fact-finding mission to better understand Cuba's COVID-19 vaccine development and vaccination efforts.It was the first time in five years that a scientific delegation with significant US presence had engaged in discussions with medical researchers in Cuba.It also included African and Caribbean members to ensure there was a diversity of scientific and public health perspectives.Together, delegation members represented a broad range of expertise in public health systems, infectious diseases, biotechnology, and vaccine development.The visit was organized by MEDICC (Medical Education Cooperation with Cuba), a US-based non-profit that promotes health-related dialogue and collaboration.Since 1997, MEDICC has facilitated exchanges between Cuban and US health professionals, scholars, policymakers, foundations, students, and leaders of medically underserved communities.Delegation organization and travel were supported in part by a grant from the Open Society Foundations.During our three days in Havana, MEDICC delegation members met with experts involved in the production and deployment of Cuba's COVID-19 vaccines.We also visited three vaccine production facilities, met with Cuban health professionals who led the country's national COVID-19 adult and pediatric vaccination campaigns, and visited a local elementary school where children and teachers described their experiences with vaccination efforts.The purpose of the fact-finding mission was three-fold: first, we wanted to learn how and why a relatively small country of some 11 million people-one facing considerable economic hardships-had developed, manufactured and deployed its own vaccines, which were shown to have over 95% efficacy in preventing severe disease and death.Second, we wanted to understand Cuba's vaccine rollout strategy and preliminary results.Third, we wanted to explore Cuba's approach to science in the context of public health, with a focus on how Cuba's COVID-19 vaccine development effort and vaccination model could reveal opportunities to reduce global inequities in access to vaccines and other health innovationsespecially given the country's existing network of international partnerships.