brhejoThe BRICS Health JournalThe BRICS Health Journal3034-47003034-4719Sechenov University10.47093/3034-4700.2025.2.3.27-40brhejo-54Research ArticleСтатьиBrazil–China relations in health: historical context, industrial challenges, and future opportunitieshttps://orcid.org/0000-0003-2558-6602Pinheiro dos SantosWellington

Wellington Pinheiro dos Santos, PhD, Professor, Department of Biomedical Engineering, Center for Technology and Geosciences

Av. da Arquitetura, SN, Cidade Universitária, Recife, Pernambuco, 50740-550

wellington.santos@ufpe.brhttps://orcid.org/0009-0000-2262-0575Menezes de CarvalhoEvandro

Evandro Menezes de Carvalho, PhD, Professor Getúlio Vargas Foundation

Botafogo Beach, 190, 7th floor, Botafogo, Rio de Janeiro 22250-145

https://orcid.org/0000-0002-9725-8862SobrinhoLuiz Vianna

Luiz Vianna Sobrinho, PhD, Researcher, Faculty of Medicine of Bahia

Av. Reitor Miguel Calmon, SN, Vale do Canela, Salvador, Bahia, 40110-100

https://orcid.org/0000-0002-0071-4850PaschoalotteLeandro Modolo

Leandro Modolo Paschoalotte, PhD, Researcher

Campinas, Zeferino Vaz University City, Barão Geraldo, Campinas, São Paulo,13083-970

https://orcid.org/0000-0002-6482-5840BittencourtRoberto José

Roberto José Bittencourt, Professor

Ceilândia, Brasília, Brazil, 71966-700 

Federal University of PernambucoBrazilGetúlio Vargas FoundationBrazilFederal University of BahiaBrazilState University of CampinasBrazilMedical School; Catholic University of BrasíliaBrazil2025231220252327–40Copyright © Pinheiro dos Santos W., Menezes de Carvalho E., Sobrinho L., Paschoalotte L., Bittencourt R., 20252025Pinheiro dos Santos W., Menezes de Carvalho E., Sobrinho L., Paschoalotte L., Bittencourt R.Pinheiro dos Santos W., Menezes de Carvalho E., Sobrinho L., Paschoalotte L., Bittencourt R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.bricshealthjournal.com/jour/article/view/54

This article analyzes the evolving health cooperation between Brazil and China as a strategic frontier in South-South collaboration. At a time of global health insecurity and technological inequality, the partnership between these two continental powers offers a transformative alternative to traditional donor-recipient models. The analysis traces a shift from commodity-based trade to a potential alliance in co-innovation, encompassing vaccines, artificial intelligence, biotechnology, and digital health. Brazil’s deep dependency on imported medical inputs and its fragmented industrial base stand in contrast to China’s stateled model of technological scaling and global health outreach. Yet, this asymmetry also reveals opportunities: Brazil’s universal health system, research institutions, and regional leadership can be aligned with China’s production capacity, digital infrastructure, and development finance to build shared technological sovereignty. The paper examines how Brazil’s renewed industrial policy under Lula’s administration opens new pathways for joint research and development, regional pharmaceutical production, and equitable technology transfer. It also confronts persistent challenges – technological imbalances, intellectual property constraints, institutional volatility, and geopolitical pressures aimed at curtailing South-South alignment. A successful partnership, the article argues, must be grounded in transparent governance, mutual benefit, and a commitment to health as a public good. It concludes with a proposal for a decentralized health innovation ecosystem in Brazil, inspired by China’s special economic zones, to overcome the historical concentration of technological power and promote equitable development across the North, Northeast, and Center-West. In doing so, the Brazil–China relationship can become a model for a more just, resilient, and multipolar global health order.

