Fernando Mussa Abujamra Aith

Intersectorial health-related policies: the use of a legal and theoretical framework to propose a typology to a case study in a Brazilian municipality

This article analyzes intersectorial health-related policies (IHRP) based on a case study performed in 2008-2009 that mapped the social policies of the city of Piracicaba, State of Sao Paulo, Brazil. The research strategy comprised quantitative and qualitative methodologies and converging information sources. Legal and theoretical conceptual frameworks were applied to the Piracicaba study results and served as the basis for proposing a typology of IHRP. Three types of IHRP were identified: health policies where the health sector is coordinator but needs non-health sectors to succeed; policies with a sector other than health as coordinator, but which needs health sector collaboration to succeed; and thirdly, genuine intersectorial policies, not led by any one sector but by a specifically-appointed intersectorial coordinator. The authors contend that political commitment of local authorities alone may not be enough to promote efficient intersectorial social policies. Comprehension of different types of IHRP and their interface mechanisms may contribute to greater efficiency and coverage of social policies that affect health equity and its social determinants positively. In the final analysis,, this will lead to more equitable health outcomes.

Prevalence of Trypanosoma cruzi infection among Bolivian immigrants in the city of São Paulo, Brazil

With the urbanisation of the population in developing countries and the process of globalisation, Chagas has become an emerging disease in the urban areas of endemic and non-endemic countries. In 2006, it was estimated that the prevalence of Chagas disease among the general Bolivian population was 6.8%. The aim of the present study was to determine the prevalence of Trypanosoma cruzi infection among Bolivian immigrants living in São Paulo, Brazil. This study had a sample of 633 volunteers who were randomly selected from the clientele of primary care units located in the central districts of São Paulo, Brazil. Infection was detected by two different ELISA assays with epimastigote antigens, followed by an immunoblot with trypomastigote antigens as a confirmatory test. The prevalence of the infection was 4.4%. Risk factors independently associated with the infection were: a history of rural jobs in Bolivia, knowledge of the vector involved in transmission, and having relatives with Chagas disease. Brazil has successfully eliminated household vector transmission of T. cruzi, as well as its transmission by blood transfusion. The arrival of infected immigrants represents an additional challenge to primary care clinics to manage chronic Chagas disease, its vertical transmission, and the blood derivatives and organ transplant programs.

O estatuto jurídico das águas no Brasil

To build the design of the Legal Status of Water in Brazil, international and national legal standards that address directly or indirectly the waters were researched and analyzed, focusing on the identification of the following elements: i) degree of formal and legal recognition of water as a fundamental human right in Brazil and in international law; ii) constitutional regime of the waters in Brazil; iii) legal status of the waters in domestic law and; iv) legal guarantees to protect the right to water. The research, qualitative, was held in the official pages of the Brazilian government and the United Nations, and the selected laws were those presenting content relevant to the theoretical construction of the Legal Status of Water in Brazil.

Produção de normas jurídicas sobre saúde no âmbito do estado democrático de direito brasileiro

Health legislation in Brazil is produced according to the country’s prevailing democratic rule of law and is mainly passed by Congress and regulated by the Federal Executive Branch. Direct popular participation is indispensable and serves to temper the exercise of power by the above-mentioned branches. Legislation enacted through this process organizes the Brazilian health system and conditions individual, collective, government, and commercial behavior and activities with the purpose of ensuring the right to health. The need for division of powers as a condition for balanced exercise of power in a society dates at least to 350 B.C., as discussed by Aristotle in Politics 1. The idea was consolidated with the advent of modern states 2 and especially in the explicit legal separation of powers under their respective Constitutions (e.g., US Constitution. http://1776.org/us-constitution/, accessed on 20/ Aug/2014). The division of government power into three branches consolidates the system of checks and balances, the principal objective of which is to balance the exercise of power, since each branch oversees and places limits on action by the other two, thereby avoiding abuses and arbitrary interventions. The complexity of social life, generating tension between the different branches of government, led to a qualitative change in the concept of rule of law, incorporating the adjective “democratic”. This signaled the need to balance traditional representative democracy (at the origin of the theory of separation of powers) with participatory democracy, a fundamental element for reinforcing the pursuit of justice in contemporary society. The field of health legislation is thus subject to constant tension between the powers and must be monitored closely by society in order to safeguard both the public interest and public health.

Health legislation and democratic rule of law in Brazil

Health legislation in Brazil is produced according to the country’s prevailing democratic rule of law and is mainly passed by Congress and regulated by the Federal Executive Branch. Direct popular participation is indispensable and serves to temper the exercise of power by the above-mentioned branches. Legislation enacted through this process organizes the Brazilian health system and conditions individual, collective, government, and commercial behavior and activities with the purpose of ensuring the right to health. The need for division of powers as a condition for balanced exercise of power in a society dates at least to 350 B.C., as discussed by Aristotle in Politics 1. The idea was consolidated with the advent of modern states 2 and especially in the explicit legal separation of powers under their respective Constitutions (e.g., US Constitution. http://1776.org/us-constitution/, accessed on 20/ Aug/2014). The division of government power into three branches consolidates the system of checks and balances, the principal objective of which is to balance the exercise of power, since each branch oversees and places limits on action by the other two, thereby avoiding abuses and arbitrary interventions. The complexity of social life, generating tension between the different branches of government, led to a qualitative change in the concept of rule of law, incorporating the adjective “democratic”. This signaled the need to balance traditional representative democracy (at the origin of the theory of separation of powers) with participatory democracy, a fundamental element for reinforcing the pursuit of justice in contemporary society. The field of health legislation is thus subject to constant tension between the powers and must be monitored closely by society in order to safeguard both the public interest and public health.

Regulação antidoping e saúde pública: limites à exposição humana ao risco sanitário e a glória desportiva

Given the current regulatory environment surrounding doping in the world, and in view of the recurring scandals linking leading athletes in a variety of sports with doping, this paper aims to provide some thoughts on the relationship between doping and public health, taking as base reference the risks doping poses to health and considering the regulatory options that have been adopted by the international community and the sports federations to control and supervise this unsporting and risky practice. The text seeks to reflect on the necessary balance between sport and health, as well as on the role of the state in preserving this balance.

Producción de normas legales sobre la salud en el estado democrático brasileño

Health legislation in Brazil is produced according to the country’s prevailing democratic rule of law and is mainly passed by Congress and regulated by the Federal Executive Branch. Direct popular participation is indispensable and serves to temper the exercise of power by the above-mentioned branches. Legislation enacted through this process organizes the Brazilian health system and conditions individual, collective, government, and commercial behavior and activities with the purpose of ensuring the right to health. The need for division of powers as a condition for balanced exercise of power in a society dates at least to 350 B.C., as discussed by Aristotle in Politics 1. The idea was consolidated with the advent of modern states 2 and especially in the explicit legal separation of powers under their respective Constitutions (e.g., US Constitution. http://1776.org/us-constitution/, accessed on 20/ Aug/2014). The division of government power into three branches consolidates the system of checks and balances, the principal objective of which is to balance the exercise of power, since each branch oversees and places limits on action by the other two, thereby avoiding abuses and arbitrary interventions. The complexity of social life, generating tension between the different branches of government, led to a qualitative change in the concept of rule of law, incorporating the adjective “democratic”. This signaled the need to balance traditional representative democracy (at the origin of the theory of separation of powers) with participatory democracy, a fundamental element for reinforcing the pursuit of justice in contemporary society. The field of health legislation is thus subject to constant tension between the powers and must be monitored closely by society in order to safeguard both the public interest and public health.