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Fiocruz turns 120 years facing the biggest challenge of the 21st century


Ricardo Valverde


Fiocruz celebrates its 120th anniversary this Monday, May 25. The date comes right when Brazil and the world are facing the biggest public health, economical, social, humanitarian and political challenge of the 21st century: the Covid-19 pandemic. The institution was founded with the name Instituto Soroterápico Federal [Federal Soroterapic Institute], with the purpose of fighting epidemics such as the bubonic plague, yellow fever, and small pox, which threatened Rio de Janeiro, then capital of the Republic. More than a century later, now in the midst of the new coronavirus pandemic, the current Oswaldo Cruz Foundation, the largest institution of biomedical research in Latin America, continues to be in the frontline against diseases.

The castle, built in mourish style, is Fiocruz main simbol. Photo: André Az.

Fiocruz president, Nísia Trindade Lima, states that “the Foundation, which is present in all Brazilian regions, has been committed day and night to presenting proposals and solutions, elaborating research that can answer to questions still without answers, formulating and implanting strategic actions of health care and promotion, such as the construction of the Hospital Center for the Covid-19 Pandemic, a reference action with the Ministry of Health, among many other initiatives”. She adds that “now that it is turning 120 years, Fiocruz strengthens its compromise with SUS [the Brazilian Public Health Service], this great fortress Brazil has at the moment, and which needs to be reinforced. Fiocruz also strengthens its committment to actions that focuse on the safeguarding the life of the population”.

Lima reminds us that “since the early 20th century and the great work carried out by Oswaldo Cruz, Carlos Chagas and many other scientists, who faced the epidemics of the time and the conditions that were then called “sertão diseases”, the diseases found in the Brazilian hinterland, such as Chagas disease, our institution is part of the country’s heritage, as it reveals the value of science dedicated to solving the great questions of the life of Brazilians. And not only of Brazilians, once the Foundation has international cooperation and reach, including in projects related to the new coronavirus pandemic”.

Lima highlights that the disease is not the same everywhere. “In Brazil, the biggest challenge is represented by the social inequality expressed by a wide range of indicators: high rates of unemployment and informal jobs, precarious living conditions, no access to basic sanitation. Add to these the high prevalence of chronic diseases among people above 18 years old, representing risk factors for one third of the adult population and the consequent high rates of Covid-19 among the youth. Last but not least, there are also many regional inequalities, especially when it comes to the number of intensive care beds”. For Lima, “this moment needs solidarity, active society participation, and strong State presence. Saving lives, strengthening the SUS and, as part of it, the Health Economic and Industrial Complex, are the challenges faced by the institution and by Brazilian society’’.

According to the president,this capacity for technological development and innovation is what allows Fiocruz to have, for instance, a scientific basis in molecular tests for diagnosis, which will give Fiocruz the condition to produce 11.6 million molecular tests by September and to contribute to speed up the processing of sample analysis via testing centrals, to provide support to the central laboratory of each state.

Among the Foundation’s actions in the fight against the new coronavirus is the already mentioned Hospital Center for the Covid-19 Pandemic, integrated to the National Institute for Infectious Diseases Evandro Chagas (INI/Fiocruz), which will have 195 hospital beds, 120 of which dedicated to intensive care and 75 to semi-intensive care, to treat patients with severe cases of infection by SARS-Covid-19 in Rio de Janeiro. Another important action is the Solidarity global clinical trial, coordinated by Fiocruz in Brazil in a partnership with the World Health Organization (WHO). The study forecasts an 80% reduction of the time necessary to generate evidence on possible treatments, and involves 18 hospitals in 12 different states in Brazil. The purpose of the study is to provide a quick answer on which drugs are effective against the Covid-19 and which ones are inneffective and should not be used.

In addition, other important initiatives in the context of the pandemic are projects in the field of vaccines, as the Bio-Manguinhos/Fiocruz (Institute of Technologyh in Immunobiologicals) has been prospecting potential partnerships based on the technological skills of the candidates. There is yet another front, in which researchers of Fiocruz Minas are now part of a network of the National Institute of Science and Technology in Vaccines for the development of a vaccine against the new coronavirus. The trial is based on a technique elaborated by Fiocruz Minas, which uses the influenza virus to generate an immune response.

As for data integration, a Covid-19 Observatory was created. The initiative develops integrated analysis (epidemiological scenarios, social impacts of the pandemic, control measures and health services, quality and safety of healthcare) and gathers the Covida Network - Science, Information and Solidarity, to monitor and produce summaries of scientific evidence; Infogripe, which follows alert levels for reported cases of SARS; and MonitoraCovid-19, a panel that estimates the situation in Brazil and its states based on the reported cases and deaths - and in other countries.

