The health economic-industrial complex: production and innovation for universal health access, Brazil.

Problem: The coronavirus disease 2019 (COVID-19) pandemic has highlighted global disparities in accessing essential health products, demonstrating the critical need for low- and middle-income countries to develop local production and innovation capabilities. Approach: The health economic-industrial complex approach changed the values that guided innovation and industrial policies in Brazil. The approach directed health production and innovation to universal access; the health ministry led a whole-of-government approach; and public procurement was strategically applied to stimulate productive public and private investments. The institutional, technological and productive capacities built up by the health economic-industrial complex allowed the country to quickly establish local COVID-19 vaccines production and guarantee access for the population. Local setting: Brazil has a universal health system that guarantees access to health for its 215 million population. Relevant changes: Public policies and actions, based on the health economic-industrial complex, guided investment projects in line with health demands, strengthened local producers, and increased autonomy in the production of health products in areas of greater technological dependence. During the COVID-19 pandemic, the country was able to rapidly scale up local vaccine production. By August 2021, Brazil had produced 74.8% (151 463 502/202 437 516) of the vaccine doses used in the country. Lessons learnt: The Brazilian example shows that low- and middle-income countries can build systemic development policies that increase their capability to produce and innovate in concert with universal health systems. This increased capacity can guarantee access to health products and supplies that are critical during global health emergencies.

Protein fraction from Sesbania virgata (Cav.) Pers. seeds exhibit antioxidant and antifungal activities.

Sesbania virgata (Cav.) Pers. seeds are protein sources with health and environmental benefits. In this research, proteins with lectin activity were identified in a protein fraction from S. virgata seeds (PFLA), as well its antioxidant and antimicrobial potentials, in addition to cytotoxic effects. To obtain PFLA, seed flour was homogenized in Glycine-NaOH (100 mM; pH 9.0; NaCl 150 mM) and precipitated in ammonium sulfate. PFLA concentrates bioactive lectins (32 HU/mL, 480 HU/gFa, 18.862 HU/mgP) and essential amino acids (13.36 g/100g protein). PFLA exerts antioxidant activity, acting as a promising metal chelating agent (~77% of activity). Analyzes of cell culture assay results suggest that antioxidant activity of PFLA may be associated with the recruitment of essential molecules to prevent the metabolic impairment of cells exposed to oxidative stress. PFLA (256 - 512 µg/mL) also exhibits antifungal activity, inhibiting the growth of Aspergillus flavus, Candida albicans, Candida tropicalis and Penicillium citrinum. Cytotoxic analysis indicates a tendency of low interference in the proliferation of 3T3 and HepG2 cells in the range of PFLA concentrations with biological activity. These findings support the notion that PFLA is a promising adjuvant to be applied in current policies on the management of metal ion chelation and fungal infections.

Perception of Health Care Providers and Users on Teleconsultation in Times of COVID-19 in Brazil: An Exploratory Interview Study.

Background: In the context of the COVID-19 pandemic in Brazil, teleconsultation was considered an important instrument in the fight against the health crisis, with temporary mandates changing the current legislation to expand its use. This study examined the perceptions of health care providers and users regarding teleconsultation. Methods: The study consisted of a national survey of 1,089 participants, of which 480 were health care providers and 609 were users, carried out through two semistructured questionnaires administered between June and August 2020, using six categories of analysis for teleconsultation-quality, remuneration, duties and responsibilities, experience and positioning regarding use, and technology-and an additional question about the benefits and harms of telemedicine. Results: The research indicated that, although face-to-face care is favored, there is an important movement toward accepting virtual care, even though there are relative differences in perception regarding the six categories analyzed. Discussion: Regarding the benefits of telemedicine, issues such as access, practicality, agility, convenience, easiness, and speed stood out as well as concerns such as contact, quality, impersonality, distance, errors, and falsehood, among others. Conclusions: Although there is evidence of benefits and limitations, bringing to light that contributions from the perception of health care providers and users can help promote debates to establish teleconsultation on a permanent basis in Brazil.

