Professor and researcher at the Department of Health Administration and Planning (DAPS) of the National School of Public Health Sergio Arouca (ENSP), Oswaldo Cruz Foundation (Fiocruz), Brazil. She is the Coordinator of the Policy, Planning, Management, and Care in Health area of the Graduate Program in Public Health (PPG-SP), where she serves as a faculty member and supervisor at the master’s and doctoral levels. She is Co-leader of the Global Health and Health Systems Research Group (ENSP/Fiocruz/CNPq, Brazil) and a researcher in the Global Health Group at the University of the Balearic Islands (Spain), where she served as a Visiting Professor between 2019 and 2020. During Brazil’s presidency of the BRICS, she coordinated the Network of Research in Public Health and Health Systems. She has extensive experience in health policy and health systems analysis from a comparative (national and international) perspective. She currently coordinates research on BRICS health systems.
EDUCATION
Postdoctoral training in Global Health (University of the Balearic Islands – UIB, Spain). PhD in Public Health from the National School of Public Health Sergio Arouca (ENSP/Fiocruz, Brazil), including a doctoral research stay abroad at the National School of Public Health/Institute of Health Carlos III (Escuela Nacional de Sanidad/Instituto de Salud Carlos III – ENS/ISCIII) in Madrid, Spain, with support from CAPES through the PDSE program. Master’s degree in Public Health, with a concentration in Planning and Management of Health Systems and Services (ENSP/Fiocruz, Brazil). Bachelor’s degree in Nursing from the Federal University of Alfenas (UNIFAL-MG, Brazil), where she conducted undergraduate research as part of the Tutorial Education Program (PET/MEC/CAPES).
RESEARCH, TEACHING, or OTHER INTERESTS
Public Health, Environmental and Occupational Health, Health Policy
Comparative analysis of the lethality pattern of Covid-19 and the response of BRICS countries to the pandemic in the context of multilateralism: An ecological study Thalyta Cássia de Freitas Martins, Adelyne Maria Mendes Pereira, Cristiani Vieira Machado, Carlos Machado de Freitas, Raphael Mendonça Guimarães Plos One, 2025 Background This article analyzes the pattern of lethality due to Covid-19 in the BRICS countries and its conditioning factors, analyzing its temporal evolution, as well as analyzing the response given by the grouping to the health crisis as a multilateral forum. Methods This ecological time-series study assessed the lethality due to Covid-19 in the BRICS countries from March 2020 to May 2023. Using the Joinpoint method, and the temporal trend analysis of the lethality rates by segmented regression for each BRICS country. Results In Brazil, the highest case fatality rate (8%) occurred in phase 1 (from April 27, 2020 to November 10, 2020), despite the peak in cases (1.2 million/week) in phase 3 (from December 31, 2021 to April 21, 2022). In Russia, phase 2 (from September 20, 2020 to March 7, 2021), which had the lowest incidence, had the second highest case fatality rate (4.5%). In India, the peak in cases in phase 2 (from March 13, 2021 to July 19, 2021) did not coincide with the peak in case fatality in the same phase. In China, the highest case fatality rate (12%) occurred in phase 1 (from March 10, 2022 to March 24, 2022), not reflecting the incidence. In South Africa, at the end of 2022, the fatality rate achieved was around 4.5%. Discussion The lethality of Covid-19 among BRICS countries showed differences related to failures in testing capacity, death information systems and access to vaccines. The group did not achieve the expected performance at an extremely opportune moment to demonstrate to the world their differential as representatives of emerging powers.
Governance and responses of health and surveillance systems to COVID-19 in BRICS countries: A scoping review protocol Adelyne Maria Mendes Pereira, Monique Azevedo Esperidião, Sílvia Karla Azevedo Vieira Andrade, João Felipe Marques Silva, Louise Celeste Rolim Silva, Adriano Silva, Isabela Barboza da Silva Tavares Amaral, Isabel Domingos Martinez dos Santos, Thalyta Cássia de Freitas Martins, Aline Degrave Plos One, 2025 The capacity of countries to respond to COVID-19 has varied, worsening inequities. Structural factors (such as socio-economic inequalities and health system financing conditions) and political-institutional factors (such as the leadership and directionality of government action) have a major influence on the structure and outcomes of national responses. An effective COVID-19 response requires strong national governance, coordination strategies, and integration between health system actions and public health surveillance measures. This scoping review aims to synthesize the evidence on the governance and responses of the BRICS countries to the COVID-19 pandemic within a context of structural inequalities, identifying lessons and gaps in the current literature. This protocol was guided by the scoping review methodology, developed by the Joanna Briggs Institute, and used the PRISMA-P reporting guidelines. Searches will be carried out on the BVS Portal, Pubmed, Web of Science, Scopus, Embase and Dimensions databases. Inclusion criteria include secondary sources in the form of scientific publications, complemented by government and institutional documents published between 2020 and 2024. Exclusion criteria exclude publications that do not involve the selected countries, focus only on local or regional level without contemplating national-level elements, and/or address with COVID-19 solely from a clinical perspective. The scoping review process will select and organize retrieved data using the Rayyan software. Six independent reviewers will select the articles, working in three pairs. The results will be described, analyzed, and categorized through a descriptive synthesis, correlating them with the research objectives and questions. Registration This protocol is registered on the Open Science Framework (OSF) (available at https://doi.org/10.17605/OSF.IO/SN5ZY) and Figshare (available at https://doi.org/10.6084/m9.figshare.25908340) platforms.
