The broad scientific program of CRICS10, focused on the contribution of evidence and knowledge for attaining the Objectives of Agenda 2030, included three Master Conferences delivered by experts from Brazil, Ecuador and the United States, all of which contributed with relevant information, innovative ideas and transformative approaches to discussions held during the Congress.
The topic of health is present in many of the Objectives of the 2030 Agenda, which establishes goals for the upcoming years for Member-States of the United Nations Organization (UN) for sustainable development. More recently, the Region of the Americas acquired a strategic and political framework specifically for health that is pioneer in the world: the Sustainable Health Agenda for the Americas (ASSA) 2018-2030.
ASSA 2030 was the theme of the opening conference of CRICS10, presented by Cristina Luna, from the Ministry of Public Health of Ecuador, on the evening of Tuesday, December 4th.
“ASSA 2018-2030 is the largest commitment agreed upon by health ministers at a regional level”, pointed out Dr. Cristina Luna. The document was elaborated by a work group composed of representatives from 18 countries of the Region, with the presidency of Ecuador and vice-presidency of Panamá and Barbados, in a process that was largely supported by public participation, through consultations that took place during one year, from October 2016 to September 2017.
“Some goals were adapted from the Sustainable Development Objectives – SDO [from the UN 2030 Agenda] in order to attend regional needs”, Dr. Luna explained. ASSA 2018-2030 is made up of 60 goals distributed in 11 objectives – two of which are directly related to the main topic of CRICS10: objective 6, “To strengthen health information systems in order to support the formulation of policies and decision-making based on evidence”, and objective 7, “To develop capacity in the generation, transfer and use of evidence and knowledge in terms of health, thus promoting research, innovation and the use of technology”, both composed of two goals each.
For Dr. Luna, “efficient management of information is directly related to development, well-being and health equity of peoples, through decisions that are informed, opportune and based on evidence”.
The second Master Conference of CRICS10 was delivered by Amanda Wilson, from the National Library of Medicine of the United States (NLM[1]), on Wednesday (5) morning. Entitled “NLM as a platform for biomedical discoveries and health informed by data: basis for collaboration in open science”, the Master Conference reported the efforts of the National Institutes of Health (NIH) in terms of information management for health based on data.
“Data is important for research, as well as for detailed monitoring of patients”, noted Dr. Wilson. According to the expert, technology can be helpful for individual treatment, for example through applications that remind patients when to take medication – and at the same time inform the doctor and maintain a record of the medication taken by the patient. Furthermore, individuals interact with the health system in many occasions throughout their lives, generating an immense volume of information. In this context, Dr. Amanda Wilson argues that technology may help to generate collective data that could lead to improvements in health.
Nowadays, health data is the focus of NLM initiatives and the basis for the institution’s strategic plan, resumed in three objectives presented by Dr. Wilson: 1) accelerate discoveries and advances in health though data-based research; 2) reach more people, in more ways, improving dissemination and commitment; 3) build a stronger work force for data-oriented research and health. According to Dr. Wilson, partnerships with federal agencies, industries, the academy and international organizations are essential: “one of our commitments is to work in strategic alliances in order to attain the objectives”, she remarked.
Sharing date is part of NIH culture, with policies that go back to the beginning of the century. The challenges faced for sharing and managing data are many, but the benefits, according to Dr. Wilson, are much larger. “Exchanging data is essential for accelerating the translation of research results in knowledge, products and procedures to improve human health”, Dr. Wilson noted.
“The 2030 Agenda in Brazil: what contributions can science offer”, was the title of the conference delivered by Henrique Villa da Costa Ferreira, from the National Secretariat of Social Articulation of the Government Secretariat of the Presidency of the Republic of Brazil, on December 6.
Ferreira remarked that we must begin now the changes we want for Brazil in 2030[2]. “The Agenda is for today”, he states. In reference to a speech delivered by Ban Ki-moon, former Secretary-General of the United Nations, Ferreira reiterates that Agenda 2030 is absolutely integrated, with objectives from different fields that are linked to each other. “For Brazil, this is an additional challenge, since our policies are strongly sectorized”, he pointed out.
“The 2030 Agenda is profoundly marked by Brazilian society”, declared Ferreira. According to the expert, the 2030 Agenda was created from the bottom-up, though a process during which the countries involved were largely consulted.
The first big challenge indicated by Ferreira for the implementation of the 2030 Agenda in the country is the internalization of the SDO. In other words, it is necessary to bring the proposed objectives from the global plan to the national plan, through strong national governance, adequacy of the goals to the Brazilian context, and definition of indicators for evaluating the delivery internally, as well as the country’s position in relation to other nations. “Brazil must go further. The 2030 Agenda goals are broad, they must be adapted to the Brazilian context in terms of the country that we expect in 2030”.
This part of the job is being well carried out, according to Ferreira. For example, global goal 3.1 forecasts a reduction in maternal mortality rates to less than 70 deaths per 100 thousand born alive. The proposal for adequacy in Brazil expects this maximum to be of 30 deaths for every 100 thousand born alive, since in 2015 Brazil already reported a MMR of 62 for every 100 thousand – and the Ministry of Health predicted a reduction of 51% of this rate until 2030.
The second and more complex challenge, according to Ferreira, is the matter of interiorization. “We are speaking of a country of continental proportions. We must bring in states and cities into the process”, he affirmed.
The increase of investments in research and development is described by Ferreira as essential for a truly sustainable development. Currently, the country invests 1,27% of the Gross Domestic Product (GDP) in science, technology and innovation (ST&I), but, according to the expert, it is necessary to increase investments to 2%.
Ferreira brought up a few successful examples from Brazilian science, which had a great impact on national economy in the areas of renewable energy, climate, bioeconomy, water and agriculture – Brazil being responsible for 6,5% of publications in the fields of biological and agricultural sciences in the world.
“ST&I are fundamental for equity, especially in a country with such a marked inequality as Brazil”, he stated. The expert recalls the National Strategy for ST&I, in force until 2018, which converges in many points with the 2030 Agenda and that “will have the Agenda as a basis for its development from now on”.
The speakers presented evidence on how efficient information management and scientific research in countries with such diverse contexts as the United States, Ecuador and Brazil, can effectively support the Region as a whole to attain the Objectives of the 2030 Agenda, and, in some aspects, possibly go even further. As the PAHO/WHO Director stated in her inaugural speech, “ASSA 2030 is a call for collective action in order to achieve elevated levels of health and well-being for the peoples of the Americas. The work of each and every one can contribute critically to inform complex decisions in all fields of public policies in health. Allow the motto ‘caring for all and not leaving anyone behind’ to invade our dreams and goals on the path to social justice, health and well-being for all”.
[1] The NLM, created in 1836, is the largest medical library in the world. Its essential services include the acquisition, preservation and dissemination of information; the conduction of research on health information; and the development and training of human resources in the field. Throughout its history, the institution has invested in methods and technologies that allow for better information management – from indexation, until the mid-20th century, digitalization, networks and, since 2016, data.
[2] Henrique Villa C. Ferreira is also executive secretary of the National Commission for the Sustainable Development Objectives (CNODS), created in 2016 by the Federal Government of Brazil and composed of representatives of the government, academy, third sector and private sector. Ferreira affirms that it is a gathering of actors with the commitment of implementing the 2030 Agenda in Brazil, associated to regulating organs that accompany the achievement of the proposed action plan, as a reference to the plan produced by the Commission to implement the 2030 Agenda in the country, with strategies, deadlines and national goals.