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Resumo O texto apresenta e discute novo encaminhamento da política do SUS dirigida ao Complexo Industrial da Saúde. Uma política dirigida à capacitação tecnológica e produtiva de empresas públicas e privadas no campo sanitário floresceu entre 2007 e 2016 tendo sido, a partir daí, enfraquecida e deformada. A despeito de seu sucesso, a denominada Política de Desenvolvimento Produtivo (PDP) apresentou algumas fragilidades que devem ser enfrentadas na eventualidade de sua retomada. Além de sugerir essa retomada, o texto propõe a ampliação da política a partir de uma articulação da principal ferramenta da PDP - as parcerias público-privadas - com outras políticas que envolvam a indústria da saúde em curso no Ministério da Saúde. Abstract The text presents and discusses a new direction of the Unified Health System (SUS) policy geared toward the Health Industrial Complex. A policy aimed at the technological and productive development of public and private companies in the health field flourished from 2007 to 2016 and has been weakened and deformed since then. Despite its success, the so-called Productive Development Policy (PDP) evidenced some weaknesses that must be tackled during its resumption. Besides suggesting this resumption, the text proposes to expand the policy by articulating the primary PDP tool - Public-Private Partnerships - with other related policies that involve the health industry operated by the Ministry of Health.

The text presents and discusses a new direction of the Unified Health System (SUS) policy geared toward the Health Industrial Complex. A policy aimed at the technological and productive development of public and private companies in the health field flourished from 2007 to 2016 and has been weakened and deformed since then. Despite its success, the so-called Productive Development Policy (PDP) evidenced some weaknesses that must be tackled during its resumption. Besides suggesting this resumption, the text proposes to expand the policy by articulating the primary PDP tool - Public-Private Partnerships - with other related policies that involve the health industry operated by the Ministry of Health.O texto apresenta e discute novo encaminhamento da política do SUS dirigida ao Complexo Industrial da Saúde. Uma política dirigida à capacitação tecnológica e produtiva de empresas públicas e privadas no campo sanitário floresceu entre 2007 e 2016 tendo sido, a partir daí, enfraquecida e deformada. A despeito de seu sucesso, a denominada Política de Desenvolvimento Produtivo (PDP) apresentou algumas fragilidades que devem ser enfrentadas na eventualidade de sua retomada. Além de sugerir essa retomada, o texto propõe a ampliação da política a partir de uma articulação da principal ferramenta da PDP - as parcerias público-privadas - com outras políticas que envolvam a indústria da saúde em curso no Ministério da Saúde.

Resumo O texto apresenta e discute os principais aspectos relacionados à dinâmica atual da indústria de vacinas no mundo e no Brasil, com foco na demanda criada pela pandemia da COVID-19. No plano global, expõe brevemente o lugar ocupado atualmente pelo Brasil no âmbito dos BRICS e expõe e analisa as opções - identidades e diferenças - da política industrial de Brasil, China e Índia no campo das vacinas. A seguir, analisa o deslocamento da indústria de vacinas de uma situação de produção exclusiva de imunizantes para um controle majoritário da grande indústria farmacêutica. Mais adiante, recupera aspectos fundamentais recentes da indústria de vacinas no Brasil, com ênfase em Biomanguinhos/Fiocruz e no Instituto Butantan. Finalmente, discute os sucessos e limitações do mecanismo de transferência de tecnologia utilizado pelas duas instituições, bem como a relevância do compromisso historicamente assumido pelas mesmas com as políticas públicas de saúde.

Resumo O texto discute modos de compreensão de ocorrências sanitárias complexas, como a pandemia envolvendo o SARS-CoV-2. Entende que a simplificação do problema ao ponto de valorizar exclusivamente os desfechos dessas ocorrências à existência de um patógeno e um humano suscetível diminui em muito a efetividade das estratégias de mitigação. Sustenta a necessidade de enfatizar as interfaces que estão presentes na construção da complexidade pandêmica e as compreende como elementos centrais no seu enfrentamento. Compreende essas interfaces como elementos estruturais do processo e relativiza as estratégias simplificadoras expressas em “balas de prata”, mormente produtos industriais. Finalmente, circunscreve esse ponto de vista ao exame da interface entre as tecnologias industriais de saúde e as variáveis políticas que modulam o acesso da população àqueles produtos.

