The configuration of the Brazilian scientific field.

This article describes the configuration of the scientific field in Brazil, characterizing the scientific communities in every major area of knowledge in terms of installed capacity, ability to train new researchers, and capacity for academic production. Empirical data from several sources of information are used to characterize the different communities. Articulating the theoretical contributions of Pierre Bourdieu, Ludwik Fleck, and Thomas Kuhn, the following types of capital are analyzed for each community: social capital (scientific prestige), symbolic capital (dominant paradigm), political capital (leadership in S & T policy), and economic capital (resources). Scientific prestige is analyzed by taking into account the volume of production, activity index, citations, and other indicators. To characterize symbolic capital, the dominant paradigms that distinguish the natural sciences, the humanities, applied sciences, and technology development are analyzed theoretically. Political capital is measured by presidency in one of the main agencies in the S & T national system, and research resources and fellowships define the economic capital. The article discusses the composition of these different types of capital and their correspondence to structural capacities in various communities with the aim of describing the configuration of the Brazilian scientific field.

Successes and failures in the control of infectious diseases in Brazil: social and environmental context, policies, interventions, and research needs.

Despite pronounced reductions in the number of deaths due to infectious diseases over the past six decades, infectious diseases are still a public health problem in Brazil. In this report, we discuss the major successes and failures in the control of infectious diseases in Brazil, and identify research needs and policies to further improve control or interrupt transmission. Control of diseases such as cholera, Chagas disease, and those preventable by vaccination has been successful through efficient public policies and concerted efforts from different levels of government and civil society. For these diseases, policies dealt with key determinants (eg, the quality of water and basic sanitation, vector control), provided access to preventive resources (such as vaccines), and successfully integrated health policies with broader social policies. Diseases for which control has failed (such as dengue fever and visceral leishmaniasis) are vector-borne diseases with changing epidemiological profiles and major difficulties in treatment (in the case of dengue fever, no treatment is available). Diseases for which control has been partly successful have complex transmission patterns related to adverse environmental, social, economic, or unknown determinants; are sometimes transmitted by insect vectors that are difficult to control; and are mostly chronic diseases with long infectious periods that require lengthy periods of treatment.

The emergence of vaccine hesitancy among upper-class Brazilians: Results from four birth cohorts, 1982-2015.

Vaccine hesitancy has been increasingly reported in Brazil. We describe secular trends and socioeconomic disparities from 1982 to 2015, using data from four population-based birth cohorts carried out in the city of Pelotas. Full immunization coverage (FIC) was defined as having received four basic vaccines (one dose of BCG and measles, and three doses of polio and DTP) scheduled for the first year of life. Information on income was collected through standardized questionnaires, and the slope index of inequality (SII) was calculated to express the difference in percent points between the rich and poor extremes of the income distribution. Full immunization coverage was 80.9% (95% CI 79.8%; 82.0%) in 1982, 97.2% (96.1%; 98.0%) in 1993, 87.8% (86.7%; 88.8%) in 2004 and 77.2% (75.8%; 78.4%) in 2015. In 1982 there was a strong social gradient with higher coverage among children from wealthy families (SII = 25.0, P < 0.001); by 2015, the pattern was inverted with higher coverage among poor children (SII = -6.0; P = 0.01). Vertical immunization programs in the 1980s and creation of the National Health Services in 1980 eliminated the social gradient that had been present up to the 1980s, to reach near universal coverage. The recent decline in coverage is likely associated with the growing complexity of the vaccination schedule and underfunding of the health sector. In addition, the faster decline observed among children from wealthy families is probably due to vaccine hesitancy.