Brazilian Government Research Articles

Press Articles from “Gazeta Polska w Brazylii” as a Source of Information about Brazilian Polonia’s Interests in the Security of the Second Republic of Poland in July and August 1939 – Selected Issues

The article aims to present an outline and analysis of the topics presented in the July and August 1939 issue of “Gazeta Polska w Brazylii” (“Polish Newspaper in Brazil”). These concerned informing the Brazilian Polish community about matters and interests crucial to the Polish state’s security. The article analyses all the issues of “Gazeta Polska w Brazylii” of July and August 1939, the available scientific literature, and other printed sources. It has been shown that “Gazeta Polska w Brazylii” was the leading periodical informing the Brazilian Polonia about matters important to the Polish state’s interests and security. On the eve of the outbreak of World War II, the dominant issues of interest to the Polish community in Brazil included the evaluation of the Brazilian government, Hitler and the Third Reich, and German actions towards the local population in the areas taken over by the German state in 1938 and 1939. The issue of the Free City of Danzig and German militarism in the region, which threatened the interests of the Second Republic and Polish citizens’ position, was also significant.

Strategies for implementing risk management in Brazilian state governments

Strategies for implementing risk management in Brazilian state governments

Analysis of public policies to combat COVID-19 in the state of Paraná, Brazil.

The COVID-19 pandemic had a great impact on several public sectors worldwide, requiring the implementation of public policies in an organized way to contain and control the disease. Thus, this study aimed to analyze public policies to face the COVID-19 pandemic in the State of Paraná, Brazil. This was a cross-sectional, retrospective, quantitative survey carried out with data from March 2020 to March 2022 in the twenty-two municipalities that host the local health regions. Data collection was documentary, carried out from the municipal Portal da Transparência website, which is dedicated to making public all expenditures, and epidemiological bulletins released by the Health Department of the state of Paraná. The variables analyzed were New Cases and Deaths, Mortality and Lethality Coefficient, Incidence Rate, Vaccination Coverage, Number of Hospital and ICU beds exclusive to COVID-19, Settled Expenses destined for COVID-19 and coping measures, namely, the Declaration of Public Health Emergency, Curfew, Mandatory use of masks, Businesses closure, Teleworking of risk groups, and Suspension of activities with crowds and of classes. After collection, data underwent descriptive analysis, and subsequently, the correlation of variables was analyzed using the Spearman test. Multiple linear regression was applied using the variable selection method called best subset selection (BSS). The dependent variables listed were incidence rate, new cases and new deaths. The results showed that coping measures, as well as the application of resources for the pandemic, were implemented heterogeneously in the municipalities studied, and the progression of the disease, the distribution of beds and vaccination occurred unevenly and may be a reflection of the limited Brazilian national governance. An important correlation was observed between the incidence rate and new deaths with vaccination coverage. In addition, the regression model showed that measures such as mandatory use of masks, closure of shops, suspension of classes, and curfew showed important correlations with the variables incidence rate, cases, and new deaths. The study highlighted the importance of carrying out a robust analysis of public policies to face emergencies of global importance so that government entities are prepared for future crises of great repercussions, such as the COVID-19 pandemic.

Estimated reduction in obesity prevalence and costs of a 20% and 30% ad valorem excise tax to sugar-sweetened beverages in Brazil: A modeling study.

