Nestor Schor

UNIFESPUNIFESPUNIFESPUNIFESPFAPESP, 29-31/08/2012

São Paulo

“Os desafios das Ciências da Saúde”

CHALLENGES

• HR: Basic, Professional and Continuous Educations

• Sustentability: Air, Water and Land pollutions

• Food Safety and Obesity

• Neglected, Infectious and Chronic Degenerative

Diseases

• Cancer

• Vaccines: Immunizations

• Drugs: abuse

• New Paradigms: New molecules and technological

advances. Development of regenerative and

organogenesis processes

HR: Basic, Profitional and

Continuous Educations

• Projetar e assim, planejar as necessidades

de RH dos Atores Multiprofissionais que

atuam no Campo da Saúde

• Dados escassos e pontuais destas

necessidades

• Incremento de RH sem planejamento

estratégico , uniprofissional e com

distribuição geográfica inadequada

• Controle de Qualidade;Acreditação e

Educação Continuada

HR: Basic, Profitional and

Continuous Educations

Demanda do Mercado de

Trabalho nos EUA exemplo: Nefrologia

• 1996

1. 6.000 Nefrologistas

2. 7.000 Técnicos

3. 50.000 Enfermeiros

4. 80.000 Pacientes

• 2020-estimativa

1. 30.000 Nefrologistas

2. 40.000 Técnicos

3. 230.000 Enfermeiros

4. 600.000 Pacientes

ASN, 2007

• Projetar e assim, planejar as necessidades

de RH dos Atores Multiprofissionais que

atuam no Campo da Saúde

• Dados escassos e pontuais destas

necessidades

• Incremento de RH sem planejamento

estratégico , uniprofissional e com

distribuição geográfica inadequada

• Controle de Qualidade;Acreditação e

Educação Continuada

HR: Basic, Profitional and

Continuous Educations

• Projetar e assim, planejar as necessidades

de RH dos Atores Multiprofissionais que

atuam no Campo da Saúde

• Dados escassos e pontuais destas

necessidades

• Incremento de RH sem planejamento

estratégico , uniprofissional e com

distribuição geográfica inadequada

• Controle de Qualidade, Educação

Continuada e Acreditação Periódica

HR: Basic, Profitional and

Continuous Educations

Investimento em RH: Pós-

Graduação

OESP p.A18, 27/08/2012

Qualidade dos Egressos ?

Destino dos Egressos ?

CHALLENGES

• HR: Basic, Professional and Continuous Educations

• Sustentability: Air, Water and Land pollutions

• Food Safety and Obesity

• Neglected, Infectious and Chronic Degenerative

Diseases

• Cancer

• Vaccines: Immunizations

• Drugs: abuse

• New Paradigms: New molecules and technological

advances. Development of regenerative and

organogenesis processes

Sustentability: Air, Water and Land

polutions

• 2012: ~ 2.6 billion lack access to sanitation

• 2015: ~ 2.7 billion without access to basic

sanitation

• Diarrhea is a major killer and largely

preventable:1.5 million deaths every year

Sustentability: Air, Water and Land

polutions • “In developing countries, the main environmentally

caused diseases are diarrheal diseases, lower

respiratory infections, unintentional injuries and

malaria”

• “Environmental control could prevent deaths:

malaria (40%), lower respiratory infections (41%) and

diarrheal diseases (94%)”

• “one third of death and disease is a direct result of

environmental causes”

Novo Surto de Malária pode atingir a

Europa

Bonalume Neto, R Folha de SP 20/08/2012

Doenças “Emergentes”

•1.640 infectados e 23 mortes nos últimos 2 meses em Dallas

•Reservatórios Naturais: Aves e Répteis

•Hospedeiros Finais: Mamíferos (homens e equinos)

•Sem passagem Homen-Homen

•Diversos tipos de Mosquitos

•Principais suscetíveis: > 50 anos, Câncer, DM,Tx e

imunossuprimidos OESP p.A18, 27/08/2012

Sustentability: Air, Water and Land

polutions • “~ 1/5 of the world's population (~ 1.2 billion) live in

areas with scarce water”

• “Poor water quality increase: diarrheal diseases as

cholera, typhoid fever and dysentery, and other

water-borne infections. Also: dengue fever, malaria,

schistosomiasis and other diseases.”

Sustentability: Air, Water and

Land polutions

Folha de São Paulo, P. A9, 6/8/2012

AMÉRICA LATINA:AGUÍFERO GUARANI

CHALLENGES

• HR: Basic, Professional and Continuous Educations

• Sustentability: Air, Water and Land pollutions

• Food Safety and Obesity

• Neglected, Infectious and Chronic Degenerative

Diseases

• Cancer

• Vaccines: Immunizations

• Drugs: abuse

• New Paradigms: New molecules and technological

advances. Development of regenerative and

organogenesis processes

Obesity

• “More than 1.4 billion adults were overweight in

2008, and > 1/2 billion obese”

• “Globally, over 40 million preschool children were

overweight in 2008”

• “Overweight and obesity are linked to more deaths

worldwide than underweight”

Obesity

• “Supportive environments and communities are

fundamental in shaping people’s choices and

preventing obesity”

• “Curbing the global obesity epidemic requires a

population-based multispectral, multi-disciplinary,

and culturally relevant approach”

