Public health challenges and emerging diseases: the case of São Paulo

Abstract

The author discusses the challenges posed by emerging infectious diseases in 100 years of public health in the state of São Paulo, Brazil. With an advanced and organized public health system, São Paulo responded to the emergence of infectious diseases by creating research institutions and control programs. The late 19th century witnessed the first modern research institution in microbiology, in response to the bubonic plague. A changing economy led to constant changes in ecosystems. The late 20th century presents a wide array of both emerging and rapidly changing infectious diseases. The present situation calls for creative solutions. Ecosystem analysis and more agile epidemiological surveillance are seen as the best alternatives.

Successes and failures in the control of infectious diseases in Brazil: social and environmental context, policies, interventions, and research needs

“…Finally, changes in urban and rural environments were associated with emergence of new infectious diseases (eg, Brazilian haemorrhagic fever, hantaviruses). [20][21][22] Diseases that were previously well controlled were reintroduced to Brazil (dengue 17 ) or underwent epidemiological changes that compromised their eff ective control (visceral and cutaneous leishmaniases, 13 hepatitis C 23 ). 24 Reductions in mortality from some diseases were not always accompanied by reduction in incidence; tuberculosis and HIV/AIDS are still a public health problem in many regions of the country, despite substantial decreases in mortality rates since the mid-1990s.…”

Ecosystem approaches and health in Latin America

“…Of these, four adopt a vector ecology approach 7,8,9,10 ; two study the interface between vector ecology and the ecosystem as a modified place 11,12 ; eight deal with the ecosystem as a place that has been modified and become disease-prone 13,14,15 , in which viruses are present 16,17 , where diseases occur 18,19 , and as the place in which intervention should occur 20 ; and nine adopt ecosystem approaches which in some way include the premises laid out in the WRI report 1 . Only one of the nine studies was published by a Brazilian researcher 3 .…”