Extinction of the SP member halts studies and hampers epidemic control measures

In the middle of the year with the highest incidence dengue fever and other mosquito-borne diseases, part of the measures and research to control and control these diseases have been suspended or reduced in the state of São Paulo after the extinction Supervisory Authority for Endemic Disease Control (SOSEN) And disrupt the work done by the servers and researchers who were part of the body.

The extinction of Sucen was determined by Law No. 17293, enacted under the administration Joao Doria (PSDB) in October 2020, and entered into force by the Governor Rodrigo Garcia (PSDB), in a decree issued in April 2022. With the end of Sucen last year, nearly 900 municipal servers in various bodies have been transferred from the secretariat.

The group formed by the researchers went to the Pasteur Institute. Other personnel remained in the CCD sectors, separating the scientific and operational teams that previously worked together. The secretary says there has been no harm or interruption in the proceedings, but admits that new research has been put on hold (Read more below).

According to officials heard by the report, one of the measures affected is the use of insecticides in areas infested with mosquitoes that transmit diseases such as dengue fever, a strategy also known as smoking. Sosen has been around since 1970 and worked in the fight against the first dengue epidemics in the state, in the 1980s and 1990s.

“Here in São Paulo, for example, the groups no longer do this spraying because the pesticide machines have moved to one place and the servers have moved to another building, where we don’t have a structure to work with pesticides, which requires specific preparation and cleaning,” said one. Extinct Sucen’s staff, who did not want to be named.

The 12 regional units in the former Socin region, most of which are in the interior of the state, no longer have the autonomy to carry out procurement and bidding processes, making it difficult to obtain inputs and renew licenses and service contracts.

according to Association of Scientific Researchers of the State of São Paulo (APqC)Some of the ongoing research at Sucen’s former facilities has been halted due to a lack of materials and new research has been rejected until the regional laboratories are formally attached to another body, such as the Pasteur Institute.

The entity claims that it was not possible, for example, to purchase liquid nitrogen, a necessary ingredient for preserving mosquitoes collected during field surveys conducted with the aim of monitoring insect populations in an effort to reduce the chance of epidemics of disease-borne diseases. by these vectors.

“Today, the activities that once belonged to Sucen are in limbo. It is not possible to start new searches. It is as if these researchers and all laboratories, from a legal point of view, do not exist, says Patricia Bianca Clessa, Head of APqC. Endangers procurement of inputs, equipment, and accountability.

In an email that Pasteur’s managers sent to the researchers in November last year, which was sent to him Estadao It was accessible, the Institute’s management claims that it is not possible to develop new research projects or receive students and scholars in the extinct buildings of Sucen due to the lack of formalization of the link between the units of Sucen and Pasteur.

Among the work affected, according to the APqC, are three observational studies that were supposed to start in the second half of 2022, one on malaria in the Atlantic Forest, another on leishmaniasis transmission and prevention, and a third on snails that host the causative agent. from schistosomiasis.

According to the researchers, another important research project that has been delayed for a year due to the difficulty of procuring inputs is potential disease surveillance. In it, teams go to the field to collect mosquitoes to evaluate later for pathogens in the insect that can cause disease in humans.

This includes monitoring for diseases that are already known, such as dengue and yellow fever, or for viruses that are circulating in other areas of the country, but have never been recorded in the state. “The idea is to prevent the epidemic before it starts,” one Sucen researcher heard.

Patricia also claims that there were labs for the defunct Sucen without cleaning and security services for several months due to the lack of someone responsible for contract renewals. The aquarium, in the Mogi Guasu unit, she says, has a license from the National Council for the Control of Animal Experiments (Konsea), an agency linked to the Ministry of Science and Technology, which expired last year for the same reason.

“Sucen’s previously exclusive fleet of vehicles available for field operations today has to be ordered, which makes work difficult. When there’s a pathology, the team needs to travel and check the area,” she says of another hurdle for servers to work. “There is a certain negligence in this whole situation because the extinction of Sucen was effective in April 2022 and no proper structure was prepared for the continuation of the work,” says the APQC Chair.

Researchers from the defunct Sucen held meetings with the Ministry of Health in an attempt to expedite the connection of the former autonomous units to the Pasteur Institute or to the CCD, so that they could resume field work, scientific research and combat actions. Diseases that are now weakened.

Disease control and epidemiological surveillance efforts are being laid off at a time when dengue fever and other viruses are on the rise in the country. According to the Ministry of Health, there has been a 46% increase in dengue cases and a 142% increase in chikungunya infections this year compared to last year.

Another point of alarm was the diagnosis of the first case of yellow fever in São Paulo since 2020. The case occurred in Vargem Grande do Sul, in the interior of São Paulo, and was confirmed at the end of January.

When contacted, the state health department stated that there is no halt to ongoing research or lack of input for studies and highlighted that measures “to control vector-borne diseases and intermediate hosts in the state of São Paulo” remain in place. done. The agency pointed out that 21 research projects are being implemented at the Pasteur Institute, including studies on yellow fever, accidents with scorpions and scorpion disease. trypanosoma cruzi, The protozoan that causes Chagas disease.

However, the dossier acknowledged that the new research to be conducted at Sucen’s former headquarters had been put on hold and said that “the working group is engaged in the integration of technical and strategic activities to coordinate monitoring and control actions for vectors, hosts and insects under the CCD.” According to the agency, the technical field formalization draft is underway, and after the structuring process is completed, new research projects will be approved.

The Secretariat also says that the restructuring of the region, with the extinction of the Socin region, “resulted in a greater integration of procedures and an expansion of technical and strategic initiatives for surveillance and combating the epidemic.” He also stated that he was carrying out “permanent measures to support municipalities in controlling the mosquitoes that transmit dengue fever”. In November, the dossier says, the Sao Paulo government transferred R$93 million to 645 municipalities to take action to control dengue, Zika and chikungunya.

With regard to the vehicle fleet, the secretariat stated that there are no restrictions on use, and that vehicle management is carried out by the administrative sector in the Department of Combating Desertification, “with the latest vehicles available for laboratories.”

With regard to stopping spraying operations, the Secretariat stated that the insecticide used is provided by the Ministry of Health, which has not received the product since November 2022, indicating the difficulty of purchasing it. When contacted, the ministry confirmed that one of the pesticides was late in distribution, but said that delivery should be normalized “in the next few days”, and that three other insecticides, which are normally distributed, can be used to control mosquitoes.

The Secretariat did not comment on the lack of cleaning and security services in the regional units in the extinct Sousen region and on the non-renewal of the Mogi-Gwaso laboratory license.

Also required, former Sao Paulo health minister Jan Gornstein, who held the post until December last year, said his administration has established a flow so that all attributes of Sucen are absorbed by the CCD.

The Minister of Health of the Municipality of São Paulo was questioned about the effects of the Sucen extinction on the city’s arthropod control measures due to the discontinuation of the use of insecticides. The file did not comment on the specific case, but said that the municipal procedures were not curtailed. “In 2023, to date, 623,955 mosquito prevention measures have been carried out Aedes aegypti”: He said 209,231 house-to-house visits, as well as 6,693 inspections of private property and strategic points, and 378,847 measures to prevent breeding sites and fogging, among other specific activities.