The Ministry of Health is prioritizing investments in new technologies that contribute to investigations regarding the zika virus. The Ministry is in constant contact with national and international research institutions, sparing no resources until it finds out how this virus works and effectively fight its spreading. The research efforts being currently developed include studies for diagnosing illnesses transmitted by the mosquito, developing vaccines and treatments for zika fever and new ways of fighting the Aedes aegypti, as well as other initiatives.
Check out below the main initiatives being currently developed in Brazil:
Zika fever vaccine
On February 11, the Ministry of Health analyzed the first international agreement signed for the development of a vaccine against the zika virus. This research will be carried out in conjunction with the Evandro Chagas Institute (IEC), an institute linked to the Ministry of Health, and the University of Texas Medical Branch, in the United States. For such study, the Brazilian government will invest BRL 10 million.
In the first year, pre-clinical trials will be carried out simultaneously in Brazil and in the United States. Essays will be conducted with lab rats in Galveston and with monkeys in Belém. Simultaneous testing will convey more agility to the process, making it possible to initiate clinical trials the following year.
The agreements provides for the creation of a Coordination Committee that will meet at least twice a year in order to analyze the progress and the results reached with this cooperation. It also provides for the participation of other international health organizations, such as the World Health Organization (WHO). IEC is the National Reference Laboratory for Arboviruses and a PAHO/WHO Collaborating Center for Reference & Research on Arboviruses. The University of Texas Medical Branch, in turn, is a WHO Collaborating Center for Vaccine Research, Evaluation and Training on Emerging Infectious Diseases.
Dengue fever vaccine
On February 22, Minister of Health Marcelo Castro signed an agreement with the Butantan Institute for financing the third and last stage of the clinical research for a dengue fever vaccine. In this stage, the vaccine will be tested on 17,000 volunteers from 13 cities in the five regions of Brazil for one year.
The Ministry of Health will invest BRL 100 million in the next two years in order to further develop this study. Overall, estimates indicate that the federal government will invest BRL 300 million. In addition to the funds provided by the Ministry of Health, funds from the Ministry of Science, Technology and Innovation (BRL 100 million) - to be provided through a FINEP (Studies and Projects Financing Agency) agreement - and from the Brazilian National Development Bank - BNDES (BRL 100 million) are also being considered. The Butantan Institute estimates that a dengue fever vaccine will be available in 2018.
The dengue fever vaccine is being developed in partnership with the United States' National Institutes of Health (NIH), and such partnership will continue for the development of a zika fever vaccine, which may lead to the generation of a pentavalent vaccine.
Development of zika fever treatments
The Ministry of Health also signed an agreement with the Butantan Institute for the development of zika fever treatments: serums and monoclonal antibodies. BRL 8.5 million will be invested in the project.
Control of zika virus-related cases of microcephaly
The Ministry of Health, the Government of the State of Paraíba and the US Centers for Disease Control and Prevention (CDC) initiated a case-control study of zika virus-related cases of microcephaly in Brazil in February. The purpose of this study is to estimate the proportion of newborns with zika virus-related microcephaly, in addition to the risk of zika virus infection. For this study, meetings are being carried out with local authorities and field studies are being executed with interviews and collection of blood samples for complementary exams related to the zika virus and other diseases, such as cytomegalovirus and toxoplasmosis.
Zika virus detection in blood bags
The Ministry of Health will include the zika virus in the NAT test carried out in blood bags throughout the country. This test is already capable of identifying the HIV, hepatitis B and hepatitis C viruses in order to control and attest the safety of blood available in national blood banks. The production of the NAT tests with zika virus detection included will be carried out by the Biomanguinhos Lab at Fiocruz, in Rio de Janeiro - holder of the NAT platform in the country. In this process, approximately 300 samples of blood contaminated with the virus will be collected and analyzed.
Estimates indicate that the test will be made available to public health network labs by the end of the year. This action will be supported by the United States so that registration processes are executed more quickly, and the expectation is that Brazil will become a reference center for the validation of molecular tests or essays that have the zika virus as their target. The agility of registration processes will be provided through an agreement signed by Anvisa and the FDA - a US regulating agency.
Training to Mercosur countries for zika virus tests
The Ministry of Health has offered to Mercousur member and associate countries training for lab tests that can detect the zika virus. This training will be provided by Brazilian national institutes through an exam using the PCR (Polymerase Chain Reaction) process. The purpose is to strengthen the region's epidemiological monitoring capabilities, monitoring the behavior of the virus and suggesting actions deemed necessary for protecting the population. In January, technicians from Paraguay, Peru, Uruguay and Ecuador were trained at the Evandro Chagas Institute (IEC).
Trivalent test (zika fever, dengue fever and chikungunya)
The Ministry of Health will acquire 500,000 national molecular biology tests for zika fever, dengue fever and chikungunya diagnoses in 2015. This new technology, being developed by the Oswaldo Cruz Foundation (Fiocruz) will allow for the simultaneous diagnosis of suspected cases of all three diseases transmitted by the Aedes aegypti mosquito during the manifestation of their clinical symptoms. These tests will be distributed to National Public Health Laboratories (LACENs). In addition to providing the tests, Fiocruz will also train professionals and provide continuous technical assistance, making sure that all conditions deemed necessary are present for the execution of the various stages of these molecular biology tests.
Eliminating the dengue fever: A challenge for Brazil
Since 2014, Fiocruz - in partnership with the Ministry of Health - has been developing the "Eliminating the dengue fever: A challenge for Brazil" project, which proposes using a bacterium - named Wolbachia - that is naturally found in the environment, including within mosquitoes. When present within the Aedes aegypti mosquitoes, this bacterium is capable of preventing them from transmitting dengue fever and chikungunya. Studies are already being carried out on the impact of this bacterium in the transmission of the zika virus. The non-profit initiative is an innovative approach used to reduce the transmission of the dengue fever virus by mosquitoes in a natural and self-sustainable way. This study is unprecedented in Brazil and Latin America, and it has been successfully carried out previously in Australia, Vietnam and Indonesia - where there are no reports of increase in the number of cases of microcephaly.
The Ministry of Health is also monitoring other initiatives, such as the use of genetically-modified mosquitoes, the use of screens impregnated with insecticide to cover doorways and windows and epidemic detection systems, as well as other actions.