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Interview

Roberto Figueira Santos: Observations of an engaged spectator

"The research in the universities have a birth certificate: it begins in 1967"

luciano andradeProfessor Roberto Figueira Santos, 78 years old, was, in the 1970’s and 1980’s, one of the most outstanding politicians in the state of Bahia, even, in a certain way, going in the opposite direction to the hegemonic current of local power, led by today’s Senator Antonio Carlos Magalhães. Governor of the State from 1975 to 1979, he also includes in his political biography stricto sensu a mandate as a federal deputy (1996/1999), besides the positions of president of the National Council for Scientific and Technological Development – CNPq (1985/1986) and Minister of Health (1986/1987), both exercised during the government of José Sarney, the first of post-military dictatorship Brazil.

Taking the term politics in its broad sense, this biography encompasses countless other positions, beginning with the post of rector of the Federal University of Bahia (UFBA), from 1967 to 1971. And, without a shadow of doubt, it leans towards the fields of higher education and of science and technology. At the moment, he is, by the way, a member of the National Science and Technology Council, with a mandate until next year. In his professional origin, a researcher and teacher from the medical area, Roberto Santos is, on other words, when not a player on this stage, at least a privileged observer of the country’s scientific and technological policy, since the far-off 1950’s.

And his look at the country, critical, livened up by vivid memories, sets off from an area that is neither central nor the most peripheral in the contemporary production of Brazilian scientific knowledge – Bahia occupies the ninth place in the ranking of domestic production by state, tying with Ceará, according to 2004 data from the Institute for Scientific Information (ISI)/Web of Science, based on the publication of scientific articles in indexed periodicals in the period from 1998 to 2002. Son of Professor Edgard Rêgo dos Santos, a leader of the organization of UFBA in 1946 and the person chiefly responsible for the inclusion of autonomous and influential units of the dance, the theater and music in the university’s structure, married for 41 years with Maria Amélia, father of six children and grandfather of six grandchildren, Roberto Santos spoke at length with Pesquisa FAPESP last August. From this agreeable conversation at his beautiful house in Quinta do Candeal, in Salvador, the main excerpts follow below.

I would like to begin our conversation by the beginning of your professional life, that is, by your activity as a researcher and teacher in the medical area.
I really have had a life with very varied activities, some of them even unforeseen, by I began with total dedication to teaching and research in medicine. I did my doctor’s course here at the Federal University of Bahia, and from there I went abroad. I spent almost three years there and, when I came back, I started to work at the university’s Hospital and Clinics, the official name of which is the Professor Edgard Santos University Hospital, which was starting to have really exceptional working conditions, and I became totally dedicated to academic activities. So much so, that when some 17 years later I was taken to an activity that obliged me to political militancy, the surprise was general, because I hadn’t given any signs that I had this inclination.

Your period abroad, straight after graduating, includes a time at Cornell University.
I was at three universities with different tendencies, in three very different cities. I traveled recently graduated – I graduated in December 1949 and went abroad in July 1950 -, at a time when Brazil had distanced itself a lot from the more advanced countries because of the war, and we then had a kind of education that was very outmoded. The war had ended five years before, the United States was then very much focused on the Marshall Plan, in support of the reconstruction of Europe, and with this, support for other regions of the world, including Latin America, was much reduced. I was one of the first scholarship holders with an opportunity of following on to centers that were the most advanced at that moment, and with this I learnt a lot of things that were not yet in circulation here, so to speak. Well, about the universities, I went first to Cornell, in New York, where I did a course that was a sort of updating to the conditions of American medicine, which were strange to us, because even whenBrazil was in contact with the more advanced countries, it was above all with those from Europe – above all, France, and something with Germany and England. But is was precisely in that period that the United States was emerging towards a new conception of clinical activity, which was my course, and towards emphasizing its scientific bases.

