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BRAZIL - THE GOVERNMENT OF PARANÁ AND THE STRANGE PURCHASE OF "BAD VACCINES"





Public-private partnership does not work

in health, says the former director of Butantan




The former director of the Butantã Institute Isaías Raw, 90, in the laboratory of the Butantan Institute



At the age of 90, the Isaias Raw researcher maintains the same agitation from the time of the medical student from USP. "I've always had that was not my professional duty," said he told Folha in his office at the Butantan Institute in Sao Paulo, where, although retired, he spent most of his days. Added to this are good doses of personal pride and an iconoclastic and combative spirit. "If I have an idea, I need to sell the idea, not to win medallions, but to put myself in the mirror and say I did it." In the following interview, Raw talks about his trajectory inside and outside the laboratory, the challenges he encountered inButantan Institute and its fight to develop a national vaccine industry. *


Leaf - Mr. always ventured out of the lab. Can you tell us a little more about this trajectory?

Isaiah Raw - I always went into what was not my professional obligation. When I entered college, I realized the need to change the teaching of science.The class on the board is not meant to teach science.What a student needs is to learn to read, study and understand the content of books and articles.



In the 1950s and 1960s, teachers did not communicate. We did not know what the other was giving in his class. Often contradictory contents have been given. If you do not learn to observe and draw conclusions, you will never train scientists. So I created the experimental course of medicine at USP, where we ended up with the idea that there is a series of compartments ordered by a teacher, everything was taught together.



I also helped to unify the vestibular exams of São Paulo, but soon it was liquidated, because it was against the interests of the owners of the colleges. I also created chemistry, electricity and biology minikits that have had a major impact on the lives of many people who have dedicated themselves to science, but he is dead too. Same destination, moreover, of the experimental course of medicine.The fact that these initiatives did not revenge you saddens you? I'm used to the idea that things start and end. The problem is that I lasted. I watched the end of all these things. The ideas end, but they have an impact. Something still remains. How did you arrive at the Butantan Institute?


He had returned to Brazil [after a period in the United States and Israel], had been removed from the USP [by AI-5] and the opportunity arose in the early 1980s to travel to Butantan, who recruited researchers.

How was he there? The institute was decomposing and serum production was in crisis. I then invented a system for serum production in which everything would happen in a closed system. The success of this whey plant was so great that I was chosen as director of Butantan [1991-1997].




At the age of 70, I had to leave management and become president of the Butantan Foundation [1998-2009]. This foundation was important because the public bureaucracy was impressive. Any bid has taken one, two years, but children with infectious diseases just can not wait so long. With the foundation, we eliminate bureaucracy. Butantan took off and we started producing 80% of the vaccines that Brazil uses, while the other institutes buy and bottle.That's what you call the Coca-Cola system, is not it?


Exactly. Coca-Cola does not count the contents of the syrup. She sells it to companies that dilute, bottle and sell. This is what happened with many institutes in Brazil, especially with Biomanguinhos [Fiocruz unit].I wanted to do differently and challenge the cartel of the four big companies that dominate the global vaccine market. Butantan had a great international prestige, since there was no vaccine producer in Latin America, because it still does not exist. That's why the industry was considered a bad example. After all, if the other developing countries embarked on the same effort, the industry would not have anyone to sell.


In an article in Folha 2011, you denounced the attempt to buy the Butantan plant. How was this episode? One day, I am warned that the sale of the industrial part of Butantan to a large laboratory was under discussion and I wrote the article denouncing the operation. Sanofi denied, but even the value, fantasy, was discussed. The proposal to buy the Butantan factories has arrived, but my cry to Folha has stopped the process.  Which does not mean that it's over. It is here that the idea of ​​public-private partnership was born. But that does not work in the 

field of health. Why?

When you make a product where the sole buyer is the government, you can not partner with a private company because the government, by investing, wants to make a profit. If you have a non-profit foundation, you can not have a partner whose goal is to make money. You have already criticized Sanofi's vaccine against dengue fever. Do you hold this position? No doubt. Sanofi has started the wrong vaccine. First, because it does not protect against all four types and has now come to the conclusion that the vaccine is a danger for those who have never had dengue fever.


