Brazil's "Health Castle" Marks Centennial
By Umberto Trigueiros, Wagner de Oliveira, and Carlos Wilson de Andrade Filho, photo Dristina Clarke/The Oswaldo Cruz Foundation
A picture-postcard Moorish castle in Rio de Janeiro is the home of the largest biomedical research institution in Latin America and one of the most respected in the world: the Oswaldo Cruz Foundation. FIOCRUZ is embarking on its second century, and it does so with feet firmly planted in tradition and eyes looking toward the future.
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FIOCRUZ, an agency of the Brazilian Ministry of Health, reaches its centennial secure in the knowledge that it has kept the dream of its creator alive. It is a multidisciplinary center for experimental medicine that fulfills a highly important social role in its country. It carries out basic and clinical research; conceives technology; produces vaccines, reagents, and medicinal drugs; develops human resources; controls quality; provides medical and hospital services; and participates actively in the formulation of national health policies-exactly as Oswaldo Cruz, a doctor and microbiologist who served as Brazil's Director of Public Health, intended.
To a large extent, the history of FIOCRUZ is the story of public health and scientific development in Brazil. Its centennial coincides with the consolidation of Brazilian scientific research, the institutionalization of public health, the rediscovery of rural Brazil, and the crea-tion of new national projects.
Its 800,000-square-meter campus has room, not only for the traditional and the modern, but also for the enchanting. A small train, built for the use of visitors, starts out from its station to make a grand tour from the castle that includes the Museum of Life, the Science Park, and the gardens of poisonous plants at the Central Library.
FIOCRUZ reaches out to the rest of Brazil through its regional research centers in Belo Horizonte, Recife, and Salvador's Advanced Technical Office in Manaus (soon to become a regional research center for the Amazon area). Its graduates fan out to all parts of the country and pass on the knowledge they have acquired. Every year more than 1,300 students are enrolled in its graduate-level courses alone.
Created in 1900, with the Pasteur Institute as its model, FIOCRUZ follows its original plan to this day. It brings varied activities together in the same space, establishes a close relationship between research and public health, and secures flexibility and financial autonomy through mutual agreements and the marketing of its products and services.
In addition, it has played a uniquely active role in national policy-making in the area of health by participating in a reorganization of the national medical and public health system, which resulted in the creation of the Unified Health System (SUS). In addition, FIOCRUZ called for health care to be recognized as a right of all citizens-a right that is now enshrined in the current constitution.
The 3,131 staff members are divided into 12 technical and scientific units, 8 of them in Rio de Janeiro, plus 7 support units and a representative in Brasília. They are trained and accustomed to respond to the requests that the institution receives from the Brazilian people.
This tradition has given it credibility in the public eye and prestige in the national and international scientific community. According to the U.S. Institute for Scientific Information (ISI), FIOCRUZ investigators rank among those who are most often cited internationally, a key criterion in the world scientific community.
Today, FIOCRUZ is one of the most important health centers in Brazil. In addition to being the largest national producer of immunobiological agents, with the capacity to turn out 200 million doses of vaccine, it has also become an important source for the supply of medicinal drugs used in the Unified Health System, producing some 300 million pharmaceutical units a year.
The quality control laboratories perform some 5,700 tests annually on products such as vaccines, drugs, cosmetics, and food. The medical care units conduct more than 60,000 clinical examinations a year and provide some 360,000 consultations. In the area of education, FIOCRUZ is the principal non-university institution in Brazil responsible for human resources development in the health field. It has already trained nearly 15,000 professionals, who are contributing to the improvement of health services, and it currently has 700 students enrolled in its master's and doctorate programs.
FIOCRUZ has also played a pioneering role in terms of the ethical responsibilities it has assumed, from setting the criteria for human and animal research to discussing guidelines for biosafety. Its ongoing exchanges with research centers and institutions around the world ensures that it has the vitality to act at the cutting edge of medical knowledge.
It is also the site of various reference centers of the Pan American Health Organiza-tion and the World Health Organization and is a participant in one of the most ambitious undertakings of contemporary biology, the international Parasite Genome Project, which is mapping the genetic code of parasites involved in diseases of public health importance, including Trypanosoma cruzi (the cause of Chagas' disease) and Schistosoma mansoni (the cause of schistosomiasis), among others.
FIOCRUZ is also in the process of setting up a scientific computing center that will enable it to use high-performance computer algorithms for processing images, studying the makeup of molecules, manipulating huge databases like the one being used in the Genome Project, and studying the population dynamics of infectious diseases.
