History and structure
In Brazil, the Unified Health System (Sistema Único de Saúde - SUS) consists of a regionalized, hierarchic network of health actions and services held jointly by federal, state, and local governments, and attends the health planning guidelines stated in the Constitution - decentralization, comprehensive care, and community participation.
The Ministry of Health in Brazil aims to use all possibilities to promote, protect, and recover health, reduce disease, control endemic and parasitic illness, improve health monitoring, improve technological and scientific knowledge about health, and offer quality of life to the population.
Three departments - Department of Science and Technology, Department of Health Economics, and Department of Pharmaceutical Care - comprise the Ministry of Health Secretariat of Science, Technology, and Strategic Inputs.

The Department of Science and Technology (Departamento de Ciência e Tecnologia - DECIT) aims to promote and enhance health research. DECIT works to enforce the agreement among consumers, workers, stakeholders and researchers around the main points of the National Agenda of Priorities in Health Research (formulated in 2004 during the 2nd National Conference on Science, Technology, and Innovation in Health). To achieve its objectives of inducing and supporting health research, DECIT executes the National Policy on Science, Technology, and Innovation in Health, which demands strong and organized operational support.
In 2005, DECIT had created a new coordination unit to implement health technology management and assessment policies, based on scientific evidence, as a strategy to strengthen regulatory power at the 3 managerial spheres in the system. This new unit, the Health Technology Assessment General Coordination (Coordenação Geral de Avaliação de Tecnologias em Saúde - CGATS), is responsible for the coordination, promotion, and diffusion of HTA in SUS. Besides, in 2007, DECIT-CGATS and partners elaborated the National Policy on Health Technology Management, aiming to institutionalize Health Technology Assessment on SUS.

Mission
Brazilian HTA General Coordination aims to:
Coordinate Brazilian National Clinic Research Network at University Hospitals and Brazilian Health Technology Assessment Network
Coordinate the HTA Work Group (GT ATS) of the Science, Technology, and Innovation Council  
Organize and qualify studies based on HTA demands, define the process, and define priority criteria in the Ministry of Health 
Monitor and assess HTA studies produced by academic institutions  
Produce reports for dissemination of HTA studies, with the aim to support decision making  
Promote professional training in Health Technology Assessment and Evidence-Based Medicine for SUS  
Promote awareness among health stakeholders regarding the importance of HTA as a management tool in SUS  
Establish international cooperation with HTA agencies 
Articulate HTA actions developed by CCTI with other Ministry of Health agencies, education and research institutions, local and state government, and social authorities.


How DECIT- CGATS works
The Ministry of Health defines priorities. DECIT – CGATS staff work with partners, eg, research institutions and public universities, elaborating on rapid reviews and requesting systematic reviews and full HTA studies.
In 2008, it was created the Brazilian Health Technology Assessment Network (Rede Brasileira de Avaliação de Tecnologias em Saúde – REBRATS), aiming to congregate HTA stakeholders and research institutions for the promotion and development of priority Health Technology Assessments for Brazilian public health system.

Dissemination activities
The HTA studies have been validated by REBRATS and disseminated to Commission for Technology Incorporation from Ministry of Health.
Presentations at technical meetings, events, and conferences, studies, findings, and other DECIT activities are presented to the general public on the Decit home page: http://portal.saude.gov.br/portal/saude/area.cfm?id_area=1026, and on REBRATS home page: www.saude.gov.br/rebrats.

Promoted Events

• I and II International Seminars on Health Technologies Management (2005/2007)
• National Network of Clinical Research in University Hospitals (2005)
• Decit + 2: Ministry of Health Action on Science, Technology, and Information (2006)
• HTA Introductory Courses (annual)
• Evidence Based Medicine (EBM) Introductory Courses (annual)
• Research for Health: Development and Innovation for SUS (2007)
• Workshop “Challenges for Implementation of a Policy of Evaluation and Management of Health Technologies in Brazil” in V annual meeting of the Health Technology Assessment international – HTAi (Montreal – Canada 2008
• Brazilian Health Technology Assessment Network meetings (2008).

Partners

• Agência Nacional de Saúde Suplementar - ANS (National Agency for Supplementary Health) 
• Agência Nacional de Vigilância Sanitária - ANVISA (National Agency for Sanitary Surveillance) 
• Cochrane Center of Brazil 
• Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq (National Council for Scientific and Technological Development) 
• Financiadora de Estudos e Projetos - FINEP (Financing Institution for Studies and Projects) 
• Fundação Oswaldo Cruz - Fiocruz (Oswaldo Cruz Foundation) 
• Universidade Federal da Bahia - UFBA (Bahia Federal University) 
• Universidade Federal de São Paulo - UNIFESP (São Paulo Federal University) 
• Universidade Federal do Rio de Janeiro - UFRJ (Rio de Janeiro Federal University) 
• Universidade Federal do Rio Grande do Sul - UFRGS (Rio Grande do Sul Federal University) 
• Universidade do Estado do Rio de Janeiro - UERJ (Rio de Janeiro State University) 
• Universidade de São Paulo - USP (São Paulo University) 
• Rede Nacional de Pesquisa Clínica em Hospitais Universitários (National Network of Clinical Research in Teaching Hospitals)
• National Council of Health Secretariats
• National Council of Municipal Secretariats of Health

Current projects (a selection):

• Assemble the National Network of Clinical Research in Teaching Hospitals 
• Betagalsidade for Fabry’s disease 
• Etanercept for severe psoriasis
• Etanercept for rheumatoid arthritis 
• Infliximab for severe psoriasis 
• Memantine for Alzheimer’s disease 
• Pegvisomant for acromegaly
• Piribedil for Parkinson’s disease
• Cost-effectiveness of diagnostic techniques for tuberculosis 
• Cost-utility of bone densitometry associated to sodium and vitamin D associated to calcium, both compared to the expectant alternative 
• Cost-effectiveness studies of varicela, rotavirus, conjugated meningococica C, conjugated hepatitis, and the pneumococic vaccines to support their incorporation in the national immunization program
• For complete list of projects and publications, visit the HTA Database.

Future Plans

• Specialized courses and Master Degree in Economic Analysis for Health Technologies 
• Other systematic reviews based on priorities defined by the Ministry of Health