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  • Title: Medical technology and developing countries: the case of Brazil.
    Author: Banta HD.
    Journal: Int J Health Serv; 1986; 16(3):363-73. PubMed ID: 3733305.
    Abstract:
    Developing countries, faced with severe resource limitations, are trying to develop modern health care services that deliver sensible medical technologies. Because of their lack of development, these countries must import much technology, while often lacking the expertise to make wise choices. In this article, the case of Brazil is examined. Brazil has shared many of the problems of other developing countries, including inadequate access of the population to health services, maldistribution and excessive use of technology, a relatively weak national industry for production of drugs and medical devices, a weak policy structure for dealing with medical technology, and little tradition of using research or policy analysis as a guide to action. Since the election in 1985 that returned Brazil to democratic rule, the government has taken active steps to address many of these problems. The example of Brazil is important for all of the developing world to examine and follow, where applicable. In addition, North American and European aid programs could play a much more constructive role in helping less developed countries develop their health care services. International organizations such as the World Health Organization must also be active in assisting such countries to improve their decisions concerning medical technology. Developing countries, in attempting to improve their health care systems, must import much technology, and they often lack the expertise to make wise choices. On site, the technologies are often inexpertly applied, and along with expensive pharmaceuticals, they become a drain on national resources. Medical literature is often hard to obtain. This article examines the case of Brazil, which has shared many of the problems of other developing countries, including inadequate access of the population to health services, due in large part to a maldistribution of resources and wealth in general, and heavy private-sector control of health services. Other problems include maldistribution and excessive use of technology, a relatively weak national industry for production of drugs and medical devices, a weak policy structure for dealing with medical technology, and little tradition of using research or policy analysis as a guide to action. Since the election of 1985 that returned Brazil to democratic rule, the government has taken active steps to address many of these problems. They include attempts to control private sector abuses (specifically, unnecessary treatments), coordinate and regionalize services, regulate equipment and its use, and control charges, attempting to introduce prospective payment where possible. There have been some steps taken to stimulate local pharmaceutical and medical equipment industries. There have been some complications with imposing import controls, since countries contributing development resources often tie assistance to purchases of equipment. The example of Brazil is an important one for developing countries to follow. North America and European aid progrms could play much more constructive roles. International organizations such as the WHO must also be active in assisting such countries in improving decisions concerning medical technology.
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