‘If the product is not for the SUS, it does not deserve public health policy priority’

Carlos Gadelha
Carlos Gadelha, Secretary of Science, Technology, Innovation and Health Complex. Credit: Lígia Formenti

Secretary of Science, Technology, Innovation and Health Complex, Carlos Gadelha defends tax rules that encourage health-related production in the country country, greater dialogue with control bodies in order to guarantee security in prices of these products in public purchases and the adoption of criteria sanitary regulations that take into account local development.

“Producing in Brazil has to be good. There has to be legal certainty.” afirmou, in an interview with WHOM.

The economist, who between 2011 and 2015 headed the secretariat, then with other denomination, says it is necessary to innovate to guarantee the strengthening of health economic industrial complex.

“We are not here just for what was already done 10 years ago. we have to do different.” The goal is to ensure that production in health encourages the social development and environmental preservation. “If the product is not for the SUS, it does not deserve public health policy priority. If it does not have environmental sustainability, it does not deserve any type of selective industrial policy. Another important point: it is necessary to guarantee well-being and the environment.”

After 70 days in office, Gadelha says he found a scene of destruction in ministry structure upon arrival. “The picture was more serious than that
described”, he observes.

The agenda for the first two months was largely devoted to listening to the sector and carry out a survey of priority needs. From the reports gathered and information received, Gadelha outlines priorities: resuming productive development partnerships, rescuing purchasing power of the State, which was shaken, and guarantee lines of financing.

Below are the main excerpts from the interview:

The arrival

Gadelha afirm that he found the secretariat without structure, with systems of very precarious information and reduced technical capacity. “If it weren’t for such a sensitive area, it would take six months to fix the system. But we can’t afford that luxury. The restructuring will be done also through partnership with states and municipalities, to identifyficar areas criticism and avoid shortages of essential products for the population.”

industrial economic complex

The secretary observes that the pandemic made clear the importance of the complex health and, at the same time, the great fragility of the system until then existing: “There was no mask, there was no fan. We managed to do the vaccine, but it could have been a much faster response than we gave. He was at the cost of many lives.”

Gadelha says it is necessary to rebuild the necessary infrastructure to give boost to the industrial complex, since the department of industrial complex had been dissolved and the executive group, with participation of numerous ministries, demobilized.

Before the pandemic, there was a climate of disrepute around the Partnerships of Productive Development (PDPs), mainly caused by delays in

When questioned about the criticisms, Gadelha, however, cites the example of Covid-19 vaccines produced at Fiocruz and at the Butantan Institute, to show how important initiatives are. Even if projects for some reason cannot be completed there is always a technological trail.

“Both were made on technological platforms brought by PDPs. At Fiocruz, were the partnerships for biopharmaceuticals. In the case of Butantan, partnership for the production of influenza vaccine. An innovative health policy has already showed its worth by saving 200,000 lives. No one can say it’s impossible or that it is not important to produce in the country. In our account there are 200 thousand lives saved.”

“It is not a goal to become an autarchy, not to have relations international. But it is unreasonable for us to have the greatest world’s universal health care system and rely on 80% of pharmaceutical raw materials produced in the exterior.”

Dialogue with control bodies

one of the reflexos of the lack of incentive for the industrial complex was the reduction of importance of PDPs. In recent years, only partnerships that were in progress continued. Many proposals were shelved.

But beyond the lack of commitment of previous governments, Gadelha recognizes there is insecurity around the topic. There are, he assesses, several points to be improved to make partnerships more attractive and effective.

The secretary cites as an example the problems related to prices in public purchases. “Currently, the same product can have several different prices: in addition to that established in the productive development partnership, there is the price of the trading sessions. Nobody can work without having a guarantee”.

With the instability in prices and, consequently, in the market, the obstacles begin even before the partnership is put into effect. many of PDPs are made through fifinancing from the National Bank of Social and Economic Development (BNDES). “But how does the bank fifinance a strategic project if the company that will be financy doesn’t have a market horizon? In some cases, it takes 5, 10 years to absorb technology”.


