From Bolsonaro to Lula: The opportunity to rebuild universal healthcare in Brazil in the government transition.

This paper takes the government transition that took place between 2022 and 2023 in Brazil as a case study and aims to analyse how a cycle of radical right-wing populist government acted to dismantle Brazil's national health system foundations. It describes how governance was built based on political-clientelism and market-privatising interests and on the adoption of long-term fiscal austerity policies, whose results are public defunding and weakening and disorganisation of the country's national health system, with a significant worsening of health indicators and the capacity to respond to the population health needs. The lessons from recent experience in Brazil should serve as learning and a source of academic and political reflection, since there is an ongoing international movement and signs of rise of radical right-wing populist regimes in several countries, which endanger the Democratic Rule of Law, institutions, and social policies. It allows putting into perspective how political cycles of this nature can affect national universal health systems, including those that have experienced substantial progress towards universal access and universal health coverage. Keeping in mind the Brazilian experience, it was possible to observe the progressive structuring of a radical right-wing neo-populism and in the sanitarian.

The history of Chagas disease: reflections on science in action.

Approaching from the perspective of the history and social studies of science, the article analyses some aspects of the early history of Chagas disease, from its discovery through initial research. It is our goal to show that historians of science can explore this topic as a way not only of remembering and narrating past events but also of examining the processes through which science is produced. To this end, we present five basic precepts that have guided historical and sociological studies of "science in action": science as a collective endeavor, as a social activity, as a set of practices, as a process that involves controversies, and as a formative process. By examining the topic in the light of these five points, we demonstrate how the history of this successful research tradition can lead us to broader reflections about the complex dynamics interweaving science and society.

Malaria as a disease and as a cultural perspective in Carlos Chagas' and Mário de Andrade's travels to the Amazon. / Malária como doença e perspectiva cultural nas viagens de Carlos Chagas e Mário de Andrade à Amazônia.

Two journeys have had an important bearing on social thought regarding the Amazon: Carlos Chagas', from 1912 to 1913, and Mário de Andrade's, in 1927. The article examines how their travel experiences influenced these two men's views and interpretations of the relation between malaria and the project to bring civilization to the tropics. In Chagas' texts, wonderment is the category that organizes his perception of the Amazon region, evinced in the idea that the pathology of the tropics challenges established knowledge of the disease. Empathy, on the other hand, is the explanatory key to understanding Mário de Andrade's critical outlook, which entails the valorization of forms of sociability, beliefs, and popular manifestations in the region, including those related to malaria.

Safeguarding people living in vulnerable conditions in the COVID-19 era through universal health coverage and social protection.

The COVID-19 pandemic is unprecedented. The pandemic not only induced a public health crisis, but has led to severe economic, social, and educational crises. Across economies and societies, the distributional consequences of the pandemic have been uneven. Among groups living in vulnerable conditions, the pandemic substantially magnified the inequality gaps, with possible negative implications for these individuals' long-term physical, socioeconomic, and mental wellbeing. This Viewpoint proposes priority, programmatic, and policy recommendations that governments, resource partners, and relevant stakeholders should consider in formulating medium-term to long-term strategies for preventing the spread of COVID-19, addressing the virus's impacts, and decreasing health inequalities. The world is at a never more crucial moment, requiring collaboration and cooperation from all sectors to mitigate the inequality gaps and improve people's health and wellbeing with universal health coverage and social protection, in addition to implementation of the health in all policies approach.

An analysis of actions taken by Fundação Oswaldo Cruz for the communication and popularization of science. / Uma análise das ações de divulgação e popularização da ciência na Fundação Oswaldo Cruz.

An analysis is presented of actions taken by the Brazilian research institution Fiocruz for the communication and popularization of science, from two perspectives. The aim was to investigate how a system for the communication and popularization of science is organized at a large scientific institution and how it is articulated with the institutional discourse. A brief review is presented of how the topic has developed over the history of Fiocruz, followed by a discussion of the way it has been addressed in its official planning documents. The science communication/popularization actions undertaken in 2015 and 2016 were mapped out and classified according to how they interact with the public, giving a better understanding of this area.

Neste trabalho apresentamos uma análise das ações de divulgação e popularização da ciência na Fiocruz a partir de duas perspectivas. O estudo tem por objetivo investigar como se organiza um sistema de divulgação e popularização da ciência em uma instituição científica de grande porte e como esse sistema se articula com seu discurso institucional. Além de fazer uma breve revisão da evolução do tema na história da Fiocruz, realizamos um levantamento de como o mesmo tem sido tratado nos documentos oficiais de planejamento. Com o mapeamento das ações realizadas em 2015 e 2016, foi possível compreender melhor esse universo e classificá-lo de acordo com suas características junto ao público.

Overview of snakebite in Brazil: Possible drivers and a tool for risk mapping.