Direct from the COVID-19 crisis: research and innovation sparks in Brazil.

BACKGROUND: The coronavirus disease 2019 (COVID-19) pandemic has spread throughout more than 160 countries, infecting millions of people worldwide. To address this health emergency, countries have organized the flow of production and innovation to reduce the impact on health. This article shows the response of the Brazilian scientific community to meet the urgent needs of the public unified health system [SUS], aiming to guarantee universal access to an estimated population of 211 million. By December 2020, Brazil had recorded more than six million cases and approximately 175,000 deaths. METHODS: We collected data on research, development and innovation projects carried out by 114 public universities (plus Oswaldo Cruz Foundation [Fiocruz] and Butantan Institute), as reported on their websites. Additionally, we examined the studies on COVID-19 approved by the National Comission for Research Ethics, as well as those reported on the Ministry of Education website as of May 15, 2020. RESULTS: The 789 identified projects were classified according to research categories as follows: development and innovation (n = 280), other types of projects (n = 226), epidemiologic research (n = 211), and basic research on disease mechanisms (n = 72). Most proposals focused on the development and innovation of personal protective equipment, medical devices, diagnostic tests, medicines and vaccines, which were rapidly identified as research priorities by the scientific community. Some promising results have been observed from phase III vaccine trials, one of which is conducted in partnership with Oxford University and another of which is performed with Sinovac Biotech. Both trials involve thousands of volunteers in their Brazilian arms and include technology transfer agreements with Fiocruz and the Butantan Institute, respectively. These vaccines proved to be safe and effective and were immediately licensed for emergency use. The provision of doses for the public health system, and vaccination, started on January 17, 2021. CONCLUSIONS: The mobilized Brazilian scientific community has generated comprehensive research, development and innovation proposals to meet the most urgent needs. It is important to emphasize that this response was only possible due to decades of investment in research, development and innovation in Brazil. We need to reinforce and protect the Brazilian science, technology and innovation system from austerity policies that disregard health and knowledge as crucial investments for Brazilian society, in line with the constitutional right of universal health access and universal health coverage.

The Coconut Water Antimicrobial Peptide CnAMP1 Is Taken up into Intestinal Cells but Does Not Alter P-Glycoprotein Expression and Activity.

Coconut antimicrobial peptide-1 (CnAMP1) is a naturally occurring bioactive peptide from green coconut water (Cocos nucifera L.). Although biological activities have been reported, the physiological relevance of these reports remains elusive as it is unknown if CnAMP1 is taken up into intestinal cells. To address this open question, we investigated the cytotoxicity of CnAMP1 in intestinal cells and its cellular uptake into human intestinal cells. Considering the importance of the P-glycoprotein (P-gp) to the intestinal metabolism of xenobiotics, we also investigated the influence of CnAMP1 on P-gp activity and expression. Both cell lines showed intracellular fluorescence after incubation with fluorescein labelled CnAMP1, indicating cellular uptake of the intact or fragmented peptide. CnAMP1 (12.5-400 µmol/L) showed no signs of cytotoxicity in LS180 and differentiated Caco-2 cells and did not affect P-gp expression and activity. Further research is required to investigate the identity of CnAMP1 hydrolysis fragments and their potential biological activities.

Development and validation of a rapid reversed-phase liquid chromatography method for CnAMP1 peptide quantification in human intestinal cell lines.

Plant foods are rich sources of biologically active peptides that may have a role in the prevention of diseases. Coconut water is a valuable beverage due to its nutrient composition and the presence of bioactive compounds, such as the peptide CnAMP1. It is unknown if CnAMP1 can be absorbed into intestinal cells. We, therefore, aimed to develop and validate a simple reversed-phase liquid chromatographic method to quantify the peptide in Caco-2 and LS180 cell lysates. CnAMP1 standards (1-200 µmol/L) and spiked cell lysates were injected onto a Reprosil-Pur 120 C18-AQ column (4.6 × 250 mm) using acetonitrile:water:trifluoroacetic acid (14.0:85.9:0.1, by volume) as mobile phase in isocratic mode at flow rate of 1 mL/min. The method achieved rapid separation (total run time of 6 min), with linear response, good sensitivity (limit of detection, 8.2 ng; lower limit of quantification, 30.6 ng) and no interfering peaks. Best recoveries (84-96%), accuracies (7.6-14.8%) and precision (1.5-8%) were found for LS180 cell lysates spiked with medium (50 µmol/L) and high (100 µmol/L) amounts of the peptide. Uptake assays detected no peptides in the cell lysates; however, after the first 15-min incubation CnAMP1 underwent partial hydrolysis upon incubation with LS180 cells (29%) and extensive hydrolysis with Caco-2 cells (93%).

