Dr. Julio Croda is elected president of the BSTM

New president will lead the Society in the 2021-2023 biennium

Infectious diseases expert, Dr. Julio Croda, was already internationally renowned for his role in fighting tuberculosis, having been president of the Brazilian Tuberculosis Research Network REDE-TB in 2018. But it was in 2020 that he became a reference in the first months of the pandemic. Infectious diseases physician and specialist by the Oswaldo Cruz Foundation (Fiocruz), Dr. Croda started his career in São Paulo before moving to Mato Grosso do Sul, where he has lived for the past 10 years. During his time at the Ministry of Health, he was Director of the Communicable Disease Surveillance Department of the Health Surveillance Department (DEVIT/SVS/MS) during the administration of Minister Luiz Henrique Mandetta. Professor of Medicine at the Federal University of Mato Grosso do Sul (UFMS) and assistant coordinator of the area of Medicine II at CAPES, at age 43 at the height of his professional and personal careers, Dr. Croda is now taking on another challenge, that of running the Brazilian Society of Tropical Medicine (SBMT).

Check out the interview with the new president-elect below.

SBMT: You take office at the SBMT with managerial experience and national and international recognition. How can this contribute?

Dr. Julio Croda: I believe that this experience allows, in some way, to give more visibility to our Brazilian Society of Tropical Medicine, either in the various representative forums or in cooperation with other societies, both national and international, in addition to seeking opportunities for the SBMT to represent its members and also groups of researchers, which is extremely relevant, especially in the global context. I intend to use this experience and this network of contacts to strengthen relationships and raise funds for our Tropical Medicine congresses, as well as for collaborative projects among its members in the future.

SBMT: You assume the SBMT with a different age profile. In your opinion, can this contribute to bringing greater participation by young people?

Dr. Julio Croda: Im a young tropicalist, but SBMT already had a president younger than me, Marcos Lacerda. I really have a profile of valuing young tropicalists, which began with the Young Researcher Award, in which I was the first president of this commission, which evaluated the awards, and where I remained for many years. There, I had the opportunity to observe different works, of high quality, that were produced and presented during MEDTROP editions. In this line, the idea is to value and attract more and more young tropicalists, precisely to ensure the renewal of society in the future, since our founders, the people who have been participating in the SBMT, are retiring, and this renewal of the staff it takes place through the valorization of young tropicalists. And how? One of my ideas, perhaps, would be to increase the value of the Young Researcher award in future congresses, give greater visibility to this award, make space in the media for these young people awarded, including creating specific sections that attract young people with specific themes for this age group.

We need to bring these people into the SBMT, which is a multidisciplinary society that allows different views on Tropical Medicine and the problems of the tropics.

SBMT: Do you already have any plans for your management at SBMT? What projects do you intend to implement?

Dr. Julio Croda: First of all, it is important to emphasize that I have the privilege of having a board composed of members who have participated in it for a long time, it helps a lot. In relation to my management in front of the SBMT, I intend to follow what is already being implemented. It is a time to value what has been done, what has been achieved so far, to understand how we can optimize our Congresses in order to ensure more adequate fundraising that allows greater sustainability to SBMT. I believe in the importance of management and in a very strong relationship with the government, a profile that has been built up over many years. We are an important society that deals with neglected diseases, and maybe it is the only society that has this detailed focus, so we need to give visibility to these diseases and the people affected by them. I want to work many public organizations in order to increasingly improve the dialogue, bringing managers to participate in the SBMT, especially with regard to neglected diseases, which is our area, our focus. With this purpose, we can establish more lasting collaborative projects, more adequate fundraising, which maintain not only METROP congresses, but future teaching and research activities on this important topic. Our management should focus on this specific scope of neglected diseases, which involves an urban environment, discussing the urbanization of these diseases. Our society has to address and lead the discussion about Chikungunya, Zika, Covid19, tuberculosis, leprosy, schistosomiasis, Chagas disease, all these diseases that have urbanized more recently and are part of the daily lives of large vulnerable communities. In terms of plan and project, it is to understand our specificities and how we can evolve in them, in order to establish collaboration and fundraising for the execution of joint projects, mainly with the government, both with regard to teaching and research.

SBMT: Will your management invest in research and events?

Dr. Julio Croda: During my term, together with the board, we want to hear many suggestions so that we can advance in these two years. Our great event is MEDTROP, a very respected Congress, from a society that was born in 1962, whose journal has been published since 1967, and which, therefore, is a very respected community, which has the only congress that addresses multidisciplinary diverse issues related to these specific diseases, neglected diseases, and also conditions in the tropics. In other words, as we have this thematic scope, and we are a multidisciplinary society, this greatly enriches the Congress, which is characterized by its extremely scientific content, which brings the very best in science and medical practice, in the practice of epidemiology, of public health. We want more and more, along with managers, to value the Brazilian Congress of Tropical Medicine and always try to work together to answer the main public health questions that afflict Brazilians. Our investment will be mostly towards MEDTROP, in the establishment of new partnerships, so that we keep the SBMT focused on the dilemmas of the community and making us available to assist public health managers in the various demands.

