In Cuba, the smallest country in the world to produce its own Covid-19 vaccines, five immunizations are currently in clinical trials. Soberana 2 and Abdala have reached Phase 3, making the island nation the only country in Latin America to reach the final stage in vaccine development. In the meantime, three other kinds of Cuban Covid-19 shots are in early trial phases.

Last month, Cuban authorities opted to begin early distribution of those two most advanced vaccines, deciding the benefits of a mass inoculation campaign outweighed the risks. The director of Cuba’s Finlay Institute of Vaccines, which developed the Soberana 2 vaccine, has said the country could produce 100 million doses by the end of the year, 70 million more than what Cuba needs internally. And while the Cuban government is focused on vaccinating its own population first, vaccine exports from Cuba may soon become a reality.

According to a draft of a speech shared with The Intercept, Cuba’s vice-minister of public health will announce the country’s intention at the Progressive International’s Summit for Vaccine Internationalism to open a discussion about how to mobilize its vaccine candidates to support other countries that request aid.

But for the time being, any such plans are likely to be limited in scope as a result of the decadeslong U.S. trade embargo and sanctions against the country. The policies severely complicate Cuba’s access to international finance, and leaders in Havana say they contribute to crippling supply shortages. At the same time, harsh sanctions restrict access to vaccines and treatments in Venezuela, where immunization rates remain low as coronavirus cases continue to climb.

The conditions in the two countries offer clear examples of how U.S. sanctions could undermine the global fight against the pandemic. While the Biden administration has pledged to lead international efforts to distribute vaccines around the world, economic restrictions on doing business with Cuba and Venezuela threaten to undermine that very promise.

Many developing countries lack the financial means to secure bilateral deals with vaccine makers on their own. As a result, more than 130 nations are relying on COVAX, a vaccine-sharing initiative backed by the World Health Organization and funded largely by high-income countries and private donors. While COVAX has fallen well behind on its original targets, G7 countries nevertheless called the platform “the primary route for providing vaccines to the poorest countries” at their summit last weekend.

One state hoping to make use of the initiative is Venezuela, where the government claims attempts to access COVAX have been hampered by U.S. sanctions. As of early 2021, the U.S. had imposed financial sanctions on over 100 Venezuelan individuals and at least eight different entities, including the government, the central bank, and the state oil company. The list expanded under Donald Trump but remains in place under Joe Biden.

President Nicolás Maduro’s government says it has aimed to work around these measures. Back in March, Maduro even cut a deal with opposition head Juan Guaidó (still recognized as “interim president” by the U.S. State Department) to free up $30 million in offshore cash frozen under American sanctions to help pay for Covid-19 shots. A month later, Venezuelan authorities said they had finally closed in on making a crucial $120 million payment to COVAX required to access vaccines, without providing details about the origins of the funds. But last Thursday, the country’s vice president Delcy Rodríguez announced that payments covering the final $10 million had been blocked.

According to a letter posted on Twitter by Venezuelan Foreign Minister Jorge Arreaza, a representative of COVAX informed the government that it had received notification from Swiss bank UBS that four operations totaling over $4.6 million had been blocked and were “under investigation.”

A spokesperson for UBS said it was “unable to comment on matters relating to potential client relationships” but noted that the bank “complies with applicable legal and regulatory requirements across jurisdictions, including respective sanction regimes, which includes at least those sanctions currently imposed by Switzerland, the UN, the UK, the EU and the USA.”

For their part, Venezuelan authorities say U.S. sanctions are to blame.

“The news that Venezuela’s last 4 payments to COVAX have been blocked—thus preventing the Venezuelan people from accessing the vaccine distribution mechanism—confirms once again the criminal nature of the unilateral, illegal, and coercive measures that the United States has imposed on Venezuela,” Arreaza told The Intercept in a statement.

A spokesperson for the U.S. State Department rejected the notion that the U.S. bears responsibility, noting that sanctions on Venezuela include broad exceptions for humanitarian goods but that banks sometimes delay transactions on their own.

“For a high-risk jurisdiction such as Venezuela, financial institutions review payments to ensure compliance with various legal requirements, including the prevention of fraud, corruption, money-laundering, and sanctions violations,” the spokesperson said. “These reviews may result in delays for payments involving Venezuela, even when U.S. economic sanctions do not prohibit such payments.”

As it stands, Venezuela is the only country in South America that has not received any shipments from COVAX, according to the UNICEF Covid-19 Vaccine Market Dashboard. When asked about the recent blocking of payments, a spokesperson for Gavi, a public-private partnership that helps coordinate COVAX, underlined the organization’s intent to distribute shots to the country.

In the meantime, Venezuela’s vaccination campaign is lagging far behind the rest of the continent. The government has received around 2.7 million vaccine doses from Russia and China, but the shots have gone out to a small share of health professionals and senior citizens. According to the Our World in Data Project at the University of Oxford, Venezuela has vaccinated just 2 percent of its population with at least one dose — well behind neighboring Colombia and Brazil, at 18 and 27 percent respectively.

CARACAS, VENEZUELA - JUNE 7, 2021: A nurse prepares a   Covid-19 dose, inside sporty of the colony January 23,  during Massive day of vaccination program against covid-19 for elderly population on June 7, 2021 in Caracas, Venezuela. (Photo credit should read Michael Mata / Eyepix Group/Barcroft Media via Getty Images)

A nurse prepares a Covid-19 vaccine dose in Caracas, Venezuela, on June 7, 2021.

