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From the One Health (OH) perspective, the achievement of better public health results depends on effective strategies and interventions based on integrated research in diverse sectors of activity (human health, animal health, agriculture, and environment). The central topic in the United Nations 2030 Agenda aims at a world free of hunger, poverty, and severe disease through the achievement of 17 Sustainable Development Goals (SDGs). The objective of the present study is to evaluate countries and applicants of technologies patented between 2015-2020. From this methodological perspective, searches have been carried out in this study on the global patent database documents available, using specific search strategies for technologies related to challenging diseases for achieving SDGs, such as neglected communicable and non-communicable diseases: diarrhea, tuberculosis, malaria, obesity, cardiovascular diseases, diabetes, lung cancer, human schistosomiasis, and Zika.

In this article, we present breakthroughs and challenges in vaccine development for COVID-19 pandemic, discussing issues related to pandemic preparedness and their implications for circular bioeconomy and sustainability. Notwithstanding the unprecedented accelerated speed of COVID-19 vaccine development, just 9 months after the emergence of the pandemic in Wuhan, China, benefiting from previous developments in SARS and MERS vaccines, significant gaps persist in global vaccine preparedness. These gaps include issues related to immunity and protection, particularly to the limited vaccine protection against recent emergence of concerning new viral variants in the UK, South Africa, and Brazil and the consequent need for vaccine redesign. We examine these gaps and discuss the main issues that could impact on global vaccine availability in the current pandemic scenario: (1) breakthroughs and constraints in development and production of leading global COVID-19 vaccines; (2) innovation and technological development advances and gaps, providing information on global patent assignees for COVID-19, SARS, and MERS vaccine patents; (3) local capacity for development and production of COVID-19, SARS, and MERS vaccines in three emerging agro-based countries (India, Brazil, and South Africa); and (4) future scenarios, examining how these issues and vaccines redesign for new SARS-CoV-2 variants could impact on global access to vaccines and implications for circular bioeconomy and sustainability in the post-COVID era.

This chapter provides an analysis of global trends in genomic vaccines, a radical innovation breakthrough (RIB), from technological foresight and pandemic preparedness perspectives, crucial in times of COVID-19. From this conceptual framework, the state-of-the-art and technological prospects for these genomic vaccines are examined, based on a search on scientific publications and on patents for the period 2010–2020, presenting the vaccine patent landscape for the period. This search provides an overview of recent breakthroughs in genomic vaccines and two other related RIBs, gene editing and gene therapy, and identifies novel strategies that could positively contribute to the development of future genomic vaccines to pandemic diseases and COVID-19. Our results evidence in the last decade extraordinary advances in genetic approaches, gene editing and gene therapy, and the rapid development of innovative DNA/RNA vaccines for the prevention and immunotherapy of an extensive diversity of diseases, from the neglected infectious ones to cancer therapy. These results highlight the flexibility of vaccine technological platforms, crucial for response to pandemics and COVID-19, including hepatitis B, varicella, chronic obstructive pulmonary disease, autoimmune diseases – systemic lupus erythematosus, lupus nephritis, and autoimmune myasthenia gravis – and finally a new nucleic acid sequence for immunogenicity to SARS-CoV-2.

Innovative preventive vaccines against emerging and neglected infectious diseases, such as Zika, dengue, influenza, and HIV/AIDS, are examined from a global sustainability perspective in this chapter, aiming to integrate public health and innovation governance approaches. Innovation-intensive vaccines with reduced adverse effects can have an enormous impact on life expectancy and on the quality of life of the global population, but in contrast only one of the SDGs, SDG3, refers directly to vaccines (3.b.1). However, this chapter also identifies seven other SDGs strongly related to vaccines and six additional SDGs related to vaccines, leading to a total of 14 vaccine-related goals in 17 SDGs. Two of these goals are related to innovation and technological development of vaccines (SDG9 and SDG17). The authors examine vaccine performance indicators and current technological and regulatory obstacles to achieve these goals, particularly affecting developing countries, and propose STI governance strategies to overcome these gaps and increase access to vaccines. Policy recommendations for vaccine funding and incentives for innovation, development, and vaccine production are made. Recommendations are also given for specific vaccine STI performance indicators and strategies to achieve the 14 vaccine-related SDGs.

