Translational science is, by definition, groundbreaking; however, without an emphasis on quality and efficiency, some innovations in healthcare may translate into unnecessary risk, suboptimal solutions, and potentially loss of well-being and even lives. The COVID-19 pandemic and the Clinical and Translational Sciences Award Consortium’s response created an opportunity for quality and efficiency to be better defined, expediently and thoughtfully addressed, and further studied as central foundations in the translational science mission. This paper presents findings of an environmental scan of adaptive capacity and preparedness to illuminate the assets, institutional environment, knowledge, and forward-looking decision-making needed to optimize and sustain research quality and efficiency.

This article assumes a balanced position between two contrasting views regarding the accessibility, quality, efficiency and financial sustainability of the Cuban healthcare system. It evaluates those issues in the 2006–20 period by identifying strengths and weaknesses based on a comprehensive statistical compilation of health indicators, physical infrastructure trends, availability of physicians and other elements to assess the system's long-term financial sustainability. Finally, it examines the likely consequences of population ageing on healthcare, including potential policies.