Brazil–China relationsglobal health diplomacyhealth industrial policySouth-South cooperationtechnological sovereigntygeopolitical economy of healthThe authors are grateful to the Brazilian research agency Conselho Nacional de Desenvolvimento Científico e Tecnológico – CNPq, for the partial support of this work.ReferencesAugusto PDVB, Macedo FGC, Sousa CET, Barbosa FM, Sanson MZ, Guanabarino MA, Borges FT. A atenção primária em saúde brasileira é para pobres? In: Borges FT, ed. O longo amanhecer do Sistema Único de Saúde: Reflexões para o SUS reexistir. [Is primary healthcare in Brazil for the poor? In: Borges FT, ed. The long dawn of the Unified Health System: Reflections for the SUS to reexist.] São Paulo–Niterói: Hucitec/EDUFF Publishing; 2021:61-73. (In Portuguese). ISBN-10: 6586039746, ISBN-13: 978-6586039740.Augusto PDVB, Macedo FGC, Sousa CET, Barbosa FM, Sanson MZ, Guanabarino MA, Borges FT. A atenção primária em saúde brasileira é para pobres? In: Borges FT, ed. O longo amanhecer do Sistema Único de Saúde: Reflexões para o SUS reexistir. [Is primary healthcare in Brazil for the poor? In: Borges FT, ed. The long dawn of the Unified Health System: Reflections for the SUS to reexist.] São Paulo–Niterói: Hucitec/EDUFF Publishing; 2021:61-73. (In Portuguese). ISBN-10: 6586039746, ISBN-13: 978-6586039740.Borges FT, Messias PGV. Uma nova institucionalidade para integrar e coordenar o SUS. In: Borges FT, ed. O longo amanhecer do Sistema Único de Saúde: Reflexões para o SUS reexistir. [A new institutional framework to integrate and coordinate the SUS. In: Borges FT, ed. The long dawn of the Unified Health System: Reflections for the SUS to reexist.] São Paulo–Niterói: Hucitec/EDUFF Publishing; 2021:91–102. (In Portuguese). ISBN-10: 6586039746, ISBN-13: 978-6586039740.Borges FT, Messias PGV. Uma nova institucionalidade para integrar e coordenar o SUS. In: Borges FT, ed. O longo amanhecer do Sistema Único de Saúde: Reflexões para o SUS reexistir. [A new institutional framework to integrate and coordinate the SUS. In: Borges FT, ed. The long dawn of the Unified Health System: Reflections for the SUS to reexist.] São Paulo–Niterói: Hucitec/EDUFF Publishing; 2021:91–102. (In Portuguese). ISBN-10: 6586039746, ISBN-13: 978-6586039740.Sturm H, Julia W, Tonaco Borges F, Dickinson A, Sottas B, Wennerholm C, Andreae C, Liljeroos M, Jaarsma T, Joos S, Bauer A. Patient’s Perception of Primary Health Care Provision With Respect to Access, Continuity and CoordinationInCept: An International Qualitative Perspective. Int J Health Plann Manage. 2025 May;40(3):538–548. doi:10.1002/hpm.3892. Epub 2025 Jan 3.Sturm H, Julia W, Tonaco Borges F, Dickinson A, Sottas B, Wennerholm C, Andreae C, Liljeroos M, Jaarsma T, Joos S, Bauer A. Patient’s Perception of Primary Health Care Provision With Respect to Access, Continuity and CoordinationInCept: An International Qualitative Perspective. Int J Health Plann Manage. 2025 May;40(3):538–548. doi:10.1002/hpm.3892. Epub 2025 Jan 3.Paim JS. O que é o SUS. [What is SUS?] Rio de Janeiro: Editora Fiocruz; 2009. (In Portuguese). 148 p. ISBN: 9788575411858, eISBN: 9788575413425. doi:10.7476/9788575413425Paim JS. O que é o SUS. [What is SUS?] Rio de Janeiro: Editora Fiocruz; 2009. (In Portuguese). 148 p. ISBN: 9788575411858, eISBN: 9788575413425. doi:10.7476/9788575413425Paim J, Travassos C, Almeida C, Bahia L, Macinko J. The Brazilian health system: history, advances, and challenges. Lancet. 2011 May 21;377(9779):1778–1797. doi:10.1016/S0140-6736(11)60054-8. Epub 2011 May 9.Paim J, Travassos C, Almeida C, Bahia L, Macinko J. The Brazilian health system: history, advances, and challenges. Lancet. 2011 May 21;377(9779):1778–1797. doi:10.1016/S0140-6736(11)60054-8. Epub 2011 May 9.Santos NR. Os desafios do Sistema Único de Saúde (SUS) diante do modelo neoliberal de saúde. In: Borges FT, ed. O longo amanhecer do Sistema Único de Saúde: Reflexões para o SUS reexistir. [The challenges facing the Unified Health System (SUS) in the face of the neoliberal health model. In: Borges FT, ed. The long dawn of the Unified Health System: Reflections for the SUS to reexist.] São Paulo–Niterói: Hucitec/EDUFF Publishing; 2021:17–40. (In Portuguese). ISBN-10: 6586039746, ISBN-13: 978-6586039740.Santos NR. Os desafios do Sistema Único de Saúde (SUS) diante do modelo neoliberal de saúde. In: Borges FT, ed. O longo amanhecer do Sistema Único de Saúde: Reflexões para o SUS reexistir. [The challenges facing the Unified Health System (SUS) in the face of the neoliberal health model. In: Borges FT, ed. The long dawn of the Unified Health System: Reflections for the SUS to reexist.] São Paulo–Niterói: Hucitec/EDUFF Publishing; 2021:17–40. (In Portuguese). ISBN-10: 6586039746, ISBN-13: 978-6586039740.Santos NR. SUS e estado de bem-estar social: perspectivas pós-pandemia. [SUS and the welfare state: post-pandemic perspectives.] São Paulo–Niterói: Hucitec/ EDUFF Publishing; 2022. 