Imported Malaria in Portugal: Prevalence of Polymorphisms in the Anti-Malarial Drug Resistance Genes pfmdr1 and pfk13.

Malaria is one of the 'big three' killer infectious diseases, alongside tuberculosis and HIV. In non-endemic areas, malaria may occur in travelers who have recently been to or visited endemic regions. The number of imported malaria cases in Portugal has increased in recent years, mostly due to the close relationship with the community of Portuguese language countries. Samples were collected from malaria-infected patients attending Centro Hospitalar Lisboa Ocidental (CHLO) or the outpatient clinic of Instituto de Higiene e Medicina Tropical (IHMT-NOVA) between March 2014 and May 2021. Molecular characterization of Plasmodium falciparum pfk13 and pfmdr1 genes was performed. We analyzed 232 imported malaria cases. The majority (68.53%) of the patients came from Angola and only three patients travelled to a non-African country; one to Brazil and two to Indonesia. P. falciparum was diagnosed in 81.47% of the cases, P. malariae in 7.33%, P. ovale 6.47% and 1.72% carried P. vivax. No mutations were detected in pfk13. Regarding pfmdr1, the wild-type haplotype (N86/Y184/D1246) was also the most prevalent (64.71%) and N86/184F/D1246 was detected in 26.47% of the cases. The typical imported malaria case was middle-aged male, traveling from Angola, infected with P. falciparum carrying wild type pfmdr1 and pfk13. Our study highlights the need for constant surveillance of malaria parasites imported into Portugal as an important pillar of public health.

Cooperação internacional em saúde do Brasil na era do SUS / Brazilian international cooperation in health in the era of SUS

Resumo O artigo aborda a presença da saúde na diplomacia da saúde e na cooperação internacional do Brasil, desde o surgimento do Sistema Único de Saúde (SUS), com ênfase na cooperação Sul-Sul e em linha com as prioridades da cooperação técnica internacional do país desde então, que enfatiza as relações com países da América Latina e Caribe (ALC) e da Comunidade de Países de Língua Portuguesa (CPLP), particularmente com os Países Africanos de Língua Oficial Portuguesa (PALOP) e Timor Leste. Ressalta os papéis do Ministério da Saúde, por meio da Assessoria Internacional em Saúde (AISA) e da Fundação Oswaldo Cruz (Fiocruz), além da Agência Brasileira de Cooperação (ABC), do Ministério das Relações Exteriores, e da Organização Pan-Americana da Saúde (OPAS). Aponta o papel do Termo de Cooperação TC-41 como um dos principais instrumentos da viabilização da cooperação. Apresenta os casos das redes estruturantes dos sistemas de saúde, assim como as negociações paradigmáticas da Convenção-Quadro sobre Controle do Tabaco, do Acordo TRIPS e da criação da UNAIDS, nos quais o papel da diplomacia brasileira foi preponderante.

Abstract This paper addresses the role of health in Brazil's health diplomacy and international cooperation since the emergence of the Brazilian Unified Health System (SUS), focusing in particular on South-South cooperation, in line with the priorities of the country's international technical cooperation since its creation. It highlights the relationship with the Latin American and Caribbean Countries (LAC) and the Community of Portuguese Speaking Countries (CPLP), more specifically, with the Portuguese Speaking African Countries (PALOP) and East Timor. It emphasizes the roles of the Ministry of Health, through the International Advisory Working Group on Health (AISA) and the Oswaldo Cruz Foundation (Fiocruz), the Brazilian Cooperation Agency (ABC), the Ministry of Foreign Affairs, and the Pan American Health Organization (PAHO). The article points out that the TC-41 Co-operation Agreement is one of the main instruments for enabling cooperation. It presents the cases of the structuring networks of health systems, as well as the paradigmatic negotiations of the Framework Convention on Tobacco Control, the TRIPS Agreement and the establishment of UNITAIDS, in which Brazilian diplomacy had a predominant role.

Assessing competencies: an evaluation of ASTD's Certified Professional in Learning and Performance (CPLP) designation.