Effects of probiotics on the lipid profile: systematic review.

Alterations in the intestinal microbiota can modulate mechanisms involving risk factors for cardiovascular diseases, including dyslipidemias The objective was to review the effects of probiotic supplementation on the prevention and treatment of changes to the lipid profile. The searches were run on the PubMed database, using the descriptors "probiotics and lipid profile" and "probiotics and dyslipidemia," with publication dates restricted to 2013 to 2018. Supplementation with probiotics significantly reduced total cholesterol, LDL-c, and triglycerides and increased HDL-c. Some benefits were observed on anthropometric variables, glycemic control, oxidative stress, inflammation, and immune system. The present study suggests that probiotic supplementation should be indicated as adjunctive treatment for dyslipidemias. Further studies should be developed to clarify long-term effects, as well as the influence of probiotics in combination with drug therapy.

Evidence-informed frameworks for cost-effective cancer care and prevention in low, middle, and high-income countries.

Evidence-informed frameworks for cost-effective cancer prevention and management are essential for delivering equitable outcomes and tackling the growing burden of cancer in all resource settings. Evidence can help address the demand side pressures (ie, pressures exerted by people who need care) faced by economies with high, middle, and low incomes, particularly in the context of transitioning towards (or sustaining) universal health-care coverage. Strong systems, as opposed to technology-based solutions, can drive the development and implementation of evidence-informed frameworks for prevention and management of cancer in an equitable and affordable way. For this to succeed, different stakeholders-including national governments, global donors, the commercial sector, and service delivery institutions-must work together to address the growing burden of cancer across economies of low, middle, and high income.

Lectin of Abelmoschus esculentus (okra) promotes selective antitumor effects in human breast cancer cells.

The anti-tumor effects of a newly-discovered lectin, isolated from okra, Abelmoschus esculentus (AEL), were investigated in human breast cancer (MCF7) and skin fibroblast (CCD-1059 sk) cells. AEL induced significant cell growth inhibition (63 %) in MCF7 cells. The expression of pro-apoptotic caspase-3, caspase-9, and p21 genes was increased in MCF7 cells treated with AEL, compared to those treated with controls. In addition, AEL treatment increased the Bax/Bcl-2 ratio in MCF7 cells. Flow cytometry also indicated that cell death (72 %) predominantly occurred through apoptosis. Thus, AEL in its native form promotes selective antitumor effects in human breast cancer cells and may represent a potential therapeutic to combat human breast cancer.

Coal fly ash ceramics: preparation, characterization, and use in the hydrolysis of sucrose.

Coal ash is a byproduct of mineral coal combustion in thermal power plants. This residue is responsible for many environmental problems because it pollutes soil, water, and air. Thus, it is important to find ways to reuse it. In this study, coal fly ash, obtained from the Presidente Médici Thermal Power Plant, was utilized in the preparation of ceramic supports for the immobilization of the enzyme invertase and subsequent hydrolysis of sucrose. Coal fly ash supports were prepared at several compaction pressures (63.66-318.30 MPa) and sintered at 1200°C for 4 h. Mineralogical composition (by X-ray diffraction) and surface area were studied. The ceramic prepared with 318.30 MPa presented the highest surface area (35 m(2)/g) and amount of immobilized enzyme per g of support (76.6 mg/g). In assays involving sucrose inversion, it showed a high degree of hydrolysis (around 81%) even after nine reuses and 30 days' storage. Therefore, coal fly ash ceramics were demonstrated to be a promising biotechnological alternative as an immobilization support for the hydrolysis of sucrose.