The text presents an updated proposal for a Health Science, Technology and Innovation Policy in Brazil, following the huge political turmoil in the country since 2019 and the COVID-19 pandemic since 2020. The proposal is presented in five sections: Scientific Research; Productive Innovation; Health Technology Assessment and Incorporation; Intellectual Property in Health; New challenges posed by the Pandemic. The authors take part in the Advisory Committee in Science, Technology and Innovation of the Brazilian Association of Collective Health.O texto contém uma proposta atualizada de política de Ciência, Tecnologia e Inovação em Saúde no Brasil e a pertinência da atualização decorre do desastre nas atividades nesse terreno verificadas no país desde o início do atual governo federal em 2019, bem como dos desafios colocados pela emergência da pandemia COVID-19 desde 2020. Ele está organizado em cinco seções, a saber: Pesquisa em Saúde; Inovação Produtiva; Avaliação e Incorporação de Tecnologias em Saúde; Propriedade Intelectual em Saúde; Novos desafios colocados pela Pandemia. Os autores fazem parte do Comitê de Assessoramento em Ciência, Tecnologia e Inovação da Abrasco.

Resumo Este documento de opinião é baseado na contribuição da ABRASCO e do CEBES para o 8º Simpósio Nacional de Ciência, Tecnologia e Assistência Farmacêutica promovido pelo Conselho Nacional de Saúde. Trata da política de Ciência, Tecnologia e Inovação em Saúde e a inscreve nos três pilares para uma agenda de desenvolvimento em saúde: O Sistema Único de Saúde, a base produtiva de bens e serviços de saúde e a capacidade instalada de ciência, tecnologia e inovação em saúde.

The text explores the theme of Brazilian sufficiency in vaccines. It presents the ways practiced in the two most important Brazilian institutions in the development and production of vaccines - the Butantan Institute and the Institute of Technology in Immunobiologicals (Bio-Manguinhos). These paths are the pure and simple purchase, the purchase of the product with technology transfer commitment, partnerships that include the fulfillment of phase 3 trials by the buyer, the new path announced by Instituto Butantan in which the partnership includes for the realization of trials in phases 1 and 2 and, finally, the invention, development and local vaccine production. The latter is only mentioned as a possibility currently not achieved. Finally, the text presents data on the chances of success in vaccine development.O texto explora o tema da suficiência brasileira em vacinas. Apresenta os caminhos praticados para a capacitação nas duas instituições brasileiras mais importantes no desenvolvimento e na produção de vacinas - o Instituto Butantan e o Instituto de Tecnologia em Imunobiológicos (Bio-Manguinhos). Esses caminhos referem-se à compra pura e simples, à compra do produto com compromisso de transferência de tecnologia, às parcerias que incluem a realização de ensaios da fase 1 pelo comprador, o novo caminho anunciado pelo Instituto Butantan no qual a parceria prevê a realização de ensaio nas fases 1 e 2 e, finalmente, a invenção, desenvolvimento e produção locais de vacinas. Este último caminho é apenas mencionado como possibilidade. Apresenta dados sobre as chances de sucesso no desenvolvimento de vacinas e louva a iniciativa do Butantan nessa nova modalidade de parceria.

The text presents and discusses the main aspects related to the current dynamics of the vaccine industry in the world and in Brazil, focusing on the demand created by the pandemic of COVID-19. At the global level, it briefly exposes the place currently occupied by Brazil within the scope of the BRICS and sets out and analyzes the options - identities and differences - of industrial policy in Brazil, China and India in the field of vaccines. Next, it analyzes the displacement of the vaccine industry, from a situation of exclusive production of immunizers to a majority control by the large pharmaceutical industry. Further on, it recovers recent fundamental aspects of the vaccine industry in Brazil, with an emphasis on Biomanguinhos / Fiocruz and the Butantan Institute. Finally, it discusses the successes and limitations of the technology transfer mechanism used by the two institutions, as well as the relevance of their historically assumed commitment to public health policies.O texto apresenta e discute os principais aspectos relacionados à dinâmica atual da indústria de vacinas no mundo e no Brasil, com foco na demanda criada pela pandemia da COVID-19. No plano global, expõe brevemente o lugar ocupado atualmente pelo Brasil no âmbito dos BRICS e expõe e analisa as opções - identidades e diferenças - da política industrial de Brasil, China e Índia no campo das vacinas. A seguir, analisa o deslocamento da indústria de vacinas de uma situação de produção exclusiva de imunizantes para um controle majoritário da grande indústria farmacêutica. Mais adiante, recupera aspectos fundamentais recentes da indústria de vacinas no Brasil, com ênfase em Biomanguinhos/Fiocruz e no Instituto Butantan. Finalmente, discute os sucessos e limitações do mecanismo de transferência de tecnologia utilizado pelas duas instituições, bem como a relevância do compromisso historicamente assumido pelas mesmas com as políticas públicas de saúde.