How long did you stay in New York?
I stayed on this adaptation course just for a little over six months. That was my first contact with a city the size of New York. Well, besides the medicine I learnt, I had to relearn a lot of basic things. To explain better; we were coming from a conception of the medical-clinical activity very much in the European style, above all the old French style, which emphasized describing diseases, how they present themselves to the observation of the clinician. The foundations of biochemistry, physiology and biophysics were very shallow – pathological anatomy was more advanced – and did not get the emphasis they came to have later, in an about-turn that occurred after the war. And then, besides what I had learnt in relation to clinical practice in the traditional sense, about medical observation, I had to relearn, shall we say, all those foundations that were still in their infancy. And then new things would come in, like genetics and immunology, which got a great impulse after the war. All this broughtafirmness to the clinical activity that used to be more instinctive before, on the basis of pathological anatomy.

For a recently graduated young man, it was a whole new world that was opening up.
Yes. When I left New York, I went to the University of Michigan, in Ann Arbor – a small town with 40,000 people, of which 20,000 were students. They had an excellent school of medicine for clinical training, but research, although it had importance, was not the main emphasis. There, I was a resident at the university hospital, but with my eyes focused on one more stage that I was to complete, as complete I did, at Harvard University, at the Massachusetts General Hospital, where I worked exclusively on hydromineral metabolism.

Which later was to become the theme for your thesis?
The theme of my thesis and the research activity I had in Bahia when I came back, which was precisely the metabolism of sodium, potassium, pH, hydrogen, oxidosis, alkalosis, in short, hydromineral metabolism. I was, for example, able to work on studies of renal and extrarenal regulation of the metabolism of potassium in our university hospital, which was very well equipped, very well organized, so that we had a chance of doing research with animals inside the hospital itself.

And could you put an animal inside the hospital?!
Yes, as, by the way, happens in several hospitals out of here. The hospital’s top floor was completely isolated from any clinical or laboratory activity. For example, I worked on the verification of sodium depression as an essential factor for an increase in the excretion of ammonia, work that was in part physiology and in part physiopathology, that is on alterations in the metabolism of water and electrolytes because of diseases. I have another professorial thesis based on work with cirrhotic sufferers from schistosomiasis. I examine how the excretion of water is subject to factors linked to the metabolism of the antidiuretic hormone made by the pituitary gland. At that time, they had launched onto the market the flame photometer, in fact, the first flame photometers were tested in the laboratory where I used to work at the Massachusetts General Hospital. This equipment gave a great impulse to the clinical study of the metabolism of the electrolytes, because a dosage that from the chemical point of view until then was very complicated became routine. The works were made public, accepted by magazines with a world-wide circulation like the American Journal Physiology.

In parallel with the research activities, you soon began to have a strong influence on teaching at UFBA’s School of Medicine, didn’t you?
Yes, I then began to be extremely active in the teaching area as well, and in 1956 I founded the residence program, which, at the time, only two hospitals in Brazil had: the São Paulo Hospital and Clinics, the pioneer, and the hospital of the Rio de Janeiro State Public Servants, an excellent hospital that afterwards ran into immense difficulties. Residency completely modified the standards of assistance in the whole of the North and Northeast.

You went back to the United States in the 1960s, didn’t you?
Yes, in 1961, 1962, I went to the Massachusetts hospital, and there I put together a technique for dosing diuretic hormone in the bloodstream. It was now a direct dosage, when before I had worked on indirect results of the action of diuretic hormones on cirrhotic patients, as I said.

The name of Professor Edgar Santos has already appeared, but we haven’t talked about him. Besides being its first rector, he was UFBA’s great organizer, and with a very strong sensibility for the space for the arts within the university. How do you see him from afar?
He was a leader in the organization of the university, and the feeling people have is precisely that, although he graduated in medicine, he had a very special sensibility for culture, for the arts. It could have been this sensibility that allowed the Federal University of Bahia to have, for example, the first college of contemporary dance, to have a college of the theater. To have, for example, a music college, which began as free music seminars, in a reaction to the conservatory style of the time, with much less formalism, with the opportunity for great musicians and music teachers from abroad and Brazil to come here, to begin with during the months of July, for some years, in activities that were not permanent, and afterwards as regular work. In short, his sensibility helped UFBA to have a whole cultural side that was more solid that other federal universities, right from the start.. And this additional penchant for the arts meant that in a few years vocations would develop here, that ending up seeking larger markets and consolidating themselves. I think that this is an important fact when we compare it with the development of science, where the Bahian’s penchant does not seem so strong to me.

