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July 6, 2001 This letter was accompanied by the Pugwash Issue Brief on Cuba and distributed to all members of the US House of Representatives. Dear Colleague, I would like to bring to your attention the June 2001 Issue Brief produced by the Pugwash Conferences on Science and World Affairs, the 1995 recipient of the Nobel Peace Prize. This newsletter explores the effects of the U.S. embargo on US-Cuban medical cooperation. I especially encourage you to read the article by Dr. Kenneth R. Bridges, Director of the Joint Center for Sickle Cell and Thalassemic Disorders at Brigham and Women's Hospital in Boston, Massachusetts. As you know, drugs and medical devices developed by Cuba are not available to Americans. This includes vaccines for heart disease, cancer, hepatitis-B and meningitis-B, although for the latter a special protocol is being negotiated because the drug is so needed and desired by the U.S. medical and pharmaceutical community. Common areas of research requiring clinical trials, such as sickle cell disease, are also denied from engaging in joint clinical trials. Cuba has also developed fetal monitoring equipment that is being used in Canada, the United Kingdom and twenty other countries, but not the United States. While only lifting the embargo will make these drugs, medical devices and opportunities for joint research truly available for all Americans, H.R. 2138, the Bridges to the Cuban People Act of 2001, takes important steps forward. For example, it would allow the import into the United States of Cuban-originated medical devices and medicines that are not commercially available in the U.S. already. I encourage you to read
the articles in the attached newsletter, and I encourage you to contact
the offices of Representatives Jose Serrano and Jim Leach to become
a cosponsor of H.R. 2138. James P. McGovern Congressman
McGovern also addressed First
Inter-American Conference of Pharmacy and Nutrition OPENING
ADDRESS June
25, 2001 I want to thank you for inviting me to help open this historic conference. I am very honored to be part of the first Inter-American Conference of Pharmacy and Nutrition. I want to express my gratitude to President Charles Monahan and the Massachusetts College of Pharmacy and Health Sciences for inviting me to attend this conference. I especially want to thank our gracious Cuban hosts, the University of Havana's Institute of Pharmacy and Food Services, and the other hemispheric cosponsors-the Catholic University of Santa Maria in Peru and the Autonomous University of Yucatan in Mexico. This is an historic event between these four distinguished medical schools and one that holds special meaning for me personally. This conference is one way in which President Monahan and I are honoring the efforts and work of our dear friend, Congressman Joe Moakley from Boston, Massachusetts, who recently passed away. Last night I spent over three hours with President Fidel Castro - where he honored Joe and discussed, among other things, this conference. He looked fit, healthy, and remarkably strong, and he expressed his support for this collaborative effort. In April 2000, Congressman Moakley and I led a delegation of Massachusetts' college and university deans and presidents on a trip to Cuba to meet with their education counterparts. The purpose of this trip was to allow these educators to interact with one another, promote exchange programs, and establish research and academic partnerships. Forty presidents of Massachusetts' universities of art, law, medicine, education, veterinary medicine, pharmacy, marine science, and many other disciplines participated in this delegation. One of the college presidents on that trip was Charles Monahan of the Massachusetts College of Pharmacy and Health Sciences. I invited President Monahan to join our delegation because his college had just begun building a new campus for the College of Pharmacy in the congressional district I represent, and I knew that he would be a valuable participant. When we arrived in Havana, Charlie met officials from the University of Havana's Institute of Pharmacy and Food Sciences. The dialogue they began during that trip to Cuba laid the groundwork for this conference. This conference-and the partnership between these two great colleges - are what Congressman Moakley and I hoped for when we first began organizing the academic delegation to Cuba last year. I want to thank again the four cosponsors of this conference for giving me a chance to see a dream become reality. But most especially, I want to express my deep admiration and respect for President Monahan. When he first traveled to Cuba with me, a little over a year ago, he came with a clear plan to create partnerships that would benefit both nations and strengthen pharmacy education. Charlie is a man who is driven to turn ideas into action. This conference is an expression of his drive to turn talk into reality. And I can't express how much I admire him and his leadership. Prior to meeting President Monahan, I thought pharmacists were people in short, white lab coats who merely counted the pills that the doctor prescribed for my father's heart condition - or for my heartburn. However, the opening of the new Massachusetts College of Pharmacy campus in my hometown helped teach me that pharmacists do much more than count pills. I now know that pharmacists are trained, healthcare professionals who are a resource for patients and our communities on a broad range of health topics - whether that be information on drug interactions, the best way to take medications, or how to use a medical device. Pharmacists are on the front lines of quality health care delivery. Working with President Monahan, I recently introduced federal legislation to help recruit more students into schools of pharmacy and to provide incentives for graduates to practice pharmacy in