The paper discusses the complex nature of the pandemic by highlighting the various intrinsic and extrinsic dimensions in the development of SARS-CoV-2 vaccines, with an emphasis on the two most advanced products in clinical testing, namely, the vaccine developed by the University of Oxford associated with the British pharmaceutical company AstraZeneca, and the one developed by Chinese company Sinovac. This choice also stems from the fact that both have testing activities, which, if successful, will lead to future production in Brazil, by Bio-Manguinhos/Fiocruz, Rio de Janeiro, and the Butantã Institute, in São Paulo, respectively. From a conceptual viewpoint, this paper builds on the reflection from the field of Collective Health that addresses the boundaries between the biological and the social spheres. It also seeks to show that, if successful and while important tools for coping with the pandemic, vaccines will not dispense with the continuity of other non-pharmacological measures already used.

Brazil has changed a lot since the enactment of the 1988 Federal Constitution. Although substantial advances have occurred in the health sector, old problems persist and new ones arise. The main goal of ensuring the universal right to health has not been achieved. The 16th National Health Conference will be held in 2019, an opportune moment to analyze the history, the present moment and the announcing trends. This text seeks to contribute to this analysis based on the results of studies on the developing health conditions of the population and the Brazilian health system in the last 30 years. It identifies the strengthening of the private sector and capital in the health sector, to the detriment of the public interest and the SUS. Finally, it discusses the strategies of the struggle for the right to health necessary and possible in the current context.Desde a promulgação da Constituição federal de 1988, o Brasil mudou muito. Na saúde, embora tenham ocorrido avanços importantes, persistem problemas antigos e novos têm surgido. O objetivo maior de assegurar o direito universal à saúde não foi alcançado. Em 2019, realiza-se a 16ª Conferência Nacional de Saúde, momento oportuno para analisar a história, o momento presente e as tendências que se anunciam. Este texto busca contribuir para essa análise, com base nos resultados de estudos sobre a evolução das condições de saúde da população e do sistema de saúde brasileiro nos últimos 30 anos. Identifica o fortalecimento do setor privado e do capital na área da saúde, em detrimento do interesse público e do SUS. Por fim, discute as estratégias de luta pelo direito à saúde necessárias e possíveis no contexto atual.

The scope of this paper is a discussion of the transformative relationship between scientific research and productive innovation, which occurred from the final quarter of the twentieth century onwards. The main characteristic of the phenomenon was an intense space-time approximation of the two activities. The human health sector has been one of the main fields where that approximation was most markedly observed. Some major conceptual bases of the reorganization are discussed, and the text examines works by Gibbons, Stokes and Lundvall-Freeman, as well as Merton, Kuhn and Bourdieu with respect to the organization of the scientific work. The paper highlights and discusses three aspects that arose from the new configuration, namely the erosion of the well-established concept of scientific knowledge as a public good, the appearance of the individual referred to as the 'entrepreneurial researcher' and the emergence of the strategy of translational research in health.Discute-se a reorganização das relações entre a produção científica e as inovações produtivas a partir do quarto final do século XX cuja expressão mais geral foi uma intensa aproximação espaço-temporal entre essas duas atividades. O setor de saúde humana foi um dos setores onde essa aproximação ocorreu com grande intensidade e o texto discute algumas bases conceituais importantes nesse processo, trazendo as contribuições de Gibbons, Stokes e Lundvall-Freeman, bem como as de Merton, Kuhn e Bourdieu no que se refere à organização do trabalho científico. Aponta e discute três processos derivados dessa reorganização, quais sejam a erosão do conceito do conhecimento científico como um bem público, a difusão de um personagem denominado ‘pesquisador empreendedor’ e o aparecimento da estratégia da pesquisa translacional.