This chapter provides an overview, from bioeconomic and global sustainability perspectives, of the main constraints to the current global vaccine innovation system for achieving Sustainable Development Goals – SDGs. Biotechnology market trends, gaps in vaccine coverage against emerging and neglected diseases, and patent protection and regulation are discussed. A structured long-term “public-return-driven” innovation model to overcome vaccine market failure is proposed.

Emerging and resurgent arboviral diseases are a major public health problem for developing countries, particularly in Latin America and Africa, for the severity of their symptoms and lethality. Vaccines are recognized as the most powerful preventive, low-risk and cost-effective interventions. For this reason, vaccines against these arboviral diseases could have an extensive impact on global health. Nevertheless, many gaps persist in innovation and technological development of these vaccines and it is necessary and urgent to accelerate new funding mechanisms and incentives, such as “patent pools”, with active participation of manufacturers in developing countries, to assure their cost-effectiveness, efficacy and minimize their potential adverse effects. In this global scenario, intellectual property, especially patents documents, have emerged as a crucial issue for vaccine development. The global patent landscape for vaccines against these four arboviral diseases has undergone drastic changes in the past 5 years, with breakthroughs resulting from advances in molecular biology and genetic engineering: DNA vaccines, recombinant vaccines based on antigens expressed in vectors (viral, bacterial, yeast) and vaccines obtained through reverse vaccinology, with the selection of potential candidates at the genetic level rather than the protein level. Our main aim is to transcend the conventional debate on vaccine development and ethical, regulatory and policy issues, already explored in many scientific publications in the past three decades and determine which of these issues should be considered new and specific to this new perspective. Finally, an adequate use of patent documents, as indicated here, can be a valuable source of information, supporting technological prospect tools in more effective knowledge governance strategies.

We discuss the complex eco-social factors involved in the puzzle of the unexpected rapid viral spread in the ongoing Brazilian yellow fever (YF) outbreak, which has increased the reurbanisation risk of a disease without urban cases in Brazil since 1942. Indeed, this rapid spatial viral dissemination to the Southeast and South regions, now circulating in the Atlantic Forest fragments close to peri-urban areas of the main Brazilian megalopolises (Sao Paulo and Rio de Janeiro) has led to an exponential increase in the number of yellow fever cases. In less than 18 months, 1,833 confirmed cases and 578 deaths were recorded most of them reported in the Southeast region (99,9%). Large epizooties in monkeys and other non-human primates (NHPs) were communicated in the country with 732 YF virus (YFV) laboratory confirmed events only in the 2017/2018 monitoring period. We also discuss the peculiarities and similarities of the current outbreak when compared with previous great epidemics, examining several hypotheses to explain the recent unexpected acceleration of epizootic waves in the sylvatic cycle of the YFV together with the role of human, NHPs and mosquito mobility with respect to viral spread. We conclude that the most feasible hypothesis to explain this rapidity would be related to human behavior combined with ecological changes that promoted a significant increase in mosquito and NHP densities and their contacts with humans. We emphasize the urgent need for an adequate response to this outbreak such as extending immunisation coverage to the whole Brazilian population and developing novel strategies for immunisation of NHPs confined in selected reserve areas and zoos. Finally, we stress the urgent need to improve the quality of response in order to prevent future outbreaks and a catastrophic reurbanisation of the disease in Brazil and other South American countries. Continuous monitoring of YFV receptivity and vulnerability conditions with effective control of the urban vector Aedes aegypti and significant investments in YF vaccine production capacity and research and development for reduction of adverse effects are of the highest priority.

