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EF: Could you give us a brief outline of the several projects and associations you are involved in to promote health and innovation in Brazil?
GC: With more than 40 years of experience in radiology, I am a leader of the Institute of Radiology at Hospital das Clínicas and the University of Sao Paulo in Brazil. This university leads radiology and nuclear medicine research in the country and has connections to the most significant organizations and businesses. For instance, we have a lab for artificial intelligence with Siemens and an important molecular imaging partnership with GE. We conduct research and produce our own radioisotopes.
With equipment like 7T MR, of which only three exist in the southern hemisphere: one in Brazil and two in Australia, we are the most significant training facility for radiologists in the country and strongly emphasize education. We frequently receive applications from other nations, particularly those in Latin America and African nations like Angola and Mozambique.
Radiology has made significant improvements to patient quality of life over the past 30 years, especially in terms of early diagnosis and aiding in more precise surgery and treatments. As a result, our expertise is highly valued in hospitals and the healthcare industry.
We began the InRad innovation project for the Hospital das Clínicas six years ago, and later we established the InovaHC, which today is Brazil’s most significant center for healthcare innovation. We serve as a hub for startups, instill a spirit of innovation and entrepreneurship in the next generation, and prepare students, young doctors, and healthcare professionals for the big transformations of the digital era.
Through InovaHC, we have collaborated internationally with Great Britain to establish a digital healthcare project and are frequently in contact with the State of Sao Paulo or the Ministry of Health, who have adopted some of our solutions in Brazil. In the field of digital health, we have several trials underway, even in the Amazon region, and are also the pioneers in the use of 5G in healthcare.
ICOS (Instituto Coalizão Saúde) is an institution that seeks to transform Brazilian healthcare, aiming to bring together the public and private healthcare sectors. As a specialized think-tank, we look for ways to improve the quality and accessibility of healthcare in Brazil and have assembled 90% of the country's producing sector. This digital health system, created in collaboration with InovaHC and the British government, was one of the efforts. Here, it is important to know that Brazil modeled SUS after the NHS in Great Britain. This is the reason why Great Britain continues to assist.
EF: What are the key roadblocks in the system, and how can dialogue between public and private stakeholders be improved to advance sustainable healthcare in Brazil?
GC: As stated in our constitution, access to healthcare is a basic human right that the state is required to provide for. Theoretically, profit should not exist in the healthcare industry, and the government should provide healthcare to its population without considering revenues. However, in praxis, this is impossible.
In Brazil, the public and private sectors collaborate to sustain the SUS and address the massive issues we have in healthcare. Despite 25% of the population being covered by private insurance, private hospitals do almost 50% of the surgeries in the public sector because there are not enough public hospitals, particularly in remote regions. Additionally, pharmaceutical products and medications for the public sector are primarily provided by the private sector. Practically speaking, this cooperation is operating fairly well. Collaboration between the sectors is not the pressing issue, but how to effectively fund healthcare in a continental nation like Brazil, especially in a context where healthcare expenses are rising due to an aging population.
EF: How would you rate the level of technology adoption in Brazil, and how do you envision the future of the healthcare industry developing?
GC: The COVID pandemic had enormous consequences on healthcare. Brazil saw more than 700,000 deaths as a result of this virus. Nevertheless, the pandemic had a positive side effect in highlighting the need for more technology in healthcare. In Brazil, this transition began with telemedicine and evolved into digital healthcare, which can increase access, lessen inequalities, and lower healthcare costs.
During the pandemic, there was a death rate differential of 3.5 across various intensive care units. Through digital education, we began certifying experts in intensive care and established a digital program of acceptable healthcare materials. The Ministry of Health adopted our initiative as a national program, and as a result, we could observe a rapid decline in the mortality rate. This is a clear example of how, with the help of digital health, we can lessen the disparity in the standard of care that medical professionals provide to patients nationwide.
Telemedicine started as online consultation, but technological advances will provide new devices to expand and transform the standard of digital health. For InovaHC, it is a crucial area for innovation since we are investing a lot in developing devices that might aid telemedicine and encourage Brazilian researchers and businesspeople to create tools better suited to the country's reality.
We learned during the pandemic that nations cannot rely on foreign healthcare imports. Brazil was extremely dependent on imported medications, vaccines, and even some basic supplies of intensive care equipment. The country is now shifting its perspective on production to become more self-sufficient. ICOS is one of the key players encouraging Brazil's federal government to create public policies for the local manufacturing of numerous health products.
EF: What are the pillars for a stronger framework for health in Brazil?
GC: The new federal and state governments have recognized the value of enhancing technology in healthcare and the need for transformation through digital opportunities.
Brazil has added a Secretary of Digital Health to the Ministry of Health, and the state of Sao Paulo has made digital health its top priority in healthcare. As ICOS, we are assisting the entities in the development of several projects.
Another aspect is strengthening the supply chain in Brazil. There are many proposals, but implementing significant systemic changes is challenging, especially in the healthcare industry. Distinct from the financial sector, healthcare involves many interactions with people, and full automation in this industry is not totally possible. We must persuade stakeholders in the sector to accept new ideas and ways of thinking.
EF: Would you like to share any last notes or make any final comments?
GC: Healthcare management is complex, especially regarding matters of economic sustainability and the prevalent judicialization in Brazil. Both of these aspects are crucial in reshaping and addressing healthcare paradigms. Even countries that have successfully established robust healthcare systems are grappling with challenges. Given our status as a developing nation with fewer resources, these issues are more pronounced. Exchanging experiences and ideas on a global scale could help us determine the best ways to lessen inequalities and improve access.