Perspectives in Health Magazine
The Magazine of the Pan American Health Organization
Volume 8, Number 2, 2003

An institute reborn
Meanwhile, the small but impressive institute Pedro Kourí had founded went into decline after his death in 1964. For more than a decade, it carried on with just 14 staff working in a 1,000-square-meter facility. Gustavo recalls that it suffered from a "lack of leadership" and the fact that Cuba's public health system was deteriorating and "resources were being directed to more serious problems."

In 1979, however, the Cuban government decided to support the institute's activities, incorporating it into the Ministry of Health and recruiting the younger Kourí as director.

The new Kourí Institute cultivated scientific relationships with countries and international organizations around the world, including in the United States. Support from the Special Program for Research and Training in Tropical Diseases (TDR), of the United Nations Development Program (UNDP), the World Bank and WHO, was critical to the institute's retooling. TDR provided training, research and project grants and helped the institute establish exchange relationships with other scientific centers around the world.

Today the Pedro Kourí Institute for Tropical Medicine comprises 52,000 square meters and 700 employees and is Cuba's leading research and training center in infectious diseases, as well as a major player in international efforts to control tropical diseases. Many of the national laboratories of Cuba are housed at the institute, along with the island's only tertiary AIDS clinic and research center. It continues to receive support from TDR as well as Canada, France, Spain, Belgium, the European Union and the Wellcome Trust, among others.

While the institute originally limited its work to parasitology and tropical medicine, it now addresses infectious diseases in general, with projects in more than a dozen research fields. These range from sexually transmitted diseases and infections in immunodepressed patients to strategies for the control of the disease-bearing mosquito Aedes aegypti.

IPK is in charge of evaluation and clinical trials for all Cuban vaccines, "which is very relevant work for our biotechnology industry because we determine the effectiveness of our products," Kourí says. Among the vaccines the institute is developing or preparing to test are a recombinant dengue vaccine and a vaccine for HIV/AIDS. IPK is also in charge of the control and evaluation of antiretroviral treatment for HIV/AIDS, which the government provides free of charge to those who are infected. (As part of Cuba's public health system, the Kourí Institute provides its services free of charge to Cuban nationals.)

In addition, the institute has a medical residency program and master's and Ph.D. programs in virology, bacteriology, parasitology, vector control, epidemiology and infectious diseases.

Kourí takes equal pride in—if not explicit credit for—Cuba's overall health achievements, many of which could not have occurred without his institute's contributions. They roll off his tongue like the names of his children: "Cuba was the first country in the Americas to eliminate polio. Vaccines against 13 infectious diseases have been developed, and so the incidence is very low. Typhoid is 0.1 percent, TB is 7.8 percent, tetanus is zero, and bacterial meningitis is 0.3 percent. Malaria is completely eradicated, and dengue outbreaks have all stopped. And AIDS is under control."

Having largely conquered its own most threatening infectious diseases—thanks in significant part to the work of IPK—Cuba has more recently taken on the role of providing assistance in this area to other developing countries. As with other national health pursuits, Kourí's institute is deeply involved in this.

Continuing in the tradition of his father, Kourí says he is especially proud of the institute's teaching function. Since 1980, it has trained more than 20,000 students, some 1,800 of them foreigners from 72 countries.

"IPK is respected throughout Latin America and beyond," says Paul Farmer, professor of medical anthropology at Harvard Medical School. "With a comparatively tiny budget—less than the budget, say, of a single large research hospital at Harvard—IPK has conducted important basic science research, helped develop novel vaccines, trained thousands of researchers from Cuba and from around the world, and developed ties with researchers in the United States, too. Gustavo Kourí has provided the leadership for all of this."

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