RESUMO Estudos sobre o ensino da patologia no Brasil são escassos e mostram um cenário desmotivador para estudantes e professores. Embora essa disciplina seja fundamental à formação médica, o distanciamento entre o seu ensino e o das demais disciplinas clínicas leva ao não reconhecimento, por parte dos estudantes, da importância da patologia para a formação profissional, especialmente na área de doenças infecciosas. O objetivo deste estudo foi investigar o processo de formação e produção do conhecimento em patologia em três faculdades de Medicina com ensino tradicional no Estado do Rio de Janeiro e seu impacto na atuação de patologistas e infectologistas. Trata-se de um estudo qualitativo com utilização da técnica do discurso do sujeito coletivo em entrevistas semiestruturadas. Foram entrevistados sete professores de patologia de duas faculdades públicas e de uma particular e dez médicos - cinco patologistas que atuavam no Rio de Janeiro e cinco infectologistas de um centro de referências em doenças infecciosas no Rio de Janeiro. A disciplina de patologia é oferecida de forma descontextualizada em períodos específicos. Professores reconhecem que aulas descontextualizadas não estimulam o interesse pela especialidade nem preparam estudantes para interação com patologistas e serviços de anatomia patológica. Para infectologistas, falta percepção da importância da patologia na graduação, o que para patologistas gera dificuldades na interação com infectologistas, resultando em preenchimento incompleto de solicitação de exames histopatológicos, dificuldade na interpretação de laudos e envio inadequado de amostras. Infectologistas e patologistas acreditam que mais aulas práticas, maior integração com a clínica e a presença do patologista em outros cenários de aprendizagem aumentem o interesse pela patologia. Todos os professores, infectologistas e patologistas pesquisados reconheceram a existência de lacunas no ensino-aprendizagem na disciplina de patologia na graduação médica e a necessidade de reformulação para torná-la uma especialidade mais interessante e alinhada à realidade profissional. ABSTRACT Studies on the teaching of pathology are scarce in Brazil and show a demotivating scenario for students and professors. Although it is fundamental for medical training, the distance between pathology and other clinical disciplines leads to students not recognizing the importance of pathology for their professional education, especially in the field of infectious diseases. The aim of this study was to investigate the teaching-learning process of pathology in three medical schools in the state of Rio de Janeiro which offer traditional teaching, and its impact on the work of pathologists and infectious disease specialists. It is a qualitative study using the collective subject discourse technique in semi-structured interviews. We interviewed seven pathology professors from the three medical schools along with 10 physicians, five pathologists working in pathology laboratories and five infectious disease specialists from a referral center on infectious diseases in Rio de Janeiro. The discipline of pathology is taught in a non-contextualized manner limited to a few semesters. Professors recognize that non-contextualized classes neither stimulate interest in the specialty nor prepare students for interaction with pathologists and pathology laboratories. For infectious disease specialists, medical undergraduates’ lack of perception regarding the importance of pathology leads to difficult interaction between pathologists and infectious disease specialists. This difficult interaction translates into incomplete histopathological requests, difficulty in interpreting pathology reports and inadequate sending of samples. Infectious disease specialists and pathologists believe that a focus on more practical activities, greater integration with clinical disciplines and the presence of pathologists in other learning scenarios would increase interest in pathology. All the professors and physicians surveyed acknowledged the existence of gaps in the teaching of pathology in medical schools and the need for a reformulation to make it a more interesting discipline and aligned with future practice.

The research agenda towards an HIV cure is building rapidly. In this article, we discuss the reasons for and methodological approach to using mathematical modelling and cost-effectiveness analysis in this agenda. We provide a brief description of the proof of concept for cure and the current directions of cure research. We then review the types of clinical economic evaluations, including cost analysis, cost-benefit analysis and cost-effectiveness analysis. We describe the use of mathematical modelling and cost-effectiveness analysis early in the HIV epidemic as well as in the era of combination antiretroviral therapy. We then highlight the novel methodology of Value of Information (VOI) analysis and its potential role in the planning of clinical trials. We close with recommendations for modelling and cost-effectiveness analysis in the HIV cure agenda.

Partnerships, technology transfer and targeted policies are needed to accelerate Brazil's participation in global vaccine research and development.

This article discusses the peculiar conditions that favoured the unexpected introduction of Zika virus into the poorest northeastern region of Brazil in 2015, its speed of transmission to other Brazilian states, other Latin American countries and other regions, and the severity of related neurological disorders in newborns and adults. Contrasting with evidence that Zika had so far caused only mild cases in humans in the last six decades, the epidemiological scenario of this outbreak in Brazil indicates dramatic health effects: in 2015, an increase of 20-fold in notified cases of microcephaly and/or central nervous system (CNS) alterations suggestive of Zika congenital infection, followed by an exponential increase in 2016, with 2366 cumulative cases confirmed in the country by the end of December 2016. A significant increase in Guillain-Barré syndrome in adults has also been reported. Factors involved in viral dissemination, neural pathogenesis and routes of transmission in Brazil are examined, such as the role of social and environmental factors and the controversies involved in the hypothesis of antibody-dependent enhancement, to explain the incidence of congenital Zika syndrome in Brazil. Responses to the Zika outbreak and the development of new products are also discussed.