The consumption of sugar-sweetened beverages (SSBs) is associated with obesity, metabolic diseases, and incremental healthcare costs. Given their health consequences, the World Health Organization (WHO) recommended that countries implement taxes on SSB. Over the last 10 years, obesity prevalence has almost doubled in Brazil, yet, in 2016, the Brazilian government cut the existing federal SSB taxes to their current 4%. Since 2022, a bill to impose a 20% tax on SSB has been under discussion in the Brazilian Senate. To simulate the potential impact of increasing taxes on SSB in Brazil, we aimed to estimate the price-elasticity of SSB and the potential impact of a new 20% or 30% excise SSB tax on consumption, obesity prevalence, and cost savings. Using household purchases data from the Brazilian Household Budget Survey (POF) from 2017/2018, we estimated constant elasticity regressions. We used a log-log specification by income level for all beverage categories: (1) sugar-sweetened beverages; (2) alcoholic beverages; (3) unsweetened beverages; and (4) low-calorie or artificially sweetened beverages. We estimated the adult nationwide baseline intake for each beverage category using 24-h dietary recall data collected in 2017/2018. Taking group one as the taxed beverages, we applied the price and cross-price elasticities to the baseline intake data, we obtained changes in caloric intake. The caloric reduction was introduced into an individual dynamic model to estimate changes in weight and obesity prevalence. No benefits on cost savings were modeled during the first 3 years of intervention to account for the time lag in obesity cases to reduce costs. We multiplied the reduction in obesity cases during 7 years by the obesity costs per capita to predict the costs savings attributable to the sweetened beverage tax. SSB price elasticities were higher among the lowest tertile of income (-1.24) than in the highest income tertile (-1.13), and cross-price elasticities suggest SSB were weakly substituted by milk, water, and 100% fruit juices. We estimated a caloric change of -17.3 kcal/day/person under a 20% excise tax and -25.9 kcal/day/person under a 30% tax. Ten years after implementation, a 20% tax is expected to reduce obesity prevalence by 6.7%; 9.1% for a 30% tax. These reductions translate into a -2.8 million and -3.8 million obesity cases for a 20% and 30% tax, respectively, and a reduction of $US 13.3 billion and $US 17.9 billion in obesity costs over 10 years for a 20% and 30% tax, respectively. Study limitations include using a quantile distribution method to adjust self-reported baseline weight and height, which could be insufficient to correct for reporting bias; also, weight, height, and physical activity were assumed to be steady over time. Adding a 20% to 30% excise tax on top of Brazil's current federal tax could help to reduce the consumption of ultra-processed beverages, empty calories, and body weight while avoiding large health-related costs. Given the recent cuts to SSB taxes in Brazil, a program to revise and implement excise taxes could prove beneficial for the Brazilian population.

Overlapping Areas Used for Artisanal Fishing and Populations of Franciscana Dolphin (Pontoporia blainvillei) in the Southwest Atlantic Ocean

This study identified the overlap between artisanal fishing areas and the Franciscana dolphin (Pontoporia blainvillei) in the Southwest Atlantic Ocean (SWAO), Brazil, to identify areas where the species was incidentally captured from the perception of artisanal fishers. Using a semistructured questionnaire, ethnographic interviews (n = 330) were carried out from 2012 to 2018 with fishers from ten communities in southeastern (ES and RJ) and southern (PR) Brazil. After the interviews, the fishers presented their fishing routes, locations and areas of incidental capture and occurrence of the Franciscana dolphin. Ninety-five fishers (29%) identified the species: 23 in northern ES, 1 in southern ES, 20 in northern RJ, and 51 in the PR. Among the 235 fishers who could not identify the species, approximately half worked in the distribution gaps. The areas of occurrence noted by the fishers coincided with those described in the “National Action Plan for the Conservation of the Toninha,” an official document from the Brazilian Government and scientific literature. The results indicate that the information provided by fishers is useful for understanding the distribution of the Franciscana dolphin and can be used in the development of management strategies to mitigate the incidental capture of the species.

Assessment of Food Insecurity Risk in Primary Health Care: The Brazilian Government Experience

Assessment of Food Insecurity Risk in Primary Health Care: The Brazilian Government Experience

Digital Transformation of Public Services in a Startup-Based Environment: Job Perceptions, Relationships, Potentialities and Restrictions

Digital transformation in public administration needs to be accompanied by more dynamic and intelligent strategies, which effect cultural change. Inspired by the business culture of startups, in 2021 the Brazilian government created the StartUp GOV.BR program to develop and accelerate the development of digital transformation projects within the Federal Government. This program aims to make digital transformation processes more proactive and flexible and generate more profitable operations. In this work, we investigated the perception of ICT practitioners (members of startups) about the program and the issues that surround it. Our goal was to identify relations, potentialities and restrictions of this program to contribute to outlining growth strategies, as well as the assets and capabilities needed to successfully transform digital public services in a startup-based environment. For this purpose, we conducted 23 focus groups with up to 12 people, totaling 175 participants. Then, we fully transcribed and qualitatively analyzed the data from each of the focus groups based on Grounded Theory. As a result, we developed maps of relationships between categories, along with narratives that help explain and understand the members’ perception of the StartUp GOV.BR program. We also listed 34 points for improvement and 62 actions to be taken to improve the program. The results achieved in this work can contribute to a research agenda of initiatives towards the Digital Transformation of public services in governments around the world combining innovative digital strategies based on the perspective of professionals.