Snakebite envenoming affects close to 2.7 million people globally every year. In Brazil, snakebites are reported to the Ministry of Health surveillance system and cases receive antivenom free of charge. There is an urgent need to identify higher risk areas for antivenom distribution, and to develop prevention activities. The objective of this study is to provide an overview of the epidemiological situation of snakebite envenoming in Brazil and explore possible drivers; as well as to create a flowchart tool to support decision-makers identify higher risk areas. An ecological-type study was carried out using data by municipality (2013-2017). Study parts: 1) Create a geocoded database and perform a descriptive and cluster analysis; 2) Statistical analysis to measure the association of snakebite and possible environmental and socioeconomic drivers; 3) Develop a flowchart to support decision-makers and the application of this tool in one state (Rio Grande do Sul) as an example. An average of 27,120 snakebite cases per year were reported at the country level. Clusters of municipalities with high numbers of snakebites are mostly found in the Amazon Legal Region. The negative binomial regression model showed association with the snakebite case count: the type of major habitat, tropical or non-tropical; temperature; percentage of urbanization; precipitation; elevation; GDP per capita; a weaker relation with forest loss; and with venomous snake richness. The state where the instrument was applied reported 4,227 snakebites in the period. Most municipalities were considered as medium risk and 56/496 as high risk according to the tool created. Snakebite cases are distributed across the entire country with the highest concentration in the Legal Amazon Region. This creates a complex situation both for better understanding of the association of environmental and socioeconomic factors with snakebites and for the distribution and maintenance of antivenom to remote areas. Research into types of antivenom with a longer shelf life without the need for refrigeration is needed.

[A Brazilian medical collection: Central Brazil in Arthur Neiva and Belisário Penna's scientific expedition and Julio Paternostro's voyage to Tocantins]. / Uma brasiliana médica: o Brasil Central na expedição científica de Arthur Neiva e Belisário Penna e na viagem ao Tocantins de Julio Paternostro.

The article addresses the role played within the social imaginary of Brazil by the scientific voyages of physicians in the first half of the twentieth century. Two texts are analyzed: a report by Arthur Neiva and Belisário Penna published in Memórias do Instituto Oswaldo Cruz and another by Julio Paternostro, released in 1945 in Viagem ao Tocantins. The former contributed to singling out pathology as defining mark of national identity during the First Republic (1899-1930), a fact that had repercussions in the following decades, as apparent in Paternostro's book, which at the time of its publication was presented as an indictment of national problems. These portraits of Brazil highlight as attributes of the country not only disease but also the geographic and, primarily, cultural distance separating the coast from the sertão.

Baixada Fluminense, in the shadow of the "Sphinx of Rio": popular movements and health policies in the wake of the SUS. / Na Baixada Fluminense, à sombra da 'Esfinge do Rio': lutas populares e políticas de saúde na alvorada do SUS.

This paper addresses the popular health movement in Nova Iguaçu-RJ in the 1970s and 1980s. Amidst political repression, residents organized themselves to find solutions to various problems, including health problems. Health demands are enhanced both by the dengue epidemic and linkages with the Brazilian health reform and a struggle for democracy. Using documental historical sources from newspapers, health dissemination papers and documents from the House of Oswaldo Cruz-Fiocruz collection, this paper concludes that the example of Nova Iguaçu reveals both the complexity of the process of political opening at the local level and efforts of conducting a health reform where it was needed the most. Resistance on the part of the medical corporation, private interests in health and the existence of a still incipient popular political organization and culture are some of the elements that account for the hardships in advancing the manifest wishes of policies. The specificities of local arenas also point to possible institutional arrangements, sometimes very peculiar and not reproducible in other settings.

O artigo revisita o movimento popular por saúde em Nova Iguaçu-RJ nas décadas de 1970 e 1980. Em meio à repressão política, moradores se organizaram para encontrar soluções para diversos problemas, entre eles os da saúde. A luta pela saúde se potencializa tanto pela epidemia de dengue quanto pelas conexões com a reforma sanitária brasileira e pela democracia. Com apoio de fontes documentais provenientes de jornais diários, artigos de divulgação em saúde e do acervo da Casa de Oswaldo Cruz-Fiocruz, o artigo conclui que o exemplo de Nova Iguaçu é revelador tanto acerca da complexidade do processo de abertura política em âmbito local quanto dos esforços de condução de uma reforma sanitária onde ela se fazia mais necessária. A resistência de parte da corporação médica, os interesses privados na saúde, a existência de uma cultura política popular ainda incipiente e um associativismo em formação são alguns dos elementos que dão conta das dificuldades em se fazer avançar os anseios manifestos no plano das políticas. As especificidades das arenas locais, também apontam para as possibilidades de arranjos institucionais, por vezes, muito peculiares e não reproduzíveis em outros cenários.

For socially engaged science: The dynamics of knowledge production in the Fiocruz graduate program in the framework of the "Brazil Without Extreme Poverty Plan".