Could you talk a little about how this vision of Professor Edgar Santos influenced your upbringing?
I’m just going to add the following: although his name became very well known because of the emphasis he gave to higher education art colleges, I think that my father’s work in relation to health was just or more important, for the fact that he had, with enormous difficulties, implanting a university hospital that represents modern medicine, and which took 11 years to be construction. Construction began in 1937, and it was inaugurated in November 1948 and started working in 1949.

It has some similarity with the São Paulo Hospital and Clinics, doesn’t it?
Yes, because Ernesto Souza Campos, a professor of microbiology in medicine from São Paulo, who afterwards was a Minister of Education, had great influence in the São Paulo project, and, years later, in the one here. Accordingly, the ground plan in the shape of an H, where the wards were on the side wings and the general services in the bar of the H, is very similar to the one in São Paulo. All in a smaller size. Souza Campos was one of the Brazilians who did the famous public health course at John Hopkins University at the end of the 1920’s and in the 1930’s, which had an influence practically the whole world over, and a lot of influence in Brazil. Many of Brazil’s prominent sanitarians did this course as a postgraduate degree. So, Souza Campos brought two very importance to the medical area: hospital administration, which was practically nonexistent at the time, and nursing as a higher education profession and an extremely important activity in the health process.

Let’s take a leap forward in time: how is it that you passed from the functions of researcher and professor to the university policy area?
I am going to do a digression to show this transition. Besides this research activity, in my early years as a chair professor (equivalent to a full professor nowadays), I dedicated myself a lot to modernize the teaching of medicine. Early specialization under the traditional pattern was very frequent, almost a rule. The medical student would start to work from his early years in a job, and there, for a question of friendship, sometimes of kinship, he would go on creating growing responsibilities and keep perfecting himself in some practices of that specialty, and would end up exercising the profession in this way, without a vision of the whole. Some who intended to go into the interior, on their own account, without any responsibility of the college, would take up two or three jobs, so as to able later, in the exercise of their profession, to provide cover for everything that there was a shortage of. The idea was then to offer a program that extend to the totality of the students and that made the student, even inside the formalism of a curriculum, create that general idea of medicine. Which is very important in other careers, but particularly important in medicine, because you deal with the human being, you are not dealing with a liver or a heart. This effort for modernization extended to other schools and led to the creation of the Brazilian Association of Medical Schools, an entity that had a very great influence both in this aspect of establishing syllabuses, pedagogical rules and hospital organization adapted to teaching, and in inserting into the teaching of medicine a notion of collective medicine and of public health, which used to be extremely precarious before.

And after this effort for modernizing teaching?
When I was absorbed with this program of reforming medical teaching, there was an election for the rector here. In 1967, there was some competition going on between some professors of the university council to replace Miguel Calmon. Then Miguel died suddenly, on the eve of the election.

But at that moment you were the State Secretary for Health.
Exactly. It was that, when I was on the program for reforming medical teaching, one of my pledges was to create, outside the university hospital as well, an opportunity for students to take up jobs at the health posts, which used to be extremely precarious. At that moment, the new governor, Luiz Viana Filho, invited me to be the Secretary for Education. I told him that I would accept being Secretary for Health, and I took office on April 7. In June, there was an election for the post of rector, and the natural name was Orlando Gomes, a jurist, a professor of the Law School, vice-rector for almost the whole term of my father, from 1946 to 1961. But there was a lot of dispute, and in this climate the federal government was contaminated by a resistance to the name of Orlando, because he had belonged to the Socialist Party, in the 1930’s. And the military government refused Orlando. In the vicinity of the election, I had gone in as the most voted name in the second ballot.

