Center for Research on Science, Technology and Society

Graziela Ferrero Zucoloto
CTS/Ipea Planning and Research Specialist
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This article was translated courtesy of The South Centre, an intergovernmental policy research and analysis institution of developing countries.

In recent decades, pharmaceutical activities have been characterized by a series of changes related to the pursuit of cost reduction, increased profitability of research and development (R&D) projects, reduction of the internal R&D structure of large companies, and growing outsourcing of technological services (Alves, 2022). The growing participation of biotechnological medicines, generally more complex and costly, in sales also emerges as a worldwide phenomenon (Vargas, 2024).

From these changes, new organizational forms emerged in pharmaceutical activities, marked by the emergence of strategic alliances between agents — who, in some cases, are competitors —which led to the strengthening of cooperation networks that can take various forms, such as consortia, joint ventures, strategic alliances, and subcontracting (Alves, 2022; Queiroz, 2024; Radaelli, 2008).

Despite this movement, which emphasizes the growth of these partnerships, Rikap (2019) demonstrated that the power asymmetry between the actors in these networks and their different nationalities remains wide. When studying large pharmaceutical companies, all concentrated in developed countries, the author revealed that while universities, public research institutions, and emerging companies associated with these large companies appeared as co-authors in scientific publications, they were practically absent from patent ownership maps, pointing to a relationship of subordination of these institutions to the leading companies.

But although technological generation and ownership remain concentrated in certain institutions, located mainly in the Global North, Alves (2022) highlighted that companies participating in these networks and accessing external sources of knowledge — that is, recipients of technology transfer — should not be considered passive, as this absorption requires a significant volume of prior knowledge and technological capabilities. Although the above characteristics reflect pharmaceutical systems where companies are privately owned and driven by the pursuit of profitability, in Cuba, a country where all companies are state-owned, various types of partnerships are also observed, both between national institutions and with foreign institutions.

In order to understand this universe, this article analyzes the agreements of Cuban institutions in the pharmaceutical sector, based on information available in the Cortellis Generics Intelligence -- Deals module database.[1] The database identified 119,821 agreements involving institutions from 146 countries between 1964 and 2022. For more details, see Chaves et al. (2024). The article presents the main participating institutions by nationality and main activity, as well as therapeutic areas and types of agreements, based on definitions originating from the cited database. 36 agreements involving Cuban institutions, concluded between 1995 and 2020, were identified.

The Cuban experience can provide reflections for the Brazilian case, considering that in both countries there are public laboratories producing medicines, while in most nations such laboratories focus solely on generating new technologies.

Results

The starting point of the analysis refers to the "ownership" of technology. Actors participating in the agreements are classified by the database as "main institution" and "associated institution, " with the "main" being the owner of the negotiated asset, acting as licensor, seller, or service provider, and receiving resources or assets from the "associated institution."

Although the literature indicates that institutions from developed countries are the main owners of technologies, while those from developing countries, with less capacity to generate innovations, are mostly recipients (Rikap, 2019), in the agreements involving Cuban institutions identified in this work, the opposite was observed: in the majority (27 agreements), Cuban institutions acted as "main" institutes, that is, they were the owners of the asset or technology being marketed. In 13, they acted as “associated” institutions.

Regarding Latin American and Caribbean countries, Cuban participation among "main" institutions, in number of agreements, was higher than that observed in most countries of similar size. Only in those of larger territorial and economic size, such as Brazil, Mexico, Argentina, Chile, and Colombia, were higher numbers of agreements identified (Graph 1).

In terms of number of agreements, three institutions stood out: the Center for Molecular Immunology (CIM), Finlay Institute and Center for Genetic Engineering and Biotechnology (CIGB). The CIM is a biotechnological institution that directs its basic research, development, and manufacturing of products for the treatment of cancer and other autoimmune diseases, with products registered for health use in 100 countries, export capacity with experience in more than 30 countries, and various joint ventures. The Finlay Institute focuses on the development and production of vaccines, including Soberana (used against COVID-19). The CIGB is a company of preventive, therapeutic, and diagnostic biopharmaceutical products for the biomedical, agricultural, and industrial sectors; it produces monoclonal antibodies and a wide range of products, including the Abdala vaccine, also against COVID-19.

All of them are linked to Biocubafarma, a group that brings together Cuban biotechnological and pharmaceutical companies whose activities are specialized by technologies, types of medicines, and/or diseases, which promotes cooperation and limits competition between them (Table 1).

The diversity of countries with which Cuban institutions interact is also a relevant aspect of the analysis. In the 13 agreements in which Cuban institutions appear as "partners," partnerships were made with institutions from eight countries, one of them Brazil. In those where Cuban institutions were the owners of the assets (Cuban institutions as "main"), agreements were made with institutions from 14 other countries, including Brazil. Several developed countries, such as the United States, were recipients of Cuban technologies or assets. In four cases (Table 2), intranational agreements (between two Cuban institutions) were observed.

Agreements with Brazilian institutions involved the manufacturing and supply of the meningococcal polysaccharide vaccine in African countries by BioManguinhos and the Finlay Institute, and the use of CIM's monoclonal antibody by the company Eurofarma.

Regarding the types of partnerships, 12 categories were identified, grouped based on an adaptation of the PAGE | 04 SOUTHVIEWS NO. 308 classification presented in Chaves et al. (2024): property strategies; R&D activities; manufacturing or supply of medicines; and exclusive patent rights (Table 3). Most agreements (19) concentrated on "R&D activities, " specifically in categories related to initial R&D and licenses for the development or marketing of medicines, regardless of whether Cuban institutions acted as main or as partners.

In agreements related to property strategies, especially in the establishment of joint ventures, Cuban institutions stand out among the main ones. These results are similar to those found, for example, in Brazil, where R&D activities and property strategies had greater relevance compared to agreements related to patents or those exclusive for the manufacturing and supply of medicines (Chaves et al., 2024).

Finally, Table 4 presents the therapeutic areas and indications included in the agreements. There is a predominance of treatments for various infections, including neglected diseases such as tuberculosis and the COVID-19 vaccine, and treatments against cancer. Both areas together represented 77.7% of the agreements. In comparison, in Brazil, the diversity of therapeutic areas identified was greater, although infections also predominated as the main area (Chaves et al., 2024).

Limitations

The Cortellis Generics Intelligence -- Deals module database collects and consolidates information on agreements in the pharmaceutical sector worldwide. However, agreements involving institutions from developed countries predominate: the top ten countries in number of agreements are present in 94.4% of the agreements identified (Chaves et al., 2024). Besides the fact that the database does not include all existing agreements between institutions in the pharmaceutical sector (only those that were possible to identify), there is no information on the representativeness of those that were mapped in relation to the total existing in each country.

In the case of the partnership between Cuba and Brazil, the number of agreements presented is underestimated. Therefore, the agreements available in the database are considered a sample of a broader universe, which may be more representative for some countries than for others.

Despite these limitations, given the scarce information available on technology transfer and other partnerships, the analysis provides, albeit partially, characteristics of the agreements and the institutions involved. Among them, the participation of Cuban institutions as owners of assets or technologies (main institution), the predominance of agreements involving R&D activities, and the emphasis on infectious and neglected diseases stand out.

[1] Accessed on July 5, 2022.

This text is part of a series of articles on Cuban pharmaceutical institutions carried out based on visits, interviews, and complementary research, and financed by the Ministry of Health through the Decentralized Execution Term (TED) No. 06, of 2022.

The opinions expressed in this publication are solely and entirely those of the author and do not necessarily reflect the views of the Institute of Applied Economic Research or the Ministry of Planning and Budget.