Interdependent islands: health policies and medical practices in the care, management, and research of a neglected disease in the Global South Laurencia Silveti, Adelyne Maria Mendes Pereira Cadernos De Saude Publica, 2025 This study analyzes medical practices related to hydatidosis in the province of Santiago del Estero, Argentina. This parasitic zoonotic disease is recognized as a significant public health problem in South America. Nevertheless, it is included among the neglected diseases as classified by the World Health Organization - those that primarily affect the poorest populations living in rural, remote, or marginalized areas with limited access to health services. The objective is to examine how hydatidosis is configured as a health issue through an analysis of medical practices involved in its care, management, and research, from Global South perspectives. A qualitative design was employed, including interviews with healthcare professionals working in the field, as well as the construction of a documentary corpus comprising technical reports from 2015 to 2023 and public policies at different levels. The study identifies three main characteristics of practices related to hydatidosis in Santiago del Estero: (1) a medical management style marked by colonial and authoritarian traits, in tension with local technical autonomy and weakened by a lack of political support; (2) fragmented healthcare processes, with limited intersectoral coordination and a predominance of biomedical and technocratic models; and (3) health research aligned with global priorities, often disconnected from local needs. These dynamics reflect a structural dependence on standardized approaches, to the detriment of contextualized and comprehensive public health strategies.
BRICS in the management of the COVID-19 pandemic: a comparative study on social distancing and vaccination measures in the nations of the bloc Thalyta Cássia de Freitas Martins, Raphael Mendonça Guimarães, Adelyne Maria Mendes Pereira Cadernos De Saude Publica, 2025 Resumo: O objetivo foi analisar, de forma comparada, as medidas de distanciamento social e vacinação implementadas pelos países do Brics em resposta à pandemia da COVID-19. Realizou-se estudo exploratório ancorado nas contribuições do institucionalismo histórico e do método histórico-comparado em ciências sociais. Dois eixos foram priorizados: as medidas de distanciamento social e de vacinação. Parte dos países do BRICS apresentaram características semelhantes, como a adoção de medidas de distanciamento social pouco extensas, flexíveis e sob coordenação descentralizada (com exceção da China); fragilidade das medidas de auxílio social (Brasil, Índia e África do Sul); e o uso de recursos biotecnológicos (presentes na China e na Rússia). A respeito da vacinação, três aspectos se assemelham: início tardio (exceto na China e na Rússia); cobertura vacinal (esquema completo) inferior a 70% da população em dezembro de 2022 (exceção para China e Brasil); e hesitação vacinal. As respostas adotadas pelos países do BRICS em termos de distanciamento social e vacinação contra COVID-19 foram diversas e relacionadas a fatores políticos, sociais e econômicos, que condicionaram a implementação de tais medidas.
Political factors and arrangements influencing primary health care financing and resource allocation: A scoping review protocol Henrique Sant’Anna Dias, Adelyne Maria Mendes Pereira, Elisabete de Fátima Polo de Almeida Nunes, Caroline Pagani Martins, Marcela Castilho, Fernanda de Freitas Mendonça, Luciana Dias de Lima Plos One, 2024 Introduction Primary health care is a key element in the structuring and coordination of health systems, contributing to overall coverage and performance. PHC financing is therefore central in this context, with variations in sufficiency and regularity depending on the “political dimension” of health systems. Research that systematically examines the political factors and arrangements influencing PHC financing is justified from a global and multidisciplinary perspective. The scoping review proposed here aims to systematically map the evidence on this topic in the current literature, identifying groups, institutions, priorities and gaps in the research. Methods and analysis A scoping review will be conducted following the method proposed by Arksey and O’Malley to answer the following question: What is known from the literature about political factors and arrangements and their influence on and repercussions for primary health care financing and resource allocation models? The review will include peer-reviewed papers in Portuguese, English or Spanish published between 1978 and 2023. Searches will be performed of the following databases: Medline (PubMed), Embase, BVS Salud, Web of Science, Scopus and Science Direct. The review will follow the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews checklist. Inclusion and exclusion criteria will be used for literature screening and mapping. Screening and data charting will be conducted by a team of four reviewers. Registration This protocol is registered on the Open Science Framework (OSF) platform, available at https://doi.org/10.17605/OSF.IO/Q9W3P
The response to COVID-19 in Argentina, Brazil, and Mexico: challenges to national coordination of health policies Cristiani Vieira Machado, Adelyne Maria Mendes Pereira, Carlos Machado de Freitas, Michele Souza e Souza, Sebastián Tobar, Suelen Carlos de Oliveira Cadernos De Saude Publica, 2024 The article analyzes the fight against COVID-19 in three Latin American countries: Argentina, Brazil, and Mexico. A multiple case study was carried out in a comparative perspective, based on a bibliographic review, documentary analysis, and secondary data, considering characteristics of the countries and the health system, evolution of COVID-19, national governance, containment and mitigation measures, health systems response, constraints, positive aspects and limits of responses. The three countries had distinct health systems but were marked by insufficient funding and inequalities when hit by the pandemic and recorded high-COVID-19 mortality. Structural, institutional, and political factors influenced national responses. In Argentina, national leadership and intergovernmental political agreements favored the initial adoption of centralized control measures, which were not sustained. In Brazil, there were limits in national coordination and leadership related to the President’s denialism and federative, political, and expert conflicts, despite a universal health system with intergovernmental commissions and participatory councils, which were little used during the pandemic. In Mexico, structural difficulties were associated with the Federal Government’s initial reluctance to adopt restrictive measures, limits on testing, and relative slowness in immunization. In conclusion, facing health emergencies requires strengthening public health systems associated with federative, intersectoral, and civil society coordination mechanisms and effective global solidarity mechanisms.
