Agustín Lage Dávila: Young scientists should be aware of their social responsibility

Interview by Erhan Nalçacı, Nahide Özkan
Translation from Spanish to English: Nahide Özkan

We had the opportunity to conduct an interview with Dr. Agustín Lage Dávila, the Cuban scientist known for his work in biotechnology, during his visit to Turkey on November 1st, 2018 as an invitee of the Turkish Pharmacists’ Association. Since its foundation in 1994 until last year, Dávila has been the director of the Cuban Center of Molecular Immunology, which undersigned outstanding achievements. Having published more than 150 papers with his team, he is one of the leading scientists of our time.

Dávila was born in 1949 in Havana and graduated from the Medical Faculty of the University of Havana in 1972. Then he specialized in biochemistry and biotechnology. We believe that this special interview will be very helpful to understand development of science in Cuba. We also believe that it will demonstrate what kind of a social and political role workers of science may play in socialism.

During the interview, Dávila showed us a lot of graphs on his computer; unfortunately, we have been able to place only two of them in the interview. However, we believe that the articles in the dossier, “Science in Cuba” will be sufficiently complementary.

Besides, Dávila gave us an unforgettable gift, a very special video recording of Fidel. In 1993, the darkest year of the Special Period, Fidel visits a biotechnology center in Santiago de Cuba and holds a meeting with scientists. There is no journalist in the meeting where Fidel draws a roadmap for Cuba to achieve in the future a leading position in biotechnology. That historical moment is recorded by one of the scientists who participated in the meeting with an amateur camera. You can watch this short but very important documentary video on the website of the Academy of Science and Enlightenment

Thank you for accepting the interview of the journal “Matter, Dialectics and Society” (MDT). This interview will be published in the next edition of MDT in January 2019, in the dossier “Science in Cuba”, in tribute to the 60th Anniversary of the Cuban Revolution. We are honored to do this interview with you, one of the most prominent scientists of our contemporary era.

I do not think that I am, but thank you.

First of all we would like to ask… You were ten years old when the revolution triumphed. Do you have any memories of those days?

When the revolution triumphed, I was nine years old. Yes, there are things that I remember. At the time of the revolution I was a child and I did not have a political conscience yet. But I remember that political issues, especially the struggle against the dictatorship, were a common theme of discussion in my family. And I strongly remember that great enthusiasm that surrounded everybody when the revolution occurred.

My personal participation in the tasks that the revolution put in front of us was with the literacy campaign of 1961. That year all schools were closed and we, with our books and notebooks in our hands, went to the mountainous regions, the most remote corners of the country to teach how to read and write. That was a significant opportunity for me to see and cognize the poverty in rural areas.

In which city were you living then?

I was living in Havana. I went to the province of Matanzas to teach how to read and write. Within the framework of the campaign, I happened to go one of the rural areas of the province of Matanzas. There we stayed for months and taught how to read and write to the villagers. I was one of the youngest among those who participated in the campaign. I was 12 years old. That experience had a significant role in the formation of my social conscience. I stayed there in Matanzas for months and I participated in the Union of Young Communists as soon as I returned from there.

What other consequences did the revolution have on your life? For example, if the revolution had not triumphed, would it have been possible for you to become such a productive scientist?

I can give a twofold answer to this question. First, the revolution did have very profound consequences. But above all, it gave a meaning to our lives. It gave us the feeling to live for something. Life should have a meaning, a purpose. It was the revolution provided us with a purpose. I can tell you a personal anecdote about how I feel about this. In one of the congresses of the Communist Party of Cuba, they asked scientists from different sectors to make speeches. I was one of those who would make a speech. While they passed me the floor, they said, “Now a scientist will make a speech”. When I took the floor, I corrected the way they presented me and I said, “No, not a scientist, now a communist who works in the field of science will make a speech”. I fell in love with the idea of communism. Just like millions of people in the world… Just like you… This is because, communism has brought together social struggles with scientific thought. The history of social struggles goes back to three thousand years. Yet, only with the ideal of communism have social struggles attained a scientific foundation.

As to the second aspect of my answer… If the revolution had not triumphed, maybe I would still have become a doctor because my father was a doctor too. But I would never have been able to become a scientist. Science in Cuba is a product of the revolution. I am sure you have heard like many others, Fidel has a very important comment on this. He said, “The future of Cuba has to be the future of scientists.” Yet, people generally do not remember when he said these words. These words were framed in 1960. That is to say, even before the literacy campaign. When Fidel said that the future of Cuba would depend on science, 30 percent of the population did not know even how to read and write. In other words, scientific progress was a part of the revolutionary program from the very first day of the revolution. Later, in 1993, during the darkest days of the Special Period, -because, as you remember, the Soviet Union disappeared in 1991- in a meeting with scientists, Fidel said, “The products of our scientific investigations will have to become the first item of our national economy”. He said, “We should develop products based on information”.  He said, “This will be the place of Cuba in the world, there will not be any other.”