SBMT: As a researcher at the Oswaldo Cruz Foundation, how do you see the current national scenario and the challenges to be overcome in this adverse moment of the political and economic situation that Brazil is going through?

Dr. Julio Croda: The scenario is very sad. There is a significant reduction in investment in science and health. And when we look at the diseases, the health problems, which are part of the scope of the SBMT, this becomes more urgent because there was already an inequality in investment, in the development of medicines, vaccines, over many years, and Covid-19 came to aggravate. Associated with this, we have a management at the federal government level that invests very little in science. We had a very relevant cut in the Science and Technology fund, which will impact the production of knowledge in Brazil, but mainly in the production of global knowledge on neglected diseases, an area in which Brazil is one of the leaders. In other words, the world will lose with this decrease in resources, with this decrease in financial investment. In addition to the impact on improving the living conditions of those people who are affected by these diseases, we also have an impact on the training of young researchers. I mean, if you dont have the resources to maintain the projects, the scholarships, we can see that there will be a generation that will not be renewed, we will have a lapse, a very large lapse of young people who will not have the opportunity to enter an academic career, that are producing for their countries, and without resources will be forced to migrate. In other words, all the investment made in the training of labor through public universities will be lost. We are experiencing an exodus of young researchers, recent graduates, young doctors, who are going to other countries. It is a sad reality to see all the Brazilian investment made throughout the training of this professional being transferred to other countries. We observe that this economic crisis, this adverse scenario, will generate more inequality because we are restricting investment in education and for new generations, which will impact the renewal of scientific staff, the training of new researchers, and, consequently, more underdevelopment. The scenario we will experience in the next ten years is regrettable, being sure that the economic crisis will last for a long time, the social crisis goes with it, hunger is already part of the Brazilian scenario, and investment in research has receded to over 20 years behind. The impact on the generation of knowledge, but mainly on the formation of new researchers, will be enormous.

SBMT: What can be done so that Tropical Medicine has priority and greater visibility with the government?

Dr. Julio Croda: Regarding visibility, it is always necessary to dialogue with the federal sphere, trying to raise awareness and seek alternatives at this time of economic crisis, especially with the Ministry of Health, since the Ministry of Science and Technology has a huge shortage of resources. The Ministry of Health has been a partner of the SBMT, recognizing the importance of discussing Tropical Medicine, neglected diseases, debating relevant themes. The SBMT is made by its members and they are extremely respected by the government and their peers. It is a society that has a lot of voice and can debate more and more with the government, work on fundraising, and give more visibility to these diseases, especially after Covid-19. We know that the burden of these diseases, which have always been neglected, will intensify. That is, diseases are not. Remembering that when we say neglected diseases we refer to neglected populations, because these diseases occur in the poorest populations in Brazil, in the large slums, in the poorest rural areas, and during the pandemic, with the economic crisis, there was an increase in this inequality, there was  worsening of the economic situation throughout the country and, therefore, we believe that there will be an increase in the impact of these diseases throughout Brazil. Our indicators temporarily decreased due to underreporting, but over the next five years we know that the number of cases and deaths related to these diseases will increase, precisely because of the lack of investment that occurred during these two years of pandemic.

So, the SBMT has to act as a protagonist with the government to face this increase in the burden of the disease and propose innovative solutions to reduce the burden of these different diseases that affect neglected populations.

SBMT: How has the Brazilian experience with tropical diseases contributed to the fight against the new coronavirus?

Dr. Julio Croda: The Brazilian experience with tropical diseases has contributed a lot to confront the new coronavirus, especially our Unified Health System (SUS), which knows how to respond, despite all the denial of science and the dissemination of fake news, the SUS, its users, its professionals, its researchers, have acquired expertise over the years. And the experience in relation to tropical diseases is no different, when, for example, we responded very well to Zika, which was an extremely successful experience. And this answer could have been used in a more appropriate way in confronting Covid-19. We have enormous expertise because weve been facing a public health emergency for a long time, and more recently weve dealt with Zika, with H1N1, and thats expertise that could have been better used. It was not used by the government, but the different actors of the SBMT actively participated in the response to Covid-19, either through technical committees, representing the Society in the ministries, in the state health secretariats, or through assertive communication in various media. We are really very proud because the SBMT has among its members people who with a lot of expertise from dealing with other tropical diseases, with other emergencies, or participated and actively contributed in the response at national, state, municipal and local levels. I believe that most tropicalists have been involved in the response to the new coronavirus and have expertise in managing that response, and recently been involved in vaccine production. Thus, Tropical Medicine contributed to this response because its members are active and have always been recognized in different spheres and scenarios.

SBMT: Eradicated diseases once again threaten the country. Tell us a little about the challenges that Brazil is facing and what must be done to control future epidemics/pandemics?

