Adolfo Álvarez Pérez, deputy director general, noted that the INHEM is involved in practically all of Cuban society's priority issues. Photo Mayda Medina

The Cuban institution responsible for the development of hygiene, epidemiology, microbiology, nutrition, and food safety, is celebrating its 115 years of service to the people's health, and projecting work to prioritize research, postgraduate instruction, and the development of scientific-technical knowledge.

The current National Institute of Hygiene, Epidemiology & Microbiology (INHEM) has its origins in the Laboratory of the island of Cuba, created May 17, 1902, established in the area of Havana's port. In December this same year, it was designated the National Laboratory, and in 1944 adopted the name National Institute of Hygiene. The facility moved, at that time, to a location on Infanta Avenue, where it has remained.

With the triumph of the Revolution in 1959, the Institute was given new, more complex tasks, and in 1969 saw its social role defined more specifically, along with the responsibility to serve as a central reference for other such centers established around the country. The INHEM reports directly to the Ministry of Public Health and is certified by this entity as a post-graduate educational center, and by the Ministry of Science, Technology, and Environment (CITMA), as a research facility.

For two decades now, the INHEM has served as the sponsor of the Cuban Academy of Sciences, and is a member of the Latin American and Caribbean Environmental Training Network affiliated with the United Nations Environmental Program (PNUMA). In 1996, it was designated a collaborating center by the World Health Organization in the area of safe housing.

Speaking to Granma International MSc Adolfo Álvarez Pérez, INHEM deputy general director, explained the center's responsibilities in conducting research in the medical sciences; coordinating the national program of investigations addressing decisive heath issues; and offering post-graduate studies.

Photo Mayda Medina

The Institute specialist also mentioned the facility’s other roles including the provision of added value scientific-technical services in the areas of sanitary microbiology and chemistry, as well as biochemistry and physiology. He indicated that workers participate as advisors in Ministry efforts to address epidemiological events in the capital and other provinces across the country.

The center plays an important role in the study of risk factors for non-infectious chronic diseases, environmental safety, and studies to evaluate risks associated with noise pollution, atmospheric contamination, and electromagnetic fields, among others.

The Institute plays a vital role in sanitary regulation. All products and services consumed by humans which are to be sold within the country, (except medicines) must be evaluated, certified, and registered by a committee of experts. Without this documentation from the INHEM, which serves as a guarantee of safety for consumers, the retail sale of these products and services is prohibited.

Beginning in 2010, as part of changes undertaken by the National Public Health System and the process of restructuring scientific entities, the National Nutrition and Food Hygiene Institute (INHA) and the National Institute of Epidemiology and Microbiology were merged to create the INHEM, with the goal of reducing organizational structures and their respective administrative apparatus, to take better advantage of technological resources, and increase scientific contributions - a process which was concluded in 2015.

According to Álvarez, the INHEM today includes a Nutrition and Food Safety Center; an Epidemiology and Environmental Health Center; and another department responsible for academics, research, scientific-technical information, and informatics. Also included are several laboratories; and a registry; plus a logistics/administration office, and an economic department.

Some 300 workers are currently employed at the INHEM, of these 109 are researchers and 83 professors - 93 hold Masters degrees and 14 doctorates. The majority of doctors working here are specialists and many have been trained in more than one field of expertise.

The National Institute of Hygiene, Epidemiology & Microbiology (INHEM), is located at 1158 Infanta Avenue, in Central Havana. Photo Mayda Medina

Academic offerings at the institution include one specialty, four post-graduate diploma programs, and more than 20 short courses. Over the last two decades, 243 MSc in Environmental Health have graduated, and 228 in Nutrition and Public Health. Some 141 specialists in Hygiene and Epidemiology have completed their studies and are lending their services across the country's Public Health System at a variety of levels. More than 80% of the researchers are accredited as professors, and many are pursuing doctorates.

The Institute is today immersed in a remodeling project and the introduction of new equipment. The main building, constructed almost 100 years ago, is being renovated, and the microbiology lab refurbished to meet international norms and expectations. The quality control certification process, in this area and others, is set to be concluded shortly.

