Relevance of national, regional and global virome projects on pandemics prediction, prevention, and control: a social network analysis of GVP-citing articles.

BACKGROUND: The Global Virome Project (GVP) was proposed in 2018 as an evolution of the USAID PREDICT project and was presented as a "collaborative scientific initiative to discover zoonotic viral threats and stop future pandemics". The immediate response was mixed, with public health and scientific communities representatives showing skepticism, if not direct opposition. OBJECTIVES: The economic, social, and health consequences of the coronavirus disease 2019 (COVID-19) pandemic demonstrated how unprepared the world was in the face of new pandemics. This paper analyses the impact of the GVP on the scientific and public health communities. METHODS: Published scientific articles that cited the two 2018 seminal publications proposing the project were analysed using social network analysis methods. FINDINGS: Encompassing the periods before and after the onset of the Covid-19 pandemic, the results indicate that (i) the concepts of the GVP have received more support than opposition in the scientific literature; (ii) its foundations should be updated to address the specific criticisms. MAIN CONCLUSIONS: Shifting focus to national virome projects can provide tangible, regional benefits that can positively contribute towards a consensus on achieving a high level of preparedness for the ever-present possibility of the following global viral pandemic.

Why do we still have not a vaccine against Chagas disease?

This review does not intend to convey detailed experimental or bibliographic data. Instead, it expresses the informal authors' personal views on topics that range from basic research on antigens and experimental models for Trypanosoma cruzi infection to vaccine prospects and vaccine production. The review also includes general aspects of Chagas' disease control and international and national policies on the subject. The authors contributed equally to the paper.

The COVID-19 pandemics and the relevance of biosafety facilities for metagenomics surveillance, structured disease prevention and control.

The coronavirus disease 2019 (COVID-19) pandemic represents an enormous challenge to all countries, regardless of their development status. The manipulation of its etiologic agent SARS-CoV-2 requires a biosafety containment level 3 laboratories (BSL-3) to understand virus biology and in vivo pathogenesis as well as the translation of new knowledge into the preclinical development of vaccines and antivirals. As such, BSL-3 facilities should be considered an integral part of any public health response to emerging infectious disease prevention, control and management. Differently from BSL-2, BSL-3 units vary considerably along the range from industrialized to the least developed countries. Innovative Developing Countries (IDCs) such as Brazil, which excelled at controlling the 2015-2017 Zika epidemic, had to face a serious flaw in its disease control and prevention structure: the scarcity and uneven geographic distribution of its BSL-3 facilities, including those for preclinical animal experimentation.

Health Science, Technology and Innovation Policy (ST&I/H): an update for debate. / Política de Ciência, Tecnologia e Inovação em Saúde (CT&I/S): uma atualização para debate.

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.

Relevance of national, regional and global virome projects on pandemics prediction, prevention, and control: a social network analysis of GVP-citing articles

BACKGROUND The Global Virome Project (GVP) was proposed in 2018 as an evolution of the USAID PREDICT project and was presented as a "collaborative scientific initiative to discover zoonotic viral threats and stop future pandemics". The immediate response was mixed, with public health and scientific communities representatives showing skepticism, if not direct opposition. OBJECTIVES The economic, social, and health consequences of the coronavirus disease 2019 (COVID-19) pandemic demonstrated how unprepared the world was in the face of new pandemics. This paper analyses the impact of the GVP on the scientific and public health communities. METHODS Published scientific articles that cited the two 2018 seminal publications proposing the project were analysed using social network analysis methods. FINDINGS Encompassing the periods before and after the onset of the Covid-19 pandemic, the results indicate that (i) the concepts of the GVP have received more support than opposition in the scientific literature; (ii) its foundations should be updated to address the specific criticisms. MAIN CONCLUSIONS Shifting focus to national virome projects can provide tangible, regional benefits that can positively contribute towards a consensus on achieving a high level of preparedness for the ever-present possibility of the following global viral pandemic.

Revisiting the concept of Innovative Developing Countries (IDCs) for its relevance to health innovation and neglected tropical diseases and for the prevention and control of epidemics.

INTRODUCTION: Countries have traditionally been split into two major groups: developed or industrialized ("the North") and developing or underdeveloped ("the South"). Several authors and organizations have challenged this classification to recognize countries that have reached an intermediate stage of social and economic development. As proposed by Morel and collaborators in 2005, the concept of Innovative Developing Countries (IDCs) defines a group of nations with impactful scientific programs. Here, IDCs are reexamined by a variety of metrics to highlight their role in health innovation through research and development (R&D) programs on neglected tropical diseases (NTDs) that also positively impact epidemic preparedness. RESULTS: To address the global changes due to expanding globalization we updated the original indicator of the number of USPTO patents deposited by individual countries per GDP and per capita to the number of international patents applications, related to applicant residence and deposited under the Patent Cooperation Treaty (PCT) per GNI (or GDP) and per capita. A comparison of the originally described ranking of top innovative countries to those in the present study revealed new members that updated the list of IDCs and showed a prominent role now played by China. Analyzing scientific publications in international journals since the introduction of the IDC concept in 2005 we found that IDCs do prioritize Neglected Tropical Diseases (NTDs) as an area of research. Finally we investigated the role of IDCs in two major public health emergencies between 2012 and 2016, the outbreaks of Ebola in West Africa and Zika in South America. An analysis of the co-authorship country networks demonstrated an important role for IDC infrastructure and personnel in the prevention and control of these epidemics. DISCUSSION AND CONCLUSIONS: Different techniques can be used to evaluate and measure innovative performance of countries. Country rankings published by traditional indexes, such as the Bloomberg Innovation Index (BII) and the Global Innovation Index (GII), only include high income economies among the top 20 performers. This is in sharp contrast to our approach, which identified 8-9 IDCs among the first 25 with China occupying the top position. Through an analysis of the pros and cons of the different methodologies, the IDC concept challenges more conventional approaches to address and estimate the innovative capacity of countries.