Dr. Julio Croda: Eradicated diseases are back and the trend is for everything to get worse, because you have Covid-19 that generated a demobilization in relation to the response to these diseases, so we have onchocerciasis, trachoma, leprosy, tuberculosis, which was extremely impacted by Covid-19, because part of the professionals who worked there were transferred to Covid-19. In addition, there was an increase in poverty, the economic crisis that began and will last for a few years will make these poorer populations suffer more from these diseases that were about to disappear in Brazil. Poverty leads to increased inequality, worsens health conditions, that is, people will live in more vulnerable situations from an environmental and geographical point of view in large communities, in large slums, they will have less access to health services, because of after the economic crisis, investment will be lower, especially in combating these tropical diseases, neglected diseases, because there is a lack of visibility; the society needs to understand the impact of these diseases, not only for the poor populations, but for everyone. It is necessary to give visibility to these people who have little insertion, who few know about, who little is debated in different forums, whose country is one of those with the greatest burden of disease. Thus, we expect a worsening of tuberculosis, leprosy, leishmaniasis, and other vaccine-predictable diseases such as measles, since vaccination coverage is very low after the pandemic. The emergence or reappearance of polio is also a risk. Our polio vaccine coverage is very low, BCG coverage, which is a vaccine that is applied at birth, which was extremely high, is now very low. In other words, we have a decrease in national coverage, a decrease in investment in health, especially for neglected diseases, an increase in poverty. This will certainly impact the increase in these diseases, the increase in the burden of these diseases, the increase in cases, and eventually hospitalization and death. There is the importance of SBMT in taking an affirmative position and presenting itself as a scientific society, a technical society, which can help managers in the response and control of these diseases, because we will, yes, observe the increase. So, it is essential, as a society, that we prepare for this increase and try to propose innovative solutions for managers so that we can combat this increase in order to reduce the entire impact of this health and economic crisis.

SBMT: What are the lessons learned from the pandemic?

Dr. Julio Croda: Among the lessons learned from the pandemic is the importance of investing in science and then we can take the example of the vaccine. It was developed in less than a year and one year after the start of vaccination, we had and are having an important reduction in cases of death in Brazil, thanks to the vaccine. Science allows the resumption of economic activity, brings security to the health service, and reduces the impact on the health sector. The vaccine is a clear example of how science can transform society, contribute to reducing suffering and the number of deaths. In other words, the main lesson is that we must invest in science. Science is transformative, it reduces social inequalities, it can transform our country into a better, more adequate, less unequal country. One of the main lessons is that if we dont invest in science and dont solve our problems with local solutions, how are we going to produce vaccine? And in this regard, Fiocruz and Butantan took leadership. Brazil is better off precisely because of these two national public institutions and laboratories. We need to value research institutions, universities, research institutes, value what is produced in Brazil, the answers we can produce to our problems. We have extremely capable, qualified researchers and thinkers in Brazil and we know that we can do and respond better to the internal demands of Brazil. After we went through Zika and now with Covid-19, with all our production in science, we do believe that society as a whole should value science more and this brings to the center of the discussion, of course, the SBMT, which discusses Covid-19, Zika, Chikungunya, dengue, Chagas disease, leishmaniasis, tuberculosis, which are diseases of the Tropics, and, in addition to them, we should occasionally bring to the debate traffic accidents, violence in big cities, slums, among many other topics. We need to bring more targeted questions and research to our local problems and, through these studies, reduce inequalities, offer better quality of life for the entire Brazilian population, and of course the SBMT has and will always have a relevant role in organizing this response and in monitoring the post pandemic science and how we can work to value science to local researchers and institutions.

SBMT: Finally, I would like you to take stock of MEDTROP Play 2021, the first virtual congress of SBMT.

Dr. Julio Croda: MEDTROP Play 2021 was the largest online congress in Brazil on the specific theme of Tropical Medicine, infectious diseases, and public health. So far, no event has been held completely online, with more than 15 simultaneous rooms. It was a very interesting congress, which managed to bring together important satellite events, among them, the VIII Virtual Workshop of REDE-TB, Entomol8, ChagasLeish, Covid-19 Forum, plus the SBMT programming in a single event, which managed the participation of various scientific societies, managers. massive presence of undergraduate students, as it is an extremely scientific congress. The experience was productive and showed our ability to carry out a fully online event. It was a great success. We are sure that our supporters and sponsors are satisfied. It was a very rewarding experience and it taught us the importance of virtual events that can be held on time over the next year. We discovered that we can use this technology for fundraising, and that we can maintain one or another virtual session at the next MEDTROP, which will be held in Belém (PA) from November 13th to 16th. Certainly, this experience of our first virtual Congress showed how MEDTROP, an extremely technical and scientific Congress, is valued among undergraduate and graduate students and health professionals. It proved that we have the ability to hold an online event. In addition, it left us a great deal of expertise in conducting this type of event, which will be used to carry out other events and other activities, including the 57th MEDTROP, which will be held next year.