Minakawa Marcia Michie, Frazão Paulo
Public Health Graduate Program, University of São Paulo, São Paulo 01246-904, Brazil.
Department of Politics, Management and Health, School of Public Health, University of São Paulo, São Paulo 01246-904, Brazil.
Vaccines (Basel). 2023 Jul 1;11(7):1189. doi: 10.3390/vaccines11071189.
Public health policies are crossed by economic and political interests that can affect the maintenance of the immunization programs and their vaccination coverages. The aim was to investigate the political and economic conditions that marked the trajectory of the Brazilian immunization program from 1980 to 2018.
Documentary research gathered data on public expenditures with epidemiological surveillance and vaccine procurement and nationwide estimates of vaccine coverage. The scientific literature on the program's implementation and the country's political and economic conditions was examined. The theoretical approach was based on historical institutionalism.
The results showed rising, high rates maintaining and falling vaccination coverages in the period. As of 2010, there was a tendency for a reduction in total federal spending on epidemiological surveillance, putting pressure on the budgets of the sub-national governments in their respective areas of coverage, and on federal spending in dollars for the acquisition of immunobiologicals and inputs.
The amplitude and complexity of the program's trajectory have been crossed by diverse dynamics conditioned by economic and political interests reflecting at a deeper level the advance of capitalism through fiscal austerity measures over democracy's aspirations for greater balance and justice in the distribution of resources.
公共卫生政策受到经济和政治利益的影响，这些利益可能会影响免疫规划的维持及其疫苗接种覆盖率。目的是调查1980年至2018年标志着巴西免疫规划轨迹的政治和经济状况。
文献研究收集了关于流行病学监测和疫苗采购的公共支出数据以及全国疫苗接种覆盖率估计值。查阅了关于该规划实施以及该国政治和经济状况的科学文献。理论方法基于历史制度主义。
结果显示该时期疫苗接种覆盖率有上升、保持在高位以及下降的情况。截至2010年，联邦政府在流行病学监测方面的总支出有减少的趋势，这给各地方政府各自覆盖地区的预算以及联邦政府用于采购免疫生物制品和物资的美元支出带来了压力。
该规划轨迹的幅度和复杂性受到多种动态因素的影响，这些因素受经济和政治利益制约，在更深层次上反映了资本主义通过财政紧缩措施对民主在资源分配方面追求更大平衡和公平愿望的推进。
