This article develops an analytical approach towards the study of health in -

* Valores obtidos por soma. Há dupla contagem, tendo em vista que o pesquisador que participa de dois ou mais grupos classificados em grandes áreas predominantes diferentes foi computado uma vez em cada grande área.

No abstract

This paper puts health questions within the context of national development and industrial policy. It follows the idea of structuralist, Marxist and Schumpeterian approaches, in which industry and innovations form determining factors for the dynamism in capitalist economies and relative positions within the world economy. All countries that have developed and started to compete under better conditions with advanced countries have had an association between strong industry and an endogenous knowledge, learning and innovation base. However, in the field of health, this vision presents problems because business interests move according to the economic logic of profit rather than to meet health needs. The notion of the health-industrial complex is an attempt to provide a theoretical reference that enables linkage between two distinct types of logic: health and economic development. This study has sought to show, on the basis of foreign trade data, how disregard for the logic of health policy development has led to a situation of economic vulnerability in this sector, which may limit the objectives of universality, equality and comprehensiveness. Within this context, a cognitive and political break with these antagonistic visions that put health needs on one side and industrial needs on the other is proposed. A country that aims to reach a condition of development and independence requires strong innovative industries and an inclusive and universal health system, at the same time.

Recognizing the importance of generating and disseminating innovation for the social and economic development of capitalist countries and the systemic, institutional, and historical nature of this process, this paper emphasizes the need to deal with innovation in

The concept and approach of the Health Economic-Industrial Complex (HEIC) were present in the advancement of the Unified Health System (SUS) in the last decades, contributing to the incorporation of an agenda related to the national pattern of development. The paper reconstructs this approach to capture its dynamics and demarcate the vision developed in this paradigm. It reveals the thinking matrices of the field of political economy that provide the analytical substrate for its development, allowing us to confront the reductionist use of the concept. It highlights, therefore, the logical foundations that guided the public policies resulting from this approach, with emphasis on the systemic approach and the use of state purchasing power, through the Productive Development Partnerships (PDP), marking the effort to articulate the social and economic realms of development. At present, this analytical perspective is even more crucial, showing that well-being not only fits into GDP but can also be a lever for a pattern of development committed to the National Health Universal System (SUS), society and economic and technological sovereignty in health.

Saúde e territorialização na perspectiva do desenvolvimento Health and territorialization from the perpective of developmentResumo A relação entre saúde e desenvolvimento é complexa e remete ao campo da economia políti-ca, dado que envolve diferentes interesses sociais, políticos e econômicos. No caso brasileiro, esta associação é particularmente relevante no que diz respeito à dimensão territorial, tendo em vista o papel central dos serviços de saúde para organização da rede urbana e delimitação de escalas e limites territoriais. No campo teórico-conceitual, o artigo explora vertentes analíticas das relações entre saúde e desenvolvimento, bem como entre a saúde e a questão territorial. A seguir, analisa a trajetória da política de descentralização e regionalização do Sistema Único de Saúde (SUS) e dos investimentos federais, que constituem a base de sua evolução espacial. A partir da revisão conceitual e dos dados empíricos, procuram-se estabelecer os nexos teóricos e político-institucionais entre saúde e desenvolvimento, buscando subsidiar a discussão dos desafios para uma nova inserção da saúde no modelo de desenvolvimento brasileiro, historicamente marcado por desigualdades econô-micas e sociais com forte expressão territorial. Palavras-chave Sistemas de saúde, Desenvolvimento regional, Investimentos em saúde, SUS Abstract The relationship between health and development is complex and lies in the field of political economy, given that it involves different social, political, and economic interests. In the Brazilian case, this association is particularly relevant in terms of the territorial dimension, in light of the central role of healthcare services in the organization of the urban network and the demarcation of territorial schedules and limits. In the theoretical-conceptual field, this study explores analytical areas that approach the relations between health and development, as well as between health and the territorial issue; and analyzes the history of the decentralization and regionalization policy in the Unified National Health System (SUS) and Federal investments that constitute the basis for its spatial evolution. Based on this conceptual review and empirical data, the study attempts to establish theoretical and political-institutional connections between health and development. The aim is thus to support the discussion on challenges facing a new role for health in the Brazilian development model, historically marked by economic and social inequalities with strong territorial overtones.

A sustentabilidade estrutural do sistema de saúde brasileiro remete ao padrão de desenvolvimento do País em função de como este se expressa e reproduz na saúde de sua população. Isso decorre não somente de sua dimensão social como também da econômica, uma vez que responde por parcela signifi cativa do produto interno bruto e da criação de empregos, e exerce relevante impacto na geração de inovação e competitividade nacional. O governo federal tem institucionalizado o papel da saúde na agenda de desenvolvimento nacional devido a seu caráter estratégico. A despeito disso, a fragilidade de sua base produtiva continua confi gurando importante vulnerabilidade para o Sistema Nacional de Saúde e para uma inserção competitiva em ambiente globalizado, sinalizando que a efetivação virtuosa da relação entre saúde e desenvolvimento envolve uma ruptura de paradigmas cognitivos e políticos que separam, de forma estanque, a ordem econômica da social. DESCRITORES: ABSTRACTThe structural sustainability of the Brazilian health system refers to the country's pattern of development according to how this pattern is expressed and reproduced in the Brazilian population. This derives not only from its social dimension, but also from the economic one, as it accounts for a signifi cant part of the gross domestic product and of job creation, and produces a great impact on the generation of innovation and national competitiveness. The federal government has institutionalized the role of health in the national development agenda due to its strategic aspect. Despite this, the fragility of its productive base continues to be a major vulnerability for the National Health System and for Brazil's competitiveness in a global environment. This signals that the virtuous establishment of the relation between health and development involves the rupture of cognitive and political paradigms that separate, in an impermeable way, the economic from the social order.