Molecular Sovereignty: Building a Blood Screening Test for the Brazilian Nation

Abstract

This article interrogates the relationship between the development of national diagnostic technologies and the exercise of sovereignty, by analysing a Brazilian project to produce a nucleic acid test (NAT) for the country’s blood screening programme. The concept of ‘molecular sovereignty’ is proposed to demonstrate that exercising sovereignty demands not only technological resources but also a sufficiently powerful and national imaginary to support local knowledge production as a means of advancing national healthcare priorities. First, this research article contextualises the political importance of blood safety for Brazil during its transition to democracy in the 1980s and the creation of its universal healthcare system. Then, it investigates how adopting the NAT led the state to invest in the production of a national technology. Third, the article unpacks the diagnostic test to consider how certain aspects of the project might ultimately strengthen the ability of global capital to cross national boundaries and create new markets. Lastly, it discusses how the project ended up creating a centralised and ‘closed’ system to avoid leaving the country vulnerable to the entry of global diagnostic companies. This case demonstrates how the molecularisation of blood, through the construction of a unified healthcare system driven by the constitutional right to health, can be deployed to construct imagined communities on the scale of a nation.

Rumo à equidade em saúde: por uma agenda de pesquisa e desenvolvimento e produção local orientada pelas múltiplas necessidades do Sistema Único de Saúde

“…Esse foco no produto final também negligencia outras vulnerabilidades. Uma delas é a necessidade de infraestruturas para desenvolvimento e produção de novas vacinas e testes 8 . Algumas iniciativas vêm buscando suprir essas lacunas, como o Centro Henrique Penna, de Bio-Manguinhos, que conta com uma planta piloto, o Centro de Produção Multipropósito de Vacinas do Instituto Butantã, com uma área de nível de segurança 3, e a previsão do Centro Nacional de Vacinas do Ministério da Ciência, Tecnologia e Inovação.…”

Towards equity in health: for an agenda for research and development and local production driven by the multiple needs of the Brazilian Unified National Health System

“…This focus on the final product also overlooks other vulnerabilities. One is the need for infrastructure to develop and produce new vaccines and tests 8 . Some initiatives have sought to address these gaps, such as Bio-Manguinhos’ Henrique Penna Center, which has a pilot plant; Butantã’s Multipurpose Vaccine Production Center, which provides for a security level 3 area; and the future National Vaccine Center of the Brazilian Ministry of Science Technology and Innovation.…”

Montenegro skin test: Distracted by the promise of modernity?

“…Bio-Manguinhos, the Institute of Technology on Immunobiologicals, is one example; in fact, this public laboratory was the second-largest supplier of the Montenegro skin test to the Brazilian Ministry of Health until 2003, when the CPPI became the only supplier. Bio-Manguinhos stopped producing the LST because it is so inexpensive and simple to manufacture, preferring to focus on higher value-added products that augment revenue and streamline the manufacturing process 6 . The LST is indeed very cheap: in 2015, the Ministry of Health paid only 7.00 BRL for each kit 7 .…”