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Letter from the editor | 271

Developments

It is not news that Brazil has a much higher number of cesarean sections than recommended by the WHO. In 2015, 1.6 million babies were born via cesarean in the country, which represents 55.5% of all births. A study by researchers from Pelotas in the state of Rio Grande do Sul shows that up to 48% of cesarean sections that year were performed before the mother went into labor. Excluding interventions for health reasons, it is estimated that 370,000 babies were born by elective surgery before 39 weeks of gestation.

Data shows that the higher the education level of the mother, the more likely the child is to be born early. The report on page 52 shows that of 163,000 women with four years of education or less, 13.2% had early-term cesarean sections, while the proportion among those with higher education was 49.2%. Early-term delivery is worrying because these children are at greater risk of various health complications in the first few weeks of life, as well as cognitive development problems in the future. The risks in early life include respiratory difficulties caused by immature lungs and an inability to suck properly, which can lead to hypoglycemia and the need to administer formulas, exposing the infant to proteins that would otherwise be unnecessary and potentially causing food allergies.

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Pesticides, along with mechanization, have allowed agriculture to expand so much that a lack of food is not why (many) people worldwide are still starving. But the pesticide industry is viewed by many with suspicion and disapproval.

A draft bill proposing new rules on registering and using such chemicals has been the subject of fierce debate. There is still no definitive evidence that food produced using pesticides is harmful to human health, but scientific research has proven the negative impact they have on the environment, contaminating flora, fauna, and the water table, and jeopardizing the health of rural workers. While environmental contamination is caused mainly by large monoculture farms producing commodities such as soybeans and sugarcane, it is the cultivation of everyday food crops that causes health problems for small and medium producers. Between 2007 and 2015, there were more than 80,000 cases.

A report by Yuri Vasconcelos presents some of the controversial aspects of the bill, including the final word on approval of new substances, a responsibility currently shared by IBAMA, the Ministry of Agriculture, and ANVISA; the criteria for assessing new products; and deadlines for such analysis. Some of the challenges that need to be addressed include the insufficient staff available to analyze registration applications, the lack of a methodology for assessing the simultaneous use of different products, and the need to provide extensive and rigorous training and supervision for rural producers on the use of personal protective equipment, correct dosages, and application methods.

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Just four months ago, this editorial ended with a celebratory comment on the 200-year anniversary of the Brazilian National Museum, which has now suffered a terrible tragedy. There are no words to express the sadness of seeing flames engulf 20 million artifacts, the research center, the graduate studies building, and the museum itself—such a unique and irreplaceable institution.

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