The paper introduces and discusses the new players that now have a growing presence on the research scene, namely the entrepreneurial researcher and the entrepreneurial university. It also discusses the current scenario of the diffusion of scientific knowledge that presents increasing problems, with difficulty in publishing results and difficulties in accessing the results of published research. It also discusses the implications of the strategy of translational research and presents and discusses some relevant ethical challenges that result from the reorganization of the relationship between science and business. In particular, it deals with conflicts of interest and the results of excessive competition between scientists and institutions in a scenario of diminished public financial support for science.O texto apresenta e discute os novos personagens que têm crescente presença no ambiente de pesquisa, quais sejam o pesquisador empreendedor e a universidade empreendedora. Discute ainda o cenário atual da difusão de conhecimento científico que apresenta crescentes problemas, com dificuldade de publicação de resultados e dificuldades de acesso a resultados de pesquisa publicados. Discute também o significado da estratégia da pesquisa translacional e apresenta e discute alguns desafios éticos relevantes que resultam da reorganização das relações entre ciência e negócio. Em particular trata dos conflitos de interesse e dos resultados da supercompetição entre cientistas e instituições em um cenário de encurtamento de apoio financeiro público à ciência.

Seeds age during storage, resulting in a decline in germination and seedling quality. Seed quality tests are important to monitor this decline. However, such tests are usually destructive and require large seed numbers and long time. For coffee seeds the standard germination test and assessment of seedling quality takes 30 days. Biospeckle has been used previously as a non-destructive optical tool to monitor biological activity in a range of tissues. Biospeckle was applied 3–6 days after imbibition (DAI) to investigate an association with coffee seedling quality after 30 days. Two distinct areas of biospeckle activity were demonstrated, concurring with the locations of the embryonic axis and the cotyledons in the apical and central seed parts, respectively. Moisture content analysis revealed that embryos of imbibed seeds contained more water than endosperm. Different areas within the endosperm did not differ in moisture content, while the moisture content of the axis was higher than that of the cotyledons, and this did not change from 4 DAI. Therefore, it was concluded that high biospeckle activity was not the result of increased water content in any seed part, but more likely of growth and metabolism in the axis and cotyledons, which had been described previously. A threshold biospeckle ratio apical : central of 1.02 after 6 days distinguished between seeds that produced dead and viable seedlings after 30 days and provided similar results as a tetrazolium test, a widely acknowledged but destructive test for seed quality. Thus, biospeckle data provided a non-destructive early parameter for seedling quality, based on embryo growth during germination.

This opinion document is based on the contribution of ABRASCO and CEBES to the 8th National Symposium on Science, Technology and Pharmaceutical Assistance promoted by the National Health Council. It deals with the policy for Science, Technology and Innovation in Health and is part of the three pillars for a health development agenda: The Unified Health System; the productive base of health assets and services; and the installed capacity of science, technology and innovation in health.Este documento de opinião é baseado na contribuição da ABRASCO e do CEBES para o 8º Simpósio Nacional de Ciência, Tecnologia e Assistência Farmacêutica promovido pelo Conselho Nacional de Saúde. Trata da política de Ciência, Tecnologia e Inovação em Saúde e a inscreve nos três pilares para uma agenda de desenvolvimento em saúde: O Sistema Único de Saúde, a base produtiva de bens e serviços de saúde e a capacidade instalada de ciência, tecnologia e inovação em saúde.