At a certain moment, the Ministry of Education, Tarso Dutra, had me sent for, and in a conversation, together with Adriano Pondé, then the acting rector, he said that there was resistance to the first name of the list, and, as I was the second, they were considering my name as rector. I said that I couldn’t accept, taking into to consideration the friendship between my family and Orlando as well, and he said that he would then have to send the list back to the university, and ask them to organize another, in short, a crisis. In those times in which political retaliations were much feared, we asked for time to consult the university council by telephone (we were in Rio, with the minister), and Orlando Gomes himself, and he was categorical, to the effect that I should accept, so as to avoid a crisis in the university. Well, the result is that I, after having had an enormous lot of work at the beginning of the Luiz Vianna government to get myself ready to be a secretary, was leaving it for the rector’s postin less than three months.

And as rector, you had to face the question of university reform.
At the end of the Castelo Branco, Luiz Viana, then Castelo’s chief of staff, and who also used to be a law professor at the university, although he had remained almost the whole time in politics, managed to convince the president that there had to be a reform of the universities. And Castelo issued a decree-law n 1966. There was no MEC-Usaid commission then (Usaid is the American agency for international development), which was only to happen when Muniz de Aragão was a minister, two or three years later. Contrary to what the student movement put about, it was only the restructuring of the university that was being taken care, and in a conception developed by Brazilian educators.

The most important thing of this reform was that the basic sectors of knowledge, which had little prominence in the original organization of the universities, came to have a far greater importance – something that eminent Brazilian educators had been advocating since the 1930’s and that only the University of São Paulo had tried, at the Medicine School and at the College of Philosophy, and afterwards at the University of Brasilia, in 1960. Well then, the decree-law that generalized this principle was from 1966 and had nothing to do with the MEC-Usaid agreement. The things are muddled, because of the complements to the restructuring carried out to face the student movement, and which seized particularly on the question of student representation.

It was made impossible for the academic directorate to work along the lines that it worked until 1967, and the central student directorate, plus the state unions, it was all canceled, in short… Both in student representation and in university government, things were altered a lot, and that is what they call university reform. But what matters to us from the point of view of the university’s scientific development, is that the restructuring I am talking about implanted the teaching of sciences into the generality of the universities. What restructuring generated, therefore, was the possibility of scientific research inside the universities.

So, for you, research in sciences at the Brazilian universities has a birth certificate with a precise date?
Yes. In February 1966, there came the first decree that really traced the line, the essential guideline, rational, intellectual guidelines and so on, but the universities thought that it was a bit vague from the point of view of implementation. Then, in the following year, there was a second decree, everything drawn up by Brazilian educators inside the Federal Education Council. I know that this truth will not be reestablished, I have talked about it on a thousand occasions, and other companions as well, but the political connotation that surrounds this question is very strong.

Do you think we are still very young in scientific research?
Yes, we have had some research since the 19th century and beginning of the 20th with the serotherapic laboratories, Manguinhos, the São Paulo Biological Institute, the Campinas Agronomic Institute etc. Among agriculture and public health, there was research in Brazil. Here, we had the Bahia Tropicalist School, but all of it outside the colleges.

Well, why do you advocate that restructuring of the university as being absolutely necessary?
It’s the following: until the University of Brasilia, all the universities were the result of the agglomeration of isolated school. With this, the basic sectors of knowledge, like mathematics, physics, chemistry, basic biology, human sciences as well, existed inside the professional faculties as a preliminary, preparatory phase. And that is why the basic sectors of knowledge were fragmented inside the universities. There would be mathematics in the Polytechnic, mathematics in Architecture, and so on, but there wasn’t mathematics as a more all-embracing unit that cultivated all the aspects of teaching and research and with a concentration of human, material and financial resources.

