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Barely one month after Brazil announced it would contract 4,000 doctors from the island for an estimated $192 million a year, President Rafael Correa said during his Saturday speech that Ecuador is planning to contract Cuban primary care physicians for $30 million a year.

“We are analyzing to bring some 1,000 Cuban family doctors,” Correa said during his routine speech Saturday morning, just a few hours after returning from a one-day visit to Cuba.

“This is a model we have to implement in Ecuador,” Correa said about Cuba’s primary care physicians, the backbone of the island’s cost-efficient medical system. He added that the Cuban doctors will be a stopgap measure while more Ecuadorean primary-care physicians are being trained in Cuba.

Cuba’s Latin American School of Medicine (ELAM) has graduated 1,400 Ecuadorean students, for which Ecuador has paid $218 million, according to that country’s health ministry. Cuba has committed to training 10,000 Ecuadorean primary-care community physicians and technicians.

Like in Brazil, the Cuban doctors will work in underserved poor neighborhoods and rural areas, practicing primary-care, family and preventive medicine.

The Ecuadorean plans further broaden Cuban efforts to diversify for-pay medical service exports. In addition to the program in Brazil, Cuba recently expanded more modest medical service programs in South Africa, Angola and Algeria, and it started programs in Saudi Arabia, Qatar, and Portugal. Also, Norway and Brazil have funded medical relief efforts involving Cuban doctors in Haiti.

While service exports — most of them medical services — a decade ago surpassed tourism as Cuba’s main source of hard currency, by far most of the healthcare exports are under agreements with oil-rich Venezuela. An estimated 30,000 medical personnel from Cuba work in Venezuela, or in third countries under programs funded by Venezuela.

Pharmaceutical industry plans

In his speech Saturday, Correa also urged Ecuador to build a pharmaceutical industry similar to Cuba’s. In 2010, Ecuadorean state pharmaceutical company Enfarma signed an agreement with Cuba for a feasibility study and preliminary engineering services for construction of a pharmaceutical plant in Ecuador. The plant will use Cuban technology and will be operated by Enfarma. Construction has yet to begin.

During his one-day visit to the island, Correa met with Cuban Health Minister Roberto Morales and other Cuban health officials to hear about how Cuba managed to achieve one of the lowest childhood malnutrition and mortality rates in the world, as well as one of the highest life expectancies in the Americas.

Cuba invests nine percent of its GDP in health care, compared to Ecuador’s seven percent. His government aspires to match Cuba’s spending, but much needs to be done to improve efficiency as well, Correa said.

“I think we have had extraordinary results, but we need to be more efficient,”  Correa said about health care in Ecuador. “Cuba has had extraordinary results, which we also hope to achieve in Ecuador.”

In Havana, Correa was accompanied by a large and high-ranking Ecuadorean healthcare delegation headed by Health Minister Carina Vance, seeking information about Cuba’s primary-care services; the family doctor system; preventive health care; production of pharmaceuticals; genetic research; and Cuba’s comprehensive care system for people with disabilities.

The Ecuadorean delegation included Doris Soliz, minister for economic and social inclusion; National Risk Secretary María del Pilar Cornejo; Technical Secretary for Disabilities Alex Camacho; as well as officials with the education and social development ministries.

The 1,000 Cuban doctors would join a couple of hundred who already are in Ecuador. As part of a bilateral heath care agreement signed in 2011, Ecuador and Cuba agreed to implement a $17 million, three-year neonatal preventive health program in the Andean country. This is in addition to more than 200 Cuban doctors already covering primary-care needs in Ecuador. Also, Cuba has helped Ecuador implement the Manuela Espejo Mission, a program started in 2009 for an estimated 300,000 Ecuadoreans with disabilities. Some 200,000 have been reached by the program so far.

Potential for pharmaceutical exports

Next to healthcare service exports, the biggest gain for the Cuban economy of closer medical cooperation with Ecuador could be pharmaceutical exports.

Since the death of Hugo Chávez in March, Correa has taken on a leadership role in the ALBA bloc, which recently took steps towards creating a common medical market. In August, the member countries of the ALBA bloc officially announced the launch of ALBAmed, a multinational body that includes a regulatory institution and a central registry for pharmaceutical and medical products. Both are expected to lower barriers for medical trade within ALBA.

In 2011, Correa pledged his country would buy up to $1.5 billion worth of Cuban-made medical drugs and vaccines that year. The pledge came after the Ecuadorean health minister toured Laboratorios Novatec and Laboratorios Farmacéuticos AICA in Havana, which produce generic versions of Aspirin and Tamiflu, as well as medical supplies such as vials and aerosols. However, arguing that Cuban products were not registered in their country, Ecuadorean critics were apparently able to significantly reduce these purchases to tens of millions of dollars; at the time, Correa publicly complained about “sabotage” in his own health ministry.


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