outstanding achievements in health biotechnology are a source of inspiration for the developing world. They are all the more impressive considering that the island is a small, relatively poor country that has suffered serious economic difficulties for more than a decade. These eco- nomic problems arose in the wake of the Soviet Union's disintegration and the political changes in Eastern Europe in the early 1990s, resulting in the collapse of Cuba's export markets, and the imposition since 1961 of a US trade embargo against Cuba, which has limited opportunities for the country's agri- culturally based economy. Despite these diffi- culties, Cuba's strong and continued emphasis on science since shortly after the 1959 revolution has resulted in a highly devel- oped health biotechnology sector. includes research on recombinant Dengue vaccine, preventative and therapeutic AIDS vaccines, cholera vaccine and a cancer therapeutic vaccine. The sector has also suc- cessfully produced diagnostic tests and therapeutics, as can be seen in Tab le 1 .I n addition, Cuba is devel- oping natural products based on the island's flora. An example is the natural anticholes- terol drug policosanol (PPG), an 8-alcohol extract derived from the wax of one of the country's main crops, sugarcane. Cuba began development of its health biotechnology sector by imitating products developed elsewhere, such as interferon-α 2b (IFN-α ), but in recent years greater empha- sis has been placed on innovation from within Cuba. The perception that innova- tion is increasing is supported by biotech- nology experts, such as James Larrick, an entrepreneur in Palo Alto, CA, who says: "Their pipeline is very, very deep now.… It's gone into an adolescence and it's looking pretty good." 1 Indeed, researchers in Cuba have filed about 500 patent applications in the health biotechnology sector based on more than 200 inventions (according to an analysis of the European Patent Office's (Munich, Germany) database, the European Network of Patent Databases, May 2003, http://www.european-patent-office.org/). These have been filed in several countries throughout the world, including the United States, Europe, Brazil, India, China and South Korea. Cuba exports biotechnology products to more than 50 countries, mainly in Latin America, Eastern Europe and Asia. Cuba's hepatitis B vaccine has been certified by the World Health Organization (Geneva, Switzerland) and is prequalified for use by United Nations purchasing agencies. The primary focus of Cuba's health biotechnology has been on developing products, rather than basic