The health economic-industrial complex: production and innovation for universal health access, Brazil.

PROBLEM: The coronavirus disease 2019 (COVID-19) pandemic has highlighted global disparities in accessing essential health products, demonstrating the critical need for low- and middle-income countries to develop local production and innovation capabilities.

APPROACH: The health economic-industrial complex approach changed the values that guided innovation and industrial policies in Brazil. The approach directed health production and innovation to universal access; the health ministry led a whole-of-government approach; and public procurement was strategically applied to stimulate productive public and private investments. The institutional, technological and productive capacities built up by the health economic-industrial complex allowed the country to quickly establish local COVID-19 vaccines production and guarantee access for the population.

LOCAL SETTING: Brazil has a universal health system that guarantees access to health for its 215 million population.

RELEVANT CHANGES: Public policies and actions, based on the health economic-industrial complex, guided investment projects in line with health demands, strengthened local producers, and increased autonomy in the production of health products in areas of greater technological dependence. During the COVID-19 pandemic, the country was able to rapidly scale up local vaccine production. By August 2021, Brazil had produced 74.8% (151 463 502/202 437 516) of the vaccine doses used in the country.

LESSONS LEARNT: The Brazilian example shows that low- and middle-income countries can build systemic development policies that increase their capability to produce and innovate in concert with universal health systems. This increased capacity can guarantee access to health products and supplies that are critical during global health emergencies.