areas where they are most needed. While I have made pharmacy education one of my top priorities in the U.S. Congress, that's really not why I was invited here to speak today. Americans who work in the fields of pharmacy, medical research, or health care and who travel to Cuba generally return to the United States angry about the medical hardships caused by the U.S. embargo and frustrated by the difficulty in engaging in joint medical research and development. I hear these complaints and concerns everyday from the medical and research community in Massachusetts. I've listened to President Monahan describe Cuba's shortage of basic pharmaceuticals. So, I was asked to talk about U.S. policy - especially the relations between the United States and our host, Cuba - and how these relations affect our two countries and, indeed, the entire hemisphere. This is my sixth visit to this beautiful island. Over the years, I have met with the highest officials of the Cuban government. I have met with leading dissidents. I have had the opportunity to meet the leaders of the vast Cuban educational system and with farmers working their fields. I have visited hospitals, community centers, churches, the synagogue here in Havana and schools throughout the country. I've dined in fancy restaurants and in the humble homes of average families. I have been blessed in being able to travel to Cuba many times because of who I am and what I do for a living. But the average U.S. citizen cannot travel to Cuba like I can. The United States, an international symbol of freedom, prohibits her own people from coming to Cuba - except under a tight set of rules and regulations, and only for specific purposes, and for which you must secure a special license from the government in order to stay in Cuba - even if that trip is only one hour long. The Americans participating in this conference today met that test. Through the work of the Massachusetts College of Pharmacy and Health Sciences, they secured a license from the U.S. Department of the Treasury in order to travel, legally, to Cuba and attend this conference. But their neighbors couldn't come. Their children couldn't come. It's not legal for them - or any American really - to decide one morning that they would like to fly to the Caribbean and stay in Cuba for a couple of days to enjoy the beaches or to appreciate the art and the culture. This is crazy. The current relationship between the United States and Cuba is an artifact from the Cold War - and it needs to be abandoned. The governments of both countries need to change the relationship, to challenge the status quo and take bold steps to reach a new accommodation of one another. Each government needs to stand up to the hard-liners and face them down. Each country needs to stop pointing fingers and take some initiative. Cuba needs to stop blaming so many of its woes and shortcomings solely on the United States. And U.S. policy needs to be more than just macho chest-pounding and a race to win votes in southern Florida. Both countries are better than this. Unfortunately, there are a handful of U.S. Senators and Representatives who can't seem to break away from the past. Most recently, this small group, led by Senators Jesse Helms and Joe Lieberman, has introduced legislation to send direct U.S. financial support to internal Cuban dissidents. To some, this doesn't sound like a bad idea. Why not help pro-democracy groups in Cuba with faxes, computers, and other material aid? Unfortunately, the aim of the legislation is not to help open more political space in Cuba, but to openly provoke a harsh response from the Cuban government and worsen relations even further between the U.S. and Cuba. The advocates of this bill have not identified which groups and individuals would qualify for assistance, nor how they would be identified and by whom. It is unclear how aid would be delivered to such groups, given restrictions both by the Cuban and the U.S. governments. And even if such assistance ever managed to reach legitimate independent and democratic groups, to receive such aid from the United States, offered in such a hostile context, would mark these groups as paid agents of the United States. Ultimately, if such a program ever came into being, and I hope it will not, it would simply provide the Cuban government with more ammunition to discredit those who bravely choose to dissent. I want to see a Cuba where everyone can exercise the freedom of speech and association, even those who disagree strongly with the current government. I want to see a Cuba where artists, writers and journalists and just average Cubans can voice and publish their views, even those that challenge the status quo. I believe Cuba would not only survive such diversity of opinion, it would thrive on it. But this legislation in the U.S. Congress will not bring that day closer. It is not fresh thinking. It is old thinking. It is the same old thinking that dreams of undermining and overthrowing the Cuban government. The history of my country is particularly unsavory - especially in Latin America and the Caribbean - where we have involved ourselves in attempts to undermine or overthrow a government. It has nearly always blown up in our face, or brought results so horrific that we stand condemned in the eyes of the international community. We don't need the old thinking of how we can score off one another; how we can hurt one another. We need to think more of how we can mutually benefit each other. Right now, each of our countries suffers from the status quo. I don't need to catalogue the economic hardships endured by the Cuban people and brought about by the embargo. Many of you will hear or see while you are here the lack of medicines and medical equipment, the lack of basic instruments in hospitals and schools. Many children suffer because they lack access to common drugs for treatable illnesses. All of these