Exploratory multi-omics analysis reveals host-microbe interactions associated with disease severity in psoriatic skin

Psoriasis (Pso) is a chronic inflammatory skin disease that poses both physical and psychological challenges. Dysbiosis of the skin microbiome has been implicated in Pso, yet a comprehensive multi-omics analysis of host-microbe interactions is still lacking. To bridge this gap, we conducted an exploratory study by adopting the integrated approach that combines whole metagenomic shotgun sequencing with skin transcriptomics. This was a cross-sectional study, adult patients with plaque-type Psoriasis (Pso) and healthy volunteers were included. Skin microbiota samples and biopsies were collected from both lesional and non-lesional skin areas on the lower back. Weighted Gene Correlation Network Analysis (WGCNA) was employed for co-expression network analysis, and cell deconvolution was conducted to estimate cell fractions. Taxonomic and functional features of the microbiome were identified using whole metagenomic shotgun sequencing. Association between host genes and microbes was analyzed using Spearman correlation. Host anti-viral responses and interferon-related networks were identified and correlated with the severity of psoriasis. The skin microbiome showed a greater prevalence of Corynebacterium simulans in the PASI severe-moderate groups, which correlated with interferon-induced host genes. Two distinct psoriatic clusters with varying disease severities were identified. Variations in the expression of cell apoptosis-associated antimicrobial peptides (AMPs) and microbial aerobic respiration I pathway may partly account for these differences in disease severity. Our multi-omics analysis revealed for the first time anti-viral responses and the presence of C.simulans associated with psoriasis severity. It also identified two psoriatic subtypes with distinct AMP and metabolic pathway expression. Our study provides new insights into understanding the host-microbe interaction in psoriasis and lays the groundwork for developing subtype-specific strategies for managing this chronic skin disease. The research has received funding from the FP7 (MAARS-Grant 261366) and the Innovative Medicines Initiative 2 Joint Undertaking (JU) under grant agreement No 821511 (BIOMAP). The JU receives support from the European Union's Horizon 2020 research and innovation programme and EFPIA. This publication reflects only the author's view and the JU is not responsible for any use that may be made of the information it contains. GAM was supported by a scholarship provided by CAPES-PRINT, financed by the Coordenação de Aperfeiçoamento de Pessoal de Nível Superior - CAPES (Brazilian Government Agency). The authors thank all patients who participated in our study.

New development: Assessing the influence of Brazil's public governance narrowness on the Brazilian Army

IMPACT This article addresses the challenges non-English-speaking countries face in implementing imported policies and how Brazil's federal-level understanding of governance impacts sectoral public organizations. The authors’ focus is on the impacts on the Brazilian Army, an understudied organization among public administration scholars, which is often called to operate in areas other than defence policy. The insights provided in the article will help researchers, policy-makers, and practitioners to navigate such challenges by advocating for a more transparent policy debate and fostering context-specific approaches to governance. ABSTRACT Concerns have been raised in Public Money & Management about Brazil's narrow view of governance and its disregard for networks. The authors extend this debate, investigating its effects on the Brazilian Army’s governance norms and structures and whether network dynamics play a role in the army's operations. A narrow understanding of governance was discovered to persist. However, networked action exists under other-than-governance labels.

Assessing the Impact of COVID-19 on Banks’ Profitability: The Role of Size in an Emerging Economy

This work investigates the impact of the COVID-19 crisis on Brazilian banks’ profitability, and if the impact was stronger for smaller banks. Brazil was highly affected by COVID-19 crisis, has a highly concentrated banking sector, and is well known for the high technology of its financial market. We collected information from 42 banks on the quarterly financial statements available in Brazilian Central Banks during the period between January/2016 and March/2021. We ran Arellano–Bond generalized method of moments dynamic panel regression and our results confirm that the COVID-19 crisis negatively impacted the profitability of the Brazilian banks and that large banks were the most affected. Brazilian government adopted anti-crisis measures that relaxed regulations in order to decrease credit spreads. This may have alleviated the impact of the crises on small banks and also encouraged the appearance of fintech companies, which competed directly with banks.