Marine sponge lectins: actual status on properties and biological activities.

Marine sponges are primitive metazoans that produce a wide variety of molecules that protect them against predators. In studies that search for bioactive molecules, these marine invertebrates stand out as promising sources of new biologically-active molecules, many of which are still unknown or little studied; thus being an unexplored biotechnological resource of high added value. Among these molecules, lectins are proteins that reversibly bind to carbohydrates without modifying them. In this review, various structural features and biological activities of lectins derived from marine sponges so far described in the scientific literature are discussed. From the results found in the literature, it could be concluded that lectins derived from marine sponges are structurally diverse proteins with great potential for application in the production of biopharmaceuticals, especially as antibacterial and antitumor agents.

The Health Economic-Industrial Complex (HEIC): a strategic area for both the modernization of the Unified Health System (SUS) and the creation of future jobs. / O Complexo Econômico-Industrial da Saúde (CEIS) como espaço estratégico para a modernização do SUS e para a geração dos empregos do futuro.

This article presents the initial results of the ongoing research on the new world of healthcare work in the context of the 4th Technological Revolution. In addition to identifying the profile and volume of employment generated by health activities in Brazil, this investigation also analyzes the main transformations in the world of work and employment caused by new technologies and their potential impacts upon the field of the Health Economic-Industrial Complex (HEIC). The methodology seeks to contribute to a new vision of health professionals, which includes not only the employment profile with its technological content, but also the professionals directly and indirectly assigned to HEIC. Applying this methodology to the databases of RAIS and Continuous PNAD from 2012 to 2019, reveals HEIC's high capacity to generate good jobs, even in a context of economic crisis. The health labor market, both for its scale, complexity, and diversity, and for its dynamism and potential in terms of the incidence of 4.0 technologies, indicates that the development of HEIC can become the engine of the country's development, associating innovation and production with the modernization of the Unified Health System (SUS) and the generation of good jobs.

Esse artigo apresenta os primeiros resultados da pesquisa sobre o novo mundo do trabalho da saúde no contexto da revolução 4.0 que buscou, além de identificar o perfil e o volume de emprego gerado pelas atividades de saúde no Brasil, analisar as principais transformações no mundo do trabalho e do emprego provocadas pelas novas tecnologias e seus potenciais efeitos no âmbito do Complexo Econômico-Industrial da Saúde (CEIS). A metodologia busca contribuir para uma nova visão dos profissionais de saúde, pois além de caracterizar o perfil ocupacional, incluindo seu conteúdo tecnológico, incorpora profissionais alocados, direta e indiretamente, no CEIS. Os resultados apresentados, fruto da aplicação da metodologia nas bases de dados da RAIS e da PNAD Contínua, para os anos entre 2012 e 2019, revelam a elevada capacidade de geração de bons empregos no CEIS, mesmo em contexto de crise econômica. O mercado de trabalho em saúde, tanto por sua escala, complexidade e diversidade, quanto por seu dinamismo e potencial em termos de incidência das tecnologias 4.0, indica que o desenvolvimento do CEIS pode se constituir em motor do desenvolvimento do país, associando inovação e produção à modernização do Sistema Único de Saúde (SUS) e à geração de bons empregos.

Spectroscopic and thermooxidative analysis of organic okra oil and seeds from Abelmoschus esculentus.

With changes in human consumption from animal fats to vegetable oils, the search for seed types, often from unconventional vegetable sources has grown. Research on the chemical composition of both seed and oil for Brazilian Okra in South America is still incipient. In this study, flour and oil from organic Okra seeds (Abelmoschus esculentus L Moench), grown in northeastern Brazil were analyzed. Similar to Okra varieties from the Middle East and Central America, Brazilian Okra has significant amounts of protein (22.14%), lipids (14.01%), and high amounts of unsaturated lipids (66.32%), especially the oleic (20.38%) and linoleic acids (44.48%). Oil analysis through PDSC revealed an oxidation temperature of 175.2 °C, which in combination with low amounts of peroxide, demonstrates its resistance to oxidation and favors its use for human consumption.