CHALLENGES

• HR: Basic, Professional and Continuous Educations

• Sustentability: Air, Water and Land pollutions

• Food Safety and Obesity

• Neglected, Infectious and Chronic Degenerative

Diseases

• Cancer

• Vaccines: Immunizations

• Drugs: abuse

• New Paradigms: New molecules and technological

advances. Development of regenerative and

organogenesis processes

Negligeable, Infectious and Chronic

Denerative Diseases

• Health Inequities:health status vs.

distribution of health resources

• ~800 million live in slum conditions (1/3 of

world's urban population)

• Maternal mortality is a key indicator of health

inequity

Negligeable, Infectious and Chronic

Denerative Diseases

• About 80% of noncommunicable diseases are in low-

and middle-income countries

• Life expectancy varies by 36 years

between countries

• Health disparities are huge in cities:

London, men's life expectancy ranges from 71 years

in Tottenham Green ward (Haringey) to 88 years in

Queen’s Gate (Kensington and Chelsea) – a

difference of 17 years

(NCD:Noncommunicable Diseases)

Cancer • There are more than 100 types of cancers

• In 2008, 7.6 million people died of cancer - 13% of all

deaths worldwide

• About 70% of all cancer deaths occur in low- and

middle-income countries

• Worldwide, the 5 most common types of cancer that

kill men are (in order of frequency): lung, stomach,

liver, colorectal and esophagus

Cancer • Worldwide, the 5 most common types of cancer that

kill women are (in the order of frequency): breast,

lung, stomach, colorectal and cervical. In many

developing countries, cervical cancer is the most

common cancer

• Tobacco use is the single largest preventable cause

of cancer in the world causing 22% of cancer deaths

• 1/5 of all cancers : caused by a chronic infection, for

example human papillomavirus (HPV) and hepatitis

B virus (HBV)

Cancer • Cancers of major public health relevance such as

breast, cervical and colorectal cancer can be cured if

detected early and treated adequately

• More than 30% of cancer could be prevented, mainly

by not using tobacco, having a healthy diet, being

physically active and moderating the use of alcohol.

In developing countries up to 20% of cancer deaths

could be prevented by immunization against the

infection of HBV and HPV

CHALLENGES

• HR: Basic, Professional and Continuous Educations

• Sustentability: Air, Water and Land pollutions

• Food Safety and Obesity

• Neglected, Infectious and Chronic Degenerative

Diseases

• Cancer

• Vaccines: Immunizations

• Drugs: abuse

• New Paradigms: New molecules and technological

advances. Development of regenerative and

organogenesis processes

Vaccines:Immunization

• Prevents between 2-3 million deaths

every year

• ~19.3 million children < 1 y.o. did not receive DTP3

vaccine.

• >1 million infants and young children die / year from

pneumococcal disease and rotavirus diarrhea

• Global measles mortality declined by 74%, Polio by >

99% and neonatal tetanus have fallen.

• Life-saving measures: vitamin A supplements to

prevent malnutrition, insecticide-treated for

protection against malaria and deworming medicine.

• Measures include adolescents and adults, with

protection for influenza and meningitis

•

Vaccines: Immunizations

-Challenge-

• Guaranty access to all population via

public health services to all disponible

Vaccines in the marked

• Add new prevention strategies :

Malaria and Cerebral Tumors as

examples

• New vaccines

Clinical Trials on Vaccines

ClinicalTrials.gov

08/2012

CHALLENGES

• HR: Basic, Professional and Continuous Educations

• Sustentability: Air, Water and Land pollutions

• Food Safety and Obesity

• Neglected, Infectious and Chronic Degenerative

Diseases

• Cancer

• Vaccines: Immunizations

• Drugs: abuse

• New Paradigms: New molecules and technological

advances. Development of regenerative and

organogenesis processes

Drugs: abuse

-Alcohol-

Drugs: abuse

-Amphetamines-

Drugs: abuse

-Cannabis-

Drugs: abuse

-Cocaine-

Drugs: abuse

-Opium-

Drugs: abuse

-Ectasy-

HIV and Injecting-Drug Users Degenhardt and Hall Lancet 379:55,2012

Drugs: abuse

-Deaths-

Drugs: abuse

-Treatment Demand-

Mental Health, Violence and Injuries

CHALLENGES

• HR: Basic, Professional and Continuous Educations

• Sustentability: Air, Water and Land pollutions

• Food Safety and Obesity

• Neglected, Infectious and Chronic Degenerative

Diseases

• Cancer

• Vaccines: Immunizations

• Drugs: abuse

• New Paradigms: New molecules and technological

advances. Development of regenerative and

organogenesis processes

New Paradigms:Total Clinical Trials

ClinicalTrials.gov

08/2012

New Paradigms: S. America Clinical Trials

ClinicalTrials.gov

08/2012

New Paradigms: Clinical Trials on

Antibiotics

ClinicalTrials.gov

08/2012

New Paradigms: Clinical Trials on

New Molecules

ClinicalTrials.gov

08/2012

New Paradigms: Total Clinical Trials

on Stem Cells

ClinicalTrials.gov

08/2012

New Paradigms:Clinical Trials on

Stem Cells in S. America

ClinicalTrials.gov

08/2012

New Paradigms:Clinical Trials on

Regenerative Medicine

ClinicalTrials.gov

08/2012

The Regeneration Recipe

23:26,2009

The Champion of Regeneration:

Salamander

They are able to regenerate: brain, spinal cord, heart and

limbs

Thank You Salamander !