Discute-se a emergência de dilemas morais nas práticas de saúde, tendo em vista a acelerada transição demográfica nos países em desenvolvimento e os crescentes custos dos sistemas públicos de saúde. São focalizadas duas dimensões do cuidado à saúde que têm ocupado um lugar importante na geração desses dilemas: a tensão entre as estratégias comerciais que contornam o mercado de produtos de saúde e a expansão do acesso a esses produtos, por um lado, e o aumento da importância das tecnociências nas práticas de cuidado à saúde, por outro. Em conclusão, é discutida a importância da arbitragem política, social e jurídica na codificação ética desses dilemas e o papel do Estado Democrático de Direito nessa arbitragem. The emergence of moral dilemmas in health care practices, in view of the rapid demographic transition in developing countries, and skyrocketing public health care costs, is discussed. The focus is on two aspects of health care that have occupied an important place in the generation of these dilemmas. On the one hand, the tension between commercial strategies involving the health products market and the expansion of access to them and, on the other, the growth of techno-sciences in health care practices. In conclusion, the importance of the political, social and juridical arbitration on the ethical codifi cation of those dilemmas and the role of a Democratic State of Law in that arbitration is discussed. El texto discute la emergencia de dilemas morales en las prácticas de salud, teniendo en cuenta la acelerada transición demográfica en los países en desarrollo y los crecientes costos de los sistemas públicos de salud. Se hace énfasis en dos dimensiones del cuidado de la salud que han ocupado un lugar importante en la generación de tales dilemas. La tensión entre las estrategias comerciales que contornan el mercado de productos de salud y la expansión del acceso a dichos productos, por un lado, y el aumento de la importancia de las tecnociencias en las prácticas de cuidado de la salud, por el otro. En conclusión, se discute la importancia del arbitraje político, social y jurídico en la codificación ética de los dilemas y el papel del Estado Democrático de Derecho en el arbitraje.

a passagem dos anos 20 para os 30 do seculo passado, Sigmund Freud era um personagem de fama mundial. Entretanto, o testemunho da 1a Guerra Mun-dial, o desalento frente aos inumeros conflitos no movimento psicanalitico, o proces-so de exclusao civil dos judeus ja entao em curso em Viena, o sofrimento pessoal com o câncer que o mataria dez anos depois e, muito provavelmente, a sensacao de insegu-ranca expressa no rearmamento alemao e no crack da Bolsa de Nova York aprofunda-ram o seu conhecido pessimismo frente a Humanidade. Esse estado de espirito gerou um famoso ensaio, de 1929 e publicado no ano seguinte, intitulado “O Mal-Estar na Civilizacao”. Nele, a partir de um enquadramento teorico essencialmente psica-nalitico, Freud declara a impossibilidade da felicidade permanente em cada humano e entre os humanos. Pondera, entretanto, a importância da busca de uma felicidade mesmo que transitoria e imperfeita, e sugere alguns caminhos para essa busca.Este ensaio toma emprestada de Freud a ideia de um ‘mal-estar’ na saude publi-ca. No Dicionario Houaiss da Lingua Portuguesa, o termo e definido por

The author discusses the challenges faced by the Brazilian graduate studies system with an emphasis on the human health sector. He identifies imbalances in the supply side of knowledge, a prime territory for graduate programs, while highlighting that a proper conceptualization of such imbalances is incomplete if it fails to incorporate the demands for scientific and technological knowledge coming from healthcare services, industry, and society. He draws on concepts from technology economics involved in the innovation systems approach. The article highlights the historical and current role of Brazilian Graduate Studies Coordinating Board (Capes), particularly its evaluation system, as an essential device for overcoming the existing challenges in Brazilian graduate studies. The author concludes by suggesting some conceptual adjustments in the agency’s work.

Translational Research (TR) appears to be developing into the key health research issue of the beginning of this century. Initially proposed in the United States, TR is spread rapidly throughout both the developed and the developing world. This article discusses the main topics it covers, such as its definition and scope and the reasons why it has emerged in the USA and in this century. It examines the relationship between TR and the basic principles of US scientific policy established at the end of World War II. It sees the demands of a mighty pharmaceutical industry, currently facing a major crisis, linked to scientific genomic and post-genomic output impairments in terms of real innovative products and processes as being the explanation for US government intervention in biomedical research via the NIH. It realizes that it is not easy to predict the future of TR and suggests that it is not sustained by a solid conceptual and theoretical framework. It also discusses the opportunities and possibilities of TR in countries with nascent national innovative systems, such as Brazil. Lastly, it suggests that the existence of a universal health system can be an important tool to provide potential research answers tin health for the demands of innovation on the part of society.