By Gadelha’s accounts, dammed investments in the health area arrive to R$ 30 billion, due to the lack of security. Resources refer to products linked to the whole complex: pharmaceuticals, equipment, new service activities.

He notes that there is currently an effort by the Federal Court of Auditors to approach the world of innovation. “We must make it clear that our objective is to expand the market, to guarantee all supplies for the SUS. We need produce better. Have successful partnerships. I can’t make a policy investment that requires terms of 5 to 10 years to fimature and I have than subjecting myself to speculative prices every year.”

The cycle is known, he says. When announcing partnerships, some producing companies of medicines significantly reduce the price in the processes of government purchases, precisely to guarantee a market. Gadelha afirma be constant: it is enough to announce a PDP, for other prices to fall. Is for control bodies, the prevailing logic is that of the lowest price. Hence the need of adjustments.

recovery strategy

The secretary assesses that the great challengefithe recovery of the institutional base of the industrial complex, with the resumption, for example, of the purchasing power of the State — shaken by the stoppage of partnerships.

“It would be important for local production to become a parameter for public purchases. And that involves a change in the regulatory framework and conversations with control bodies.”

The economist cites another example to show that adjustments need to be made. One of the mechanisms to encourage the health industry is compensation technological: when in a purchase contract there is also the forecast of a technological investment in the country.


This was used to build a linear accelerator factory for radiotherapy, in the city of Jundiaí, São Paulo, for example. “Did not work, mainly due to the tax burden. In some cases you pay more taxes producing locally. That’s why we talk not about tax exemption, but in tax equality. We need to go headlong into tax reform. Competitive equality is fundamental.”

Gadelha also cites the resumption of filong-term nancing via BNDES, Financier of Studies and Projects (Finep) and other agencies. “The area is strategy for health and well-being, deserves special treatment so that the people encourage investment in local production and innovation.”

A third aspect addressed by the secretary is the area of ​​sanitary regulation. He defends another look, which takes into account local production. “In addition security eefiCácia, which are non-negotiable issues, it would be important, perhaps, thinking about local development as an important agenda of our regulation.” For this, it intends to speak with members of the National Agency of Health Surveillance.

return deadlines

Gadelha points out that it is important to bear in mind that investments in the complex have no immediate feedback.

“Everything in health is delicate and complex. In this area, either you do politics with long horizon, medium term, or better not to do. Otherwise it would play outside public resources. We do not start producing vaccine, medicine, ventilator or mask, overnight. In health there is no bed, there is a bed. That to at the same time allows working in a technological gradient that goes from technologies onlyfisticadas, such as advanced therapies, genic to other more

the priorities

For the secretary, it would be important for the country to work on a technological gradient short (up to five years) and medium-term responses. In his assessment, the policy needs to take into account various aspects of health. On the one hand, invest in production in areas of greater business interest.

“We cannot fall into the trap of focusing on tropical diseases”, it says. In your evaluation, it is necessary to bear in mind the need to guarantee the right to health. And the way to achieve this is through investment in technological capacity and meet all needs.

“Monopoly is bad for health. The key is to attract investment and productive articulation in Brazil at the technological end, where interest business is very big. Including in partnership with companies. it would have as a criterion for the company to be national or foreign? No. Our only criterion will be to produce in Brazil or not. We are inviting companies. We are going to turn the page and we are going to invest in the country again.”

At the same time, Gadelha says it is important to encourage the production of medicines for neglected diseases which, according to him, are of interest to small and medium-sized companies. “One option is to make a mix, in which they produce items that are more profitable and others that are less profitable, but equally important.”

“ If the product is not for the SUS, it does not deserve priority of public health policy. If you don’t have environmental sustainability, does not deserve any type of selective industrial policy. Another important point: it is I need to guarantee well-being and the environment.”