As governments fight over which country will get the most vaccines soonest (and at the best price) and whose pharmaceutical companies will make the most money, it’s easy to think that there’s no other realistic way of producing and distributing the vaccines needed to roll back and, hopefully, eventually stop the coronavirus epidemic. In December, the People’s Vaccine Alliance reported that rich countries, with 14 percent of the world’s population, had bought up 53 percent of all the vaccines likely to be successful—which was enough to vaccinate their populations three times over.

So it is not surprising that the increase of vaccines approved or nearing approval—I think there are now around seven or eight—seems not to have done much, if anything, to reduce the cutthroat competition or the prices.

The propaganda claims that only the prospect of huge profits can persuade pharmaceutical companies to invest in developing and producing vaccines, and so, in the end, the market has to rule in this situation (even though some of the privately patented vaccines were developed wholly or in part by government subsidies).

But there is evidence that it could be done differently. Cuba—a poor country with about half the population of Australia, and which has been labouring under a United States economic blockade for six decades—has begun a Phase 3 test of Soberana 2, the vaccine considered the most effective among the four that its scientists have been developing and testing. Soberana 2 is a recombinant protein vaccine, which does not require extreme refrigeration.

If the Phase 3 test is successful, the Cubans hope to inoculate their entire population by the end of this year. But they are planning to produce up to ten times the number of doses that are required for Cuba. The country—partly because of the US blockade—does not have the capacity to produce the planned 100 million doses in one year. The government is therefore seeking to partner with pharmaceutical companies in Europe or Canada to produce Cuba’s patented vaccine.

The extra vaccine is to be exported, but not at the excessive prices demanded by Big Pharma. Cuba’s past practice with its patented medical treatments is that it seeks to recover its costs: it provides the treatments free or at concession prices to poor countries and charges near market rates for licences to wealthy countries. This approach is part of Cuba’s well-known medical missions to scores of countries around the world. The United Nations estimated in 2019 that 30,000 Cuban doctors were providing health services in 67 countries in that year. This is one of the factors that has won Cuba much international good will and support against the US.

Cuba’s development of a vaccine is certainly not a “miracle of the market”. It’s a matter of what a society considers important. As part of a strategy to survive against the blockade and ongoing threats from the US, not long after Cuba’s 1959 revolution, the government decided to specialise in medicine and microbiology. It is not a coincidence that the name of the vaccine, Soberana, is the Spanish word for “sovereignty”.

Perhaps, in the not too distant future, “soberana” might become an international term meaning “Health doesn’t have to depend on pharmaceutical company profits”.