MoH Research Priorities Agenda did not include Chagas disease, regrets Dr. Pedro Tauil

Publicação: 4 de February de 2019

To avoid the return of household transmission of Chagas Disease it is necessary to keep entomological surveillance in the previously endemic area and researches to prevent the eventual return of transmission. Also, new effective control measures for oral transmission should be investigated

Scientific and technological research in health is an indispensable component for enhancement actions in the population’s health promotion, protection and recovery

The Science and Technology Department (Decit/SCTIE/MS) published in January the National Agenda of Priorities in Health Research (NAPHR). The document intends to align the current health priorities to the scientific, technological and innovation research activities and guide the available resourced to invest in strategic research fields. The construction of a system for science, technology and innovation for health and the definition of the research priorities have contributed to the strengthening of the Unified Health System (SUS), through the incorporation of new knowledges and technologies.

The epidemiologist and professor of the Center for Tropical Medicine at the University of Brasília (UnB), Professor Emeritus Dr. Pedro Tauil, says the NAPHR is broad and approaches most of the problems currently faced by health services in Brazil. However, he notes that, for example, in relation to Chagas disease, in which Brazil was responsible for 70% of the world’s deaths in 2017, the Agenda left unnoticed. “We are living the risk of returning household transmission and the need to control oral transmission, because contaminated food, exists. I think research is needed to prevent the return of household transmission and to control oral transmission of the disease”, he warned.

Asked about what to expect from the NAPHR for researches on neglected diseases, when for example, in 2017, Brazil registered almost half of all new dengue cases in Latin America and the Caribbean; accounted for 70% of the deaths in the world by Chagas Disease and contributed with 93% of the new leprosy cases in the Americas, with almost 66 thousand cases in 2017, the Science, Technology and Strategic Inputs of the Ministry of Health, Denizar Vianna de Araujo, said that Brazil, as big as it is and holding almost 40% of the Latin American population, will concentrate, in absolute numbers, a high incidence of cases in epidemic events. “In this context, research on dengue, leprosy, Chagas’ disease and other neglected diseases will remain to be considered priority themes in the various axes of NAPHR These issues can be financed through public notices, which will be launched by the Ministry of Health in the upcoming years”, he clarifies.

According to a report published in late January by G-Finder, an international body that analyses data of research investments in the development of health products of over 200 private, public and philanthropic organizations, the Ministry of Health is one of the world’s top 12 funders for dengue research. Still according to the report, the MoH, by the Science, Technology and Strategic Inputs Secretariat, was the fourth largest funder of studies related to the control of vectors linked to neglected diseases.

Public resources and expenditures cutbacks

The president of the Brazilian Society of Tropical Medicine (BSTM), Dr. Sinval Pinto Brandão Filho, warns that the heavy cutbacks in Science and Technology imposed by the Federal Government in the past years have lead Brazilian scientific production to a very difficult and precarious situation and, in his opinion, certainly the NAPHR is somehow affected by them, once many projects in development are listed within their scope. Regarding the damages caused by cutbacks in Brazil’s scientific budget, around half the amount available in recent years, Dr. Sinval is emphatic to say this will have a very negative impact on the continuity of relevant studies in several Brazilian institutions, as the Brazilian Society of the Progress of Science (BSPS) and associated entities, such as the BSTM, have alerted in continuous meetings in the National Congress’ Science, Technology and Innovation Commission and their discussion forums.

Dr. Pedro Tauil agrees. According to him, the effect of the rupture created by these cutbacks on scientific production in the past years are very strong and discouraging for researchers. He emphasizes that in no ways the NAPHR “It is just a list of the main identified problems. It should call attention for the strengthening of the funding sources for these researches”, he says. He also warns for the fact that research dynamics not always allows them to be interrupted and then resumed, since there is a chance to lose efforts, sometimes irrecoverable. “It’s not easy to set up and maintain research teams. Disruption of funding, for example, can de-structure a team, encouraging researchers to even consider moving abroad”, he adds.

Asked whether the impact of approving this constitutional amendment, that sets a ceiling for the Federal Government spending for the next 20 years influenced the NAPHR, secretary Denizar Vianna de Araújo stresses the Priorities Agenda was based on the main research problems identified by technicians and managers of all secretaries at the Ministry of Health, aiming to support decisions about strategic research funding for the Unified Health System. “The NAPHR was designed aiming to optimize health planning and outcomes, to avoid duplicate research funding, to redirect efforts, and to strengthen links with partner institutions and agencies”, he says.

The impact of resource cuts has motivated many researchers to leave Brazil and seek refuge in countries and universities where they can raise funds to develop their work. According to Dr. Sinval, this situation can only be reversed with the resumption of budget investments, recovering and even increasing reasonable desired levels for a country as big as Brazil and its scientific community, and that are on the joint agenda of the BSPS and its associated entities. He acknowledges the NAPHR has great importance, once it places in the agenda, at an important moment of government changes, priority research themes, some already underway, and others to be developed in new projects. “We are always hopeful that there will be a reversal of the current picture of the negative impact of the cutbacks and how the NAPHR is always updating itself, so we hope that the points that remain in evidence for prioritization will be kept when the timely update for this important document”, he finishes.

The Secretary of Science, Technology and Strategic Inputs at the Ministry of Health clarifies that the NAPHR is an advisory document that, besides providing support for strategic planning, it represents an important tool for articulating with research funding institutes and foundations, aiming to establish public and private partnerships to strengthen the funding of health research and direct efforts towards strategic and relevant issues for the SUS. He explains that the NAPHR is an advisory document and will be a guiding tool for the promotion of health research by the Ministry of Health, especially, in the work of the Science and Technology Department. According to him, the promotion science and technology within the MoH has been stable for the past three years and the planned actions have been carried out regularly. “Funding of MoH research is not restricted to the Decit, there are other areas that also work with research promotion”, he concludes.