A carnival learning party: crossing cultural borders through coding literacy

This experience report aims to describe the conceptual and logistical features of Coding Carnival, a Brazilian-American collaboration on teaching computer programming as literacy. It is a descriptive study, with a qualitative inquiry into the Eisner methodology approach (2017). In the fall of 2019, through a sponsorship from the Brazilian government, Corrêa came to study concepts of coding literacy with Vee, an English professor at the University of Pittsburgh. They elected to design a reading group focused on teaching coding in K12[1] contexts. Readings included Brazilian and American scholars of literacy and coding, alongside hands-on activities. The culmination of the reading group was a "Coding Carnival," two public all-ages events with a theme of Brazilian carnival to demonstrate hands-on coding activities and to help families learn coding literacy together. The power and identity relationships inherent to literacy, as well as its symbolic and technological features, connected "coding literacy" with Brazilian literacy theory--in particular, the potential of individual transformation and emancipation described by P. Freire (1981). D’Ambrosio's "ethnomathematics" helped us to see how cultural, physical, and social conditions shape the mathematical thinking embedded in coding practices (D’Ambrosio, 2002). The coding literacy theory, presented by Vee (2017), in conversation with Bers’ ideas of teaching coding as a second language, helped us to bridge the gap between teaching in the humanities and understanding technical concepts in programming through a carnival learning party.[2] [1] K–12 is an abbreviation of kindergarten (K) for 5– 6-year-olds through twelfth grade (12) for 17–18-year-olds, corresponding to the first and last grades, respectively, of free basic education in the USA. [2] This study was approved by the University of Pittsburgh Institutional Review Board under the number STUDY19100176.

Renewable energy and green extractivism: transitions or reconfigurations?

This article discusses the implications of projects implemented by corporations in the energy sector based on their use of the notions of energy transition, decarbonization and renewable energy. We analyzed documents from business organizations, civil society, the Brazilian government and the United Nations containing data and representations regarding wind power projects and the production of green hydrogen. Interviews were also conducted with women from the quilombola community in Cumbe, located in the municipality of Aracati, in the Brazilian Northeastern state of Ceará, who have been affected by a wind power project. We have sought to develop an analysis that contrasts, on the one hand, the discourse of multilateral institutions and corporations that justify so-called clean energies as a means of combating climate change and, on the other, the perceptions of populations affected by a wind energy project in terms of the impacts and meaning they attribute to such projects.

Breast cancer treatment access disparities: A retrospective cohort study of breast cancer in patients treated at a high-complex cancer center in southern Brazil.

e13689 Background: More than seventy-three thousand new breast cancer cases are expected in Brazil for the year 2023, representing the most common malignancy in this country. Delaying time to treatment initiation has been associated with increased risk of worse outcomes. The Brazilian government developed several initiatives to accelerate the access of cancer patients to treatment in an adequate time-bound. One of these is a federal law defining that oncological treatment should begin within 60 days of pathological diagnosis. Methods: This retrospective study analyzed data of newly diagnosed breast cancer patients in 2022–2023 in Hospital de Clinicas de Porto Alegre (HCPA), a public hospital in Porto Alegre, Brazil. The primary objective was to build a predictive model of risk factors that could delay the time to first treatment beyond 60 days from diagnosis. The present analysis describes the socio-demographic characteristics of these patients and explores their impact on the time to oncologic treatment initiation. This project was approved by the Ethics and Research Committee (registration CAAE 71160423.7.0000.5327). Results: 184 patients who started their oncological treatment between 2022-2023 in HCPA were enrolled; 32 patients (17,3%) had their first treatment after 60 days from the diagnosis while 152 (82,7%) were treated before 60 days; 106 (57,3%) patients had studied up to elementary school and 32 (17,3%) were non-white; 53 patients (23%) had been submitted to biopsy outside HCPA. Patients who started their first treatment before 60 days had a mean of 38 days from diagnosis to first treatment while those treated after 60 days had a mean of 75,6 days. To evaluate how socio-demographic factors impacted the time to treatment initiation, a multivariate Poisson log-linear model adjusted for race, city of residence, stage of the disease, and type of first treatment considered different variables. Higher educational level had a statistically significant effect, with a rate ratio (RR) of 0.32 (95% CI 0.157 - 0.650, p < 0.05). We also found that performing biopsy in our institution instead of doing it elsewhere had a statistically significant impact on the time to first treatment, with an RR of 0.512 (95% CI 0.274 - 0.957, p = 0.036). Ethnicity was not related to delay of treatment (p-value=0.125). Conclusions: This study identified that socio-demographic factors are crucial to guarantee the appropriate time to start treatment for breast cancer patients in a middle-income country. Higher educational level had a positive impact on time-to-treatment initiation, as well as to perform biopsy in the same institution patients were treated. In this first analysis, ethnicity, clinical staging, and type of first treatment did not meet the statistical criteria to be considered relevant and the accrual of more patients is needed for further conclusions.

