In the contemporary global landscape, the concept of an isolated national economy has become a fiction. Nations do not compete solely for territory or natural resources but for their ability to integrate into productive and innovative ecosystems. This dynamic is particularly evident in the health sector, where the complexity of technological development demands interdependence among countries, companies, and research institutions. Innovation, when treated as a strategic vector, depends not only on internal incentives but also on global collaborative networks.
The interconnection between nations in the production of sophisticated goods and services has been widely demonstrated in sectors such as semiconductors and biotechnology. No country, no matter how developed, can produce alone all the necessary inputs and knowledge to compete at the technological frontier.
The example of the iPhone, cited by economists like Eric Beinhocker, illustrates how a single product can depend on supply chains spread across dozens of countries. The iPhone is designed by Apple in the United States, but its components are manufactured and assembled in various parts of the world. The processor may be produced in Taiwan, the OLED screen from South Korea, the battery from China, and the sensors from Japan. The final assembly, in most cases, takes place in China.
This level of global interdependence demonstrates how modern production requires a collaborative ecosystem that transcends national borders. This logic is replicated in health, where the research, development, and manufacturing of medicines, vaccines, and medical devices are distributed globally.
Paul Romer, awarded the Nobel Prize in Economics in 2018 for his contributions to the theory of endogenous growth, provides crucial insights into this dynamic. Romer argues that sustainable economic growth depends on the accumulation of knowledge and technological innovation, factors that are amplified when integrated into global collaboration networks. His work highlights that effective public policies should encourage knowledge sharing and the formation of international partnerships to drive innovation.
The COVID-19 pandemic made this reality evident. The accelerated development of mRNA vaccines was only possible due to collaboration among universities, startups, major pharmaceutical companies, and governments worldwide. A country attempting to develop a vaccine entirely within its borders would hardly have achieved the necessary speed and efficiency. This reveals a fundamental truth: a nation's prosperity depends on its strategic integration into innovation ecosystems.
The Health Sector as a Strategic Pillar
Health is not just a matter of social well-being but a critical factor in national competitiveness. A robust ecosystem of biomedical research and pharmaceutical innovation strengthens a country on multiple fronts: it boosts the economy, attracts investment, and increases national resilience in health crises. However, this ecosystem cannot be built in isolation.
The United States, for instance, leads health innovation not only due to the volume of public and private investments but because it is part of a broad global collaboration network. European laboratories, Israeli startups, Asian scientists, and clinical data collected worldwide feed its innovation capacity. This strategy differs from a protectionist approach that attempts to nationalize entire supply chains. Success lies not in producing everything internally but in coordinating flows of knowledge, technology, and human capital.
The concept of industrial clusters, as discussed by Michael Porter in his theory of national competitive advantages, reinforces this idea. Clusters are networks of companies, research institutions, and specialized infrastructure organized around a specific knowledge or industrial production area, driving innovation and competitiveness.
While Porter emphasized industrial clusters as engines of economic growth, his logic can be extended to innovation ecosystems, which encompass not only companies and research institutions but also public policies, funding, international partnerships, and global knowledge-sharing.
While clusters operate at a more regionalized and sectoral level, ecosystems are broader structures capable of integrating different actors and fostering an environment conducive to innovation on a larger and more dynamic scale. Porter argues that a country’s competitiveness depends on the existence of clusters—concentrations of companies, research institutions, and specialized infrastructure in specific sectors—that drive innovation and economic development.
This logic can be expanded to innovation ecosystems, which operate on an even broader scale, connecting not only businesses and institutions but also public policies, funding, international collaboration, and global knowledge flows. In the health sector, these clusters become even more essential, given the high cost and complexity of biomedical research.
Industrial clusters, as discussed by Porter, are essential to boosting competitiveness and innovation, as they concentrate knowledge and resources in a given productive area. However, innovation ecosystems go further by integrating diverse actors and allowing more complex interactions, including government incentives and transnational cooperation, making them a crucial factor for competitiveness in strategic sectors such as health.
