Abstract

In this interview, Jairnilson Paim, coordinator of the Health Policy Analysis Project in Brazil (2003-2017) and of the Political Analysis in Health’s Observatory (OAPS), supported by CNPq, highlights the OAPS’s purposes in socializing the knowledge produced in research and to stimulate the political analysis in health from facts in the conjuncture. He reports that the Observatory has three layers, one consisting of 11 research axes, another showing the specific policies accompanying and the most visible that disseminates news and analysis of the conjuncture. It emphasizes a positive appreciation of the OAPS experience, highlighting the theoretical-methodological rigor and the search for evidence with the greatest possible objectivity, although inspired by democratic and emancipatory values for Brazilian society.

You are the coordinator of the project ‘Health Policy Analysis in Brazil (2003-2017)’, which is linked to the Observatory of Political Analysis in Health (OAPS). What motivated the founding of OAPS and how it was set up?

Our project was submitted to the CNPq [National Council for Scientific and Technological Development] as part of a call for proposals in 2013. The team that developed that submission had already presented the idea of the OAPS. It was conceived as a new way of looking at the experiences of teachers, researchers and postgraduate students at the Institute of Public Health [ISC] in order to articulate a research network regarding health policy. The OAPS was considered to be a fundamental vehicle for interaction between research centers, as well as being a space for dialogue and communication with society, including all the different segments of the public. The OAPS was designed to socialize the knowledge produced by different investigations and studies, and also to provide a stimulus for health policy analysis based on facts.

Visits to various European and Canadian observatory sites were very useful in this process, as was a visit to the United Kingdom by the OAPS Executive Coordinator, Maria Guadalupe Medina, to learn about ongoing experiments at the London School of Hygiene and Tropical Medicine, where the European Observatory for Health Systems and Policies is based.

Once our proposal was accepted and the resources for the project were approved, Prof. José Carvalheiro, who is a member of the OAPS Advisory Board and the São Paulo Health Institute, arranged a meeting for our team - Mariana Adeodato (communication), Gilson Rabelo (web design) and Maria Guadalupe Medina (executive coordination) - with senior staff and technicians of the Observatory of Innovation and Competitiveness, which is based in the Institute of Advanced Studies at the University of São Paulo (USP), Brazil. This original team invited other colleagues to build the OAPS, performing a pre-launch in the city of Salvador and the final launch at Abrascão [Brazilian Congress of Public Health] in Goiânia in 2015 with the support of our journalists, Inês Costal and Patrícia Conceição.

On that particular occasion, I stressed that the OAPS was not intended to merely metaphorically observe the stars, but to scrupulously examine reality and, if possible, to intervene within that reality.

What will people find if they access the OAPS?

I have learned a lot from our team that works in the network of researchers, but a more complete answer could be provided by the OAPS technical team and the Virtual Documentation Center (CDV), which is attached to it. At the risk of sounding superficial, I would state that the OAPS has three layers. The first layer is the deepest and the most academic; it consists of 11 research axes that produce studies and research which results in dissertations, theses, articles, chapters and books. The second layer is intermediate; it provides the timelines of each axis, as well as the monitoring matrix of policies under investigation through the analysis of the following four vectors: implementation; financing; social participation and results. The teams working within the research axes provide annual updates regarding facts in relation to these topics. Finally, the third layer is the most visible because it is within this layer that journalistic work, conducted at the relevant time, produces and disseminates news and analysis regarding current health policies, which, in fact, sets the tone of the OAPS. This layer of the organization provides news, interviews, banners, bi-monthly newsletters, events, and the space for debates and thought.

The OAPS was officially launched at the 11th Brazilian Congress of Public Health in July 2015. How do you assess its development so far? Was it possible to implement what was planned for the OAPS? Were some objectives thwarted?

I have a very positive opinion about this first year of the OAPS, and this positive opinion is shared by many members of the Management and Advisory Councils, as well as our researchers, technicians and postgraduate students. I believe that we have implemented many initiatives that were not originally foreseen and the special magazine ‘One Year of Experiences’, which we published as the OAPS anniversary edition, illustrates the achievements of both the OAPS and the CDV. The latter is led by Professor Carmen Teixeira, in collaboration with Maria Clara Guimarães and Creuza Silva, among others.

