Healthcare in Brazil
After the end of a 20-year military dictatorship, significant action began to take place regarding healthcare in Brazil. As a result of the long political struggle, healthcare as a right became enshrined in the Constitution in 1988. The Sistema Único de Saúde is the name of the public healthcare system in Brazil. Decentralized in its nature, both state and federal governments finance the system.

After a major reform in 1996, nearly 70% of the Brazilian population uses this system. The people who need it the most are those who cannot afford private health insurance, which tends to be the lower middle class, especially those who live in impoverished areas like the favelas. According to James Macinko, an associate professor of public health, the reform resulted in “Brazil [having] the lowest rate of catastrophic health expenditures (2.2 percent) of nearly any other country in the region.”

How the System Works

The system’s promise is providing equitable healthcare in Brazil, regardless of one’s socioeconomic background. As a result, many people of lower socioeconomic backgrounds received healthcare. In 1994, the government started an initiative called the Family Health Strategy. The program intended to provide healthcare services in people’s homes. While the intention of the program was not to strictly target the poor, those who reaped the greatest benefits were people of low income and living in impoverished areas.

The program was a medical success. It improved data accuracy regarding mortality, increased immunization rates to 100% and reduced unnecessary hospitalization for chronic diseases. However, most critically, it reduced the inequity in access and utilization of healthcare services. The government also created a program called Mais Medicos in 2013 which resulted in many foreign doctors (mainly from Cuba) arriving in Brazil and being placed in marginalized communities that lacked much-needed medical care.

Recurring Issues

The situation of healthcare in Brazil does raise a lot of concerns. For one, it is still sensitive to political and economic pressures. An example of this occurred in 2014 when Brazil experienced a deep recession. This resulted in the government taking austerity policies after failing to improve the economy through other means. These other means include price controls and stimulus packages. This led to lower tax revenues and significant cuts in healthcare during 2015.

On the political side, there is a recent example of Prime Minister Jair Bolsonaro capitalizing on the unpopularity of Cuban doctors by the Brazilian medical community. In the process, he made offensive accusations against the foreign professionals, required the doctors to take examinations to practice medicine in Brazil, forbade the Cuban government from taking away 75% of the doctors’ wages and mandated the doctors to have their families move to Brazil. This series of actions have alienated both the Cuban government as well as the Cuban medical practitioners which resulted in many leaving the country. This created a hole and vacuum that the government has tried yet failed to fill using Brazilian doctors. As of January 2019, 1,533 positions remain unfilled. The people who suffer most are the marginalized communities who desperately need those doctors.

Brazil’s Healthcare and Technology

Strong suggestions have emerged that one way to make Brazilian healthcare more resilient is by adding more investments to the existing infrastructure in order to make it more adequate. When it comes to making healthcare in Brazil more efficient, the leading solution providers are tech startups. They hone the power of technological innovation to address the inefficiencies in the system. One example is the startup iClinic, a Software as a Service that helps doctors with visitor management, organization of electronic records and remote telehealth consultations. It has had 22,000 customers which represent 7.5% of the market share.

On the mobile front, there are apps like Dieta e Saude. This has helped over a million and a half people make better choices regarding their dietary and exercise routines. When it comes to prescriptions, Memed is a startup that has emerged to fill the dire need for e-prescription management. It provides its services to more than 50,000 doctors. Errors occur in over 77% of prescriptions due to a lack of digitization. E-prescription management services help by reducing those errors through the use of scanning.

These are just some of the examples that make healthcare in Brazil more efficient, cost-effective and less dependent on the public healthcare system. As a result of these factors, public healthcare in Brazil will be in less need of government spending and less sensitive to political and economic pressures.

– Mustafa Ali
Photo: Pixabay

Medicine in Africa
54gene, an Africa-based research project, is reshaping medicine in Africa. It emerged in 2019 with the monumental goal of developing a database of African genomes that researchers could use to generate new vaccines for diseases unique to Africa. The organization’s targeted research focuses on genomic studies of non-communicable diseases, like cancer and sickle cell disease, and infectious diseases, like bacteria and parasites. To develop a genome reflecting Africa’s genetically diverse population, the 54gene biobank in Nigeria contains biological samples from the surrounding area.

The Need for African Genome Research

Currently, Caucasians are the most genetically researched, despite being a minority in the world population. At the time of 54gene’s launch, it had collected only 3% of genetic testing from Africa. The organization’s African genome research creates an opportunity to develop medicine unique to the African population. With technological advances, genetic testing is creating more precise and personalized medicine. It is 54gene’s mission to create a more equitable research pool and to include Africans in medical advances.

54gene’s recent funding has brought the project over $19 million, expanding its lab capabilities. The project received $4.5 million in seed funding and another $15 million in Series A funding. The cash flow into the project demonstrates the importance of their research the potential impact of this medical discovery. By funding this research, there is an acknowledgment of the gap in genetic testing and a means to address the disparity. The significant growth of the company is an investment in African healthcare and a phenomenon in global health advancements.

The Benefits of Genetic Mapping in Africa

The genotypes of Africans are the most genetically diverse in the entire world, and 54gene’s research has the potential for massive breakthroughs in developing new drugs tailored to their genome. The exclusion of Africans from genetic research has resulted in the exclusion of an entire continent from personalized medication. Fortunately, 54gene’s genetic mapping uses collected DNA samples to build drugs tailored to specific populations. The project has the potential of revolutionizing healthcare in Africa, with its long-term value increasing with technological advances in the medical field.

The organization aims to create research and co-develop drugs for diseases that disproportionately affect Africans. For example, records have determined that 92% of the world’s malaria cases occur in Africa. Customized medicine could lessen the effects malaria has on future generations of Africans. 54gene aims to not only produce research and drug trials but to also make it affordable. Its founder has a commitment to balancing the for-profit side of the business with the need to enhance medicine in Africa. Since the arrival of the pandemic, 54gene has also directed efforts to COVID-19 testing and screening for more immediate needs.

54gene is addressing major issues of inequality in the medical field and improving medicine in Africa. The organization’s African genome research is making strides in African healthcare. Its research has the potential to target non-communicable and infectious diseases that affect the African population on a larger scale. Not only is this research imperative, but it is a movement towards leveling the quality of medical treatment on a global scale.

Eva Pound
Photo: Flickr