The Introduction of Nucleic Acid Tests (NAT) for Blood Screening in the Brazilian Public Healthcare System: Negotiating and Assembling Technologies for the Nationalization of ‘NAT Brasileiro’ (2005–2013)

  • Koichi Kameda


Nucleic acid tests (NAT) considerably reduce the window period necessary to detect HIV and hepatitis B and C, and have been employed as complementary tools for enhancing blood safety since the end of the 1990s. Even as most industrialized countries have already adopted the test, low- and middle income-countries – where the seroprevalence of blood-borne diseases is high – considering the introduction of NAT face challenges related to resources availability. Costs are related to infrastructure, equipment, consumables, technical expertise and the kits themselves, whose global market is shared by two products manufactured by multinational companies. This chapter analyzes the consortium ‘NAT brasileiro’ created to produce a local version of the nucleic acid test for the blood services linked to the public healthcare system in Brazil. On the basis of qualitative fieldwork, I investigate the strategies used by the Brazilian laboratories to nationalize the kit through capturing and assembling its various components. The chapter contributes to revealing the challenges and limits to the production of in vitro tests for infectious diseases in Brazil, as well as the repercussion of such an initiative to the national healthcare innovation system.



The authors thank the interviewees who participated in this research; the ANRS and Sidaction for funding this PhD project (ANRS 12307 – B74); and the following people who read and contributed specifically with the revision of this paper: Andy McDowell, Matthieu Quet, Ashveen Perbaye, Ilana Lowy, Jessica Pourraz, Alila Brossard and Juliana Veras.


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© The Author(s) 2019

Authors and Affiliations

  • Koichi Kameda
    • 1
  1. 1.CERMES3-EHESSParisFrance

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