Read the Conversation

EF: What are your priorities for 2023?

MM: We are focusing on three prominent issues this year: a new legal structure of Fiocruz, technology adoption, and internationalization.  

Our legal transition is allowing us to have more influence as a strategic institution for the Brazilian state, while the second focus is related to improving our Science and Technology infrastructure. During the pandemic, we encountered limitations that hindered our efficient response to the spread, as well as constraints that could impede our reaction to future threats. In response, we are investing in the sector to enhance local preparedness and production.

As for the internationalization of Fiocruz, President Lula recently inaugurated the International Agenda to put Brazil back on the international stage, and we are responding to this government priority by expanding our operations and influence to China, Europe, Latin America, and Africa. The President has given us vocal support to increase our presence in these regions.  

The internationalization initiative has two primary goals. The first is incentivizing Fiocruz to cooperate with other countries in a model of South-South cooperation to help other countries develop their public health systems. This has been a component of our work since the 1970s, but we are now directing more resources to this objective. The second technological goal is to focus Fiocruz's resources on innovative development projects.

We are also developing new models to expand our participation in Brazil’s national market. We currently have a presence in 11 states, from the southern to the northern regions. We are receiving many invitations to install units in new territories and broaden our reach in the country. To achieve this, we are developing a new model of nationalization through strategic partnerships. These collaborations with established science and technology institutions are necessary for inaugurating sustainable processes in each state because this expansion requires human resources, budget, and infrastructure.  

Additionally, we are increasing our focus on preparedness and local production projects. During the Covid pandemic, Brazil represented 3% of the global population. Still, we accounted for 11% of global deaths, showing the need to focus on preventive concepts to avoid similar threats in the future. Fiocruz was vital to Brazil's response to the pandemic; we produced over 250 million vaccines, 20 million molecular tests, and 70 million rapid tests. We also played an essential role in coordinating Brazil in terms of moving samples, organizing laboratories across the country, facilitating communication between these existing labs, and establishing four centralized national labs to process molecular tests. In many aspects, we played a governmental part during the pandemic. To build on this experience, we are now working with the government to build a national system, while simultaneously stepping into an international role in Latin America to contribute to this type of cooperation in countries across the region.  

We are discussing our position as developer and distributor of the new COVID-19 vaccine with the World Health Organization and the Pan American Health Organization. After developing our own vaccine, we are considering how best to deploy this technology and offer it to partners across Latin America. Vaccine distribution is a new holding for Fiocruz, and we are sending people to train and increase the capacity of labs in the region to come closer to achieving this goal.  

EF: What is Fiocruz doing to generate investment to make science sustainable in Brazil?

MM: Fiocruz, a science and technology organization, has played a vital role in Brazilian Public Health history, particularly in the biomedical domain. Alongside this, we allocate resources for professional training. We operate a technical school to prepare young individuals for the public health sector. In addition, we oversee eight applied research institutions throughout Brazil, along with the National School of Public Health.

Our institutional presence spans the country across three distinct facilities: one focused on vaccine development and production, another responsible for drug and pharmaceutical development, and the third dedicated to molecular diagnostics. We value a cohesive model and system instead of fragmented efforts in science, teaching, and production. This integrated approach distinguishes us globally.

Operating as a non-profit entity, we channel our efforts in research, technical development, and production towards strengthening our national health system and providing the populace access to new offerings. Conversely, we manage two facilities using a for-profit model. These demanding and high-cost ventures need substantial investment. While research and teaching are budget-friendly activities, product and vaccine development and production incur significant expenses. Our efforts to persuade the government to invest in innovation and production are progressing.

Fiocruz serves as the industrial cornerstone of our National Health System. We supply cost-effective, quality products and safeguard the system from price fluctuations imposed by international pharmaceutical corporations.

With the unveiling of a new product line in Brazil, we are striving to build a business model that allows Fiocruz to provide products at an approximately 10% cost of the international market price. We have a goal to ensure not only our own sustainability but also the sustainability of the National Health System. We are improving our production with a new vaccine facility that will increase our capacity by six times. Getting vaccines to the world is the biggest priority of the health sector, and Brazil will become an international player in this field.

EF: What should be the base for a sustainable health industry market in Brazil?

MM: Making products affordable and available for the world population has to be the first fundamental component. Between 2019 and 2020, 25% of the world population had acquired 75% of the available COVID-19 vaccines in production. One of the reasons we saw the resurgence of so many variants of the disease was unequal vaccine distribution; some areas of the world were discarding vaccines while large percentages of the population were without access.

During the pandemic, private companies received public funding to develop vaccines but then charged 30-100 dollars per vaccine, even to countries with developing economies. In addition to distribution, we must delve into production concerns and ensure the cost-effective manufacturing of products globally. Fiocruz is positioned to supply products and set up an international network of producers. While expecting every country to manufacture vaccines might not be feasible, we can establish regional agreements to oversee production effectively.

During the World Health Assembly in Geneva, the prevailing consensus emphasized that health is not a zero-sum game. Progress made by companies loses value, if lives are lost and the environment deteriorates. Numerous individuals still profit from exclusive products inaccessible to most of the population. This needs to change.  

EF: What would be your advice for the next generation of scientists, researchers, and innovators?

MM: Democracy is Life, and Health is Democracy. Prioritizing population health is crucial. Therefore, we have to democratize science to ensure affordability and equality.

Fiocruz is very actively pursuing this calling. Located within an impoverished neighborhood, we are engaging with the local community and beyond to promote access to science. We firmly believe that science has to reach more people, and we have many incentives to attract people, especially those from lower income levels.  
We must actively integrate diversity to open new angles and perspectives. Science needs to include the people that it will impact.  

My generation witnessed the most innovative acceleration of processes in the world, but we have destroyed the world as we went along. Now, we need to put science at the service of creating a better world and a healthier planet. We need to increase the diversity of production because, otherwise, technology will not contribute to a better and more equal future on Earth.

September 2023