It was all pulverized. This applies to physics, to chemistry, to basic biology, to the human sciences, and the greatest motivation for restructuring was precisely to pick up these bits and concentrate one a large unit of mathematics, or of physics, or of chemistry. This is what was fundamental, there started to exist a mathematics, a physics, a chemistry with a concentration of the research media that used to be pulverized. And I an sure that it was because of this, more than exclusive dedication, that research came to flourish.

But you yourself say that, in Bahia, research did not flourish as you had dreamt.
I think there was a certain timidity from the personnel of the basic sector of knowledge, and the traditional colleges continued to dominate the government of the universities. The people did not feel it had power, did not feel supported, neither internally, in the institution, nor in the community at large to face up to prestige of the traditional sectors. Sectors that did not have exclusive dedication, which is something that came far more recently, and for this reason was producing little, from the scientific point of view.

Actually, they were physicians who used to teach physiology, biochemistry etc. and at the same time had the daytime at their disposal to exercise the medical profession, as generalist or specialist professionals. But the important thing is that the Brazilian university has gone ahead in spite of all the difficulties, all the lack of money and everything else. What the university has today in people studying for their master’s and doctor’s degrees, producing theses and transforming these works into articles in well regarded magazines and periodicals and so forth is impressive. And there is no doubt that the training and the quality of the teaching staff have improved a lot.

Well, if the Brazilian postgraduate system, today, forms 7,000 doctors a year, it can only have effects in this direction.
Yes, this didn’t exist before. The way how a person would arrive at the top of his career was very much on the basis of personal relationships, that master – apprentice thing, without a formal nature, without any criterion for acceptance, nothing. There was the entrance examination, but the examination is a moment in the life of the citizen, and the way how the tests were done in the old days would be more favorable to those who would learn things by heart and repeat them. Today, there is an assessment of the capacity for creating and carrying out works. The question is that, partly because of this as well, our research is not very innovative, so then there is that stuffiness that comes from the time of the Jesuitical education, from the scholastic heritage, this story that comes from ages ago that the Portuguese brought us. So we know that until a few decades ago the story was more on the basis of learning by heart. And not of transmitting concepts of science as something that is always subject to caution, to reexamination.

Let’s take another leap forwards and see how you dealt with science and technology when you became governor of Bahia, in 1975.
A short time ago, we were talking about scientific culture, and I want to bring to mind that one of the things I did with most affection in my government, although it wasn’t large scale from the material and financial point of view, was a science and technology museum in Pituaçu, to foster scientific concepts amongst the younger generations. There was a special opportunity for this, because Bahia was rapidly industrializing itself, first with the Aratu Industrial Center and, later on, with the Camaçari Petrochemical Complex, which represented an investment of US$ 4 billion in an interval of four years. It was something new, and we thought of preparing the museum for presenting things to children in a dynamic and lively way. We opened the museum at the end of 1978, and in March 1979 I left the government. The result was that the science and technology museum vanished. It was a project that even involved an English participation – the English are good at doing this sort of thing with little money-, cooperation from Petrobras, with models of oil rigs, three-dimensional models of petrochemical products, and so forth. We created a museum-school, which involved buses to pick up pupils from the public primary school and take them to the museums, including the science and technology museum. Then the teachers would go to the museum before, to find out about it, and it is impressive how all this died.

But, for us not to be unfair, one has to remember that in some areas there is a respectable research tradition in Bahia. I am, for example, referring to researches in the area of tropical medicine. Could you comment a bit about why this area is a success, while physics, even biochemistry etc., remain backwards?
Medicine, health, really had a past that was sustained by the presence of the faculty of medicine in the Bahia environment. The school of medicine, though, was not the fundamental factor for the researches that were carried out in the second half of the 19th century, for example. The most noteworthy researchers did not get on with the school. But in the 20th century, with the Hospital and Clinics, Bahia continued to be an environment much valued by the researchers, because it continued to have an intense poverty, rich for research, and at the same time started to have a new condition in both laboratory and clinical terms.