Public policy planning associated with the management of the Science, Technology, and Innovation is decisive to improve public health. It is important to develop novel strategies to plan, supervise, manage, use and evaluate research using indicators that extrapolates metrics in current use. In 2011, the Brazilian government introduced the Brazil Without Extreme Poverty plan (BWEP) that aimed to integrate several conditional cash transfer programs (CCT). The original that aimed to integrate of the CCTs were expanded in order to integrate social justice and dignity that induced several actions towards the promotion of social development of the beneficiaries. An induced action involved a partnership between BWEP (From the Ministry of Social Development), CAPES (Brazilian Higher Education Agency) and The Oswaldo Cruz Foundation (FIOCRUZ, a Public Health Institution), that dedicated scholarships for PhD and postdoc students committed to the BWEP to promote health research in its multiple approaches and the vulnerable associated population. Using the Social Studies of Science and Technology (SSST) framework, this paper analyzes the dynamics of knowledge production in the context of program implementation. Herein, we report on the follow-up activities performed in BWEP Health Action, directing research projects to align with the goals of the program, evaluating the progress of these research, and defining strategies for improved their management. We analyze the advances and difficulties encountered in the implementation, monitoring and evaluation of this innovative program in the academic training level, and we emphasize the critical need to expand and improve similar initiatives aimed at guiding the scientific and technological production in health to meet the social demands.

Public health and social ideas in modern Brazil.

Public health in Brazil achieved remarkable development at the turn of the 20th century thanks in part to physicians and social thinkers who made it central to their proposals for "modernizing" the country. Public health was more than a set of medical and technical measures; it was fundamental to the project of nation building. I trace the interplay between public health and social ideas in the late 19th and early 20th centuries. Physicians and social thinkers challenged the traditional belief that Brazil's sociocultural and ethnic diversity was an obstacle to modernization, and they promoted public health as the best prescription for national unity. Public health ideas in developing countries such as Brazil may have a greater impact when they are intertwined with social thought and with the processes of nation building and construction of a modern society.

[Brazilian scientists visit the Amazon: The scientific journeys of Oswaldo Cruz and Carlos Chagas (1910-13)]. / Os cientistas brasileiros visitam a Amazônia: as viagens científicas de Oswaldo Cruz e Carlos Chagas (1910-1913).

The article analyzes reports from two scientific journeys into the Amazon conducted by the Instituto Oswaldo Cruz, in 1910 and 1913, under the leadership of Oswaldo Cruz and Carlos Chagas, respectively. These reports contributed to the construction of representations and images of the region. Field observations not only provided data for the study and control of tropical diseases but also had a hand in the movement to denounce the serious sanitation conditions under which rubber workers labored. Journeys through the Amazon valley put the scientists in direct contact with the environment and with sick populations; these travels also made them face the huge challenges of learning about malaria and trying to control it. Analyses of these reports are part of studies on 'portraits of Brazil', which raise issues within the history of public health policies. In this endeavor to reveal the process by which scientific records are constructed, we worked with primary sources,from manuscripts to official texts.

Pandemia e interdisciplinaridade: desafios para a saúde coletiva / Pandemic and interdisciplinarity: challenges for collective health

RESUMO Este artigo discute o papel da interdisciplinaridade na análise e no enfrentamento da crise sanitária e social global suscitada pela pandemia de Covid-19. Defende-se a necessidade de se repensarem as divisões entre mundo natural e sociedade, com destaque para a questão ambiental, e a nova conformação do campo da informação e comunicação e seus impactos na sociedade contemporânea. Entende-se a pandemia de Covid-19 como um fenômeno inteiramente novo que põe em evidência, por vezes em aceleração, uma série de tendências, mas que pode implicar inflexões e mudanças cujo rumo não está dado. Destaca-se a centralidade da área de saúde coletiva no esforço interdisciplinar para a definição de agendas científicas e, também, de propostas de políticas públicas. Conclui-se que o fortalecimento de pesquisas interdisciplinares especialmente atentas às interrelações de sistemas naturais e sociais são e serão essenciais para a superação da crise atual e das prováveis emergências sanitárias futuras.

ABSTRACT This article discusses the role of interdisciplinarity in analyzing and dealing with the global health and social crisis caused by the COVID-19 pandemic. It defends the need to rethink the divisions between the natural world and society, with emphasis on the environmental issue, and the new conformation of the field of information and communication and its impacts on contemporary society. The COVID 19 pandemic is understood as an entirely new phenomenon that highlights, sometimes accelerating, a series of trends, but which may imply inflections and changes whose direction is not given. The centrality of the field of collective health in the interdisciplinary effort to define scientific agendas and also public policy proposals is highlighted. It is concluded that the strengthening of interdisciplinary research, especially attentive to the interrelationships of natural and social systems, is and will be essential for overcoming the current crisis and probable future health emergencies.

The history of Chagas disease: reflections on science in action

Approaching from the perspective of the history and social studies of science, the article analyses some aspects of the early history of Chagas disease, from its discovery through initial research. It is our goal to show that historians of science can explore this topic as a way not only of remembering and narrating past events but also of examining the processes through which science is produced. To this end, we present five basic precepts that have guided historical and sociological studies of "science in action": science as a collective endeavor, as a social activity, as a set of practices, as a process that involves controversies, and as a formative process. By examining the topic in the light of these five points, we demonstrate how the history of this successful research tradition can lead us to broader reflections about the complex dynamics interweaving science and society.