COVID-19 in Latin America: inequalities and response capacity of health systems to health emergencies Isabel Domingos Martinez dos Santos, Cristiani Vieira Machado, Adelyne Maria Mendes Pereira, Carla Lourenço Tavares de Andrade Revista Panamericana De Salud Publica Pan American Journal of Public Health, 2023 Objetivo. Identificar correlações entre a covid-19, características demográficas e socioeconômicas e capacidade dos sistemas de saúde latino-americanos para resposta a emergências sanitárias. Método. Realizou-se um estudo ecológico, utilizando dados secundários de 20 países latino-americanos relativos a incidência, mortalidade, testagem e cobertura vacinal para covid-19 no período de 2020 a 2021, assim como informações demográficas e socioeconômicas. A preparação dos países para responder a emergências sanitárias foi explorada a partir do Relatório Anual de Autoavaliação dos Estados Partes da Organização Mundial da Saúde de 2019 sobre a implementação do Regulamento Sanitário Internacional (RSI). Realizaramse análises estatísticas por meio do teste de correlação de Spearman (rho). Resultados. Observou-se correlação positiva alta do produto interno bruto per capita e do índice de desenvolvimento humano com incidência de covid-19, testagem e cobertura vacinal; e entre proporção da população idosa e cobertura vacinal. Não foram identificadas correlações entre os indicadores da covid-19 e as capacidades prévias de implementação do RSI. Conclusões. A ausência de correlação entre indicadores relativos à covid-19 e a capacidade de implementação do RSI pode estar relacionada a limites dos indicadores utilizados ou da ferramenta de acompanhamento do RSI como instrumento indutor da preparação dos países para enfrentamento de emergências sanitárias. Os resultados sugerem a importância de condicionantes estruturais e a necessidade de estudos longitudinais, comparativos e qualitativos para compreender os fatores que influenciaram a resposta dos países à covid-19.
The increase of philanthropic entities in the SUS: what does this scenario reveal? João Felipe Marques da Silva, Brígida Gimenez Carvalho, Adelyne Maria Mendes Pereira, Elisabete de Fátima Almeida Nunes, Fernanda de Freitas Mendonça, Stela Maris Lopes Santini, Silvia Karla Azevedo Vieira Andrade, Edinalva de Moura Ferraz Revista De Saude Publica, 2023 O artigo analisa aspectos da mudança da natureza jurídica de instituições privadas de assistência à saúde, de estabelecimentos “com” para “sem” fins lucrativos. Trata-se de uma pesquisa exploratória, apoiada no referencial de análise de políticas, com foco em dados secundários, provenientes do Sistema de Cadastro Nacional de Estabelecimentos de Saúde (SCNES), de 2012 a 2020, e estudo de caso. Os resultados apresentam aumento dessas entidades em todas as regiões do país e evidências de que se comportam como estabelecimentos com fins lucrativos. A mudança de natureza jurídica oculta um processo mais amplo de mercantilização implícita dos serviços de saúde, incentivado por políticas estatais e relacionado às isenções previstas em lei.
Federalism and health policy: The intergovernmental committees in Brazil Cristiani Vieira Machado, Luciana Dias de Lima, Ana Luiza d'Ávila Viana, Roberta Gondim de Oliveira, Fabíola Lana Iozzi, Mariana Vercesi de Albuquerque, João Henrique Gurtler Scatena, Guilherme Arantes Mello, Adelyne Maria Mendes Pereira, Ana Paula Santana Coelho Revista De Saude Publica, 2014