The president says that all today’s actions are connected to the robust legacy of Oswaldo Cruz: the formatting of an institution that combines science, technology (to manufacture biological products, such as vaccines and drugs), education, health, and national projects. “A historical landmark in Fiocruz’s history, and therefore a really intense one, originates from our institutional matrix, designed by the first generation of scientists that Oswaldo Cruz brought together in Manguinhos. In other words, our committment to using the knowledge generated here to formulate public health policies”.

The Instituto Soroterápico Federal, founded in 1900, and turned into Oswaldo Cruz Institute in 1908, was created as a response to a huge public health emergency: the need to produce a serum against the bubonic plague, which had reached the city of Santos and threatened the then federal capital, Rio de Janeiro. As director of the Oswaldo Cruz Institute and general director of Public Health, Oswaldo Cruz expanded the institution’s research agenda and fomented the production of knowledge in different areas, such as microbiology and tropical medicine, which made the institution capable of acting also against the yellow fever epidemic that was hitting Rio de Janeiro hard in the early 20th century. The institution was also at the head of the fight against the Spanish flu, with the scientist Carlos Chagas leading the charge. Just as in today’s pandemic, the Spanish flu also relied on quarentine and social isolation as main combat weapons.

Another very relevant historical event, a result of this matrix, is the national presence of Fiocruz. There are units of the Foundation in all of Brazil’s regions today. But the presence of the institution in the national territory began with scientific expeditions, also in the first decades of the 20th century, which followed the expansion of the National State in works to modernize its infrastructure, such as the construction of railways, regional development projects in the Amazon and works against droughts in the North-East. The institutional base made it possible to conjugate laboratory research, clinical work, and expertise for fieldwork done in the building sites.

“The role played by the institution in these expeditions was fundamental to consolidate tropical medicine as a scientific discipline, as well as to strengthen its protagonism in public health debates, such as in the sanitarist movement of the 1920’s, which saught to implement federal health policies such as the creation of a Ministry of Health, and in the formulation of national development projects. In brief, this is the matrix we are proud of, that inspires us and challenges us to improve the institution and its different areas of influence, to promote the health of the population, the strengthening of the SUS and of CT&I policies, and of the country’s autonomous development”, highlights Nísia.

“More than a century later, Fiocruz is still qualified and committed to providing answers to the Brazilian society, in the form of scientific knowledge, products, and basic healthcare, as well as response to public health emergencies, an example of which is the very serious event a few years ago, when we faced a triple epidemic of dengue fever, zika, and chikungunya, and in the re-emergence of yellow fever. We are seeing it now, once more, in the Covid-19 pandemic”. For the president, “the greatest lesson of Oswaldo Cruz and of our great founders was looking ahead as a basis for our actions in the present. It is treating the diversity of the country as an asset. It is using the innovative pulsion of our excluded people, not lacking in fight and creativity”.

Fiocruz today

The Oswaldo Cruz Foundation (Fiocruz) is the most prominent Institution of Science and Technology in Health in Latin America. Bound to the Ministry of Health, its mission is to produce, disseminate and share knowledge and technologies, aiming at strengthening and consolidating the Unified Health System (SUS, acronym in Portuguese for the Brazilian public health system) and the promotion of health and quality of life for the population.

Since its foundation in 1900, Fiocruz has dedicated itself to coping diseases that most affect Brazilian population. For its scientific contribution, the institution has become a reference in the understanding and treatment of Chagas disease, yellow fever, dengue, Zika, malaria, TB, HIV/AIDS and others.

Besides its presence in all regions of Brazil, Fiocruz has historically maintained a strong international presence through cooperation and exchange with health and science and technology institutions and international agencies in more than 50 countries in all continents. International cooperation has always been a value and a commitment for the Foundation, which is recognized by WHO with six collaboration centers.

Fiocruz in figures

Today, Fiocruz is the Brazilian public institution with the highest number of partnerships for productive development (PDPs), relying on 50 reference laboratories and departments articulated in international networks to solve public health issues. It is also the world’s largest manufacturer of yellow fever vaccines; it has partnerships with research institutions of 50 countries, and coordinates the world’s biggest network of human milk banks, which also counts on other countries. Fiocruz is the country’s main non-university institution for the training and qualification of human resources for the SUS.

In 2019, Fiocruz produced 129 million doses of vaccines and 116 million units of pharmaceutical drugs. It supplied 243 million punits of pharmaceutical drugs, 9 million vials and syringes of biopharmacological drugs, and 6 million reactives for diagnostics. It also ran five thousand quality tests on health products, treated 82 thousand patients and ran 312 thousand reference laboratory tests.

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