281 рр. (In Portuguese). ISBN-10: 8584043055, ISBN-13: 978-8584043057.Santos NR. SUS e estado de bem-estar social: perspectivas pós-pandemia. [SUS and the welfare state: post-pandemic perspectives.] São Paulo–Niterói: Hucitec/ EDUFF Publishing; 2022. 281 рр. (In Portuguese). ISBN-10: 8584043055, ISBN-13: 978-8584043057.Carvalho EM. Renascimento da Rota da Seda e sua extensão até a América Latina. In: Carvalho EM, Veras D, Steenhagen P, eds. A China e a Iniciativa Cinturão e Rota: Percepções do Brasil. [China and the Belt and Road Initiative: Perceptions from Brazil.] Rio de Janeiro: FGV Direito Rio; 2023:17–38. (In Portuguese). ISBN: 978-6586060-49-2.Carvalho EM. Renascimento da Rota da Seda e sua extensão até a América Latina. In: Carvalho EM, Veras D, Steenhagen P, eds. A China e a Iniciativa Cinturão e Rota: Percepções do Brasil. [China and the Belt and Road Initiative: Perceptions from Brazil.] Rio de Janeiro: FGV Direito Rio; 2023:17–38. (In Portuguese). ISBN: 978-6586060-49-2.Pereira LBV, Ribeiro LS. Comércio, investimentos, moeda e a Iniciativa Cinturão e Rota: em que ponto os interesses brasileiros podem encontrar os interesses chineses? In: Carvalho EM, Veras D, Steenhagen P, eds. A China e a Iniciativa Cinturão e Rota: Percepções do Brasil. [Trade, investment, currency, and the Belt and Road Initiative: where do Brazilian interests align with Chinese interests? In: Carvalho EM, Veras D, Steenhagen P, eds. China and the Belt and Road Initiative: Perceptions from Brazil.] Rio de Janeiro: FGV Direito Rio; 2023:143–174. (In Portuguese). ISBN: 978-65-86060-49-2.Pereira LBV, Ribeiro LS. Comércio, investimentos, moeda e a Iniciativa Cinturão e Rota: em que ponto os interesses brasileiros podem encontrar os interesses chineses? In: Carvalho EM, Veras D, Steenhagen P, eds. A China e a Iniciativa Cinturão e Rota: Percepções do Brasil. [Trade, investment, currency, and the Belt and Road Initiative: where do Brazilian interests align with Chinese interests? In: Carvalho EM, Veras D, Steenhagen P, eds. China and the Belt and Road Initiative: Perceptions from Brazil.] Rio de Janeiro: FGV Direito Rio; 2023:143–174. (In Portuguese). ISBN: 978-65-86060-49-2.Macinko J, Mullachery PH. Primary care experiences among Brazilian adults: Crosssectional evidence from the 2019 National Health Survey. PLoS One. 2022 Jun 7;17(6):e0269686. doi:10.1371/journal.pone.0269686.Macinko J, Mullachery PH. Primary care experiences among Brazilian adults: Crosssectional evidence from the 2019 National Health Survey. PLoS One. 2022 Jun 7;17(6):e0269686. doi:10.1371/journal.pone.0269686.Edward T. Hall. Beyond Culture. New York: Anchor Press/Double day., Knopf Doubleday Publishing Group, 1976. 270 pp. ISBN: 9780385124744, 0385124740Edward T. Hall. Beyond Culture. New York: Anchor Press/Double day., Knopf Doubleday Publishing Group, 1976. 270 pp. ISBN: 9780385124744, 0385124740Massuda A, Dall’Alba R, Chioro A, Temporão JG, Castro MC. After a far-right government: challenges for Brazil’s Unified Health System. Lancet. 2023 Mar 18;401(10380):886-888. doi:10.1016/S0140-6736(23)00352-5. Epub 2023 Feb 22.Massuda A, Dall’Alba R, Chioro A, Temporão JG, Castro MC. After a far-right government: challenges for Brazil’s Unified Health System. Lancet. 2023 Mar 18;401(10380):886-888. doi:10.1016/S0140-6736(23)00352-5. Epub 2023 Feb 22.Paschoalotto MAC, Lazzari EA, Castro MC, Rocha R, Massuda A. Advances, challenges, and prospects for the Unified Health System (SUS) resilience. Ciência & Saúde Coletiva. 2025;30:e22072024. doi:10.1590/1413-81232025306.22072024Paschoalotto MAC, Lazzari EA, Castro MC, Rocha R, Massuda A. Advances, challenges, and prospects for the Unified Health System (SUS) resilience. Ciência & Saúde Coletiva. 