From HIV in organ transplants to dengue-contaminated transfusions, Brazil’s public health scandal escalates.

Public health at risk due to hurricane in Brazil after six patients from the state of Rio de Janeiro became infected with the HIV virus from their organ transplants. This is a black page for the state system, because it was not just a human error, but, as the first investigations show, conspiracy created for greater gain without paying attention to the necessary controls. At the moment four people were arrestedone of the owners of the private clinical pathology laboratory of Dutor Salem and three of his employees. According to Brazilian law, All donor organs must be serologically tested for HIV, hepatitis B, hepatitis C and other infections.. Police are now investigating why the virus was not detected in the transplanted organs. Problems began to emerge in September when a patient who had received an organ from one of those donors was admitted to the hospital with neurological symptoms and tested positive for HIV, despite not having the virus before the surgery. The case may spread to many other patients. According to the prosecutor leading the case, Elisa Ramos Pittaro Neves“The suspects and the laboratory” have already “produced dozens of false positives and false negatives for HIV, even in tests performed on children.”

Except, Investigations will need to determine whether fraud is behind serious medical errors. when researching organs for transplantation. Rio de Janeiro’s regional pharmaceutical council said the private laboratory was not on its register, nor were its pharmaceutical employees. According to the newspaper Or a globeAccording to the government transparency portal, until October this year, the laboratory concluded a contract for services worth 21.58 million reais ($3.79 million). According to a Brazilian newspaper, the technical feasibility of conducting the exams was questioned by a competitor during the bidding process. It also turned out that one of the owners of the laboratory is the cousin of the former Minister of Health of the state of Rio de Janeiro. Dr. Luizinhocurrently federal representative of the Progressive Party. The lab was hired three months after the secretary left his post. The politician said that he had known about the laboratory for more than thirty years and hoped that the perpetrators would be punished. Many are now wondering why the public laboratory of the Arthur de Siqueira Cavalcanti State Institute of Hematology, the so-called Gemorio Rio de Janeiro, considered an outstanding center of Brazilian medicine, was not used. In this laboratory, 286 donor samples are being retested to see if there are any other cases, and for now the center will be responsible for analyzing new organs for the transplant network.

A technician at the pathology laboratory of the Dutor Salem clinic, whose signature was on the HIV tests, told the newspaper about this. Folha de Sao Paulo that he was used as a dummy, that is, he did not conduct tests and the certificate was later issued by a subsidiary company for which he did not even work. The laboratory denies the accusations. For the San Pablo Civil Police, “for the purpose of obtaining benefits,” the laboratory did not test reagents daily, indicating possible contamination. “To get more profit, the laboratory ordered them to be carried out weekly.“, said the Secretary of the Civil Police, Felipe Curi. President of the National Health Surveillance Agency (Anvisa), Antonio Barra Torresdescribed the situation as “very serious” and added that “it threatens the trust of a person who is already in such a delicate state of health and needs a transplant, which in itself is of great concern.” This event now only adds to the patient’s suffering,” he said.

In addition, according to the newspaper Oh globe The same laboratory has a contract with the Health Foundation, linked to the government of Rio de Janeiro, to conduct 1.7 million tests in 18 units of the state’s public network. The Federal Medical Council (CMF) asked the Ministry of Health to “take responsibility for its mission and offer answers so as not to jeopardize the credibility of the functioning of the national organ transplantation system throughout the country.” The CMF also reiterated to the authorities the need for clinical testing laboratories, “especially those providing services to the public health system, SUS, to be subject to exhaustive monitoring by the Health Surveillance Service, asking that they actually comply with the relevant criteria and protocols for their operation.” . The statement said that “this is an unacceptable situation that highlights the failings in the management of a very complex health sector, putting the lives of countless Brazilians at risk.” The Ministry of Health called for an urgent review of the entire transplant system in Rio de Janeiro. However, Minister Nisia Trindade admitted that she was aware of the case on September 14, but did not alert the police. “From the moment the new cases were confirmed and evidence began to emerge, I notified the Federal Police,” he said.

The scandal with organs infected with the HIV virus is not the only one that has caused controversy these days. In Parellas, a city in the northeastern Brazilian state of Rio Grande do Norte, at least eight patients lost an eye in public cataract surgery. Of the 48 people who had the surgery, 15 contracted a bacterial infection called endophthalmitis, which caused them to lose one eye. The municipality’s health department has launched a public investigation to determine what happened and possible liability.

Another problem that has arisen in recent days is that COVID-19 vaccinesadapted to the XBB coronavirus variant. Of the 12.5 million doses purchased last May for 725 million reais, 4.2 million did not reach their destination. 3 million are even expired, and 1.2 million will be exchanged for doses with a longer shelf life. As a result, the government does not have vaccines for immediate delivery. However, of the 8.26 million doses donated, only 3.1 million have been administered. 8 out of 10 people were not vaccinated, despite the fact that bivalent against coronavirus is recommended for the weakest groups and is included in the childhood vaccination schedule. Among the states with the lowest COVID-19 vaccination coverage are the Amazonian states of Mato Grosso (10.1%), Tocantins (12.1%), Acre (12.9%), Maranhão (13.2%) and Roraima ( 13.3%).

Alberto CebaboPresident of the Brazilian Society of Infectology (SBI), said CNN Brazil that “one of the biggest challenges we face is getting people to understand the need to take these doses, the importance of vaccination, because the disease continues to emerge en masse and continues to kill; This year alone, Brazil has recorded more than 5,000 deaths from Covid-19,” he said. In a statement, the Health Ministry promised that 1.2 million doses, intended exclusively for children, would arrive in the coming days. But it’s not just vaccines that are missing against Covid-19: A study by the National Confederation of Municipalities shows that 6 out of 10 cities report a lack of vaccines for children against diseases such as meningitis, measles, chickenpox and rubella, as well as against COVID-19.

And with the return of the heat, Brazil will also have to deal with dengue fever. In 2024, the country recorded 5,661 deaths from this disease, caused by the Aedes aegypti mosquito. According to the Ministry of Health’s arbovirus monitoring database, the number of infections already stands at 6,546,063 probable cases. This is the worst result in Brazilian history. San Pablo leads the way with 1,862 deaths, followed by Minas Gerais with 1,055, Paraná with 682 and the Federal District with 440. And in the coming months, with the arrival of summer, the scenario is likely to worsen.

In addition, in recent days the alarm has gone off due to another problem. The Sao Paulo state government is investigating. three cases of patients contracting dengue fever as a result of blood transfusion. Currently, the Ministry of Health guidelines for blood donation do not include testing for dengue virus. However, since March, the Brazilian Health Surveillance Agency (Anvisa) and the Ministry of Health have published a technical note updating recommendations for the control of dengue in blood donations. It recommends that people who have been sick for 30 days or have had sexual relations with people infected or vaccinated against dengue should not be considered eligible donors.

Finally, there is a race in Brazil to renew patents on some foreign drugs to treat diabetes and autoimmune diseases such as psoriasis. In fact, the legislative vortex was created after the ruling of the Supreme Electoral Court in 2021, according to which no molecule can have protection for more than 20 years after filing an application for registration with the National Institute of Industrial Property (INPI). But pharmaceutical companies whose patents were still being extended under another law, the Industrial Property Act 1996, have now filed requirements with the requirement to retain these rights until the expiration of the period established above. We’ll have to see if they succeed.