Interestingly, there was only one buyer for the vaccine, the State of Paraná. What will he do with this vaccine now? What is the relationship between the governor of the State of Paraná and the Minister of Health? The minister is a politician, he does not understand public health or vaccines. And the Butantan Vaccine with NIH [National Institutes of Health, USA] Against Dengue, Should be Ready When? We are at the end of clinical trials. The vaccine should finally come out next year, but very late. We lost two years, because Anvisa did not release our vaccine for the test, although he released Sanofi's vaccine. As Mr. maintains intellectual vigor at the age of 90?


The important thing is to stay alert. I read each week "Science", "Nature" and other scientific journals. M. Do you have hobbies? No, I never had. My hobby is here, so I have to defend Butantan.







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cast redacao http://www1.folha.uol.com.br/ciencia/2018/01/1951801-parceria-publico-privada-nao-funciona-na-saude-diz-ex-diretor-do-butantan.shtml



THE GOVERNMENT OF PARANÁ AND THE STRANGE PURCHASE OF

BAD VACCINES


(Ruth Bolognese) - The government of Paraná owes a clear and definitive explanation of the revelation of former director of the Butantã Institute, Isaías Raw, who has surprised the purchase of 500 thousand doses of the Sanofi dengue vaccine Brazil in 2016. The cost has reached 50 million reais.


In addition to doubts about the effectiveness against the four types of the disease, the vaccine is a danger for anyone who has ever had dengue fever. Thirty municipalities in Paraná have had vaccination campaigns and received the product. And in two of them, Assaí and Paranaguá, the vaccine was given to children from the age of 9 years. The former director of Butantã, Brazil's most respected institute, spoke to Folha de São Paulo about the subject and raised serious questions about the purchase. The former director categorically said that Sanofi, the manufacturer of the vaccine, had made the wrong vaccine and, oddly, there was only one buyer, the Paraná government. "And what will the state do 

with this purchase now?"


He also asked: "What is the relationship between the Government of Paraná and the Minister of Health Minister is a politician, does not include public health or the vaccines," he said?. And others information that makes this purchase even stranger is the fact that the World Health Organization, WHO, only recommends that vaccination be done with 50% of dengue cases or more in the population.Paraná started the campaign without to prove that one of the 30 muncipes had this percentage of the disease , so when will the Beto Richa government explain it?
source of images google source copywriting https://contraponto.jor.br/o-government-of-parana-and-breakfast-compra-das-vacinas-erradas/


Governor Beto Richa launched Tuesday (26) the dengue vaccination campaign in Paraná and announced that 500,000 people will be vaccinated in the 30 municipalities with the highest viral circulation of the disease. Vaccination begins on August 13th.Paraná is the first of the Americas to campaign publicly against dengue fever. The state government will invest R $ 50 million in the acquisition of the vaccine. At the ceremony held in Paranaguá, in the presence of the Minister of Health, Ricardo Barros, the governor signed a protocol with the French company that manufactures the vaccine, Sanofi Pasteur, for the purchase of 500 000 doses. At the launch of the campaign, ten people were vaccinated.



The goal is to vaccinate at least 80% of the target audience. On the day of the campaign, Saturday, August 13, health clinics will be open all day. The campaign will continue for three weeks, until August 31, in the basic health services of the cities concerned."We launched the first public immunization campaign against dengue fever in the Americas, thanks to the efforts of our Health Secretariat, which has shown great skill and competence in its actions." In addition to the vaccine, we also launched multiplex tests to diagnose dengue, zika and chikungunya, "said the governor.


The vaccine should be given in three doses, with an interval of six months between each application. In addition to this first phase, in August, there will be new campaigns in February 2017 and August 2017. According to the governor, this year's vaccination will have an effective impact next summer, since the first dose already protects the disease, thus avoiding new epidemics.


 "We have concrete actions that respond to the interests of our people, we have invested R $ 50 million here to acquire these doses, but it is important to underline the direct and indirect damage caused by dengue fever." R $ 330 million losses of the epidemic, with the mobilization of the state to meet the families affected, hospitalized people and the purchase of equipment, as well as the indirect impact on the economy of tourists and people who have stopped working. It's not spent, it's an investment we make in public health to protect our people, "said Richa.