Explaining Brazil's Stance on the Ukraine War

Brazil's diplomatic stance on the Ukraine War should be understood within the context of broader geopolitical tensions. Brazil's position goes beyond geopolitical hedging and represents a strategic alignment with the global South based on a vision aimed at stimulating economic development through cooperation. This article highlights Brazil's reluctance to criticise Russia, articulates its grievances with the West and explains the Brazilian government's conviction that a stronger alliance with the global South can result in economic gain. Ultimately, Brazil's new foreign policy is shifting from its historical commitment to non‐alignment and pragmatism and reveals a growing inclination to challenge liberal international norms.

Towards XAI agnostic explainability to assess differential diagnosis for Meningitis diseases

Meningitis, characterized by meninges and cerebrospinal fluid inflammation, poses diagnostic challenges due to diverse clinical manifestations. This work introduces an explainable AI automatic medical decision methodology that determines critical features and their relevant values for the differential diagnosis of various meningitis cases. We proceed with knowledge acquisition to define the rules for this research. Currently, we have established the etiological diagnosis of Meningococcaemia, Meningococcal Meningitis, Tuberculous Meningitis, Aseptic Meningitis, Haemophilus influenzae Meningitis, and Pneumococcal Meningitis. The data preprocessing was conducted after collecting data from samples with meningitis diseases at Setif Hospital in Algeria. Tree-based ensemble methods were then applied to assess the model’s performance. Finally, we implement an XAI agnostic explainability approach based on the SHapley Additive exPlanations technique to attribute each feature’s contribution to the model’s output. Experiments were conducted on the collected dataset and the SINAN database, obtained from the Brazilian Government’s Health Information System on Notifiable Diseases, which comprises 6729 patients aged over 18 years. The Extreme Gradient Boosting model was chosen for its superior performance metrics (Accuracy: 0.90, AUROC: 0.94, and F1-score: 0.98). Setif’s hospital data revealed notable performance metrics (Accuracy: 0.7143, F1-Score: 0.7857). This study’s findings showcase each feature’s contribution to the model’s predictions and diagnosis. It also reveals critical biomarker ranges associated with distinct types of Meningitis. Significant diagnostic effect was found for Meningococcal Meningitis with elevated neutrophil levels ( > 40%) and balanced lymphocyte levels (40%–60%). Tuberculous Meningitis demonstrated low neutrophil levels ( < 60%) and elevated lymphocyte levels ( > 60%). H. influenzae meningitis exhibited a predominance of neutrophils ( > 80%), while Aseptic meningitis showed lower neutrophil levels ( < 40%) and lymphocyte levels within the range of 50%–60%. The majority of the AI automatic medical decision results are twinned with validation by our team of infectious disease experts, confirming the alignment of algorithmic diagnoses with clinical practices.