The quest for a cure for HIV remains a timely and key challenge for the HIV research community. Despite significant scientific advances, current HIV therapy regimens do not completely eliminate the negative impact of HIV on the immune system; and the economic impact of treating all people infected with HIV globally, for the duration of their lifetimes, presents significant challenges. This article discusses, from a multi-disciplinary approach, critical social, behavioral, ethical, and economic issues permeating the HIV cure research agenda. As part of a search for an HIV cure, both the perspective of patients/participants and clinical researchers should be taken into account. In addition, continued efforts should be made to involve and educate the broader community.

A análise microbiológica dos mexilhões reflete a qualidade do habitat aquático, pois estes animais podem reter em seus organismos diversos patógenos, dentre os quais aqueles pertencentes à família Vibrionaceae. No presente estudo foi avaliada a presença de Vibrio spp. em mexilhões (in natura e pré-cozidos), comercializados na Estação Experimental de Cultivo de Mexilhões, situada em Jurujuba, Niterói, Rio de Janeiro. Foram avaliadas 86 amostras, tomando como procedimento, o enriquecimento em Água Peptonada Alcalina (APA) adicionada de 1 e 3% de NaCl, isolamento em Agar Tiossulfato Citrato Bile Sacarose (TCBS) e confirmação das colônias típicas por análise bioquímica. Dentre as 12 espécies de Vibrio identificadas destacaram-se como de maior prevalência as espécies Vibrio alginolyticus, V. cholerae não-O1, V. parahaemolyticus, V. carchariae e Vibrio vulnificus. A relevância epidemiológica destes patógenos associada a casos de gastrenterite humana após consumo de mexilhões crus ou parcialmente cozidos, reforça a importância de alertar as autoridades de Vigilância Sanitária sobre sua presença na cadeia alimentar e seus riscos para a Saúde Pública.The microbiology analysis of mussels reflects the aquatic environment quality because these animals retain various pathogens such as Vibrionaceae family microorganisms in their organism. In the present investigation, we evaluated the presence of Vibrio spp. in mussels (in natura and precooked) commercialized at an Experimental Station Mussel Culture in Jurujuba, Niterói, Rio de Janeiro. A total of 86 samples were analyzed using the enrichment in Alkaline Peptone Water (APW) added to 1 and 3% of NaCl, isolated in Thiossulfate Citrate Bile Sucrose Agar (TCBS) and confirmed that there were suspect colonies by biochemical tests. The results showed the identification of 12 different Vibrio species whereby Vibrio alginolyticus, V. cholerae non-O1, V. parahaemolyticus, V. carchariae and V. vulnificus were the prevalent species. The epidemiological relevance of these pathogens associated with cases of human gastroenteritis after in natura or precooked mussels show the need to alert Sanitary Officials about their presence in the food chain and their risks to Public Health.

A análise microbiológica dos mexilhões reflete a qualidade do habitat aquático, pois estes animais podem reter em seus organismos diversos patógenos, dentre os quais aqueles pertencentes à família Vibrionaceae. No presente estudo foi avaliada a presença de Vibrio spp. em mexilhões (in natura e pré-cozidos), comercializados na Estação Experimental de Cultivo de Mexilhões, situada em Jurujuba, Niterói, Rio de Janeiro. Foram avaliadas 86 amostras, tomando como procedimento, o enriquecimento em Água Peptonada Alcalina (APA) adicionada de 1 e 3% de NaCl, isolamento em Agar Tiossulfato Citrato Bile Sacarose (TCBS) e confirmação das colônias típicas por análise bioquímica. Dentre as 12 espécies de Vibrio identificadas destacaram-se como de maior prevalência as espécies Vibrio alginolyticus, V. cholerae não-O1, V. parahaemolyticus, V. carchariae e Vibrio vulnificus. A relevância epidemiológica destes patógenos associada a casos de gastrenterite humana após consumo de mexilhões crus ou parcialmente cozidos, reforça a importância de alertar as autoridades de Vigilância Sanitária sobre sua presença na cadeia alimentar e seus riscos para a Saúde Pública. The microbiology analysis of mussels reflects the aquatic environment quality because these animals retain various pathogens such as Vibrionaceae family microorganisms in their organism. In the present investigation, we evaluated the presence of Vibrio spp. in mussels (in natura and precooked) commercialized at an Experimental Station Mussel Culture in Jurujuba, Niterói, Rio de Janeiro. A total of 86 samples were analyzed using the enrichment in Alkaline Peptone Water (APW) added to 1 and 3% of NaCl, isolated in Thiossulfate Citrate Bile Sucrose Agar (TCBS) and confirmed that there were suspect colonies by biochemical tests. The results showed the identification of 12 different Vibrio species whereby Vibrio alginolyticus, V. cholerae non-O1, V. parahaemolyticus, V. carchariae and V. vulnificus were the prevalent species. The epidemiological relevance of these pathogens associated with cases of human gastroenteritis after in natura or precooked mussels show the need to alert Sanitary Officials about their presence in the food chain and their risks to Public Health.

