Brazil: Alison Fine
Class of 2013, Schulich School of Medicine and Dentistry
1. Which aspects of Pandemic Preparedness is most pertinent to your country and why?
Dengue is a concern in Brazil with 120 570 cases of dengue including 647 dengue haemorrhagic fever (DHF) cases, with 48 deaths by March 28, 2008. Separately the State of Rio de Janeiro reported 57 010 cases of dengue fever (DF) including 67 confirmed deaths and 58 deaths under investigation. The co-existence of serotypes DEN-3 and DEN2 in the State of Rio de Janeiro has caused an increase in severe dengue serotypes. In response the Ministry of Health is recruiting additional health professionals to the hospitals and public health and emergency services professional for community based interventions (mosquito control)
Yellow fever has caused 48 cases as of Feb 2008 and 13 deaths. In response to these cases Brazil has suspended exports of the vaccine and requested vaccine from the International Coordinating Group on Vaccine Provision for Yellow Fever Control (YF-ICG) in a vaccination campaign for 7 million people
Brasil has approximately 40% of the total number of the malaria cases in the Americas mainly based in the Legal Amazon Region, a sparsely populated area. Malaria cases have shown a downward trend due to urbanization and population migration. Control measures include Treatment and Diagnosis Guidelines, Monitoring anti malarial drug resistance, vector control with insecticides and insecticide treated mosquito nets.
In 2007 Brazil had 114,000 cases of TB and 92,000 new cases per year. Funding and DOTS expansion are addressing the control of TB however, rates of case detection and treatment success are below the global targets. 14% of the 72% of those with TB tested for HIV were positive and other vulnerable groups include indigenous populations and prisoners.
2. How would you as the WHO Ambassador of your country address this issue?
Access to vaccines is a concern for Brazil with an ongoing dengue epidemic. Development of a malaria and a new yellow fever vaccine also of interest. Brazil's major vaccine producer, the state-owned Oswaldo Cruz Foundation (known as Fiocruz), of Rio de Janeiro, has entered a tech transfer deal with London-based GlaxoSmithKline (GSK), to produce a pneumococcal vaccine as well as develop vaccines against dengue fever, yellow fever and malaria.
3. How has your country addressed Pandemics in the past? What would you have done
differently?
In 2009, the A/H1N1 flu virus sickened nearly 40,000 Brazilians, 1,705 of whom died. In March of 2010 the vaccination campaign will being to vaccinate 81 million people starting with at risk groups. The vaccines were produced by Brazil’s Butantan Institute, however 18 million doses of the vaccine will be imported. Continuing importation of vaccines is not feasible for Brazil due to many public health costs and a high level of poverty and improving vaccine manufacturing is a priority.
4. Which countries do you see yourself becoming allies or rivals with? Why?
Importation of vaccines to cover our manufacturing shortfalls needs to be addressed by an increase in our biotechnology capacity. Research, development and innovation is a governmental focus as well as export of immunobiologicals such as the yellow fever and the meningitis AC vaccines. Due to our recent technology transfer deal I envision allying myself with Great Britain. India is also a potential ally due to their past production of generic pharmaceuticals. Brazil’s poor delivery of health-care service can be addressed by partnering with Cuba, a historical trade partner, which has vastly increased its healthcare capacity.