One of the goals that we have not yet achieved is creating a dialogue with managers from the Unified Health System [SUS], although some attempts have been made in this respect, such as the request that was made to the Municipal Health Department in the city of Salvador to propose a seminar between its management teams and members of the OAPS. However, we understand that the difficult political situation in Brazil over the last two years, as well as the process of the municipal elections of 2016, hampered this initiative. The OAPS Governing Board has been discussing the matter and we are scheduling a meeting with the new municipal managers in March 2017.

What has the OAPS developed in relation to scientific production in the area of health policy, planning and management? What else should be produced?

In addition to the dissertations and theses that have been approved during the last two years in this area of public health, we published three books through the publisher of the Federal University of Bahia (EDUFBA) based on studies by OAPS researchers. Several articles have been submitted for publication in the Revista Ciência & Saúde Coletiva, which is produced by Abrasco [Brazilian Association of Public Health], and a special issue of the Revista Saúde em Debate, produced by Cebes [Brazilian Center for Health Studies], is being prepared which will include the results of studies and research conducted by the OAPS. This editorial work has been performed by Professor Carmen Teixeira with the help of Professor Lígia Vieira da Silva and Professor Isabela Pinto. It is also worth mentioning the preparation of the Análise Política em Saúde [Health Policy Analysis] glossary conducted by Professor Carmen Teixeira and Paloma Silveira, who is an OAPS researcher and CNPq grant holder, with the assistance of several members of the research network. This text was submitted to the Consultative Council and made available for public consultation for more than a month; it received excellent contributions from interested parties, which were incorporated into the original text, adding their names to the list of authors. This will be published as an e-book by EDUFBA. Several papers by researchers, postgraduate students and graduate students from the eleven axes within the OAPS have also been presented at scientific events. Follow-up work performed by Professor Ana Luiza Vilasbôas indicates that we will achieve the goals established at the outset of the project.

Based on the experience of accumulated research in the network, by the end of the project we intend to produce a systematization of the most promising theoretical-methodological contributions regarding the investigation of health policies and health policy analysis.

The OAPS has published notes and statements from entities and researchers on subjects related to the SUS and also Brazil’s political-economic situation. Is the OAPS politically neutral or does it have a position?

The OAPS’s mission is to provide a space for reflection and the critical analysis of health policies in Brazil through the work of a network of Brazilian researchers working in several research centers regarding health policy, planning and management.

The regulation approved by the Management Council and the Advisory Council sets out the principles that guide the position of the OAPS in Article No. 5. These principles are as follows: a) a commitment to the defense of health as a right of individuals, and to citizenship as a principle in the relationship of individuals with the state; b) a commitment to the construction and strengthening of public, universal health systems based on the principles of the solidarity, equity, universality and integral nature of health care; c) the production of critical thinking about reality, based on scientific and ethically responsible bases; and d) autonomy of thought in relation to the particular interests of groups or institutions.

Consequently, the OAPS is not neutral. Although it is based on theoretical-methodological rigor and the search for evidence with the greatest possible objectivity it is also based on democratic and emancipatory values that we intend to spread throughout Brazilian society.

Personally, I understand that in critical situations, such as occurred in Brazil after the presidential elections of 2014, neutrality can be synonymous with connivance and everyone who supports democracy and the right to health must take a stand. The OAPS has taken a position on recent threats to social rights, the SUS, and democracy by disseminating analytical texts and position papers on the most varied individual and collective subjects, as well as posting messages on its website and the ISC billboard on the Canela campus in the city of Salvador. However, the OAPS has avoided signing political manifestos and position papers because it is not an entity of civil society and it faces difficulties in positioning itself within networks in an accelerated environment. However, the OAPS will make statements from the Advisory Board of the OAPS research network in the face of actions and proposals that violate the principles of its regulations. With regard to the OAPS as ‘a space for dialogue and communication with society’, in addition to disseminating texts and videos on our website we are planning to produce at least four documentaries aimed at various public groups such as managers, workers, graduate students and organizations within civil society.

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