So, besides some people from Bahia itself, many researchers came from outside in this area of infectious and contagious diseases, the transmittable diseases. Even in the 1930s and a bit later, Otavinho Mangabeira, who was a researcher from Manguinhos, an entomologist, took advantage of a few local talents, and brought, amongst other people, Samuel Pessoa, a professor in parasitology at USP, to carry out some very important work and to train a lot of people. All this at an institute that used to be called the Oswaldo Cruz, afterwards came to be the Gonçalo Muniz Foundation, and, later, now in the 1990’s, became once again a center of the Oswaldo Cruz Foundation, with a group of researchers of the best caliber, amongst them Bernardo Galvão, an excellent researcher. He is a Bahian, spent many years in Rio, and in the 1980’s started to study AIDS a lot. When I was in the Ministry of Health, he was there, they were setting up a very specialized biology laboratory.

Is there some specific field where things are now doing well, some specific disease better researched in Salvador than in other Brazilian cities?
Besides Chagas and schistosomiasis, which are, shall we say, the traditional things, there’s leptospirosis, there’s AIDS, and above all less publicized, less well-known viral diseases that they are studying, and with some very good results, and with acceptance in the medical literature that selects these things.

How do you perceive the country as a whole today in the matter of research?
Well, São Paulo is a case apart. In the country in general, I think that, with postgraduate studies, the opportunities for fixing people in regularprograms at the universities and the full time dedication system, there has been a very great evolution of scientific production, demonstrated not least by the number of publications of articles in the international magazines that are on indexed databases. There is an awakening, a very rapid change, albeit much more in the scientific area than in the technological area. It was the universities who kept the flame of scientific and technological research alight, with some prospect, however small, of innovation. Companies were much slower in waking up to this, and they have been awakening recently very much because of the need to export.

On this question of support for an environment propitious to both scientific and technological development, there is a curious problem in Bahia, which is the long standing official resistance to the implantation of a state research support foundation. When you governed the state, was there not climate for creating this foundation?
In my period of government, the effort of investing funds was concentrated on the Ceped, the Research and Development Center, which was founded in the government of Luiz Viana. The Ceped carried on a lot of work in the petrochemical area, in perfecting petrochemical processes, because the petrochemical complex was beginning. It did a lot of work in agribusiness and in agroindustry. In metallurgy, as copper was starting to be produced here, there was a need for the Ceped to dedicate itself to non-ferrous metallurgy. Accordingly, the Ceped had a very important role over many years. And it died. Finished.

But why was a research support foundation not created right away?
On the occasion of the state constitutional assemblies, in 1989, many states created support foundations, including Bahia, at least in the law. But, after some time, one or two years, the foundation ceased to exist. It used to be run by a council that had a participation in other bodies of the community, and it was transformed into a council with an appointment mechanism that was much more bound up with the government of the state itself.

So you think that the formal framework is ready for research to be supported effectively?
Yes, it already exists. Certainly, after a delay, a very large reduction in impulse in relation to it had at the beginning, but, at the moment, it is in existence.

When you occupied the presidency of the CNPq, did you try in any way to mobilize the research systems in the states outside the Southeastern Region?
I stayed only a year at the CNPq. But, if I already had an inclination for this kind of activity, from then on, I was really gripped, and since then, much of what I have carried out, written or spoken is related to this question of science and technology as an absolutely decisive factor for the country’s development, not to be postponed nor to be refused. At the CNPq there was, when I took office, a very great distrust of the scientific community in relation to government institutions. It was a community that had put up a very great resistance to the military government, and in the transition, there were was still a lot of what was called “authoritarian rubble”. So I had to face up to and come through all this. But from the point of view of work specifically, in the first place, I had a great concern with the pulverization of the CNPq’s resources. I was doing a calculation at the time, that if you took, in a rather rough bookkeeping, the total of funds taken by the CNPq by the number of projects that it was financing, would work out on average between US$ 5,000 and US$ 10,000 per project. That is, next to nothing. What can you do with US$ 5,000? No way. At the same time, there was a practice that was that those who came in to be financed never leave.