The number of classrooms has been increased, and work is underway on two new labs which should be finished later this year, allowing the Institute to expand the scientific-technical services it offers, to better respond to epidemiological events and the needs of its own researchers.

Álvarez explained that the center has historically maintained ties with similar scientific institutions around the world. He mentioned the University of Nottingham in Britain and the Belgian Institute of Tropical Medicine, noting that an important collaboration agreement has been reached with the Osvaldo Cruz Foundation's National Public Health School, in Río de Janeiro, Brazil.

He referred to the development of another series of projects being conducted backed by the Pan American Health Organization; the United Nations Children's Fund (UNICEF); the World Food Programme (WFP); the United Nations Organization for Education, Science, and (UNESCO); and the United Nations Development Programme (UNDP).

These scientific investigations are directed toward finding solutions to the principal health issues facing Cubans, including the death rate associated with non-infectious chronic diseases; the maternal-infant program’s implementation; epidemiological challenges and events; and research on social issues. The latter includes an emphasis on the role of families, which has led to the establishment of a Cuban Network on Health Determinant Factors.

He indicated that, at this time, the INHEM is confronting several challenges related to the application of results from national surveys on food consumption and health; the elaboration of guides on nutritional best practices; and the standardization of protocols and methods used to analyze and address concrete problems, including the organization of healthcare services.

"The Institute participates in practically all of the priority issues in Cuban society, and plays a leading scientific role within and beyond Cuba. We are organizing a working group to adopt public policies with members from all of the leading bodies, taking a multi-sectoral approach," Álvarez said.

A similar opinion was shared by researcher Santa Jiménez Acosta, with more than 30 years of uninterrupted work at the Institute. She reports that she has witnessed the application of results from her research, "Within the highest levels of the country's leadership, our proposals are analyzed, and I can mention, as an example, steps taken to fortify wheat flour with vitamins and minerals, used to make bread and crackers. This likewise happened with (fruit) compote for children and nutritional supplements for pregnant women."

In the decade of the 1970's, Jiménez and her group investigated the caloric energy used by sugar cane cutters with a high level of productivity, in order to provide the necessary food provisions required for their physical work, and later extended their research to construction and forestry workers. They have studied the eating habits of the Cuban population, with an emphasis on vulnerable groups like the elderly and children.

At this time, her team is drafting nutritional guidelines for children under two years of age, based on the norms proposed at the International Nutrition Conference, held in 2014. At this gathering, international organizations emphasized the importance of every country having an educational tool to disseminate information about healthy diets.

Jiménez noted, "Although I have seen my investigations applied, I think that work must continue on closing the gap between scientific gains and social application. I believe our government has been very respectful and concerned about taking action in accordance with scientific results."

In agreement is technician Ailén Camejo Jardines, who works in the Sanitary Laboratory department and is responsible for conducting micro biotic analyses of foods (meat, cold cuts, vegetables, canned goods, grains, and milk products), looking to determine the presence of microorganisms, and certify that they are safe for human consumption and can be sold.

Camejo began working at the INHEM in 2005, as a recent graduate of an intermediate level technical school. He subsequently enrolled in the university Health Technology program, and is now pursuing a Masters degree in Clinical Microbiology, conducting research for his thesis on salmonella. He reports that he has received much support for his professional development at the Institute.

Likewise, university graduate Emilyen Benítez Mas, described her efforts in social communication, noting that her work on institutional communication and public information campaigns on health issues is based on research conducted at the INHEM.

Benítez is currently participating in a study on the drafting of guides for pregnant women and for mothers not breastfeeding their babies. She emphasized, "I have high expectations at the center, since I need to develop professionally and at the same time address issues of importance. I participated in the Health for All International Fair, and the Health Convention, both held in 2015; the International Hygiene and Epidemiology Forum; the Health Promotion Conference; and am currently organizing activities for the celebration of the Institute's 115th anniversary."

According to INHEM staff members, the center makes an extraordinary social contribution given the role it plays and the importance of research conducted here, but above all, in carrying out its mission to advise decision-makers in the Public Health System on health policies to be introduced, to protect the country epidemiologically, while using resources rationally. They all share a common commitment to contribute to society, promoting health for all and for the good of all.