Antinociceptive and anti-inflammatory effects of a lectin-like substance from Clitoria fairchildiana R. Howard seeds.

Lectins are proteins that have the ability to bind specifically and reversibly to carbohydrates and glycoconjugates, without altering the structure of the glycosyl ligand. They are found in organisms such as viruses, plants and humans, and they have been shown to possess important biological activities. The objective of this study was to purify and characterize lectins in the seeds of Clitoria fairchildiana, as well as to verify their biological activities. The results indicated the presence of a lectin (CFAL) in the glutelin acid protein fraction, which agglutinated native rabbit erythrocytes. CFAL was purified by column chromatography ion-exchange, DEAE-Sephacel, which was obtained from a peak of protein retained in the matrix by applying 0.5 M NaCl using the step-wise method. Electrophoretic analysis of this lectin in SDS-PAGE indicated a two band pattern protein molecular mass of approximately 100 and 116 kDa. CFAL proved to be unspecific to all carbohydrates/glycoconjugates in common use for the sugar inhibition test. This lectin showed no significant cytotoxicity to human red blood cells. It was observed that CFAL has anti-inflammatory activity in the paw edema induced by carrageenan model, in which a 64% diminution in edema was observed. Antinociceptive effects were observed for CFAL in the abdominal writhing test (induced by acetic acid), in which increasing doses of the lectin caused reduction in the number of contortions by up to 72%. It was concluded that the purified and characterized lectin from the seeds of Clitoria fairchildiana has anti-inflammatory and antinociceptive activity, and is not cytotoxic to human erythrocytes.

[Health Economic-Industrial Complex: the economic and material basis of the Brazilian Unified National Health System]. / Complexo Econômico-Industrial da Saúde: a base econômica e material do Sistema Único de Saúde.

The article aims to make a theoretical and political discussion of the concept of the Health Economic-Industrial Complex (CEIS), updating the concept to a contemporary context of technological transformation and of challenges for universal health systems, particular the Brazilian Unified National Health System (SUS). In a context of asymmetric globalization, of emergence of a technological revolution, and of the (re)placement of structural barriers that keeps Brazilian society in its historical movement of inequality, vulnerability, and exclusion, we need to rethink healthcare by resuming and updating an agenda that privileges the historical-structural factors of Brazilian society, the international insertion of the country, and its relationship with an extremely asymmetric diffusion of technical progress, knowledge, and learning, dissociated from local social and environmental needs. With a methodology that involves the analysis of the brazilian response to COVID-19, the commercial balance of the CEIS, and the access to COVID-19 vaccines, the study shows that health is a central part of the economic and social structure and reproduces the characteristics of the national development pattern within it. An equitable society, with quality of life, committed to social rights and the environment is structurally conditioned by the existence of an economic and material basis that supports it. This systemic and dialectical view is the main theoretical and political contribution intended by our study, which seeks to contribute to a collective health approach integrated with a political economy view.

O artigo tem como objetivo fazer uma discussão teórica e política do conceito do Complexo Econômico-Industrial da Saúde (CEIS), atualizando a visão para o contexto contemporâneo de transformação tecnológica e dos desafios para os sistemas universais de saúde e do Sistema Único de Saúde (SUS), em particular. Em um contexto de globalização assimétrica, de emergência de uma revolução tecnológica e de (re)colocação de barreiras estruturais que trancam a sociedade brasileira em seu movimento histórico de desigualdade, vulnerabilidade e exclusão, necessitamos repensar a saúde, retomando e atualizando uma agenda que privilegia os fatores histórico-estruturais da sociedade brasileira, a inserção internacional do País e sua relação com uma difusão extremamente assimétrica do progresso técnico, do conhecimento e do aprendizado, dissociados das necessidades sociais e ambientais locais. Mediante uma metodologia que envolve a análise da resposta brasileira à COVID-19, da balança comercial do CEIS e do acesso a vacinas para COVID-19, o artigo evidencia que a saúde é parte central da estrutura econômica e social e reproduz as características do padrão de desenvolvimento nacional em seu interior. Uma sociedade equânime, com qualidade de vida, comprometida com os direitos sociais e o meio ambiente é condicionada pela existência de uma base econômica e material que lhe dê sustentação. Essa visão sistêmica e dialética é a principal contribuição teórica e política pretendida pelo artigo, que procura contribuir para uma abordagem de saúde coletiva integrada com uma visão de economia política.