The governor pointed out that Paraná has the technical capacity and the adequate infrastructure to integrate a new vaccine into the public system. "We are one of the best public health systems in the country and our immunization campaigns achieve the best coverage, which gives us the credibility to innovate to advance disease control in the state.

DIFFERENTIATED  - Minister Ricardo Barros has welcomed the decision of the Government of Paraná. "The Paraná government is initiating immunization, with its own resources, which will certainly protect the state population in a differentiated way," Barros said. He explained that for the moment, there is no budget forecast, nor the authorization of the National Commission for New Technologies Incorporation for SUS (Conitec) for the incorporation of the vaccine by the Ministry of Health. "To fight against the priority of Aedes Mosquitoes Ministry. The people who do not rest in the fight against the mosquito, which transmits other diseases, in addition to dengue, "he said. INCREASED THREE TIMES


 - The decision to vaccinate the population is a plus to control the strategy of dengue in Parana and does not replace the necessary precautions to fight against the mosquito Aedes aegypti. The transfer of state government resources to fight against the mosquito that transmitted dengue has already reached more than 120 million reais, without however preventing new epidemics of the disease.The incidence of dengue fever in Parana tripled from 2013 to 2015. Regarding the last epidemiological period (August to July 2015 2015), the number of dengue cases has increased by 55%. More than 80% of the state's population, about 9 million people, live in areas with viral circulation.




"With the incorporation of the vaccine in the epidemic counties, you can reduce the viral circulation of dengue in the state, the protection also indirectly of unvaccinated people," said the state health minister, Sezifredo Paz.

TECPAR  - Paraná will also expand its participation in the availability of the vaccine in the country through the Paraná Institute of Technology (Tecpar). The first 500,000 doses are purchased by the State Department of Health through direct purchase from the company. The new stages of the campaign (2nd and 3rd doses) will be imported via Tecpar, in a partnership established for the availability of the dengue vaccine in the country. "The partnership with the French laboratory Sanofi Pasteur is the result of broader cooperation, involving other technologies of interest to the country, the institute and the laboratory," says the president of Tecpar Julio Felix. Presence


- Deputy Governor Cida Borghetti took part in the ceremony;secretaries of infrastructure and logistics, José Richa Filho;Justice, Labor and Human Rights, Artagão Júnior;Environment and Water Resources, Antônio Carlos Bonetti;of Social Communication, Márcio Villela; and Planning, Cylleneo Pessoa; the head of the military house, Colonel Adilson Castilho Casitas; the Consul General of France in São Paulo, Damien Loras; the Speaker of the Paraná Legislative Assembly, Ademar Traiano; and the state deputy Mauro Moraes. BOX 1The Secretary of Health prepares the campaign strategy


After the launch of the dengue vaccination campaign on Tuesday (26), with the signing of the protocol of intentions to acquire the 500 000 doses of the dengue vaccine, the Ministry of Health prepares the campaign in the 30 priority communes . "On August 6, we will bring together the health professionals involved in the vaccination of the 30 counties being considered for extensive training on the vaccine and campaign strategy," says Health Surveillance Superintendent Cleide Oliveira.


The choice of municipalities was based on the epidemiology of the disease in Paraná, considering municipalities with three or more epidemics in the last five periods, between 2010 and 2015; current incidence with cutting above 500 cases / 100,000 population; number of hospitalizations for severe dengue fever; number of hospitalizations for dengue and the age distribution of dengue cases during the current period (August 2015 to July 2016). After technical studies carried out by the Department of Health, it was determined that in 28 of the Paraná priority municipalities for the campaign, the population to be vaccinated covers the age group between 15 and 27 years. This range concentrates about 30% of dengue cases in Paraná.


In the municipalities of Paranaguá (Litoral) and Assaí (North), the vaccine will be aimed at the age group between the ages of nine and 44, since the two cities have an incidence of more than 8,000 cases per 100,000 inhabitants. In Paranaguá, the number of people entitled to the vaccine reaches 90,000 people.