The emergence of moral dilemmas in health care practices, in view of the rapid demographic transition in developing countries, and skyrocketing public health care costs, is discussed. The focus is on two aspects of health care that have occupied an important place in the generation of these dilemmas. On the one hand, the tension between commercial strategies involving the health products market and the expansion of access to them and, on the other, the growth of techno-sciences in health care practices. In conclusion, the importance of the political, social and juridical arbitration on the ethical codifi cation of those dilemmas and the role of a Democratic State of Law in that arbitration is discussed.

This commentary describes how the Brazilian Ministry of Health's (MoH) research support policy fulfilled the National Agenda of Priorities in Health Research (NAPHR). In 2003, the MoH started a democratic process in order to establish a priority agenda in health research involving investigators, health managers and community leaders. The Agenda was launched in 2004 and is guiding budget allocations in an attempt to reduce the gap between scientific knowledge and health practice and activities, aiming to contribute to improving Brazilian quality of life. Many strategies were developed, for instance: Cooperation Agreements between the Ministry of Health and the Ministry of Science and Technology; the decentralization of research support at state levels with the participation of local Health Secretariats and Science and Technology Institutions; Health Technology Assessment; innovation in neglected diseases; research networks and multicenter studies in adult, women's and children's health; cardiovascular risk in adolescents; clinical research and stem cell therapy. The budget allocated by the Ministry of Health and partners was expressive: US$419 million to support almost 3,600 projects. The three sub-agenda with the higher proportion of resources were "industrial health complex", "clinical research" and "communicable diseases", which are considered strategic for innovation and national development. The Southeast region conducted 40.5% of all projects and detained 59.7% of the resources, attributable to the concentration of the most traditional health research institutes and universities in the states of São Paulo and Rio de Janeiro. The second most granted region was the Northeast, which reflects the result of a governmental policy to integrate and modernize this densely populated area and the poorest region in the country. Although Brazil began the design and implementation of the NAPHR in 2003, it has done so in accordance with the 'good practice principles' recently published: inclusive process, information gathering, careful planning and funding policy, transparency and internal evaluation (an external independent evaluation is underway). The effort in guiding the health research policy has achieved and legitimated an unprecedented developmental spurt to support strategic health research. We believe this experience is valuable and applicable to other countries, but different settings and local political circumstances will determine the best course of action to follow.

In Brazil, chronic noncommunicable diseases (CNCDs) are the leading cause of death and a major contributor to the national disease burden. This article describes CNCD research funded by the Ministry of Health Department of Science and Technology (DECIT) to support the production and dissemination of scientific evidence for the national health system, in accordance with the National Agenda of Priorities in Health Research, and within the context of Brazil's epidemiologic transition. Data were obtained from Ministry of Health database management systems. CNCD-related projects financed by DECIT from 2002 to 2009 were analyzed by research theme (cancer, obesity, hypertension, diabetes, cardiovascular diseases, CNCDs in general, and CNCD risk factors) and geographic region. In terms of funding and number of projects, the most-supported research theme was cancer, and the most-supported region was the Southeast. Project type varied widely, ranging from basic scientific studies to highly technological research and development. Results obtained included epidemiologic profiles and surveillance, cost, and quality-of-life data.

Recognition for the growing role of extra-academic demands and players in the dynamics of human resource training for the market and, in particular, for research is discussed. Their synergies with the movement towards maturation of the sectoral system of healthcare innovation and with the priorities of the Sistema Único de Saúde (Brazilian National Health System) are discussed. The methodological adequacy of the process for evaluating these trends used by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior (Coordination Office for Advancement of University-level Personnel) is analyzed. In a general manner, these trends mean adding new indicators for technological and social productivity to the predominantly academic criteria that already exist. The continuation and deepening of ongoing initiatives aimed at bringing in new formats for postgraduate programs and courses and new courses customized for the demands of the extra-academic market, among other markets, either of a social or technological-business nature, are discussed. In addition, the deepening of initiatives for stimulating postdoctoral training work, which is scarce in Brazil, is discussed.