Este artículo tiene como objetivo plantear una discusión teórica y política del concepto de Complejo Económico-Industrial de la Salud (CEIS), actualizando la visión para el contexto contemporáneo de transformación tecnológica y de los desafíos para los sistemas universales de salud y el Sistema Único de Salud (SUS), en particular. En un contexto de globalización asimétrica, de emergencia de una revolución tecnológica y de (re)colocación de barreras estructurales que encierran a la sociedad brasileña en su movimiento histórico de desigualdad, vulnerabilidad y exclusión, necesitamos repensar la salud, retomando y actualizando una agenda que privilegia los factores histórico-estructurales de la sociedad brasileña, la inserción internacional del País y su relación con una difusión extremadamente asimétrica del progreso técnico, del conocimiento y del aprendizaje, disociados de las necesidades sociales y ambientales locales. Por medio de una metodología que implica el análisis de la respuesta brasileña a la COVID-19, la balanza comercial del CEIS y el acceso a las vacunas contra la COVID-19, este artículo pone de manifiesto que la salud es parte central de la estructura económica y social y reproduce las características del estándar de desarrollo nacional en su interior. Una sociedad equitativa, con calidad de vida, comprometida con los derechos sociales y el medio ambiente está condicionada estructuralmente por la existencia de una base económica y material que la sustente. Esta visión sistémica y dialéctica es el principal aporte teórico y político pretendido por el artículo, que busca contribuir a un abordaje de la salud colectiva integrado con una visión de economía política.

Fulfillment of the brazilian agenda of priorities in health research.

This commentary describes how the Brazilian Ministry of Health's (MoH) research support policy fulfilled the National Agenda of Priorities in Health Research (NAPHR). In 2003, the MoH started a democratic process in order to establish a priority agenda in health research involving investigators, health managers and community leaders. The Agenda was launched in 2004 and is guiding budget allocations in an attempt to reduce the gap between scientific knowledge and health practice and activities, aiming to contribute to improving Brazilian quality of life. Many strategies were developed, for instance: Cooperation Agreements between the Ministry of Health and the Ministry of Science and Technology; the decentralization of research support at state levels with the participation of local Health Secretariats and Science and Technology Institutions; Health Technology Assessment; innovation in neglected diseases; research networks and multicenter studies in adult, women's and children's health; cardiovascular risk in adolescents; clinical research and stem cell therapy. The budget allocated by the Ministry of Health and partners was expressive: US$419 million to support almost 3,600 projects. The three sub-agenda with the higher proportion of resources were "industrial health complex", "clinical research" and "communicable diseases", which are considered strategic for innovation and national development. The Southeast region conducted 40.5% of all projects and detained 59.7% of the resources, attributable to the concentration of the most traditional health research institutes and universities in the states of São Paulo and Rio de Janeiro. The second most granted region was the Northeast, which reflects the result of a governmental policy to integrate and modernize this densely populated area and the poorest region in the country. Although Brazil began the design and implementation of the NAPHR in 2003, it has done so in accordance with the 'good practice principles' recently published: inclusive process, information gathering, careful planning and funding policy, transparency and internal evaluation (an external independent evaluation is underway). The effort in guiding the health research policy has achieved and legitimated an unprecedented developmental spurt to support strategic health research. We believe this experience is valuable and applicable to other countries, but different settings and local political circumstances will determine the best course of action to follow.

[Vulnerabilities of Brazil's domestic pharmaceutical and biotech industry in the context of the COVID-19 pandemic]. / Vulnerabilidades das indústrias nacionais de medicamentos e produtos biotecnológicos no contexto da pandemia de COVID-19.