The goal is to vaccinate at least 80% of the target audience.The D-Day of the campaign will take place on Saturday, August 13 and the health clinics will be open all day. The campaign continues for three weeks, from August 13 to 31, in the basic health units of the cities concerned.



MUNICIPALITIES CONTEMPLATED, BY REGIONAL HEALTH (RS):

Paranaguá;
Foz do Iguaçu;
Santa Terezinha de Itaipu;
São Miguel do Iguaçu;
Boa Vista da Aparecida;
Tapira;
Santa Izabel do Ivaí;
Cruzeiro do Sul;
Santa Fe;
Munhoz of Melo;
Marialva;
Paiçandu;
São Jorge do Ivaí;
Maringa;
Mandaguari;
Sarandi;
Iguaraçu;
assai;
Ibiporã;
Jataizinho;
Porecatu;
Bela Vista do Paraíso;
Cambé;
Londrina;
Sertanópolis;
Leópolis;
São Sebastião da Amoreira;
Itambaracá;
Cambara;
Maripa.

BOX 2 Parnanguara Vaccine reports the strength of the epidemic in the municipality Parnanguara Walace Domingues was one of the first to take the first dose of the vaccine. He is a painter and works as a volunteer in the cleaning of the city."I have had dengue fever twice before and I almost died, and I am very happy with the offer of the vaccine, which is sure to significantly reduce the incidence of the disease here on the coast," said Walace. In addition to the friend who died of dengue, Domingues' father, sister and brother-in-law also contracted the disease. "Paranaguá has had a big epidemic, but fortunately, the wait for next year is better," he said.

The director of the Port Authority of Paranaguá and Antonina, Luiz Henrique Dividino, recalled that Porto was one of the first in Brazil to launch a campaign against dengue fever. "We have done educational work in the seven municipalities of the coast, we carry out daily cleaning in the port and, in addition, also take measures for ship crews, including materials in Portuguese and English," he explained. BOX 3 WHO recommends immunization to fight the disease




In April 2016, the World Health Organization (WHO) recommended the use of a dengue vaccine in endemic countries, such as Brazil, recognizing the need to expand disease control strategies. Publication of WHO recommendation comes one week after Paraná government announced decision to acquire vaccines for cities facing dengue crisis

According to WHO, the impact of dengue fever in terms of medical costs and lost workdays is significant. Studies show an average cost of $ 1,500 per patient and 18.9 work days lost. "On the basis of this calculation and the recording of more than 55,000 cases in this epidemic period, the estimated cost of dengue fever in Parana is over R $ 330 million a year, which supports this important strategy. prevention, "says Sezifredo Paz. In 1950, only nine countries faced dengue epidemics. Currently, this number reaches 100 countries. Brazil concentrates 60% of dengue cases in the Americas. In the current epidemiological period, between August 2015 and July 2016, the


BOX 4 Vaccine launched and approved by Anvisa Dengvaxia, the vaccine produced by the French company Sanofi Pasteur is a pioneer in the world and was approved by the National Health Surveillance Agency (ANVISA) in December 2015, after 20 years of research and proof of their effectiveness. It is indicated for the prevention of dengue fever caused by serotypes 1, 2, 3 and 4 in persons aged 9 to 45 living in endemic areas.


To ensure its effectiveness, three doses are needed, with an interval of six months between them. The first dose of the vaccine guarantees 70% effectiveness, but it is necessary to take the second and third doses to ensure an adequate immune response. The main contraindications concern pregnant women, nursing mothers and immunocompromised mothers.


The vaccine is effective against all types of dengue (4 serotypes) offers a 93% reduction against serious diseases (those leading to death, such as dengue haemorrhagic fever) prevents 8 to 10 hospitalizations, reducing hospitalization costs and prevents two out of three cases of dengue fever.The results obtained with the vaccine are in line with the World Health Organization's (WHO) goal of reducing dengue mortality by at least 50% and morbidity by at least 25% by 2020. 

source of images google writing Source http://www.aen.pr.gov.br/modules/noticias/article.php?storyid=90131&tit=Richa-anuncia-vacinacao-contra-dengue-para-500-mil-pessoas -em-30- municipalities

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