The need for clearly-defined health research policies and priorities has been emphasized in the international scenario. In Brazil, this process began in 2003, when a group appointed by the National Health Council proposed 20 sub-agendas to account for the various health research specificities. The second step was to identify research priorities for each sub-agenda during national seminars involving 510 researchers and policymakers. The 2nd National Conference on Science, Technology, and Innovation in Health was held in July 2004. During the preparatory phase, 307 cities and 24 States organized local conferences, involving 15,000 participants. Some 360 health sector delegates were appointed during the local conferences, in addition to those from the education and science and technology sectors. During the Conference, the national policy was approved and 3 other sub-agendas were introduced and approved. The national policy and the priority agenda are currently guiding investments by the Ministry of Health for research and development, and to a certain extent those from the Ministry of Science and Technology as well. From 2003 to 2005, 24 calls for proposals were launched; as a result, 3,962 research projects were submitted and 1,300 financed. A necessidade de estabelecer uma política de ciência e tecnologia em saúde e prioridades de pesquisa em saúde foi destacada no cenário internacional. No Brasil, estes processos iniciaram em 2003, quando um grupo designado pelo Conselho Nacional de Saúde propôs 20 subagendas para abarcar as especificidades da pesquisa em saúde. O segundo passo foi identificar prioridades em cada subagenda, durante seminários nacionais envolvendo 510 cientistas e gestores. A 2ª Conferência Nacional de Ciência, Tecnologia e Inovação em Saúde ocorreu em julho de 2004. Durante a fase preparatória 307 municípios e 24 Estados organizaram conferências locais, envolvendo 15 mil pessoas. Do setor saúde foram indicados 360 delegados nas conferências locais, além dos indicados pelos setores de educação e ciência e tecnologia. Durante a conferência, a política nacional foi aprovada e três novas subagendas foram introduzidas e aprovadas. Atualmente, a política nacional e a agenda de prioridades estão guiando os investimentos de recursos para pesquisa e desenvolvimento do Ministério da Saúde e, de certa forma, do Ministério da Ciência e Tecnologia. Entre 2003 e 2005, 24 editais de pesquisa foram lançados, nos quais foram recebidas 3.962 propostas de pesquisa e aprovadas 1.300.

The deficiencies in Brazilian science and technology policies with regard to the challenges of the twenty-first century are discussed, while acknowledging that these policies have in some respects been very successful. The importance of health research within the framework of general endeavors in science, technology and innovation in this country is also demonstrated. The distribution of research around the world is then summarized, and a specific position is claimed for Brazil, along with some other countries, within the global panorama. Some elements needed for maturation of the sectoral system for health innovation are discussed. Finally, the need for the presence of the Ministry of Health within the panorama of health research, for this maturation process to take place adequately, is discussed.

The challenge of providing quality while maintaining costs at affordable levels for society has motivated the implementation of health system reforms in various countries, seeking “allocative efficiency”, namely, prioritizing actions with the best cost-effectiveness ratio. This situation assigns increasing value to the adoption of evidence-based practices and policies. In Brazil, however, there was a persistent mismatch between scientific output and the use of its results in defining health policies and services. The Department of Science and Technology (DECIT), strengthened by the creation of the Secretariat of Science, Technology, and Strategic Inputs under the Ministry of Health in 2003, has contributed to identifying and promoting strategic research for the SUS. The main guidelines for the work by DECIT are provided by the National Agenda for Research Priorities in Health and the National Policy for Science, Technology, and Innovation in Health (PNCTIS), both approved during the 2 nd National Thematic Conference in 2004. The Conference included extensive involvement by health researchers, professionals, managers, and users of the National Health System (Guimaraes R, et al., Cad Saude Publica 2006; 22:1775-94). Participation by SUS managers has been crucial for including health problems on the scientific research agenda. An example is the growing participation by State health departments in the management of the Research Program for the SUS, implemented in all States of Brazil financed by DECIT and State Foundations to Support Research. The presence of the DECIT in the national coordination of health research has also allowed Brazil to establish multicenter studies and collaborative networks that require broad dialogue among many stakeholders. The Longitudinal Study on Adult Health (ELSA) and the National Networks for Clinical Research and Cell Therapy are examples of this exercise, demonstrating maturity in the management of health research investments. From 2003 to 2009, DECIT financed more than 3,700 research projects and made available R$650 million in funds, 60% of which from its own budget and the rest from partner institutions. In the area of specialized care, the strengthening of the scientific basis for incorporating products and services into the SUS requires serious attention, without which the system’s sustainability will be in jeopardy. Considering the need to guarantee the Constitutional right to health, the high costs of new diagnostic and therapeutic techniques, and the growing recourse to court injunctions by users of the SUS to ensure their access to treatment and medicines, decisions by health managers at the 3 levels of government must be backed by cost-effectiveness and cost-utility estimates. In this sense, the creation of the Commission for the Incorporation of Technologies by the Ministry of Health in 2006, the consolidation of the Division for Health Technology Assessment under DECIT, the establishment of the Brazilian Network for Health Technology Assessment (REBRATS), and the approval of the Technology Management Policy in the SUS are important initiatives. Specifically, DECIT has already issued three calls for research projects on health technology assessment and hired 278 studies. These efforts notwithstanding, much remains to be done. In the current context, perhaps the main challenge is to define an organizational structure to promote technology research and assessment in the SUS, ensuring the continuity and extension of the actions under way. Dealing with this challenge requires participation not only by health managers, professionals, and community representatives of social control in the SUS, but also by members of the scientific community.