Organization
The Oswaldo Cruz Foundation, as an agency of the Brazilian Ministry of Health, carries out activities in the area of health science and technology, including basic and applied research; education; in-hospital and outpatient referral care; the formulation of public health strategies; information dissemination; human resources development; the production of vaccines, medicinal drugs, diagnostic kits, and reagents; quality control; and the development of health technology.
All in all, the work of FIOCRUZ is a key aspect of government action in the fields of public health and health science and technology. This can be seen in its contribution toward self-reliance in the supply of immunobiologicals, the technology it develops for the diagnosis of communicable diseases, its provision of technical support for public health monitoring activities, its programs for the formation of human resources in health science and technology, and the referral care that it provides.
The Foundation's budget is made up of funds from the national treasury, resources received under agreements and projects carried out with international development agencies, and direct income from the sale of products and services.
Scientific Contributions
The secret of the Foundation's eminent success in research lies in the particular combination of its spirit of investigative freedom and social commitment. Nothing is off-limits to the researchers, and no public health need of Brazilians has been ignored by the scientists.
The discovery of Chagas' disease was a prime example of the institution's success. For the first and only time, a single medical researcher described a new disease and discovered the causative agent, the vector, and the manner of transmission. Carlos Chagas alone had made the commitment to go deep into the interior of Brazil to study the disease and help save the poor and the sick.
In contrast to the case of Chagas' disease, where the work of FIOCRUZ introduced a new disease, in other instances quite the opposite happened and diseases that had long tormented Brazilians were driven into extinction by the Founda-tion's efforts and their names are now almost unknown today.
Such was the case, for example, of blackleg, a disease that decimated the country's cattle in the early decades of the 20th century and was eradicated using a vaccine developed by Rocha Lima, Gomes de Faria, and Alcides Godoy in 1908.
Adolpho Lutz of the Foundation developed a complete description of the fungus that causes paracoccidioidomycosis, and Henrique da Rocha Lima discovered the microorganism that causes exanthematic typhus. This same Rocha Lima, with the help of Arthur Neiva, also identified the coffee borer, an insect that was badly damaging Brazil's economy.
The practical benefits of research conducted at FIOCRUZ may be seen on the other side of the world as well. In the early 1900s, Henrique Aragão discovered the virus that causes infectious myxoma, a disease in rabbits, which made it possible to control the population of this animal in Australia, where it had become a plague.
It was at FIOCRUZ that Gaspar Viana discovered Leishmania braziliensis, the agent of a new type of leishmaniasis-the mucocutaneous form. This discovery revolutionized the treatment of the disease, which had been killing 70 to 90 percent of its victims.
The scientific collections that have been built up over 100 years are repositories of highly valuable information for researchers from all over the country and abroad. The entomology collection has some 800,000 insects and acarids, while more than 4,000 sample lots of freshwater mollusks can be found in the malacology collection.
The bacteria collection, with 5,000 samples, includes one of the most complete repositories in the world of entero-bacteria. The helminth collection, which has 33,000 samples, is the only one of its kind in Latin America. The mycology collection, in turn, brings together 1,877 fungi from Brazil and other countries, and it was thanks to this resource that the Pasteur Institute was able to rebuild its own collection after it was destroyed during World War II.
The scientists at FIOCRUZ were the first in the country to isolate the hepatitis A, AIDS, and dengue viruses, thus opening up numerous lines of research for the development of diagnostic tests and vaccines specific to conditions in Brazil. In the 1980s, FIOCRUZ brought the world's attention to the existence of two new virus groups that cause diarrhea: Picobirna and Picotrirna.
Enzymes and oligonucleotides emanating from the Foundation's technology development laboratories are sent to other research laboratories to help create a genetic engineering infrastructure in Brazil. In 1991, an antigen of Trypanosoma cruzi produced at FIOCRUZ using the recombinant DNA technique was recognized by the World Health Organization as the most efficient and reliable indicator for the diagnosis of Chagas' disease.
A vegetal molluscicide for combating schistosomiasis-and plant-based remedies for malaria-are the most recent results of the application of modern biotechnology techniques to the study of Brazilian flora. At FIOCRUZ, its wealth of knowledge in biotechnology is teaming up with the natural wealth of biodiversity and pointing the way to the future.
Umberto Trigueiros and Wagner de Oliveira are Communications Officers at FIOCRUZ, and Carlos Wilson de Andrade Filho is a journalist in PAHO's Brasilia office.