You studied medicine in 1960s and 70s.

Yes, I started studying medicine in 1966 in Havana.

We know that medical education in Cuba has a very communitarian nature. Did such an atmosphere also encourage being a scientist?

I am really very happy that you asked me this question; I believe that there is a very significant issue here. Those who work in the field of medicine and even those who make theoretical production in this field tend to think that communitarian medicine and scientific progress are two completely separate things. The US-based system approach has a significant role in this. Indeed in the USA there is substantial progress in high technology but the health system has a very narrow coverage; many people are out of the coverage of health services. In other countries, in turn, there are attempts to make the health system as inclusive as possible, but the technology is backward. In this respect, the most beautiful part of the Cuban health system is that it brings together communitarian health services with high technology.

I can give you the example of the hepatitis b vaccine. The hepatitis b vaccine, which was produced with sophisticated recombinant DNA technology, is administered to a hundred percent of the children in Cuba. That is to say, in Cuba, research and development based on high technology and communitarian health services they do not exclude one and other; they complement each other.  Again, for example, the clinical trials of our lung cancer vaccine, which people are very curious about, have yielded very successful results. Now we have passed to the phase of population-based tests. The Villa Clara province has been selected for the tests. The population-based tests have been programmed so as to cover the whole population. The program covers all patients without any selection process. Even patients at the age of 95 have been included in the program. Thus we will be able to modify the test results so as to determine the survival rate at the population level. In clinical trials it is very difficult to determine the survival rate at the population level; because patients are selected in this type of trial.

The atmosphere in Cuba is of course very encouraging in terms of becoming a scientist. To give an example I will tell you another personal anecdote, which I do not have the chance to tell in scientific conferences. In 1989, I was working in a laboratory of the Cuban Cancer Institute. We were conducting research in the field of molecular biology. We were in September, and one day Fidel came to the laboratory. I did not know that he was coming. But I did sense that there was something going on. The Minister of Public Health had called me and asked me, “Today you will be there, you will not leave the laboratory, right?” and he asked me not to leave the center. Fidel stepped in at around three o’clock in the afternoon. He started to walk around in the laboratories asking many questions. Then we sat down in a room; we were six or seven scientists including the directors of the laboratories. Fidel started to ask questions about monoclonal antibodies. And along with the meeting, he started to develop the idea of establishment of a research institute and a production center under the institute. He asked us which countries produced the highest amount of antibodies in the world. We gave him data on the antibody-producing companies in Europe and the US. We were sitting around a table just like this. He looked at the data and then he looked at us, and asked, “Are you not planning to compete with these companies?” This is how the idea of establishment of the Molecular Immunology Center came up in that meeting.

You were the director of the Molecular Immunology Center in 1990s, during the “Special Period”, the most difficult years of Cuba after the dissolution of the Soviet Union with a counterrevolution. And a legend was created in the field of biotechnology under the inhumane blockade of the USA, and we know that you made great efforts to make that legend come true. How did such a scientific breakthrough happen in such difficult conditions?

Let me show you some photographs from the time of foundation of the Molecular Immunology Center. We started the construction of the building in 1991. The Soviet Union disappeared at the end of the same year. We had only erected the columns of the building. Fidel came to the construction site and said, “The construction of this center will be completed”. There was such a determination.

[Photo: Center of Molecular Immunology in Havana]

Here I would like to tell you another pleasant memory of mine. I do not have the chance to tell these memories in conferences, but here I can tell among communists, right? Fidel chose the location of the construction site of the Molecular Immunology Center. In that area there was a banana field then. We visited the site, we spoke, and then Fidel got into his car and left. My friends told me the rest of story. They drove away something like one kilometer and Fidel asked, “Did you tell the workers on the banana field what we will construct in that location? Did you tell them why we will have to remove the banana trees?” The answer was no. He stopped the car, got out of the car and sent the driver back to the field to speak to the banana workers there. What we see in Fidel is a combination of farsightedness in terms of scientific progress and deep sensitivity towards workers.

