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This paper aims to present an ex-post analysis of industrial and science, technology and innovation (sti) policies to the Health Industrial Complex, between 2003-2017 in Brazil, from the perspective of the public health value. We concluded that the intention to meet social health needs was present in the policies' design, however, the lack of objectivity and clarity in their definitions made it difficult to articulate the three fields of policies. [ABSTRACT FROM AUTHOR]

Civil society engagement around health care and population health improvement is an important driver towards Health for All. Research can improve the effectiveness of health activism by examining the resources, structures and strategies of civil society engagement. However, research to support such engagement faces epistemological and methodological challenges which call for specific research strategies. A four year multi-country study was undertaken by the People's Health Movement, a global network working for health for all. The research took place in six countries (Brazil, Colombia, DR Congo, India, Italy, South Africa) and globally, and was directed to understanding five domains of civil society engagement: movement building; campaigning and advocacy; capacity building; knowledge generation, access and use; and engaging with governance. The research plan and methods of data collection and analysis were tailored to address the objective of improving activist practice, while negotiating research challenges identified during the design phase. Results include insights into the practice of civil society engagement in relation to the five domains of activist practice, as well as experience gained in managing six methodological challenges which we describe as: making meaning, aligning research and action, managing power relations, valuing experiential knowledges, chaos and contingency, challenging preconceptions. Researching activism can produce useful insights into practice as well as support continuous improvement in the effectiveness of such activism. However, there are significant methodological challenges that can be addressed through appropriate strategies. More research, building on the approach described in this paper, can contribute to more effective civil society activism for health. [ABSTRACT FROM AUTHOR]

The global health community is increasingly advocating for the local production of pharmaceuticals in developing countries as a way to promote technology transfer, capacity building and improve access to medicines. However, efforts to advance drug manufacturing in these countries revive an old dilemma of fostering technological development versus granting access to social services, such as healthcare. This paper explores the case of Brazil, a country that has developed large-scale health-inspired industrial policies, but is, yet, little understood. Brazil’s experience suggests that progressive healthcare bureaucrats can create innovative practices for technology and knowledge transfers. It also demonstrates that highly competitive pharmaceutical firms can collaborate with each other, if a government provides them the right incentives. Reforming regulatory policies is crucial for guaranteeing high-quality products in developing countries, but governments must play a crucial role in supporting local firms to adapt to these regulations. These findings send a strong message to global health policymakers and practitioners on the conditions to create a suitable environment for local production of medical products. [ABSTRACT FROM PUBLISHER]

Most policies, explicitly or implicitly, involve sharing responsibilities between different organizations, such as departments, government spheres, ministries, or private organizations. Thus, in recent decades, networks have become increasingly common in public policies. The Brazilian health system - given its size and geographic scope - is an example of complexity and sometimes fragmentation in policy implementation. In this context, the government adopts the concept of Healthcare Networks (RASs) in the operation of its health system. A characteristic that defines RASs is their regional character, since it is necessary to go beyond the municipal borders for the optimization of resources. This scenario of interregional relations becomes denser when the territory in question is configured in an urban superstructure, as is the case in metropolitan regions. Thus, this paper proposes the discussion of the case of Healthcare Networks in the Brazilian metropolitan regions and describes, in greater detail, the case of Campinas Metropolitan Region. [ABSTRACT FROM AUTHOR]

This paper describes the Brazilian health system, which includes a public sector covering almost 75% of the population and an expanding private sector offering health services to the rest of the population. The public sector is organized around the Sistema Único de Saúde (SUS) and it is financed with general taxes and social contributions collected by the three levels of government (federal, state and municipal). SUS provides health care through a decentralized network of clinics, hospitals and other establishments, as well as through contracts with private providers. SUS is also responsible for the coordination of the public sector. The private sector includes a system of insurance schemes known as Supplementary Health which is financed by employers and/or households: group medicine (companies and households), medical cooperatives, the so called Self-Administered Plans (companies) and individual insurance plans. The private sector also includes clinics, hospitals and laboratories offering services on out-of-pocket basis mostly used by the high-income population. This paper also describes the resources of the system, the stewardship activities developed by the Ministry of Health and other actors, and the most recent policy innovations implemented in Brazil, including the programs saúde da Familia and Mais Saúde. [ABSTRACT FROM AUTHOR]