During a pandemic, economic, technological, and health systems' vulnerability become even more evident. A key challenge in Brazil is to control the trade deficit and difficulty in access to medicines and health products, even their development. Brazil's heavy external dependency on health inputs and products is one of the negative factors in confronting the global health emergency caused by SARS-CoV-2. The article aimed to discuss the vulnerabilities of the domestic chemical and biotechnological subsystem in the face of the current pandemic, with a focus on the pharmaceutical and biotech industry and the linkage between the fields of health and political economics. A qualitative study was performed with a literature review and analysis of secondary data as the methodological procedures. The results revealed low investment in public health, low innovation capacity, the pharmaceutical industry's profile, external dependency, currency exchange policy, patents, and other factors, demonstrating the major vulnerability in innovation and technology in the domestic pharmaceutical and biotech industry and the essential nature of linkage between various fields, especially health and the economy, for the incorporation of a systemic vision that creates the conditions to reduce vulnerabilities in the response to the pandemic and promote a development project for the country.

Em tempos de pandemia, a vulnerabilidade econômica, tecnológica e dos sistemas de saúde fica ainda mais exposta. No Brasil, os maiores desafios são o controle do déficit da balança comercial e a dificuldade de acesso a medicamentos e produtos da saúde ou até mesmo de seu desenvolvimento. A forte dependência externa de insumos e produtos para a saúde é um dos fatores negativos do país no enfrentamento da emergência sanitária mundial ocasionada pelo novo coronavírus SARS-CoV-2. Nesse contexto, o artigo procurou discutir as vulnerabilidades do subsistema de base química e biotecnológica nacional diante da atual pandemia, tendo como foco a indústria de medicamentos e de produtos biotecnológicos e a articulação entre os campos da saúde e da economia política. Realizou-se pesquisa qualitativa, utilizando, como procedimentos metodológicos, revisão bibliográfica e análise de dados secundários. Os resultados encontrados, relacionados a baixo investimento em saúde pública, baixa capacidade de inovação, perfil da indústria farmacêutica, dependência externa, política cambial, patentes, entre outros, demonstram a grande fragilidade inovativa e tecnológica da indústria de medicamentos e produtos biotecnológicos e a essencialidade de articulação entre diversos campos, em especial, da saúde e da economia, para incorporação de uma visão sistêmica, que crie condições para redução das vulnerabilidades, no que tange ao enfrentamento da pandemia, e equacione um projeto de desenvolvimento para o país.

En tiempos de pandemia, la vulnerabilidad económica, tecnológica y de los sistemas de salud queda aún más expuesta. En Brasil, uno de los mayores desafíos es el control del déficit de la balanza comercial, así como la dificultad de acceso a medicamentos y produtos de salud o incluso de su desarrollo. La fuerte dependencia externa de insumos y productos para la salud es uno de los factores negativos del país en el combate a la emergencia sanitaria mundial, ocasionada por el nuevo coronavirus SARS-CoV-2. En este contexto, el artículo procuró discutir las vulnerabilidades del subsistema de base química y biotecnológica nacional ante la actual pandemia, poniendo el foco en la industria de medicamentos y de productos biotecnológicos, así como la coordinación entre los campos de la salud y economía política. Se realizó una investigación cualitativa, utilizando como procedimientos metodológicos la revisión bibliográfica y el análisis de datos secundarios. Los resultados hallados, relacionados con la baja inversión en salud pública, baja capacidad de innovación, perfil de la industria farmacéutica, dependencia externa, política de cambio, patentes, entre otros, demuestra la gran fragilidad innovadora y tecnológica de la industria de medicamentos, así como de productos biotecnológicos, y la necesidad de una coordinación entre diversas áreas, en especial, de la salud y economía, para que se incorpore una visión sistémica, que cree condiciones para la reducción de las vulnerabilidades, en lo que atañe al combate de la pandemia y que cree un proyecto equilibrado de desarrollo para el país.