2025;30:e22072024. doi:10.1590/1413-81232025306.22072024Coelho TCB, et al. Financiamento da saúde. In: Paim JS, de Almeida NA, orgs. Saúde coletiva: teoria e prática. [Health financing. In: Paim JS, de Almeida NA, eds. Public health: theory and practice.] 2ª ed. Rio de Janeiro: MedBook; 2023:268–295. (In Portuguese). ISBN: 978-8583691211.Coelho TCB, et al. Financiamento da saúde. In: Paim JS, de Almeida NA, orgs. Saúde coletiva: teoria e prática. [Health financing. In: Paim JS, de Almeida NA, eds. Public health: theory and practice.] 2ª ed. Rio de Janeiro: MedBook; 2023:268–295. (In Portuguese). ISBN: 978-8583691211.World Health Organization. WHO global report on traditional, complementary and integrative medicine 2024 Geneva; 2024. 124рр. World Health Organization © ISBN 978-92-4-011138-7 (electronic version), ISBN: 978-92-4-011139-4 (print version)World Health Organization. WHO global report on traditional, complementary and integrative medicine 2024 Geneva; 2024. 124рр. World Health Organization © ISBN 978-92-4-011138-7 (electronic version), ISBN: 978-92-4-011139-4 (print version)Figueira KRCA, Carvalho NLF, Borges FT. Dinheiro público como a viga mestra da saúde no Brasil. In: Borges FT, ed. O longo amanhecer do Sistema Único de Saúde: Reflexões para o SUS reexistir. [Public money as the cornerstone of healthcare in Brazil. In: Borges FT, ed. The long dawn of the Unified Health System: Reflections for the SUS to reexist.] São Paulo–Niterói: Hucitec/EDUFF Publishing; 2021:77-90. (In Portuguese). ISBN-10: 6586039746, ISBN-13: 978-6586039740.Figueira KRCA, Carvalho NLF, Borges FT. Dinheiro público como a viga mestra da saúde no Brasil. In: Borges FT, ed. O longo amanhecer do Sistema Único de Saúde: Reflexões para o SUS reexistir. [Public money as the cornerstone of healthcare in Brazil. In: Borges FT, ed. The long dawn of the Unified Health System: Reflections for the SUS to reexist.] São Paulo–Niterói: Hucitec/EDUFF Publishing; 2021:77-90. (In Portuguese). ISBN-10: 6586039746, ISBN-13: 978-6586039740.Veras D. Entre o choque e a adaptação: Brasil, China e cultura empresarial. In: Carvalho EM, Veras D, Steenhagen P, eds. A China e a Iniciativa Cinturão e Rota: Percepções do Brasil. [Between shock and adaptation: Brazil, China, and corporate culture. In: Carvalho EM, Veras D, Steenhagen P, eds. China and the Belt and Road Initiative: Perceptions from Brazil.] Rio de Janeiro: FGV Direito Rio; 2023:241–273. (In Portuguese). ISBN: 978-65-86060-49-2.Veras D. Entre o choque e a adaptação: Brasil, China e cultura empresarial. In: Carvalho EM, Veras D, Steenhagen P, eds. A China e a Iniciativa Cinturão e Rota: Percepções do Brasil. [Between shock and adaptation: Brazil, China, and corporate culture. In: Carvalho EM, Veras D, Steenhagen P, eds. China and the Belt and Road Initiative: Perceptions from Brazil.] Rio de Janeiro: FGV Direito Rio; 2023:241–273. (In Portuguese). ISBN: 978-65-86060-49-2.Oliveira A. A Iniciativa Cinturão e Rota e a imagem internacional da China: uma análise sobre o soft power chinês e a presença midiático-cultural chinesa no Brasil. In: Carvalho EM, Veras D, Steenhagen P, eds. A China e a Iniciativa Cinturão e Rota: Percepções do Brasil. [The Belt and Road Initiative and China’s international image: an analysis of Chinese soft power and Chinese media and cultural presence in Brazil. In: Carvalho EM, Veras D, Steenhagen P, eds. China and the Belt and Road Initiative: Perceptions from Brazil.] Rio de Janeiro: FGV Direito Rio; 2023:297–327. (In Portuguese). ISBN: 978-65-86060-49-2.Oliveira A. A Iniciativa Cinturão e Rota e a imagem internacional da China: uma análise sobre o soft power chinês e a presença midiático-cultural chinesa no Brasil. In: Carvalho EM, Veras D, Steenhagen P, eds. A China e a Iniciativa Cinturão e Rota: Percepções do Brasil. [The Belt and Road Initiative and China’s international image: an analysis of Chinese soft power and Chinese media and cultural presence in Brazil. In: Carvalho EM, Veras D, Steenhagen P, eds. China and the Belt and Road Initiative: Perceptions from Brazil.] Rio de Janeiro: FGV Direito Rio; 2023:297–327. (In Portuguese). ISBN: 978-65-86060-49-2.

The authors declare that there are no conflicts of interest present.