The Secretary of Health State of Minas Gerais, with the support of the Ministry of Health, have been making extensive effort to universalize the primary health care, given its strategic role in the formation the networks of the health care in the Unique Health System (SUS). Therefore, began to encourage the adoption of the Family Health Teams through of the "Program Structuring Health at Home". Associated with this program, was created the Master Plan of the Primary Health Care (PDAPS), whose goal it's provide an instrument to territorial planning and management of these service, qualifying them to fulfill the role as gateway of the network of the health in the SUS. The aim of this paper is discuss the territorial planning of the primary health care and the networks of the health care the SUS in Minas Gerais, Brazil. The hypothetical premise of the discussion is the existential interdependence between primary health care, networks and the territory. The methodology is based on a theoretical study and descriptive, on one side, and a theorical analysis and critical, of another. Therefore, have a dimension of discovery of the relationship between networks, territory and primary health care, on one side, and a dimension of note about the ways how this is being planned, of another. The results indicate improvements in the construction of networks in Minas Gerais, but there are also theoretical issues and methodological that needs to be addressed, especially on the forms of territorial definition of the services. [ABSTRACT FROM AUTHOR]

The obesity epidemic is rapidly advancing in South America, leading to inevitable health consequences. Argentinian and Brazilian health policies try to become adapted to the new economic and social framework that follows from this epidemic. It is in incipient and ineffective control so far since the prevalence of obesity was not restrained. The Argentine national legislation is more advanced, through the so-called "Ley de Obesidad." In Brazil, there are numerous local initiatives but still not a comprehensive law. National policies relating to decisions regarding obesity are discussed in this paper. Trends in decisions issued in higher courts of Argentina (Supreme Court of Justice of the Nation-CSJN) and Brazil (Supreme Court of Justice-STF), in the last 15 years, seek to clarify the approach of each country and court´s resolutions. Marked differences were found in their positions. Finally, legal and health solutions to this obesity epidemic are proposed. [ABSTRACT FROM AUTHOR]

This paper aims to draw the historical framework of the Nutritional Care Program for People with Special Dietary Needs (PAN), the advancements and challenges in public policy for people with special dietary needs in the city of Curitiba, Parana state, Brazil. Historically, PAN was created to replace the former Enteral Diets and Special Milks Program and to organize nutritional care in the city, so as to offer better nutritional care to these people, based on the principles of the Unified Health System (SUS). In this perspective, we attempted to draw the historical framework of PAN in the management of public policies within the SUS, and at such a landmark, the impact in management, professionals and users involved in this process. [ABSTRACT FROM AUTHOR]

Investing in the necessary theoretical relationship between Humanization and Mental Health Policies of the Brazilian health system, this paper argues, through the theoretical dialogue between them, the idea that the proposals set forth in such policies are coherent answers to the main contradictions of the intricate national public health system. So are presented: the theoretical basis of the aforementioned ministerial policies; their relations with the society demanded as public policy; and finally, how the combination of both provide essential contributions to the continuity of the Unified Health System (SUS ). The essay methodology was used, according to updated methodological bibliography, listing authors and their contributions in order to defend the views of the authors. We conclude that the public encouragement of protagonizsm of society undermines the logic of biological training courses for health professionals and flattens human relations within the SUS , fortifying it and giving it essential reason for existence to the Brazilian society. [ABSTRACT FROM AUTHOR]

This paper aims to discuss the relation between individual and collective autonomy and health promotion. In order to do so, it reviews the literature on the conceptual course of health promotion since the Ottawa Charter, emphasizing the amplification of autonomy as a guide for health promotion actions. It also highlights the importance of health promotion strategies in Brazil, which prioritize public policies in order to decrease social inequalities. In particular, Brazilian policies are addressed towards increasing individual and collective autonomy. [ABSTRACT FROM AUTHOR]

ABSTRACT The National Institute of Public Policy for Alcohol and Other Drugs (INPAD) is based at the Federal University of São Paulo, Brazil, and was created to collect scientific evidence regarding epidemiology, develop new therapeutic approaches, study health economics and provide education to subsidize the proper measures to change the Brazilian scenario of alcohol and drug consumption. Policies directed towards the control of alcohol and drugs in Brazil are fragmented, poorly enforced and therefore ineffective. The unregulated market of alcohol in Brazil has contributed to the worsening health of the Brazilian population. Since 1994, INPAD has participated actively in academic debates and discussions about alcohol and drug policies and their effects on the political welfare of the country. Many scientific papers and books have been published on this subject, and the internet and other media have provided excellent opportunities for the dissemination of specialized information to the general population. [ABSTRACT FROM AUTHOR]

