Strengthening national public health institutes: Fiocruz’s perspective
The Oswaldo Cruz Foundation (Fiocruz) is a state-owned science and technology organisation and a leading Brazilian pharmaceutical producer. It plays a central role in formulating and implementing health policies aimed at ensuring equitable access to health in all its dimensions. Grounded in the constitutional principle of health as a universal right and a state obligation, it seeks to strengthen Brazil’s public health system, which serves over 200 million people, and to foster access through innovation, services and production, an immense challenge in a country as uneven and vast as Brazil.
For 125 years, Fiocruz has transformed knowledge into life-saving action through education, surveillance, research, innovation, hospital services and the industrial production of vaccines, medicines, diagnostics and advanced therapies. This complex system of science and technology has built critical preparedness capacities thanks to hard learning during the Covid-19 pandemic. This has helped Brazil predict and respond to health emergencies and placed Fiocruz at the centre of global discussions on prevention, preparedness and response, in close coordination with Brazil’s Ministry of Health and the World Health Organization.
Two political choices stand out as particularly impactful for advancing global health security: establishing mechanisms to coordinate global efforts on local production and reinforcing the role of national public health institutes.
Fiocruz, as Brazil’s national public health institute, drawing on its institutional experience from national initiatives and international cooperation, is particularly well positioned to advance both agendas, under the WHO’s guidance and through collaboration with international organisations. This has enabled it to play a strategic role within Brazil’s presidencies of the G20 in 2024 and BRICS in 2025.
In the G20, Fiocruz is part of the Brazilian delegation to the Health Working Group. In 2024, Fiocruz contributed to Brazil’s efforts on the Global Alliance against Hunger and Poverty and advocated for the Global Coalition for Local and Regional Production, Innovation and Equitable Access, for which Fiocruz was nominated as the secretariat. Fiocruz also hosted the first conference of the G20 national public health institutes, drawing attention to the vital role they play in translating political decisions into effective health policies.
As a think tank, Fiocruz coordinated two sub-taskforces on health within the Think 20, a G20 engagement group made up of a global network of think tanks, in close collaboration with the Institute of Applied Economic Research. Its researchers contributed over 10 policy briefs, providing evidence-based recommendations to G20 leaders on pressing health issues encompassing the social and environmental determinants of health.
In the BRICS, Fiocruz coordinates three initiatives delegated by the Ministry of Health: the Vaccine R&D Centre, the Network of Research on Public Health and Health Systems, and the conference of BRICS national public health institutes. The first two were highlighted in the leaders’ declaration at Rio in July, and the conference was acknowledged in the health ministers’ declaration in June in Brasilía.
Building regional and global networks
These contributions reflect the foundation’s commitment to advancing global health equity through knowledge, innovation and diplomacy, and underscore the relevance of multilateral forums and, above all, the power of cooperation in shaping global responses.
To advance capacity for pandemic prevention, preparedness and response, Fiocruz manages several activities. At the national level, it has developed the ÆSOP (Alert-Early System of Outbreaks with Pandemic Potential), which combines mathematical modelling, machine learning and data science to integrate multiple sources of information and support epidemiological surveillance in making agile and evidence-based decisions. This open platform is the front line of Fiocruz’s performance along with the WHO Hub for Pandemic and Epidemic Intelligence in Berlin.
At the regional level, in partnership with the Pan American Health Organization, Fiocruz chairs the Strategic Advisory Group on Increasing Regional Innovation and Production Capacities for Medicines and Other Health Technologies. It also accesses manufacturing capacities for vaccines in Latin America and the Caribbean, provides a Mercosur training programme that combines theoretical instruction with hands-on training, and manages six PAHO Collaborating Centres on primary health care, leptospirosis, teaching for the health technical workforce, human milk bank, global health and South-South cooperation, and pharmaceuticals policies.
Fiocruz also chairs three networks of national public health institutes – in Latin America and the Caribbean, in Ibero-America and in Portuguese-speaking countries – underscoring its commitment to build critical capabilities by strengthening these institutions regionally.
At the global level, Fiocruz coordinates the WHO Collaborative Open Research Consortium on Flavivirus and supports capacity building on genomic surveillance to Latin American, Caribbean and
Portuguese-speaking countries. It also integrates the Leadership Committee of the International Pathogen Surveillance Network and hosts the WHO Hub for the development and production of vaccines using mRNA in Latin America. It participates in the Coalition for Epidemic Preparedness Innovations’ network of vaccine manufacturers in the Global South and chairs the Pasteur Network, an alliance of 32 institutes across 25 countries and five continents, fostering a dynamic and diverse community of knowledge and expertise, now also focused on pandemic preparedness.
Fiocruz also cooperates closely with Unitaid, the Drugs for Neglected Diseases initiative and the Special Programme for Research and Training in Tropical Diseases, and actively contributes to key pandemic preparedness initiatives such as the 100 Days Mission and the Global Therapeutics Development Coalition.
Through its international and regional partnerships, Fiocruz is strengthening surveillance, expanding production capabilities and developing the health workforce, integrating these efforts into a robust ecosystem aimed at reducing dependence on outdated technologies.
In a world marked by risks to multilateralism, strengthening local production and consolidating the role of national public health institutes are urgent imperatives. Fiocruz’s experience demonstrates the potential of combining science, innovation and cooperation to build better-prepared health systems committed to promoting a fairer and more sustainable world, where no one is left behind.