The American Society of Training and Development's (ASTD) Certified Professional in Learning and Performance (CPLP) program is purported to be based on the ASTD's competency model, a model which outlines foundational competencies, roles, and areas of expertise in the field of training and performance improvement. This study seeks to uncover the relationship between the competency model and the CPLP knowledge exam questions and work product submissions (two of the major instruments used to test for competency of CPLP applicants). A mixed qualitative-quantitative approach is used to identify themes, quantify relationships, and assess questions and guidelines. Multiple raters independently analyzed the data and identified key themes, and Fleiss' Kappa coefficient was used in measuring inter-rater agreement. The study concludes that several discrepancies exist between the competency model and the knowledge exam and work product submission guidelines. Recommendations are given for possible improvement of the CPLP program.

A concepção brasileira de "cooperação Sul-Sul estruturante em saúde" / Brazil's conception of South-South "structural cooperation" in health*

No despontar do novo milênio, as necessidades em saúde dos países pobres além de não terem diminuído parecem ter piorado, devido a uma complexa interação entre vários fatores, que resulta em agudas iniquidades, num mesmo país e entre os países. Essa situação crítica questiona, mais uma vez, a cooperação internacional para o desenvolvimento e estimula a reflexão. Nesse processo, a cooperação Sul-Sul tem ganhado crescente importância. No início do século XXI, a cooperação internacional, principalmente no âmbito Sul-Sul, passou a ocupar um lugar estratégico na política externa brasileira e a saúde é considerada um tema prioritário nessa agenda. Este artigo discute a concepção brasileira de "cooperação estruturante em saúde" entre os países em desenvolvimento. Apresenta uma breve revisão histórica sobre a cooperação para o desenvolvimento e a cooperação em saúde; elabora o conceito de "cooperação estruturante em saúde", discute a proposta brasileira formulada ao longo da última década e a sua implementação até o presente momento. A abordagem brasileira está centrada no conceito de "construção de capacidades para o desenvolvimento", mas inova em dois aspectos: integra formação de recursos humanos, fortalecimento organizacional e desenvolvimento institucional; e rompe com a tradicional transferência passiva de conhecimentos e tecnologias. É cedo para avaliar o seu impacto, mas essa cooperação vem sendo implementada com base em cinco aspectos estratégicos, políticos e técnicos interrelacionados: (a) priorização da cooperação horizontal; (b) foco no desenvolvimento de capacidades em saúde; (c) iniciativas coordenadas no contexto regional; (d) forte envolvimento de ministros da saúde na construção de consensos estratégicos e políticos; e (e) estimulo à parceria entre saúde e relações exteriores

At the dawn of the new millennium, not only have poor countries' health needs not diminished, but they seem to have worsened due to a complex interplay among many factors that result in huge inequities within and between countries. This critical situation calls international development cooperation into question once again and prompts new thinking. In this process, South-South cooperation has steadily gained importance. At the start of the 21st century, international ­ particularly South-South ­ cooperation has come to occupy a strategic place in Brazilian foreign policy, and health is a priority item on this agenda. This paper examines the Brazilian conception of horizontal "structural cooperation in health". It presents a brief historical review of international development cooperation and health cooperation, explores the concept of "structural cooperation in health", and discusses the Brazilian proposal formulated over the past decade and its implementation to date. This Brazilian approach centers on the concept of "capacity building for development", but innovates in two respects: by integrating human resource development with organisational and institutional development and by breaking with the traditional passive transfer of knowledge and technology. It is still early to evaluate its impact, but this cooperation has been implemented on the basis of five interrelated strategic, political and technical considerations: (a) priority for horizontal cooperation; (b) focus on developing health capabilities; (c) coordinated initiatives in the regional context; (d) strong involvement of health ministers in building strategic and political consensus; and (e) encouraging partnership between ministries of health and foreign relations

Ensaio crítico sobre a cooperação internacional em saúde / Critical essay on international cooperation in health

Este ensaio discute as necessidades de cooperação internacional em saúde, o modelo dominante da cooperação neste campo, algumas alternativas ao mesmo − que inclui a cooperação Sul-Sul - e prognósticos para o cenário cooperação internacional, considerada parte da diplomacia da saúde

This essay discusses the need for international cooperation in health, the current dominant model of cooperation in the area, as well as a few alternatives to this model - such as South-South cooperation - and prognoses for the international cooperation sphere, considered a part of health diplomacy