We completed the construction of the center in 1994. Those were the hardest years for Cuba. The country had lost 35 percent of its GDP. If any country in the world loses 10 percent of its GDP, this would result in a big social crisis. We, in turn, lost 35 percent. But our country succeeded to survive. During the construction phase, we used to go there on bicycles; there was not any vehicle because of the lack of fuel. And we managed to get out of that crisis. I would like to show you a graph. It compares the situation today in Cuba with its situation in 1950s. It shows how the country has changed throughout this period. It includes data on the unemployment rate, infant mortality rate, life expectancy, etc. In 1950s, sugar exports comprised 80 percent of total exports. Almost all the industry was in the hands of the USA. The unemployment rate was around 35 percent. Here you can see how the picture changed in the twenty first century. The unemployment rate fell to 3 percent, infant mortality rate fell to 4.2 per thousand. Here you can see the situation of the national economy in the Special Period. We could reach the GDP level of 1989 only in 2005-2006. We lost fifteen years. Now we have left behind the most critical phase of the Special Period but we still need to strengthen the national economy, which will be possible with science and technology. I believe that the most significant issue of political struggle in the field of science is that scientists should understand that what they do in the field of science is part of a bigger problem, the problem of social development. When people understand this, they already act with a huge motivation.

[Graph 1: Average life expectancy in Cuba after the revolution]
[Graph 2: The decrease in infant mortality rate, which is considered as the most significant health indicator in Cuba]

What do you think have been the most significant achievements of the Cuban biotechnology sector since 1991?

The most important is that biotechnology has become a sector of the national economy. There are many scientists in many countries; but the academic world is separated from the entrepreneurial world. There are many good universities but the academic world is generally financed by the public budget. The entrepreneurial world, in turn, belongs to the private sector and it is profit-oriented. The most fundamental achievement in Cuba is that science has become an economic power. BioCubaFarma, the biggest biotechnology company in the country, is a prominent part of the Cuban economy and its products become rentable in a short time period such as 4-5 years. For example, it took eight years for the world’s first biotechnology company, which was founded in California, USA, to become rentable. This makes sense in general, because it takes long time for companies based on R&D activities to become rentable. In this respect, BioCubaFarma is an interesting example because we know that only 15 percent of the biotechnology companies in developed companies become rentable. The rest of them survive on risk capital.

The other most significant achievement is, of course, the solutions that the Cuban biotechnology sector offers in the field of health. Here I can show you some graphs demonstrating the huge improvement that our hepatitis band meningitis b vaccines have made in the health of the Cuban population. Sometimes in the classroom I tell my students, “What might be the source of motivation to work 12 hours per day for thirty years? It is the pleasure of looking at these graphs for ten minutes.”

One of the biotechnology centers in Cuba is the Immunoessay Center. There they produce diagnostic systems. The branches of the center are scattered throughout all the municipalities of the country. All pregnant women and newborn babies are subjected to several tests in these centers. Here, again, we see an example of combination of high technology with universal health policy. It is calculated that this center responsible for the two-point decrease in infant mortality rate in the country. That is to say, if the rate is 4 per thousand today, it would have been 6 per thousand if there have not been the center. When the infant mortality rate is below 10 per thousand, it is very difficult to decrease it even one point. When the infant mortality rate is 60 per thousand, for example, it is relatively easy to decrease it to 30 per thousand. It is sufficient to provide clean water and guarantee extensive vaccination. But below 10 per thousand, you need high technology to decrease it even one point. Thus I can say that since 1990s the biggest two achievements of the Cuban biotechnology sector are that the sector has turned into an economic power in exports and that our health indicators have dramatically improved.

Here I will show you a photograph of the Center of Neurosciences. One of the equipment produced in this center is of critical importance. This computerized equipment is used to make tests on newborn babies. They put electrodes on the heads of the babies and send electrical signals to the brain. According to the response of the auditory cortex they test whether the baby can hear or not. This is a very important test because parents can understand whether their babies hear or not only towards one year of age, which is too late because if the baby cannot hear, he or she already develops mental retardation until that age. This test is systematically applied to the risk-group babies in Cuba. They apply the test for example if parents are hearing-impaired or if the mother has used some risky medicine during pregnancy. Thus they diagnose the possible hearing impairment at an early phase and prevent mental retardation through appropriate intervention. Also, the center has another diagnostic kit to check the thyroid hormone level in newborn babies. As you know, babies with hypothyroid have mental retardation. With this diagnostic kit they take a blood sample from the umbilical cord of the baby and check the thyroid level. Babies with hypothyroid are orally given a drop of thyroid and thus mental retardation is prevented. The cost of the drop is only 20 centavo. The director of the center is a friend of mine. He showed me his photos with young university students whom he treated twenty years ago with that drop. Cuba is the second country in the American continent that has been able to develop this technology. The first one was Canada, and Cuba has been the second.