Why do we still have not a vaccine against Chagas disease?

This review does not intend to convey detailed experimental or bibliographic data. Instead, it expresses the informal authors' personal views on topics that range from basic research on antigens and experimental models for Trypanosoma cruzi infection to vaccine prospects and vaccine production. The review also includes general aspects of Chagas' disease control and international and national policies on the subject. The authors contributed equally to the paper.

Ivermectin efficacy against Biomphalaria, intermediate host snail vectors of Schistosomiasis.

The impact of ivermectin on adult snails of the genus Biomphalaria (B. glabrata, B. tenagophila and B. straminea), B. glabrata infected with Schistosoma mansoni, snail egg-masses cercariae and miracidia, as well as on guppy fish (Poecilia reticulata) was examined and evaluated. Biomphalaria snails, egg-masses, parasite stages and guppies were all exposed to different concentrations of ivermectin for 24 h, followed by regular observations of mortality. The calculated lethal doses of ivermectin were around an LD50 of 0.03 µg ml-1, and an LD90 of 0.3 µg ml-1 for the three species of snails. Specimens of B. glabrata actually shedding parasite cercariae all died when exposed to ivermectin at a concentration of a mere 0.01 µg ml-1. Ivermectin B1a, the major (80%) component of commercially available ivermectin, proved to be inactive, and it was the minor (20%) component, ivermectin B1b, which caused snail death. Snail egg-masses were not affected, even at the highest concentration of 100 µg ml-1. With respect to S. mansoni parasite stages, 0.2 µg ml-1 ivermectin killed 50% of cercariae and miracidia within five minutes, rising to 90% after 30 min. Mortality of guppy fish within 24 h of exposure to ivermectin at concentrations of 0.5 µg ml-1 and 0.01 µg ml-1, were 100% and 30%, respectively. The concentration of 0.01 µg ml-1 that killed Schistosoma mansoni-infected snails only caused 30% mortality in guppy fish. Ivermectin can be considered a promising molluscicide, especially as it is more potent against infected snails than uninfected ones, although it has no impact on egg-masses. Ivermectin and its derivatives could be explored in the search for a new agent to help control schistosomiasis transmission.

Política de Ciência, Tecnologia e Inovação em Saúde (CT& I/S): uma atualização para debate / Health Science, Technology and Innovation Policy (ST& I/H): an update for debate

Resumo 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.

Abstract 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.

Política de Ciência, Tecnologia e Inovação em Saúde (CT&I/S): uma atualização para debate / Health Science, Technology and Innovation Policy (ST&I/H): an update for debate

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.

Genetic evidence and host immune response in persons reinfected with SARS-CoV-2, Brazil

Mostra que uma primeira exposição à Covid-19 em casos brandos ou assintomáticos pode não produzir resposta imunológica e que a pessoa pode se reinfectar, inclusive, com a mesma variante. A segunda infecção pode provocar sintomas mais fortes do que a primeira. Os dados mostram que para a parcela da população que tem a doença na forma branda (em que não é necessária a hospitalização) isso não significa que fique imune ou que uma reinfecção evolua de forma benigna. O estudo indica ainda que a reinfecção pode ser mais frequente do que se supõe.

Proposal for a telehealth concept in the translational research model.

OBJECTIVE: To review the conceptual relationship between telehealth and translational research. METHODS: Bibliographical search on telehealth was conducted in the Scopus, Cochrane BVS, LILACS and MEDLINE databases to find experiences of telehealth in conjunction with discussion of translational research in health. The search retrieved eight studies based on analysis of models of the five stages of translational research and the multiple strands of public health policy in the context of telehealth in Brazil. The models were applied to telehealth activities concerning the Network of Human Milk Banks, in the Telemedicine University Network. RESULTS: The translational research cycle of human milk collected, stored and distributed presents several integrated telehealth initiatives, such as video conferencing, and software and portals for synthesizing knowledge, composing elements of an information ecosystem, mediated by information and communication technologies in the health system. CONCLUSIONS: Telehealth should be composed of a set of activities in a computer mediated network promoting the translation of knowledge between research and health services.

The Human Hookworm Vaccine.