Identification of bioactive peptides released from in vitro gastrointestinal digestion of yam proteins (Dioscorea cayennensis).

Bioactive peptides have been broadly studied for their contribution to human health. This study aimed to identify bioactive peptides generated by in vitro gastrointestinal digestion of yam proteins. Yam protein concentrate (YPC) was submitted to simulated digestion. Gastric phase hydrolysate (GPH) and total gastrointestinal phase hydrolysate (GIPH) had their peptides identified by nanoLC-ESI-MS/MS. Peptide sequences were subjected to a database-driven (BIOPEP) bioactivity search. In vitro tests included: Antioxidant activity, DNA damage protection, ACE-inhibitory activity and antibacterial activity against the bacteria Escherichia coli, Salmonella sp. and Lysteria monocytogenes. Simulated digestion generated small peptides (mostly MW < 3500 Da), several of them with potential bioactive sequences predicted in silico. In both GPH and GIPH biological activities were detected, although GIPH displayed stronger DNA damage protection and antibacterial activity against Escherichia coli. The digestion of yam proteins releases promising biologically active peptides which can contribute to the prevention of bacterial infection and chronic degenerative diseases, with beneficial effects to human health.

Healthcare telemonitoring and business dynamics: challenges and opportunities for SUS.

OBJECTIVE: To point out challenges and opportunities for the Brazilian Unified Health System (SUS) with the use of telemonitoring to face the increasing costs of non-communicable chronic diseases, based on its general panorama in Brazil, business dynamics and reapplication of data from American studies. METHODS: Quali-quantitative approach with exploratory research. The field work focused on the analysis of the national market from private companies, since no experiences or studies related to this theme were identified in the SUS. To analyze the panorama and market dynamics, we investigated the offer of this technology based on the products and services available and their demand by reference hospitals the ten largest private health plan companies. To support the central discussion, we analyzed the reduction of costs with hospital admissions by the SUS due to chronic non-communicable diseases sensitive to telemonitoring (HCDST), using data from Datasus and some American studies from the MEDLINE/PubMed database. RESULTS: Although in the embryonic phase, business agents search for new business opportunities, whereas public initiatives for the use of telemonitoring in collective health seem inexistent. The reapplication of U.S. data would reduce spending on HCDST and provide benefits, such as the reduction in emergency room care, acute hospitalizations, readmissions and home care time, among others, which point to even greater economic gains. CONCLUSIONS: The development of a major project to reduce HCDST using this technology has the potential to advance in a comprehensive network of primary care, contribute to a greater dynamism of the national productive and innovative base and induce innovations along the chain of this emerging industry.

Access to vaccines in Brazil and the global dynamics of the Health Economic-Industrial Complex. / Acesso a vacinas no Brasil no contexto da dinâmica global do Complexo Econômico-Industrial da Saúde.

This study analyzed the main economic trends, market structure, production, and innovation in vaccines against infectious diseases at the global and national levels, observing the effects on access to vaccination in Brazil and on the sustainability of the Brazilian Unified National Health System. In order to update a global overview of R&D and the market, the authors conducted a literature search and drew on a competitive intelligence database. In order to understand Brazil's role in this context, with the Health Economic-Industrial Complex as the structural focus, the authors accessed information from the Brazilian Health Regulatory Agency, the National Immunization Program, and the Questel Orbit Intelligence database on patent protection in Brazil; identified the technologies transferred to public institutions in Brazil; and analyzed the trend in the trade balance deficit in health. The analysis revealed a global trend of concentration of vaccine production in a few leading pharmaceutical companies and the exacerbation of economic and technological asymmetries in the vaccine sector. In Brazil, the study identified technological weaknesses, risks, and manufacturing bottlenecks that impact the guarantee of immunizations in the country and showed that despite the installed industrial base, public policies and actions by domestic manufacturers have not been sufficient to confront and overcome the global context of structural dependence. In conclusion, the study indicates the need for progress in the Brazilian national strategy to link domestic production, technological capacity-building, and innovation in the vaccine sector to help guarantee universal access to health in Brazil.