There is also what can be called good mateship, which means, not refusing the project that comes from the researcher. The result was this pulverization. Well, it is plain that the argument was that the money was too little, no doubt it was and continues to be too little, and will always be too little, but that was also a pretext for not upsetting, for not facing up to the scientific community. I tried to expedite things to reduce this, but as time was short… Well, the other thing is that, in spite of all my zeal for the development of the basic sciences, which was very well demonstrated in the practice of my life, the basic science people had a very great distrust in relation to the division of funds with the technological part. But the council is for scientific and technological development… There was a moment at which one imagined separating this a bit, with the idea that if the CNPq were only for science it would be better. This is an illusion. You can’t divide and finish by leaving technology without anything. Well, finally, there was the question of the regional distribution. But, in actual fact, it had to be recognized that this problem of regional distribution also arose a lot from the lack of initiative of many of the units of these poorer regions.

Aren’t you picking a fight with the scientific community with this assessment?
We know that the predominance of people from the East and from the South, on the decision-taking bodies, also had importance for the poor distribution. There was a certain disdain for the quality of what came from the Northeast or from the North, that’s true. But, on the other hand, there was a great lack of initiative. I’m saying that from here, my native land. I tried to stimulate the presentation of proposals, above all in certain areas whose importance I was convicted of, such as the area of agronomy, but folks would move slowly.

Didn’t they send the projects?
With the exception of some few units that already had a tradition, generally speaking the requests were very weak. We would try to level things out, find room for and stimulate what came from the poorer regions, but knowing that the cry that they are persecuted, they are not properly valued etc. is not exactly a true one.

And in the Ministry of Health?
Health meant practically taking care of the prevention of transmittable diseases. The diseases of poverty, the infectious and contagious diseases. And it used to be a very small ministry. And the population at large had assistance in the area of the infectious and contagious diseases, but outside these they would find no help, the health area had nothing to do, it had no money, it didn’t have sufficient personnel, while the Ministry of Social Security in those days was swimming in money. Well, there was a movement of the so-called sanitarians, which is an expression that is improper, even, to join the part of health that, in bureaucratic terms, was in the Ministry of Social Security, with health properly speaking. At that point, the Ministry of Health, which used to be a poor little thing, became enormous, with some money that used to be with Social Security. That created some problems to start with, there was even a moment at which things got worse, but afterwards they became more rational.

But wasn’t there any way how the Ministry of Health could link up with the area of research that was focused on health? Was there no possible mechanism for this?
There already was Fiocruz in the structure, traditionally connected with the Ministry of Health. The strength of research in the Ministry of Health was with Fiocruz and continues so, we support this strongly. Well, still restricted at that moment to the infectious and contagious diseases, a moment when there was an explosion of malaria, in the Amazon region. Which was an interesting question. Because, during the Second World War, some very potent insecticides had arisen, to do away with the mosquito, and “aralen”, or chloroquine, the first of the more effective antimalarials. Even before that, Sucam, the Public Health Campaigns Superintendency, was founded and did an excellent job that did away with malaria in this half of Eastern Brazil.

But, in the Amazon, these same things and the same people failed. The Amazon has something that I think is yet to be discovered, something that feeds the mosquito. In those days when I arrived at the ministry, a great migration was going on, above all of farmers from states of Rio Grande do Sul, from Santa Catarina, Paraná etc. to the Amazon. These people would arrive without any immunological defense, virgin, ready to be attacked by the mosquitoes. Then, there was a devastation. At that point, we worked a lot on this question of malaria, we were also working a lot on the spotted fevers, on Chagas, on schistosomiasis, in short there were problems, and big ones, in this area of the transmittable diseases, above all in the poor regions, and there were also instruments, albeit a bit antiquated, which were Sucam and the Cesp Foundation, which were part of the Ministry of Health.

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