Hookworm infection is one of the world's most common neglected tropical diseases and a leading cause of iron deficiency anemia in low- and middle-income countries. A Human Hookworm Vaccine is currently being developed by the Sabin Vaccine Institute and is in phase 1 clinical testing. The candidate vaccine is comprised of two recombinant antigens known as Na-GST-1 and Na-APR-1, each of which is an important parasite enzyme required for hookworms to successfully utilize host blood as a source of energy. The recombinant proteins are formulated on Alhydrogel(®) and are being tested in combination with a synthetic Toll-like receptor 4 agonist. The aim of the vaccine is to induce anti-enzyme antibodies that will reduce both host blood loss and the number of hookworms attached to the gut. Transfer of the manufacturing technology to the Oswaldo Cruz Foundation (FIOCRUZ)/Bio-Manguinhos (a Brazilian public sector developing country vaccine manufacturer) is planned, with a clinical development plan that could lead to registration of the vaccine in Brazil. The vaccine would also need to be introduced in the poorest regions of Africa and Asia, where hookworm infection is highly endemic. Ultimately, the vaccine could become an essential tool for achieving hookworm control and elimination, a key target in the 2012 London Declaration on Neglected Tropical Diseases.

Enabling policy planning and innovation management through patent information and co-authorship network analyses: a study of tuberculosis in Brazil.

INTRODUCTION: New tools and approaches are necessary to facilitate public policy planning and foster the management of innovation in countries' public health systems. To this end, an understanding of the integrated way in which the various actors who produce scientific knowledge and inventions in technological areas of interest operate, where they are located and how they relate to one another is of great relevance. Tuberculosis has been chosen as a model for the present study as it is a current challenge for Brazilian research and innovation. METHODOLOGY: Publications about tuberculosis written by Brazilian authors were accessed from international databases, analyzed, processed with text searching tools and networks of coauthors were constructed and visualized. Patent applications about tuberculosis in Brazil were retrieved from the Brazilian National Institute of Industrial Property (INPI) and the European Patent Office databases, through the use of International Patent Classification and keywords and then categorized and analyzed. RESULTS/CONCLUSIONS: Brazilian authorship of articles about tuberculosis jumped from 1% in 1995 to 5% in 2010. Article production and patent filings of national origin have been concentrated in public universities and research institutions while the participation of private industry in the filing of Brazilian patents has remained limited. The goals of national patenting efforts have still not been reached, as up to the present none of the applications filed have been granted a patent. The analysis of all this data about TB publishing and patents clearly demonstrates the importance of maintaining the continuity of Brazil's production development policies as well as government support for infrastructure projects to be employed in transforming the potential of research. This policy, which already exists for the promotion of new products and processes that, in addition to bringing diverse economic benefits to the country, will also contribute to effective dealing with public health problems affecting Brazil and the World.

Development, health, and international policy: the research and innovation dimension / Desenvolvimento, saúde e política internacional: a dimensão da pesquisa & inovação

O objetivo central deste texto é discutir desenvolvimento e saúde sob a ótica da influência da governança da saúde global, utilizando como traçador a dimensão das políticas de pesquisa, desenvolvimento e inovação em saúde, que se referem, de um lado, a insumos importantes para o sistema de saúde - como fármacos e medicamentos, vacinas, reativos para diagnóstico e equipamentos e, de outro, a conceitos e práticas inovadoras para o aperfeiçoamento dos sistemas de saúde e da saúde pública. Examina os dois principais macroprocessos que influenciam o desenvolvimento e a saúde: a Agenda do Desenvolvimento para o pós-2015 e o processo sobre pesquisa e desenvolvimento, propriedade intelectual e acesso a insumos em saúde em curso na Organização Mundial da Saúde. Conclui que muito há que ser feito para que a referida Agenda possa representar um pacto político internacional coerente e viável, e que os dois macroprocessos relacionados com a inovação em saúde precisam ser agilizados, mas para isto torna-se necessária a democratização da participação dos maiores interessados - os pacientes e, de modo geral, a população dos países mais pobres - pois só desta maneira será superada a "soma zero" em que se encontra o embate entre os representantes de Estados-membros nos debates atuais.

Mobilização para um programa de pesquisa translacional em Leishmanioses: uma solução para saúde pública / Mobilization for translational research program on Leishmaniasis: a solution for public health

Este artigo tem como objetivo registrar o processo de articulação de pesquisadores e gestores de Ciência e Tecnologia que culminou com a estruturação de um programa de pesquisa translacional para busca de soluções acerca de novos tratamentos para as leishmanioses. Em que pese a expressiva massa de publicações na área de leishmaniose, ainda persiste a falta de acesso a tratamentos efetivos para pacientes. O aumento no número de casos registrados tem alarmado os gestores de saúde pública. Na contramão da situação que se apresenta o número de pesquisas científicas na área tem crescido nos últimos anos colocando o Brasil entre os países com maior número de publicações científicas na área junto aos EUA e India. A estratégia de aproximar e ativar uma rede de pesquisadores no campo e direcioná-los a um programa de pesquisa translacional será o foco de ação nos próximos dez anos.