Integrating science, technology and health policies in Brazil: incremental change and public health professionals as reform agents

Brazil has encouraged an ambitious set of policies toward the pharmaceutical industry, aiming to foster technological development while meeting health requirements. We characterize these efforts, labeled the “Health-Industry Complex” (Complexo Industrial da Saúde, CIS), as an outcome of incremental policy change backed by the sustained efforts of public health professionals within the federal bureaucracy. As experts with a particular vision of the relationship between health, innovation, and industry came to dominate key institutions, they increasingly shaped government responses to emerging challenges. Step by step, these professionals first made science and technology essential aspects of Brazil’s health policy, and then merged the Ministry of Healths’s new focus on science, technology, and health, with industrial policy measures aimed toward private firms. We contrast this depiction of these policy changes with a conventional view that relies on partisan orientation of the Executive