History and structure
In Brazil, SUS is the acronym for the Unified Health System (Sistema Único de Saúde - SUS), the public health system consisting of a regionalized, hierarchic network of health actions and services held jointly by federal, state, and local governments and subject to 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 Brazilian people.

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 induce and enhance health research. Decit works to enforce the agreement among users, workers, managers, 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.

Acknowledging the importance of social involvement, the Ministry of Health established the Science, Technology, and Innovation Council (Conselho de Ciência, Tecnologia e Inovação - CCTI), which has been involved in formulating, coordinating, and monitoring the National Policy on Science, Technology, and Innovation in Health.

In 2005, Decit created a new coordination unit to implement health technology management and assessment policies, based on sound scientific evidence, as a strategy to strengthen regulatory power at the 3 managerial levels 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.

Mission
Brazilian HTA General Coordination aims to:

• Coordinate the HTA Work Group (GT ATS) of the Science, Technology, and Innovation Council (CCTI) 
• 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 work development for human resources in HTA for SUS 
• Promote awareness among managers 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.

Dissemination activities
The HTA studies are validated by CCTI and disseminated through various forums and agencies:

• CCTI produces studies available for decision making 
• 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

Promoted Events:
- I International Seminar on Health Technologies Management (2005)
- Decit + 2: Ministry of Health Action on Science, Technology, and Information (2006)
- HTA Introductory Courses (annual)
- Evidence Based Medicine (EBM) Introductory Courses (annual).

Partners

• Agência Nacional de Saúde Suplementar - ANS (National Supplementary Health Agency)
• Agência Nacional de Vigilância Sanitária - ANVISA (National Sanitary Surveillance Agency)
• Brazilian Cochrane Collaboration
• Conselho Nacional de Desenvolvimento Científico e Tecnológico - CNPq (National Council of Scientific and Technological Development)
• Financiadora de Estudos e Projetos - FINEP (Agency for Financing of 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)

Current projects (a selection)

• Assemble the National Network of Clinical Research in Teaching Hospitals
• Amplification and detection of nucleic acids tests for HCV
• Betagalsidade for Fabry disease
• Etanercept for psoriasis
• Etanercept for rheumatoid arthritis
• Infliximab for psoriasis
• Laronidase for mucopolysacaridose
• Memantine for Alzheimer disease
• Piribidil for Parkinson disease
• Sildenafil for pulmonary hypertension
• Cost-effectiveness of diagnostic techniques for tuberculosis
• Cost-effectiveness of 3 screening models for uterine neoplasias
• 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 meningocócica 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 Health Technologies Management (2007/2008)
• National Policy on Health Technologies Management (in progress) 
• Other systematic reviews based on priorities defined by the Ministry of Health 
• Brazilian Network for HTA - REBRATS (in progress) 
• New drugs for chronic hepatitis B and C - clinical and cost-effectiveness multicenter study
• II International Seminar on Health Technologies Management.