The transformation of the biotechnology sector into an economic power and attainment of such advances in health services are indeed groundbreaking achievements. Have the biological aggressions of the US against Cuba played any role in the development of the sector?

Yes, I think that they also played a role. This is not my field of expertise, so I have not dealt with it personally. However, for example, when Cuba suffered the first dengue fever outbreak the virus that caused the pandemic was not previously known on the continent. Thus there are suspicions that the virus was introduced into the country. Besides, we have suffered other plant and animal diseases caused by other biological agents that were introduced into the country. It is a shame that science is used for such purposes, but it is not surprising since the US has been the first country to use the atomic bomb.

You are also a member of the national parliament in Cuba since 1993. How do your scientific activities interact with your political post? Did your political post have any effect on your scientific achievements?

I was a member of the parliament for 25 years. But I am not a deputy any more. As you know, we are discussing a new draft constitution in Cuba; soon we will submit it to a referendum. The new draft proposes limitation of elected political positions with two terms; that means 10 years in case of a deputy. I was a deputy for much longer time. And I learned a lot. I think my activities as a scientist and the work I did as a deputy have mutually fed each other. I was elected as a deputy from a rural municipality of Sancti Spiritus whose economic activities are based on agriculture and livestock production. Regional development projects, which we call municipality development programs, have much in common with scientific projects. Development projects, say, livestock production development projects, are mentally based on a transformation structure very similar with that of scientific projects. I believe that the experience I had as a scientist has been successful for the municipality. However, I learned much more than that I was able to teach. I learned how to deal with the problem of development of a region, how the local government worked, and how local party organizations functioned. Thus, I might have contributed to the region, but the process has taught me much more. After 25 years, my task as a deputy terminated in the last elections. Now, a friend of mine, a female scientist from the Center of Genetic Engineering has been elected from the same region. Somebody from the same sector has been elected. One of the most interesting things that have been done in Sancti Spiritus is that a strong link has been developed between the faculties of the university and the food production companies in the municipality.

Are you also a member of the Communist Party of Cuba? If so, when did you become a member? What kind of a meaning has the role you played in the construction and defense of socialism in Cuba given to your life?

Yes, I am a member of the party. As I told you before, I participated in the Union of Young Communists when I was 12 and I became a member of the party when I was 30. I have been a militant of the Communist Party for all my life. As regards to the meaning it gave to my life… As I said in the beginning of the interview, above all, it gave a purpose to my life. I think the most unfortunate thing for a person is not to have a purpose in life. It is a blessing to have a purpose in life. If I were to born again, I would again enter the Union of Young Communists and become a member of the Communist Party. I am telling this without a slightest sense of shame; because I know that there are people that are ashamed of having been communists once upon a time. I have the opportunity to visit many countries for conferences or other purposes and this topic comes up frequently. They ask me if I am a member of the party, and I say, “Yes, I am a militant of the party”.

Do you have any message for the young workers of science in Turkey?

The humanity is evolving to a society that is more and more based on knowledge. And knowledge is becoming a fundamental factor of development. You see this in any country, in any system. This is the reality for Cuba; this is the reality for Turkey, for any other country in the world. Young people who step into the world of science should be aware that they have a responsibility far beyond the sphere of science, a responsibility for the development of the society they live in. My message to the young scientists in Turkey might be the following: assume this responsibility and enjoy this responsibility. Science had never had such a key role in the history of the humankind. In the eighteenth, nineteenth century, science was a field of activity of small academic groups. Today, in turn, science is at the center of everything. Thus, it is of great importance not only to improve science but also to forge a link between science and social life. Of course, scientists in Turkey will do this in the specific conditions of Turkey while scientists in Cuba will do it in their own conditions. Diderot, one of the prominent philosophers of the French Revolution, has a beautiful saying. He roughly says, “One should study the spirit of his own country and understand where it is heading to so that his efforts are never left behind his country but are always in front of it.”

Thank you very much, we have learned a lot. We are honored to document such a life; what you have told will be very inspiring for the youth.

I do not think that my life is special. There are many lives like mine. I do not say this for modesty; this is the reality. There are thousands of people that have lived similar lives. The world of science is like a big workshop; there are a lot of things going on inside. If I may say so, the world of science is a world that “makes a lot of noise”. I believe that it is very critical for the youth to grasp the essence and assume the responsibility that I mentioned above.