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Opinion

Role of public sector companies in health

FAPESP’s new initiatives in promoting technological development in the universities are fundamental for Brazil and for the universities themselves, which have endeavoring to channel part of their activities towards national priorities, and thus creating products and jobs. The health sector is a special case. It was Pasteur who conceived the institute for both research and production, ensuring that research would be transformed into a product to serve society. This is the century-old model that was implanted in the Butantan Institute, and which has been given new life today.

Since 1985, the Ministry of Health has invested about US$ 150 million in the production of serums and vaccines. It was Butantan that showed, when it received some US$ 40 million in investment from the National Health Foundation (Funasa), that the problem was not just one of renewing the infrastructure, but of investing in technological development. This development is different from the kind carried out in the universities: it is not enough to develop technology on the bench; it has to be converted into a process of production that meets the requirements of Good Manufacturing Practices, to produce with consistency and at prices compatible with the funds available at the Ministry of Health.

Making use of the support of dozens of projects financed by FAPESP and other agencies, Butantan was recognized by the World Health Organization as one of the laboratories with the best and largest number of installations for scaling-up production. No other public sector manufacturer has had the same kind of strategy, and the number of institutes that were taking part in the project has been coming down from the original 17, year after year. Not only have the small Brazilian public sector producers been disappearing, but so have practically all the institutes of the Pasteur kind in developing countries.

The macro-industry of vaccines, which is today concentrated into five companies, has responded by offering (as in the case of drugs against Aids) “charitable” prices, at around 10% of the prices charged in the Northern Hemisphere. How long will this program last? Probably, until the last public sector producer closes its doors. Brazil today produces about 80% of the vaccines that it hands out free of charge to the newly born and to the aged. Of these, Butantan manufactures 75% of the doses (DTP, diphtheria/tetanus, hepatitis B, BCG, rabies in cell culture), and the Oswaldo Cruz Foundation (Fiocruz), 24% (measles, yellow fever), and the rested is accounted for by the Institute of Technology of Paraná and the Ataulfo Paiva Foundation.

When vaccination of the elderly started to be put into practice, Butantan accounted for 48 million doses of diphtheria/tetanus, and agreed to the transfer of technology for the production of 14 million anti-flu doses. It replaced the purchase of three years of vaccine to be bottled it with Brazilian technology, saving US$ 30 million a year! It will be producing the vaccine in 2003, and will be using it as the basis for a new vaccine.

With Fiocruz, it will be launching the DTP/ Hemophilus B vaccine, and, in the following year, DTP/hepatitis B/ Hemophilus B. The pharmaceutical companies, both public and private sector, are manipulation industries, with no tradition in synthesis, nor experience in biological products. In the current scenario, they will not be the answer for the creation of an industry using technology developed in the country. FAPESP’s support is, therefore, fundamental for Butantan’s projects for technological development and for making use of the projects carried out on the university benches, which will only become a product at institutes like Butantan.

Director of the Butantan Institute, in São Paulo

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