O ecossistema aquático é o habitat de mexilhões (Perna perna), animais filtradores que refletem a qualidade ambiental através de análise microbiológica de sua carne. No presente trabalho avaliou-se a presença de patógenos emergentes (Aeromonas hydrophila e Plesiomonas shigelloides), em mexilhões in natura e pré-cozidos coletados por pescadores da Estação Experimental de Cultivo de Mexilhões situada em Jurujuba, Niterói, Rio de Janeiro. Foram analisadas 86 amostras de mexilhões (43 in natura e 43 pré-cozidos) as quais foram submetidas a enriquecimento em Água Peptonada Alcalina (APA) acrescida de 1 e 3% de Cloreto de Sódio (NaCl) e em solução Salina de Butterfield, incubadas a 37ºC por 24 horas. Em seguida, foram semeadas em Ágar Seletivo para Pseudomonas-Aeromonas (GSP), Ágar Tiossulfato Citrato Bile Sacarose (TCBS) e Ágar Inositol Bile Verde Brilhante (IBB). A análise geral dos resultados permitiu a identificação de Areomonas spp e Plesiomonas shigelloides em 86% das amostras de mexilhões in natura e pré-cozidas avaliadas. A posterior caracterização bioquímica permitiu a identificação das espécies Aeromonas media (37,10%), A. hydrophila (15,50%), A. caviae (14,80%), A. veronii biogrupo veronii (11,60%), Aeromonas sp. (7,36%), A. sobria (4,20%), A. trota (4,20%), A. schubertii (1,31%), A. jandaei (1,31%), A. veronii biogrupo sobria (0,52%) e Plesiomonas shigelloides (2,10%). A relevância epidemiológica desses microrganismos em casos de gastrenterite humana, após consumo de mexilhões crus ou parcialmente cozidos, revela a importância de alertar as autoridades de Saúde Pública no Brasil, sobre a presença desses patógenos na cadeia alimentar e seus riscos para a saúde humana.The aquatic ecosystem is the habitat of mussels, filtrating animals that reflect the ambient quality through microbiological analysis. In the present investigation, we evaluated the presence of emergent pathogens (Aeromonas hydrophila and Plesiomonas shigelloides) from in natura and pre-cooked mussels collected by workers at the Experimental Station Mussels Cultive situated in Jurujuba, Niteroi, Rio de Janeiro. A total of 86 mussels (43 each in natura and precooked) were analyzed and the samples were submitted to enrichment in Alkaline Peptone Water (APW) added of 1 and 3% Sodium Chloride (NaCl) and Butterfield's Saline incubated at 37ºC for 24 hours. After, the samples were streaked onto Pseudomonas-Aeromonas Selective Agar (GSP), Thiossulfate Citrate Bile Sucrose Agar (TCBS) and Inositol Brilliant Green Bile Salts Agar (IBB). Aeromonas spp and Plesiomonas shigelloides were isolated from 86% in natura and precooked mussels avaliated. The biochemical characterization showed strains of Aeromonas media (37.10%), A. hydrophila (15.50%), A. caviae (14.80%), A. veronii biogroupe veronii (11.60%), Aeromonas sp. (7.36%), A. sobria (4.20%), A. trota (4.20%), A. schubertii (1.31%), A. jandaei (1.31%), A. veronii biogroupe sobria (0.52%), and Plesiomonas shigelloides (2.10%). The epidemiological relevance of these microorganisms in cases of human gastroenteritis after mussels consumption without fully cooking reveal the importance to alert the Brazilian health authorities on the presence of these pathogens in food chain and the risks for human health.

Brazil has earned international notoriety in thefight against AIDS. It is best known as the first developing country to provide free, universal access to antiretroviral treatment (ART) for all patients. In so doing, Brazil accomplished what many believed impossible: effectively delivering ART in a resource-limited setting while challenging the norms of the international pharmaceutical industry. The success of this effort shattered the illusion that ART could only be for rich countries, jolted cautious international organizations into action, and gave new hope not only to millions of people living with HIV in the developing world but also to their families and communities.