This paper aims to problematize the itinerancy as a way to operationalize care in the territory. With the creation of the Unified Health System, the notion of territory has become an organizing principle of work processes in primary health care and mental health policies. In the delicate field of coordination between these policies, itinerant practices now have a strategic importance in the deinstitutionalization of practices and construction of integral care. We take the deinstitutionalization and the integrality as conceptual operators that make the difference that Psychiatric and Health reforms want to print in the care practices. Warned that by joining in a posture of active search in the life territory of users, the itinerant practices fall in a field of tensions, which can both be called to work as a part of the State apparatus to population control, as in a strategic place for the construction of a contextualized care to users" way of life. We believe that it is possible to resist the social control mandate and build an ethics of care with itinerancy to explore the political power of the movement and transform the users' territory in a laboratory for the invention of life. [ABSTRACT FROM AUTHOR]

This paper briefly outlines how the political scenario and the mobilization of different actors have contributed to the construction of a public health policy in response to the AIDS epidemics in Brazil. Three factors are presented and discussed: the political context of the 1980s, characterized by redemocratization, growth of social movements, and consolidation of the Brazilian health care reform; the socio-cultural context of the 1970s and 1980s, characterized by achievement of individual freedom, which was key to the organization of the AIDS movement; and finally the actions carried out in the international scenario to support the sustainability of the Brazilian domestic policy and the reinforcement of a global response to face the epidemics in lower-middle income economies. [ABSTRACT FROM AUTHOR]

This article analyses Brazilian state policy for indigenous health based on the inquiry of the recent historical, political and managerial process that resulted in the creation, in 1991, of the National Health Foundation (Funasa). I t attempts to bring together two lines of thought triggered by the examination of the Funasa Museum collection and by interviews with Funasa employees. T he threads thus woven should make possible, on the one hand, (i) to trace a genealogy of the National Health Foundation, and, on the other, (ii) to highlight its role in setting the hurdles that prevent the consolidation of a political field of respect for diversity in indigenous health policy. T he paper, therefore, consists of an approach which aims at pulling together biographic narratives with institutional memory. [ABSTRACT FROM AUTHOR]

In an earlier paper (Dressler, 2001), I suggested that medical anthropology as a research enterprise could not ignore either meaning or structure in human social life in the production of health. Rather, drawing on the early work of Bourdieu, I argued that we need to take into account both how the world is configured by the collective meanings we impose upon it, as well as the social structural (and physical) constraints on our behaviour that exist outside those meanings. Human health can be understood, in part, as the intersection of meaning and structure. Here, my aim is to extend this perspective in three ways. Firstly, I present an expanded theoretical framework within which collectivei meaning and social structure can be conceptualised. A useful theoretical framework must take into account paradoxical features of culture, including the seeming contradiction that it is a property both of social aggregates and of individuals, and that, ultimately, social structural constraints external to individuals depend on shared meaning. Secondly, I review recent research employing this perspective conducted in Brazil, the southern United States and Puerto Rico. These studies have all employed a 'structural-constructivist' theoretical orientation, using especially the concept of 'cultural consonance', or the degree to which individuals incorporate shared meaning into their own beliefs and behaviour. Where individual efforts to attain a higher cultural consonance are frustrated by structural constraints, poor health results. Thirdly, I consider some of the policy implications of this perspective. While much work in traditional public health focuses on a highly individualised notion of meaning (as in 'health beliefs'), it seems unlikely that the health of populations can be altered substantially without taking into account the structures that constrain individual action. [ABSTRACT FROM AUTHOR]

This article explores the mobilization of power by health workers during policy implementation, showing how in a context of discretion and resource scarcity they can reproduce inequalities in access to health services. The argument innovates theoretically by supplementing the 'street-level bureaucracy' literature, which emphasizes frontline worker discretion, with a conceptualization of power as domination encompassing the shaping of behavior, the constitution of subjects and the reproduction of inequality. Empirically, the article focuses on Brazilian community health workers (agentes comunitários de saúde , CHWs). CHWs are a neglected but highly important segment of the health workforce that traditionally functions as a link between the health system and disadvantaged groups. The article examines how Brazilian CHWs act as street-level bureaucrats mobilizing power in their interactions with users. They operate within a severely under-resourced public health system, the Sistema Único de Saúde , which places constraints upon their action and forces them to make allocation decisions with little training and support. The article highlights the ways in which inequalities in access to health services are reproduced (inadvertently or not) through the practices, discursive styles and classifications of CHWs. Methodologically, the paper is based on ethnography with 24 CHWs and interviews with 77 other CHWs in Brazil. • Develops a novel framework for analysing health worker discretion and power. • Supplements the street-level bureaucracy approach with the concept of domination. • Explores the mobilization of power by Brazilian community health workers. • Shows how policy implementation can reproduce inequality in access to healthcare. [ABSTRACT FROM AUTHOR]