Nos últimos anos, o Brasil fez um esforço significativo de construção de um sistema de ciência e tecnologia para a saúde Este artigo descreve o contexto, as estratégias e os resultados da implantação desse sistema, baseando-se em documentos oficiais e na experiência dos autores como gestores da Política Nacional de Ciência, Tecnologia e Inovação em Saúde. Dentre os resultados observados, destacam-se: a ocupação, pelo Ministério da Saúde, de uma posição de liderança no fomento à pesquisa em saúde; um aumento expressivo do montante derecursos públicos alocados na pesquisa; a persistência de dificuldades burocráticas na gestão da política científica; e a ampliação do volume de publicações científicas. De modo geral, constatase que, apesar de limites e obstáculos, o país tem avançado na produção de conhecimento científico orientado para subsidiar as políticas de saúde.

Background New approaches and tools were needed to support the strategic planning, implementation and management of a Program launched by the Brazilian Government to fund research, development and capacity building on neglected tropical diseases with strong focus on the North, Northeast and Center-West regions of the country where these diseases are prevalent. Methodology/Principal Findings Based on demographic, epidemiological and burden of disease data, seven diseases were selected by the Ministry of Health as targets of the initiative. Publications on these diseases by Brazilian researchers were retrieved from international databases, analyzed and processed with text-mining tools in order to standardize author- and institution's names and addresses. Co-authorship networks based on these publications were assembled, visualized and analyzed with social network analysis software packages. Network visualization and analysis generated new information, allowing better design and strategic planning of the Program, enabling decision makers to characterize network components by area of work, identify institutions as well as authors playing major roles as central hubs or located at critical network cut-points and readily detect authors or institutions participating in large international scientific collaborating networks. Conclusions/Significance Traditional criteria used to monitor and evaluate research proposals or R&D Programs, such as researchers' productivity and impact factor of scientific publications, are of limited value when addressing research areas of low productivity or involving institutions from endemic regions where human resources are limited. Network analysis was found to generate new and valuable information relevant to the strategic planning, implementation and monitoring of the Program. It afforded a more proactive role of the funding agencies in relation to public health and equity goals, to scientific capacity building objectives and a more consistent engagement of institutions and authors from endemic regions based on innovative criteria and parameters anchored on objective scientific data., Author Summary The selection and prioritization of research proposals is always a challenge, particularly when addressing neglected tropical diseases, as the scientific communities are relatively small, funding is usually limited and the disparity between the science and technology capacity of different countries and regions is enormous. When the Ministry of Health and the Ministry of Science and Technology of Brazil decided to launch an R&D program on neglected diseases for which at least 30% of the Program's resources were supposed to be invested in institutions and authors from the poorest regions of Brazil, it became clear to us that new strategies and approaches would be required. Social network analysis of co-authorship networks is one of the new approaches we are exploring to develop new tools to help policy-/decision-makers and academia jointly plan, implement, monitor and evaluate investments in this area. Publications retrieved from international databases provide the starting material. After standardization of names and addresses of authors and institutions with text mining tools, networks are assembled and visualized using social network analysis software. This study enabled the development of innovative criteria and parameters, allowing better strategic planning, smooth implementation and strong support and endorsement of the Program by key stakeholders.