This article examines the Brazilian innovation policy for vaccines and its impact on infectious diseases, with emphasis on advances in translational science. The results indicate significant progress, with a rapid increase over the past two decades in the number of vaccine research groups, indicating scientific excellence. Advances and gaps in technological development and in public–private partnership initiatives were also identified. We stress the crucial role of partnerships, technology transfer, and targeted policies that could accelerate Brazil's participation in global vaccine research and development. We propose that new strategies should be urgently conceived to strengthen the links between the scientific and technological policies, the National Health System, and the National Immunizations Program in Brazil to provide access to low-cost vaccines to address major public health challenges. We also discuss the lessons learned from the Brazilian experience in the implementation of governmental policies on vaccine innovation that could be applicable to other developing countries.

BACKGROUND: HIV infection in children is an important public health problem in the world mainly in poorer countries. If all recommendations are followed the elimination of HIV vertical transmission is a concrete possibility. This study aims to estimate vertical transmission rates of HIV in Sao Paulo State Brazil based on pregnant women diagnosed and reported in 2006 identifying potentially associated factors. METHODS: This study involves a retrospective cross-sectional analysis of information systems and records of infected pregnant women and children exposed to HIV. The rate of vertical transmission was estimated and variables associated with the antenatal delivery and postnatal periods were analyzed by the chi-square test and Fisher exact test was used for variables with an expected frequency

BackgroundThe AIDS epidemic in Brazil remains concentrated in populations with high vulnerability to HIV infection, and the development of an HIV vaccine could make an important contribution to prevention. This study modeled the HIV epidemic and estimated the potential impact of an HIV vaccine on the number of new infections, deaths due to AIDS and the number of people receiving ARV treatment, under various scenarios.Methods and findingsThe historical HIV prevalence was modeled using Spectrum and projections were made from 2010 to 2050 to study the impact of an HIV vaccine with 40% to 70% efficacy, and 80% coverage of adult population, specific groups such as MSM, IDU, commercial sex workers and their partners, and 15 year olds. The possibility of disinhibition after vaccination, neglecting medium- and high-risk groups, and a disease-modifying vaccine were also considered. The number of new infections and deaths were reduced by 73% and 30%, respectively, by 2050, when 80% of adult population aged 15-49 was vaccinated with a 40% efficacy vaccine. Vaccinating medium- and high-risk groups reduced new infections by 52% and deaths by 21%. A vaccine with 70% efficacy produced a great decline in new infections and deaths. Neglecting medium- and high-risk population groups as well as disinhibition of vaccinated population reduced the impact or even increased the number of new infections. Disease-modifying vaccine also contributed to reducing AIDS deaths, the need for ART and new HIV infections.ConclusionsEven in a country with a concentrated epidemic and high levels of ARV coverage, such as Brazil, moderate efficacy vaccines as part of a comprehensive package of treatment and prevention could have a major impact on preventing new HIV infections and AIDS deaths, as well as reducing the number of people on ARV. Targeted vaccination strategies may be highly effective and cost-beneficial.

Este artigo discute os sistemas de proteção social na América Latina e as perspectivas para reformas sociais na região, tomando como referência os padrões existentes de relacionamento entre a sociedade e o Estado. Duas abordagens presentes na literatura sobre o tema são analisadas e questionadas: a primeira diz respeito à adoção de tipologias referidas às diferentes modalidades de Welfare State na classificação dos distintos sistemas de proteção social na região; a segunda refere-se à identificação de uma suposta crise do Welfare State no cenário internacional, que se expressaria necessariamente, nos sistemas latino-americanos de proteção social, por uma extensão da concepção econômica neoliberal a esse campo. Fundamentada em discussão conceituai e em referências empíricas, a autora questiona ambas as abordagens e conclui tentando mostrar que a complexa realidade latino-americana exige tratamento teórico e metodológico compatível com o cenário de heterogeneidade estrutural dominante na região. Taking as a reference point current patterns in relationships between society and the State, the article discusses social protection systems and prospects for social reforms in Latin America. Two approaches found in the literature on this topic are analyzed and questioned. In classifying the region's different social protection systems, the firstapproach adoptstypologiesreferred to the different modalities of Welfare State. The second identifies a supposed crisis of the Welfare State on the international stage, one that is seen as necessrily expressed in Latin American social protection systems through the extension of the neoliberal economic conception to this field. Based on a conceptual discussion and empirical references, the author questions both approaches andconcludes by attempting to show that Latin America's complex reality demands a theoretical and methodological treatment compatible with the scenario of structural heterogeneity prevalent in this region. Cet article étudie, avec comme référence les modèles de rapports qui s'établissent entre la société et 1'Etat, les systèmes latino-américains de protection sociales ainsi que les perspectives de réformes socialcs s'offrant à la légiun.Dans la littérature consacrée à ce thème, deux modes d' abordage sont présents. L'auteur les analyse et les reraet ici en question. Le premier mode consiste à classer les différents systèmes de protection sociale selon des typologies qui s'efforcent d'en cerner les modalités. Quant au second, il se base sur une hypothèse selon laquelle il existe actuellement une crise internationale du Welfare State et que cette crise atteint necessairement les systèmes latino-amé-ricains de protection sociale en raison de l'envahissement de ce domaine par la théorie économique néo-libérale. L'auteur s'appuie sur une analyse concep-tuelle et sur des références empiriques pour remettre en question ces deux modes d'abordage. Elle tente en conclusion de montrer que la réalité latino-américaine est complexe, qu'elle exige donc un traitement théorique et métho-dologique compatible avec le cadre d'hétérogénéité structurelle qui prédomine dans la région.