From securitisation to martialisation: Logistics of humanitarian protection in Brazil’s Amazon

The association between logistics and militarised humanitarianism is expanding as a strategy for managing migrants' productive and reproductive lives. In Brazil, despite a progressive humanitarian visa policy, the national army remains responsible for the logistics of a severely underfunded humanitarian operation in Brazil’s Amazon. This study, based on participatory action research with 300 migrants, introduces the notion of martialisation to show political and socioeconomic dimensions that are juxtaposed in the military logistics of humanitarian zones and subsequently experienced as a dominant structuring process of exploitation. These are securitization of migration linked to at once the deepening of market liberalism and the normalisation of military intervention within productive and reproductive processes. Findings show that the military leadership in Brazil’s humanitarian response reveals a multi-scalar phenomenon of military rule that contributes to sustaining the repressive labour regime in Brazil’s Amazon. It articulates the structures of labour subordination with the micromanagement of reproductive measures by which migrants are controlled, exploited, and dispossessed of their rights. The conclusion makes the case for the collective organization of migrants in pursuit of transformative action.

Entrepreneurship and innovation in public management

Social entrepreneurship comprises a recent form that has as its main objective the carrying out of activities (through products and services) that have a social impact, that is, that enable development, improving people's quality of life, combined with sustainability. In this sense, the objective was to analyze the Social Work Project (SWP), which is a project of the Caixa Econômica Federal (a Brazilian Government Federal Bank) in partnership with Forcon Condominiums, a private company that was hired to foster social entrepreneurship at Residential Buena Vista I and III, in Goiânia, GO. The final report of the execution of the SWP was analyzed as part of the methodology employed and 30 people were interviewed about the impact of the project on their lives. Questions about whether the entrepreneurial activity improved the quality of life, about Forcon's participation in the development of activities, the Public Powers, and the difficulties encountered for the exercise of the activity were asked. The results showed that most of the beneficiaries of the project were women, between 18-29 years old, who sought to undertake small businesses in the area of aesthetics, especially salons and manicures. KEYWORDS: Planning; Public Policies;Social work

The State, Political Power, and the Financialization of Agrarian Space in Brazil

The analysis of this paper is focused on economic development and environmental surpluses. It emphasizes the importance of agrarian space as well as the state’s role in organizing society to favor capitalist development. The paper employs a Marxist theoretical framework to define the difference between the state and the government. It uses this framework to examine some of the main features of the PT government and its role in promoting rural financialization in Brazil. The paper examines major subsidized financial products as well as their public cost. It concludes that the state’s role in the financialization process was not just a choice on the part of the Brazilian government but also a reflection of the economic power exerted by financial and agrarian capital.

Laboratory-based surveillance of chronic kidney disease in people with private health coverage in Brazil

BackgroundAlthough approximately 25% of Brazilians have private health coverage (PHC), studies on the surveillance of chronic kidney disease (CKD) in this population are scarce. The objective of this study was to estimate the prevalence of CKD in individuals under two PHC regimes in Brazil, who total 8,335,724 beneficiaries.MethodsOutpatient serum creatinine and proteinuria results of individuals from all five regions of Brazil, ≥ 18 years of age, and performed between 10/01/2021 and 10/31/2022, were analyzed through the own laboratory network database. People with serum creatinine measurements were evaluated for the prevalence and staging of CKD, and those with simultaneous measurements of serum creatinine and proteinuria were evaluated for the risk category of the disease. CKD was classified according to current guidelines and was defined as a glomerular filtration rate (GFR) < 60 ml/min/1.73 m² estimated by the 2021 CKD-EPI equation.ResultsThe number of adults with serum creatinine results was 1,508,766 (age 44.0 [IQR, 33.9–56.8] years, 62.3% female). The estimated prevalence of CKD was 3.8% (2.6%, 0.8%, 0.2% and 0.2% in CKD stages 3a, 3b, 4 and 5, respectively), and it was higher in males than females (4.0% vs. 3.7%, p < 0.001, respectively) and in older age groups (0.2% among 18-29-year-olds, 0.5% among 30-44-year-olds, 2.0% among 45-59-year-olds, 9.4% among 60-74-year-olds, and 32.4% among ≥ 75-year-olds, p < 0.001) Adults with simultaneous results of creatinine and proteinuria were 64,178 (age 57.0 [IQR, 44.8–67.3] years, 58.1% female). After adjusting for age and gender, 70.1% were in the low-risk category of CKD, 20.0% were in the moderate-risk category, 5.8% were in the high-risk category, and 4.1% were in the very high-risk category.ConclusionThe estimated prevalence of CKD was 3.8%, and approximately 10% of the participants were in the categories of high or very high-risk of the disease. While almost 20% of beneficiaries with PHC had serum creatinine data, fewer than 1% underwent tests for proteinuria. This study was one of the largest ever conducted in Brazil and the first one to use the 2021 CKD-EPI equation to estimate the prevalence of CKD.