drugs, equipment and medical devices would be available from the United States or elsewhere if the embargo were ended. While an unintended benefit of the 40-year-old embargo is that Cuba has developed a remarkable self-reliance in terms of both health care and biotechnology, it could achieve much more were the current constraints removed. What we don't hear so much about is how the people in the United States suffer from the current status quo. And I'm not talking about not being able to lay out on a beautiful beach, drink delicious rum drinks and smoke the best cigars in the world. I'm talking about life and death issues. Let me take a moment to talk about just one of these. In Massachusetts, the state where I'm from, in the city of Boston, several hospitals and medical centers are engaged in research on treating and curing sickle cell disease. As you all know, this disease mainly affects African-Americans in the United States, and people of African decent throughout the Caribbean and Latin America. Approximately 70,000 people in the United States suffer from sickle cell disease. Most are not followed at comprehensive medical centers that perform clinical trials. Neither a registry nor a clinical trials network exists in the United States. While the U.S. government funds ten Comprehensive Sickle Cell Centers, for a variety of reasons, these centers have given clinical trials a low priority. Cuba, however, has a well-established patient care network. Excellent facilities for patient trials exist both in Havana and in Santiago de Cuba. More importantly, Cuba has a registry of patients with sickle cell disease, which is a valuable tool in clinical investigation. Lifting the embargo, at least as it applies to medical care, would allow American and Cuban physicians to work together on the problems of sickle cell disease. Patients with sickle cell disease from the eastern provinces alone of Cuba would significantly expand the number of people enrolled in multinational clinical trials. It has been estimated that enrollment of patients in joint research protocols between the U.S. and Cuba would speed the process of identifying useful interventions and treatment of sickle cell disease, reducing the time needed for an effective trial from 8-to-10 years down to 3-to-4 years. In short, lifting the embargo would benefit a most vulnerable group of Americans with a debilitating and often deadly disease. It could save lives. Let me give you another example. With over 400 patents in the field of biotechnology, Cuba's research community has produced a variety of products ranging from vaccines and cancer therapy drugs to fetal monitoring equipment. These include anti-meningitis B and hepatitis B vaccines, both of which have been certified by the World Health Organization. In fact, the anti-meningitis B vaccine is so desired by drug companies in the United States and by victims of meningitis B that the U.S. is negotiating a way for a major U.S. pharmaceutical company to purchase the vaccine from Cuba and make it available in the United States. Cuba also has developed new drugs and therapies for the treatment of heart attacks and heart disease, and for the treatment of cancer and viral diseases. In the pipeline, Cuba has several products including combined vaccines, a cholera vaccine, and AIDS vaccines. At present, Cuba exports its products to over 20 countries, including those in Latin America, the United Kingdom and Canada. But not, of course, to the United States. More than ever, in today's globalizing world, nations need to work together to prosper. Illness, injury and suffering, unlike political dogma, could care less about national boundaries. Sickle cell disease is a scourge both in the United States and in Cuba - and the current embargo policy has injured people suffering from the disease in both countries, as well as throughout the hemisphere. Perhaps the true symbol of the status quo between the United States and Cuba should be a six month old infant showing the first signs of sickle cell disease. We don't need to identify her nationality. She's just a baby - suffering, and doomed to suffer, her entire life. What if she were your baby girl? Or mine? Would we be so willing to let the current situation go on and on? The international community has long called upon the United States to end its 40-year-old embargo and upon Cuba to open up its society to greater freedom of speech and association. Even the Pope - in his historic visit to Cuba in 1998 - urged my government to end our economic sanctions against Cuba. The peoples of both countries want us to end our hostilities. The countries of the Western Hemisphere and the world want us to end our hostilities. The time is long past for us to engage each other and to have normal relations between our two nations. The only thing standing in the way is politics - and politicians in both countries who are just too comfortable with the ways things are. During the final days of the Clinton Administration, I had several conversations with the President and sent several letters urging that he travel to this island - and begin the process of normalizing relations. Obviously, that did not happen. We now have a new Administration and a new President. I would renew my request. And not withstanding some unfortunate rhetoric coming from the Administration, I hope President Bush will demonstrate the maturity and common sense to lead our two countries to a better day. So much more could be achieved - for all the Americas - if this last remnant of the Cold War were ended. It is in this spirit that I wish you the very best success over the next days and in future partnerships that might be created from this meeting. This truly is a historic event. Thank you for allowing me to be part of this historic conference.
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Pugwash
Workshop Report, Havana, Cuba, 15-17 February 2001