O ecossistema marinho é o habitat natural de bactérias como Vibrio parahaemolyticus, um importante patógeno causador de gastrenterite humana associada ao consumo de alimentos marinhos. Na presente investigação, foi avaliada a presença de V. parahaemolyticus a partir de 86 amostras de mexilhões in natura e pré-cozidos. Vibrio parahaemolyticus foi isolado a partir de 11,6% dos mexilhões in natura e pré-cozidos avaliados. Todas as cepas avaliadas demonstraram-se urease positivas e 28,5% Kanagawa positivas sugerindo um potencial patogênico para o homem. Houve a predominância do sorotipo O10:K52 e a identificação da cepa emergente O3:K6. Esses resultados apontam para a relevância epidemiológica de V. parahaemolyticus em casos de gastrenterite humana após consumo de mexilhões sem cozimento adequado (100ºC/15min). Além disso, é importante alertar as autoridades de Vigilância Sanitária no Brasil quanto a sua presença na cadeia alimentar e seus riscos para a Saúde Pública. The marine ecosystem is the natural habitat of bacteria like Vibrio parahaemolyticus, an important pathogen that cause human gastroenteritis associated with seafood consumption. In the present investigation, the presence of V. parahaemolyticus in 86 in natura and precooked mussel samples was evaluated. Vibrio parahaemolyticus was isolated from 11.6% of the in natura and precooked mussels. All strains tested were urease-positive and 28.5% were Kanagawa-positive, which suggests that they have pathogenic potential for humans. There was predominance of the O10:K52 serotype and the emerging O3:K6 strain was identified. These results show the epidemiological relevance of V. parahaemolyticus in cases of human gastroenteritis following mussel consumption without adequately cooking them (100°C/15min). Moreover, it is important to alert the Brazilian Sanitary Surveillance authorities regarding their presence in the food chain and their public health risks.

The marine ecosystem is the natural habitat of bacteria like Vibrio parahaemolyticus, an important pathogen that cause human gastroenteritis associated with seafood consumption. In the present investigation, the presence of V. parahaemolyticus in 86 in natural and precooked mussel samples was evaluated. Vibrio parahaemolyticus was isolated from 11.6% of the in natural and precooked mussels. All strains tested were urease-positive and 28.5% were Kanagawa-positive, which suggests that they have pathogenic potential for humans. There was predominance of the O10:K52 serotype and the emerging O3:K6 strain was identified. These results show the epidemiological relevance of V. parahaemolyticus in cases of human gastroenteritis following mussel consumption without adequately cooking them (100 degrees C/15 min). Moreover, it is important to alert the Brazilian Sanitary Surveillance authorities regarding their presence in the food chain and their public health risks.