Abstract PO1-09-09: The journey of HR positive, HER2 negative metastatic breast cancer’s patients: heterogeneities and barriers in Brazilian public health system- a national survey

Abstract Background: Breast cancer is the most common neoplasm in Brazilian women, with high percent of patients diagnosed in advanced stages. Metastatic breast cancer (mBC) is a challenge in the country, where 75% of the population is covered by public health system (Sistema Único de Saúde, SUS). We conducted an on-line survey to describe the journey of human epidermal growth factor receptor 2-negative (HER2-), hormone receptor positive (RH+) mBC patients across public scenario in Brazil. Methods: An on-line survey comprised of 39 to 48 (depending on the kind of some questions, which could open another question in case of affirmative answer) objective questions were sent by e-mail to180 oncologists working in public and private health care system. Questions were focused on assessing wait time for first treatment after admission in the hospital in both systems, availability of oncological drugs within SUS according to essential medicines list by World Health Organization, and presence of palliative and multidisciplinary teams in both systems. Continuous variables were measured by median and mean. The level of statistical significance adopted was 5% with Teste p two-sided. Analyses were performed using SAS statistical software (version 25.0). Results: We had 150 respondents working in SUS and private health system, which fulfilled the inclusion criteria to participate in this survey. The other 30 respondents were excluded from the study because they worked exclusively in SUS or exclusively in the private system, and their answers were not analyzed. Median wait time for surgery was 60 days in the SUS (N=150) and 30 days in the private health system (N=150) e (p &amp;lt; 0,0001). Regardless of chemotherapy provided, median waiting time was 30 and 15 days in the SUS (N=150) and the private health system (N=150), respectively (p &amp;lt; 0,0001). Most oncologists in the SUS (N=125, 83.3%) pointed to endocrine therapy as their first-choice treatment in mBC. Concerning endocrine therapy in the SUS, Gonadotropin-Releasing Hormone Agonist (GnRHa) was available, and it was prescribed by 54 (36.0%) and Fulvestrant for 72 (48.0%) of respondents. Considering chemotherapy, weekly paclitaxel alone or combined with platin were available and they were prescribed by 124 (82.6%) and 109 (72.6%) of oncologists respectively. Vinorelbine was available and it was prescribed according to oncologists’ report by 109 (72.6%) and Pegylated liposomal doxorubicin (PLD) by 38 (25.3%) of oncologists. Oncologists answered agree or strongly agree that they had a multidisciplinary care team in SUS 77,3% (N =116) versus 87,3% (N=131) in the private system (p=0.022). Concerning palliative care 66,09% (N= 99) in the SUS versus 82,0% (N=123) in the private system answered that they agreed or strongly agreed that this service was available (p=0.001). Conclusions: The Brazilian government has continuously improved delivery of services and medicines via the public system (SUS), but there are still significant differences within this system and versus the private sector. Unavailability of endocrine therapy agents as GnRHa and Fulvestrant, and some chemotherapy agents as PLD and Vinorelbine for high percentage of patients, raises the existence of disparities within SUS. Also, longer waiting times for treatment in the SUS, lower availability of support teams such multidisciplinary and palliative care, they point out disparities between SUS and private health systems. The lack of a National Cancer Control Program and low health investment by Brazilian government might explain the difference in cancer patients’ access. Citation Format: Heloísa Resende, Igor Soares, Angélica Renó, Ana Cunha, Vinícius Aguiar, Letícia Tureta, Viviane Pereira. The journey of HR positive, HER2 negative metastatic breast cancer’s patients: heterogeneities and barriers in Brazilian public health system- a national survey [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO1-09-09.