All the contents of this chapter, except where otherwise noted, is licensed under a Creative Commons Attribution-Non Commercial-ShareAlike 3.0 Unported.Todo o conteúdo deste capítulo, exceto quando houver ressalva, é publicado sob a licença Creative Commons Atribuição -Uso Não Comercial -Partilha nos Mesmos Termos 3.0 Não adaptada.Todo el contenido de este capítulo, excepto donde se indique lo contrario, está bajo licencia de la licencia Creative Commons Reconocimento-NoComercial-CompartirIgual 3.0 Unported. Caminhos da saúde pública no BrasilJacobo Finkelman (Org.

The COVID-19 pandemic is unprecedented. The pandemic not only induced a public health crisis, but has led to severe economic, social, and educational crises. Across economies and societies, the distributional consequences of the pandemic have been uneven. Among groups living in vulnerable conditions, the pandemic substantially magnified the inequality gaps, with possible negative implications for these individuals' long-term physical, socioeconomic, and mental wellbeing. This Viewpoint proposes priority, programmatic, and policy recommendations that governments, resource partners, and relevant stakeholders should consider in formulating medium-term to long-term strategies for preventing the spread of COVID-19, addressing the virus's impacts, and decreasing health inequalities. The world is at a never more crucial moment, requiring collaboration and cooperation from all sectors to mitigate the inequality gaps and improve people's health and wellbeing with universal health coverage and social protection, in addition to implementation of the health in all policies approach.

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Snakebite envenoming affects close to 2.7 million people globally every year. In Brazil, snakebites are reported to the Ministry of Health surveillance system and cases receive antivenom free of charge. There is an urgent need to identify higher risk areas for antivenom distribution, and to develop prevention activities. The objective of this study is to provide an overview of the epidemiological situation of snakebite envenoming in Brazil and explore possible drivers; as well as to create a flowchart tool to support decision-makers identify higher risk areas. An ecological-type study was carried out using data by municipality (2013–2017). Study parts: 1) Create a geocoded database and perform a descriptive and cluster analysis; 2) Statistical analysis to measure the association of snakebite and possible environmental and socioeconomic drivers; 3) Develop a flowchart to support decision-makers and the application of this tool in one state (Rio Grande do Sul) as an example. An average of 27,120 snakebite cases per year were reported at the country level. Clusters of municipalities with high numbers of snakebites are mostly found in the Amazon Legal Region. The negative binomial regression model showed association with the snakebite case count: the type of major habitat, tropical or non-tropical; temperature; percentage of urbanization; precipitation; elevation; GDP per capita; a weaker relation with forest loss; and with venomous snake richness. The state where the instrument was applied reported 4,227 snakebites in the period. Most municipalities were considered as medium risk and 56/496 as high risk according to the tool created. Snakebite cases are distributed across the entire country with the highest concentration in the Legal Amazon Region. This creates a complex situation both for better understanding of the association of environmental and socioeconomic factors with snakebites and for the distribution and maintenance of antivenom to remote areas. Research into types of antivenom with a longer shelf life without the need for refrigeration is needed.

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Public health in Brazil achieved remarkable development at the turn of the 20th century thanks in part to physicians and social thinkers who made it central to their proposals for "modernizing" the country. Public health was more than a set of medical and technical measures; it was fundamental to the project of nation building. I trace the interplay between public health and social ideas in the late 19th and early 20th centuries. Physicians and social thinkers challenged the traditional belief that Brazil's sociocultural and ethnic diversity was an obstacle to modernization, and they promoted public health as the best prescription for national unity. Public health ideas in developing countries such as Brazil may have a greater impact when they are intertwined with social thought and with the processes of nation building and construction of a modern society.

As atividades de construção de infra-estrutura de comunicações realizadas pela Comissão Rondon (1900-1930) notabilizaram-se por seus contatos com sociedades indígenas. Pouco conhecidas são as pesquisas científicas feitas por seus membros indissociáveis dos objetivos de modernização, ocupação e integração do interior do país por parte do então recém-instaurado regime republicano. Este artigo analisa o impacto das atividades científicas da Comissão em áreas como botânica, geologia e zoologia, assim como o inédito campo de trabalho que elas ofereceram para pesquisadores e naturalistas brasileiros crescentemente incorporados às suas diferentes viagens de exploração.

OVID-19 diagnostics, therapeutics and vaccines are powerful reminders: health technologies can help to shape the way in which societies control disease. Challenges in ensuring global, equitable access to these fruits of biomedical research and development (R&D) during the COVID-19 pandemic have highlighted the urgency of reorienting the system towards the public interest. The first step is a clearer articulation of what R&D in the global public interest is. That is what we seek to do here.There are four major concerns about biomedical R&D, despite its impressive technological advances amid profound transformations in how knowledge is generated and used. The first is the lack of medicines in areas where market incentives are inadequate to attract private investment, such as for neglected diseases of poverty, bacterial infections and emerging infectious diseases 1 . Second is the slow pace of progress in some areas, such as Alzheimer's disease 2 . Third is the risk of harm, such as adverse drug reactions. The final concern is restricted access to technologies, caused by high prices, insufficient production or inadequate supply 3 .These concerns pre-date the emergence of the coronavirus SARS-CoV-2, but the pandemic has underscored the urgency of addressing them. That requires looking beyond just one country or sector.Biomedical R&D is increasingly global. Historically, it was concentrated in the advanced industrialized countries (excluding Inequitable access to the fruits of research during the COVID-19 pandemic highlights the urgency -and feasibility -of overhauling the R&D system.