The emergence and re-emergence of infectious diseases and their rapid dissemination worldwide are challenging national health systems, particularly in developing countries affected by extreme poverty and environmental degradation. The expectations that new vaccines and drugs and global surveillance would help reverse these trends have been frustrated thus far by the complexity of the epidemiological transition, despite promising prospects for the near future in biomolecular research and genetic engineering. This impasse raises crucial issues concerning conceptual frameworks supporting priority-setting, risk anticipation, and the transfer of science and technology's results to society. This article discusses these issues and the limitations of social and economic sciences on the one hand and ecology on the other as the main theoretical references of the health sciences in confronting the complexity of these issues on their own. The tension between these historically dissociated paradigms is discussed and a transdisciplinary approach is proposed, that of social ecosystem health, incorporating these distinct perspectives into a comprehensive framework. A emergência e reemergência de doenças infecciosas e sua rápida disseminação em escala global estão desafiando os sistemas nacionais de saúde, em particular nos países em desenvolvimento afetados pela pobreza extrema e pela degradação ambiental. As expectativas de que novas vacinas e medicamentos e a vigilância global contribuiriam para impedir essas tendências têm sido até aqui frustradas pela complexidade da transição epidemiológica, em que pese às perspectivas promissoras da biologia molecular e da engenharia genética. Esse impasse levanta questões cruciais relacionadas às estruturas conceituais que embasam a definição de prioridades, a antecipação de riscos e a transferência dos resultados da ciência e da tecnologia para a sociedade. Este artigo discute essas questões e as limitações das ciências sociais e econômicas, de um lado, e da ecologia, de outro, como principais referências teóricas das ciências da saúde, para enfrentar sozinhas a complexidade desses cenários. A tensão entre esses paradigmas historicamente dissociados é discutida, e uma abordagem transdisciplinar é proposta - ecossistema social e saúde -, incorporando essas distintas perspectivas em um referencial teórico abrangente.

Resumo: O presente ensaio, a partir de uma análise da crise da política de saúde no País, de sua subordinação à Previdência Social e dos determinantes do padrão atual de intervenção do Estado no setor, examina a proposta de integração das ações de assistência médica prestadas pelos diversos organismos públicos (INAMPS, Secretarias Estaduais, Secretarias Municipais e Universidades), especialmente levantando questões relativas aos rumos da política de saúde em âmbito estadual.

Orientador: Mauricio Tragtenberg Dissertação (mestrado) - Universidade Estadual de Campinas, Instituto de Filosofia e Ciencias Humanas Resumo: Não informado Abstract: Not informed Mestrado Mestre em Antropologia Social

O presente trabalho apresenta a proposta metodológica e os resultados consolidados do levantamento realizado, de modo descontínuo, ao longo de período de 6 meses (outubro de 86 a março de 87) da oferta tecnológica da FIOCRUZ. As definições conceituais e os procedimentos utilizados são apresentados de modo detalhado, por tratar-se de trabalho inédito na área de saúde. Também são apresentadas as 76 ofertas mapeadas, tecendo-se breves comentários, sobre sua relevância para o quadro sanitário nacional, bem como sobre a importância da pesquisa para as atividades de gestão tecnológica em saúde.The present work presents the methodological proposal and the consolidated results of the survey done, in a discontinue manner, during 6 months (from October 86 to march 87) of the FIOCRUZ technological supply. The conceptuals definitions and the procedures utilized are presented in a detailed manner, due to the fact that is an unplublished work in the health area. It also presents 76 listed supplies doing short comments about its importance to the national sanitary chart, and also about the importance of the research to the activities o f technological management in health.

The book is based on original data and field studies from Brazil, Thailand, India and Sub-Saharan Africa. Focusing on the issue of universal and free access to treatment (a goal now taken to heart by the international community), it assesses the progress made and presents a rigorous diagnosis of the obstacles that remain, especially the constraints imposed by TRIPS and the poor state of most public health systems in Southern countries. In so doing, the book renews our understanding of the political economy of HIV/AIDS in these vast regions, where it continues to spread with devastating social and economic consequences.

We examine the implications of the very low competitiveness of the Brazilian vaccine RD&I system, which precludes the development of all the important vaccines required by the National Immunization Program (NIP), severely impacting the healthcare of the population. In a country dramatically affected by COVID-19 pandemic and by an exponential increase in emerging and neglected diseases, particularly the poor, these RD&I constraints for vaccines become crucial governance issues. Such constraints are aggravated by a global scenario of limited commercial interest from multinational companies in vaccines for neglected and emerging diseases, which are falling into a “valley of death,” with only two vaccines produced in a pipeline of 240 vaccines. We stress that these constraints in the global pipeline are a window of opportunity for vaccine manufacturers in Brazil and other developing countries in the current paradigm transition towards Vaccinology 4.0. We conclude with recommendations for a new governance strategy supporting Brazilian public vaccine manufacturers in international collaborations for a sustainable national vaccine development and production plan by 2030.