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The legacy of Joseph Schumpeter 23 is a primary reference for addressing relationships that involve innovation and economic development. Brazilian government investment has remained pretty much stable since , while private sector investment increased somewhat With its strong demand for commodities to feed a fast-growing population, China has protected exporting nations from falling demand in North America and the EU, since However, the most recent analysis reveals that the commodity boom has reached an end, revealing structural deficiencies, in particular in Brazil and the Russian Federation Expenses with drugs and the like are quite significant in Brazil.

This premise is supported by Vargas et al. In this sense, one of the strategic areas to foster innovation resulting in new drugs for the population is Clinical Research, which acts as a bridge between biotechnology research and manufacturing. The State, as the intermediary, formulates and enforces measures to generate development for the social apparatus Unlike other market goods such as electronics or food, health is a public asset, also subject to market failures, but one that involves human life, the greatest asset of all Supporting the healthcare process requires involving numerous different players in a range of networks, built specifically for this context, but without ignoring individual safety and care.

Over time, understanding how these interests are interrelated was decisive for designing policies and integration mechanisms. The priorities of clinical research should be included in all 24 sub-agendas of the National Agenda of Healthcare Research Priorities as a strategy. Niches with a high potential for success are vaccine and immunobiological production, and new diagnostic techniques.

New products for treatment, prevention and health promotion such as herbal medicines, drugs and medicines, blood derivatives, homeopathic drugs and inputs for supplemental practices, as well as health prevention and promotion 11 , Even though National Agenda of Healthcare Research Priorities is unquestionably relevant for equal distribution of research funds, it is also essential to consider that, while desirable, professionals are not always ready to use the results. Bringing together those who do research and those who make policies could be a strategy to consider 31 , Clinical research as performed at universities and teaching and research institutions contributes to this premise, as it provides opportunities for training healthcare professionals, technical and scientific exchange, development and improvement of teaching and research methods, and new therapeutic options for patients, which can be used by hospital managers to help steer teaching, research and care activities.

Clinical Research is research on human beings or on materials of human origin such as tissues, specimens or cognitive phenomena , where an investigator or team member interacts directly with participants. In-vitro studies using human tissue not associated with a living individual are excluded. Clinical research includes: a the mechanisms of human disease; b therapeutic interventions; c clinical trials; d the development of new technologies. Clinical research is also used by healthcare managers to make decisions, with studies to supplement scientific evidence and subsidize decisions common to the practice of Healthcare Technology Assessment.

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This practice is based on the premise of defining clinical guidelines and protocols, regulating drug prices and formal policies for assessment, incorporation and management of technologies within SUS Clinical trials are one type of clinical research, designed to investigate the efficacy and safety of medicinal products and medical procedures in human beings, making it possible for them to be used in medical practice.

For the most part they are multi-center, multi-institutional and sometimes multi-sector or multi-national, depending on the complexity involved in the processes in question. They tend to involve centers of excellence with highly trained professionals using research protocols designed according to strict ethical and good clinical practice criteria, solid knowledge bases and backed by prior studies and knowledge of how the target disease evolves.

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The entire clinical process, from planning through study end, must follow well established regulations set by the agencies created to protect participant rights Conep and Anvisa in Brazil , ensuring results of high scientific quality 35 , These studies are conducted in phases, as shown in Figure 2. If the results of a phase are positive, the study moves on to the next one. Source: Pinho et al.

Each phase in clinical trials must complete certain elements in order to achieve scientifically robust and reliable results. This is general data as, in the case of clinical trials for some pathologies, such as in the complex case of cancer, certain specificities must be taken into consideration. This leads to multi-sector agreements involving the government, development agencies, universities, hospitals, etc.

Regarding the milestones we analyzed, the federal government has clearly made an effort to provide the instruments required to promote the production of health and healthcare. One interesting question is the possibility of a conflict of interest between private enterprise and public healthcare market vs. It is essential to understand what science, technology and innovation mean within the dynamics of the different players. For example, including the pharmaceutical industry in partnerships for performing clinical trials, using the infrastructure created within the RNPC, may be a strategy to strengthen the necessary development of clinical research in Brazil.

Centre for Health Policy and Innovation

This teaches us that collaboration as a network, as described by Martins 38 , enables the incorporation and sharing of knowledge in production processes. Added to this is the fact that, when signing a partnership agreement and sharing resources, each player enables strategic directionality, in the sense of composing the mission, goals and functions of this type of bond, expressed in the agenda of priorities defined by SUS.

The Healthcare Production Complex undeniably and increasingly needs science to maintain itself. Clinical research creates scientific knowledge to tackle public health issues, using subsidies to generate new technologies or improve existing techniques, processes and technologies, produced, marketed and sold in the different segments, and thus feeding the entire Economic-Industrial Healthcare Complex. This idea covers networks and their connections. Thus, assessing these relationships in the context of this article means considering the progressive strengthening and extension of the interaction between the research and development system and the healthcare production system, and its ability to fund itself, and management of the State regulatory structure.

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Marques EC. Freeman C. London: Pinter; National systems of innovation: Toward a theory of innovation and interactive learning.

London: Anthem Press; Nelson RR. National innovation systems: a comparative analysis. Oxford: Oxford university press; Costa LS. Rio de Janeiro: Fiocruz; Almeida-Andrade P.

WHO | Centre for Health Policy and Innovation

Pesquisa no Brasil: a reforma tardia. Defining and implementing a national policy for science, technology, and innovation in health: lessons from the Brazilian experience. Cad Saude Publica ; 22 9 Goldbaum M, Serruya SJ. Cad Saude Publica ; 22 3 Iozzi FL. Schumpeter JA. In: Journal of Economic Literature ; Campinas: Saberes Editora; Unesco Science Report: towards In: Fiocruz. Revista Continentes ; 1 7 Revista Brasileira de Enfermagem ; 63 5 Silva R, Caetano R. Cad Saude Publica ; 27 4 Elias FTS. Dainese SM, Goldbaum M. The study will adopt a multi-method approach, with qualitative and quantitative data-gathering and analyses.

This will involve desk research, a literature review, workshops, key informant interviews across stakeholder groups, a survey, case studies and economic modelling. The emerging insights report is based on the insights from the first phase of the study and discusses what has been learnt so far through stakeholder interviews and workshops. It highlights that successful innovation in the health system happens when combinations of drivers come together at national and local levels, and discusses how this happens in practice.

These drivers span:. The second phase of the study will build on the insights gained thus far to identify what are likely to be the highest impact actions that could enhance the contribution of innovation to health system performance.