Photo: Michael Mata/Barcroft Media via Getty Images

In Cuba, where 18 percent of the population has received at least one dose, vaccine breakthroughs are the product of unique circumstances: heavy state spending on education and health care, close ties between researchers and public health officials, and a biotech sector that has flourished since the 1980s. They’re also reflective of how the Cuban government is accustomed to getting by without international support. The country has navigated around the U.S. trade embargo since 1962, making painful adjustments after the fall of the Soviet Union in 1991. According to José Angel Portal Miranda, Cuba’s health minister, 85 percent of the country’s Covid-19 “treatment protocol” has been developed using “national sources.”

Despite a “commitment to technological sovereignty,” as Portal Miranda described it, the Cuban government says various U.S. sanctions are hindering its ability to fight the pandemic — and not just when it comes to exporting vaccines.

The list of U.S.-imposed restrictions on Cuba in place today is lengthy. After a thaw in U.S.-Cuba relations under President Barack Obama, the Trump administration tightened sanctions by implementing a new blacklist of Cuban businesses; imposed a policy change that allows Americans to sue firms profiting from property nationalized after the 1959 revolution; and enacted a ban on the use of “U-turn transactions,” cracking down on the ability of banks to process fund transfers outside the U.S. and thereby sidestep some of the sanctions. All the while, a broad-reaching trade embargo — known in Cuba as “the blockade” — remains in effect.

Early in the pandemic, while Havana dispatched more than 2,000 doctors to assist nations around the world, the country struggled to obtain critical foreign-made medical supplies to treat its own population. In April 2020, the Cuban government said a Colombian cargo carrier declined to deliver a large shipment of masks and ventilators sent by Chinese billionaire Jack Ma because the shipper had an American shareholder. Cuban authorities also hoped to obtain ventilators from familiar Swiss suppliers, but claim new business was made impossible after the firms were acquired by a U.S.-based owner.

Similar challenges have continued well into this year, amplified by one of Trump’s last maneuvers as president: Just days before leaving office, he reclassified Cuba as a state sponsor of international terrorism. As Reuters reported in March, that new designation restricts Cuba’s access to international financing as its economy emerges from a massive recession, having slid 11 percent in 2020. And while Cuba has no problem producing vaccines, it does claim to face a significant shortage when it comes to syringes, as many pharmaceutical producers are based in or have ties to the U.S.

According to Global Health Partners, a New York-based NGO focused on international medical aid, Cuban authorities need some 30 million syringes for their vaccination campaign but are 20 million short of that goal. Last month, the Commerce Department granted a special license allowing Global Health Partners to raise money from Americans to distribute supplies.

“There are multiple exemptions and authorizations under the U.S. embargo on Cuba, and the United States has, for decades, permitted the export to Cuba of agricultural products, medicine, medical devices, and other humanitarian supplies,” said a State Department spokesperson. “In cases where prior U.S. government licensing is required, we note our continued willingness to review requests from those interested in providing such humanitarian items.”

At this weekend’s Progressive International summit, Cuba will be joined by delegations from Venezuela, Argentina, Bolivia, and Vietnam, alongside other politicians, health experts, and a handful of pharmaceutical manufacturers. While the summit will likely feature criticism of the World Trade Organization’s inability to agree to suspend patent rights on vaccines and highlight what participating countries view as lackluster commitments from global superpowers, organizers also hope the meeting will result in deals to share technology and expand manufacturing capacity.

“We hope that we’ll come out with tangible agreements and also build a future alliance that can work to confront the system which is restricting vaccine rollout around the world,” James Schneider, communications director for Progressive International, told The Intercept.

According to a Data for Progress poll the group commissioned and shared with The Intercept ahead of publication, a majority of Americans believe Washington’s policies toward Cuba and Venezuela need to change for the sake of fighting the pandemic.

66 percent of those polled said they support “lawmakers suspending the US embargo so Cuba can provide life-saving treatment to poor countries,” including 79 percent of Democrats and 54 percent of Republicans. Meanwhile, 67 percent said they “support the US waiving sanctions on certain countries to enable them to receive the medication, equipment, and vaccines they need to fight the COVID-19 pandemic.” Just 22 percent oppose the idea.

Schneider said the data shows Americans recognize the importance of international cooperation to fight the virus. In an earlier poll from Data for Progress, 60 percent of respondents called on Biden to support the WTO proposal to waive patents and remove intellectual property barriers from Covid-19 vaccine and treatment technology.

“Promoting global health in the midst of a pandemic all around the world is also in the interests of citizens of the U.S., because when they say no one is safe until everyone is safe, in this pandemic that is absolutely true,” Schneider said. “The longer that it goes on for, the more likely there are mutations that will drag everything backwards.”

“Only the joint action of countries and their governments, based on respect, solidarity and cooperation, will guarantee success in the battle against this pandemic—and protect the planet from similar crises,” said Portal Miranda in a statement to The Intercept.

On the campaign trail, Biden expressed interest in reverting to Obama-era policies on Cuba, arguing that better engagement with the nation improved ties with the region at-large. But in office, Biden has yet to move toward détente or make a significant break from his immediate predecessor. Last month, the State Department listed Cuba — along with Iran, North Korea, Syria, and Venezuela — as states “not cooperating fully with United States antiterrorism efforts.” The move was a renewal of one made last year under Trump.

“We’re having political opposition to states being put ahead not only of the health interests of the people that live in those countries, but [also the ability] of those countries to help other countries in their region,” Schneider said. “This ultimately sets back the ability to end the pandemic everywhere around the world, including in the U.S.”