Nigerian and Indonesian health ministers visit Fiocruz with focus on vaccines and dengue fever

The production of vaccines and diagnostic kits and the use of Wolbachia mosquitoes on a large scale were topics that led to the visit of the Nigerian and Indonesian Health ministers to Fiocruz on 2/8. With different agendas, they visited the Manguinhos Campus in Rio de Janeiro at different times and took part in meetings with members of the Foundation's units.

The similarities in health challenges between countries and the process of developing immunobiologicals motivated the visit of the Minister of Health of Nigeria, Muhammad Ali Pate (photo: Pedro Paulo Gonçalves)

The similarities in the health challenges between the two countries and the development process to produce diagnostic kits, reagents, vaccines and other immunobiological products motivated the visit of the Nigerian Coordinating Minister of Health and Social Welfare, Muhammad Ali Pate, to Bio-Manguinhos. A physician and former Julio Frenk Professor of the Practice of Public Health Leadership in the Department of Global Health and Population at Harvard University, Pate had turned down taking up the appointment to become the chief executive of the Global Alliance for Vaccines and Immunizations (Gavi). He stressed that the COVID-19 pandemic has shown the importance of countries not relying solely on the foreign market, a perspective shared by the vice president of Education, Information, Education and Communication, Cristiani Machado.

"This is an important moment to exchange ideas. Both Brazil and Nigeria are populous countries, with many common problems and the need to strengthen the public health system," said Cristiani Machado.

With 213.4 million inhabitants, Nigeria has almost the same population as Brazil (214.3 million) – which makes it essential having a large-scale production. Minister Pate said that the country's production capacity for immunobiological was dwindling as it was difficult to compete with the price offered by the foreign market, but that in October last year, president Ahmed Bola Tinubu's government launched a program to foster the development of domestic production of vaccines, medicines and diagnostic kits. "We want to learn, and it is important to learn from Brazil. The United States has a very different context. We do not have 20 years for that. We want to know how you did it," said minister Pate.

"We want to learn, and it is important to learn from Brazil. The United States has a very different context. We do not have 20 years for that. We want to know how you did it," said Minister Pate (photo: Pedro Paulo Gonçalves)

Having been with Fiocruz for 50 years, senior scientific advisor Akira Homma, former president of the Foundation and director of Bio-Manguinhos, explained how this development came about, highlighting the need for a government policy to support the process. "There was an investment of millions of dollars, making it possible to transfer technology. Vaccine production takes five, six, eight years... You need to build facilities, train staff, bring in modern technology," he explained. "Companies invest billions of dollars. We invested millions of reais," he said.

As a doctor, the minister was concerned about the safety of the blood used in his country, hence his interest in blood analysis and diagnostic kits. Javan Esfandiari, president of Chembio Diagnostics Inc, Bio-Manguinhos' partner in the production of tests, highlighted how in-house production lowers product costs. At the meeting, the Nigerian minister learned a little more not only about Bio-Manguinhos' production, but also about the National Institute for Quality Control in Health (INCQS/Fiocruz) and its work with the Brazilian Health Regulatory Agency (Anvisa) and the Ministry of Health.

The meeting was attended by the Reagents directors, Antonio Ferreira and João Baccara; the Molecular Diagnostics specialist, Patrícia Alvarez; Rafael Alexandrino Macedo from the Reagents Department; the advisor to the Biological Production Directorate, Carla Wolanski; Maria Letícia Borges dos Santos, from the Business Development Division; Monique Costa Mattos, from the Commercial Division; and the Institutional Relations Coordinator, Denise Lobo; as well as the advisor to the Vice-Directorate for Diagnostic Reagents at Bio-Manguinhos, Christiane Marques; and the advisor to the Center for International Relations in Health (Cris/Fiocruz), Erika Kastrup. Long-standing partners Chembio Diagnostics Inc. also took part with Sales and Marketing Manager, Josué Juliatto, and Senior Technical Manager, Pedro Paulo Ribeiro.

The Nigerian delegation, aside the coordinating minister of Health and Social Welfare, also comprised the coordinator of the Presidential Initiative to Unlock the Healthcare Value Chain, Abdu Mukhtar; the technical advisor to the Ministry of Health, Mayowa Alade; and the senior special adviser to the Coordinating Minister on Strategic Communication, Stakeholder Engagement and Advocacy, Barrister Chinedu Moghalu, visited the IVD Reagents Facility and the Vaccine Technology Complex (CTV).

Application of Wolbachia in big cities

Also on Thursday, Fiocruz welcomed the Indonesian Minister of Health, Budi Gunadi Sadiki, and his delegation of health professionals and managers from the country, as well as the ambassador to Brazil, Edi Yusup. The group came to the Maré Campus (also in Rio de Janeiro) to learn more about the operation of the Wolbachia Project in Brazil, a method developed by the World Mosquito Program (WMP) that reduces the incidence of dengue, chikungunya and Zika and conducted in the country by Fiocruz. They also visited the Moorish Castle and met with representatives from Fiocruz at Bio-Manguinhos, on the Manguinhos Campus, where they generally talked about vaccine production.

The vice-president of Research and Biological Collections, Maria de Lourdes Oliveira, received the Indonesian Health Minister, Budi Gunadi Sadiki (photo: Peter Ilicciev)

Indonesia recently implemented the Wolbachia method. According to the minister, the visit to Fiocruz will be important for gathering information to help expand the project in the region. During a presentation on the initiative by the coordinator in Brazil, Fiocruz researcher Luciano Moreira, the minister asked about the challenges of implementation, costs, results and integration with other methods of prevention and control of arboviruses in cities with high populations, such as Rio de Janeiro.

"We've just implemented Wolbachia in five cities, but not in municipalities as large as Rio de Janeiro did. When we heard that Fiocruz was conducting the method in big cities like Rio, we were curious to know how they produce mosquitoes, how they convince people... and we were able to learn a lot today," commented minister Sadiki.

Among the areas of interest cited by the group are also tackling malaria and tuberculosis. The minister recalled that, together with Brazil's Health minister, Nísia Trindade Lima, he is a member of the Tuberculosis Vaccine Accelerator Council, created by the World Health Organization (WHO) in 2023 to facilitate the licensing and use of new and effective vaccines against the disease.

Visit to Fiocruz will be important to gather information that helps in the territorial expansion of the Wolbachia Project in the country (photo: Peter Ilicciev)

In 2022, Fiocruz took part in a hybrid meeting of the G20 Health during Indonesia's presidency of the bloc, the theme of which was Lesson learned from Fiocruz’s VTD on ensuring sustainable research and manufacturing activities. On this occasion, Marco Krieger, vice president of Production and Innovation at Fiocruz, made the presentation with the support of the Special Advisory on International Affairs (Aisa) of the Ministry of Health and Cris/Fiocruz.

The day before, Minister Nísia Trindade and Minister Sadikin signed a memorandum of understanding aimed at establishing cooperation in the field of health. The aim is to strengthen a partnership with a special focus on the themes of health services; health resilience, including emergencies and the safety of pharmaceutical and medical devices; human resources in health; and technology, including digital health and biotechnology, among others.