Access to vaccines in Brazil and the global dynamics of the Health Economic-Industrial Complex

Abstract

Os autores agradecem a Marco Nascimento, Leandro Safatle e Felipe Kamia (Coordenação das Ações de Prospecção e Grupo de Pesquisa sobre Desenvolvimento, Complexo Econômico-Industrial e Inovação em Saúde/Fiocruz), pelas sugestões sobre a análise e os levantamentos efetuados. Também à Leila Longa (Coordenação de Gestão Tecnológica/ Fiocruz), à Fabrícia Pimenta (Centro de Desenvolvimento Tecnológico em Saúde/Fiocruz), e aos profissionais do PNI/Ministério da Saúde pelas suas valorosas contribuições no levantamento de informações em suas respectivas áreas de atuação. Este artigo contou com suporte financeiro do Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq), bolsa de produtividade de pesquisa de C. A. G. Gadelha. 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.