Innovation Ecosystems: The Challenge for Emerging Countries
Brazil has advanced in structuring a health innovation ecosystem through the Economic-Industrial Health Complex (CEIS), a strategic initiative of the federal government. With projected investments of R$ 42 billion by 2026, CEIS aims to strengthen national production of strategic inputs for the Unified Health System (SUS), reducing external dependence and promoting innovation. The plan involves incentive programs for local production, partnerships for vaccine and medicine development, infrastructure modernization, and support for startups and sector companies.
This approach strengthens scientific and technological sovereignty by integrating key players such as Fiocruz, the Butantan Institute, universities, support foundations, and the Brazilian Hospital Services Company (Ebserh). Ebserh plays a strategic role in managing federal university hospitals, which serve as centers of excellence for professional training, scientific knowledge production, and the development of new health technologies. This integration of education, research, and healthcare ensures that innovations generated in academic laboratories are quickly tested and implemented in SUS, expanding the social impact of science and strengthening the country's technological autonomy.
Additionally, the National Confederation of Industry (CNI) and other organizations work on mapping challenges and opportunities in the sector, ensuring that the national strategy aligns with global trends. In this way, Brazil positions itself more competitively in biotechnology and medical innovation while ensuring the sustainability of SUS and fostering a robust innovation ecosystem.
Brazil has a robust infrastructure in health and science, with institutions of excellence such as Fiocruz, the Butantan Institute, and several highly regarded federal and state universities. The purchasing power of SUS, combined with support foundations and technology parks across the country, could be strategically coordinated to strengthen national scientific and technological sovereignty.
CEIS already represents a significant step toward constructing an integrated national health innovation plan, fostering synergy among these entities and ensuring continuous funding for research and development. While it does not resolve all sector vulnerabilities, this strategy points toward strengthening Brazil's technological autonomy.
This would include incentives for biotech startups, technology transfer programs between universities and companies, and public-private partnerships focused on innovation. By doing so, Brazil could reduce its dependence on imported inputs, stimulate local production, and establish itself as a relevant player in the global biotechnology and medical innovation landscape.
The Role of Regulatory Agencies in Innovation Ecosystems
The role of regulatory agencies such as the National Health Surveillance Agency (ANVISA) and the National Supplementary Health Agency (ANS) is crucial within the health innovation ecosystem. ANVISA plays a fundamental role in regulating medicines, medical devices, and clinical research, ensuring quality, safety, and efficacy standards. ANS, on the other hand, regulates the health insurance sector, promoting a balance between consumers and providers while encouraging the adoption of new technologies in the industry. Additionally, institutions like the National Institute of Industrial Property (INPI) directly influence innovation by setting guidelines for patents and intellectual property rights.
Efficient coordination among these entities is essential to creating a regulatory environment that fosters scientific and technological development while protecting public interests. Within the context of CEIS and the national health innovation strategy, regulatory harmonization is a determining factor in accelerating the development of new technologies, reducing bureaucracy, and enhancing sector competitiveness.
Regulatory agencies also play a key role in attracting investments and internationalizing Brazil’s health industry. Regulatory predictability and alignment with international standards make the country more attractive to companies and researchers, expanding Brazil’s capacity to integrate into global innovation ecosystems. Thus, ensuring a modern, agile, and globally aligned regulatory environment is fundamental to strengthening technological sovereignty and national competitiveness.
The advancement of innovation ecosystems, particularly in the health sector, depends on the seamless interaction between industry, research institutions, government policies, and regulatory frameworks. The role of agencies such as ANVISA, ANS, and INPI is not just supervisory but enabling—facilitating the balance between rigorous standards and fostering a dynamic environment for scientific and technological progress.
Innovation does not happen in a vacuum. It flourishes in well-structured ecosystems where public and private stakeholders collaborate to streamline processes, attract investments, and accelerate the adoption of cutting-edge solutions.
Countries that successfully align their innovation policies with global trends while maintaining strategic autonomy will not only drive economic development but also enhance their global influence in critical sectors like health and biotechnology.
It requires collaborative networks, knowledge exchange, and the ability to integrate into global dynamics. For policymakers, understanding this reality and actively engaging in the construction of these ecosystems is imperative to ensure not only economic growth but also national sovereignty and competitiveness.
by Marcio de Paula
Brazilian Health Innovation Institute - IBIS
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