"The competent physician, before giving medicine to his patient, acquaints himself not only with the disease he wishes to cure, but also with the habits and constitution of the sick person." Marcus Tullius Cicero

In recent times, globalization has succeeded in connecting the world's population, shortening distances, increasing the movement of people internationally and facilitating global and immediate access to any type of information. Based on this, it could be said that this transversal element has benefited the world in terms of connection and accessibility, which is true. At the same time, it is also true that it has deepened social and political dilemmas in global contexts, such as the immigration of civilians illegally from one country to another; it has reduced physical contact and human relations; and it has increased the difficulties in terms of public health and sanitation in the world.

Factors pertaining to human actions, linked to defining elements in the complex scenario of life such as quality, productivity, relationships or effectiveness, have taken precedence in recent times over fundamental values such as respect, safety or hope itself. In order to be more and more productive, the spectrum of health in the world has entered in many periods of human history, to second and third planes. Likewise, the work carried out by mankind in the last decades, around immunization processes, development of new medicines and campaigns in favor of awareness and preventive medicine, are light on the path and axis of vital support, both in the present and in the life of new generations in the future.

Deriving in the local and regional contribution as a starting point, Panama's progress in scientific research has strengthened the optimization of immunization processes, in addition to projecting new ways and paths to understand and decipher human behavior in more depth. All in line with the detailed learning of the immune system and, therefore, in favor of the progressive achievement of a better quality of life. Since its origins, Panama has been strengthening solid foundations in medicine and health, thanks to the extensive immigration of professionals throughout the twentieth and twenty-first century. In the case of the country, immigration has been successful in nation building, bringing knowledge and experience to each of the public/private sectors, including the medical and health sector. The creation and construction of the Panama Canal at the beginning of the last century attracted many foreigners, including U.S. doctors and scientists, who contributed to the development of tropical medicine research, transforming the country into the main center of scientific studies in the region.

Advances in health and technology have transformed the way of thinking and acting in the lives of Panamanians. The increased development of digital applications that seek to facilitate the operation and application of processes in "telehealth" and "telemedicine", the incorporation of artificial intelligence technologies in business areas such as customer service or the application of advances in robotics in the scientific environment, highlight how Panama has managed to adapt to the process of globalization and this digital era that highlights the technological contribution in each of the processes of human life. Examples such as the country's rapid action in isolating the A-H1N1 influenza virus strain and delivering it to the regulatory departments of the Pan American Health Organization (PAHO) in 2009, expose unusual actions that continue to place Panama as a reference in health, technology and processes in the region.

The effective coexistence between private companies, the public sector and the state in Panama significantly reduces bureaucratic processes, making rapid progress in the application of measures and bills that encourage investment, technological development and scientific progress in favor of health and quality of life in Panama. Dr. Jorge Motta, former director of the Gorgas Memorial Institute of Health Studies (Icges) and former secretary of the National Secretariat of Science, Technology and Innovation (Senacyt), points out how the presence of the State in Panama has facilitated the implementation of social projects, allowing access and relationship with private companies, in a safe and progressive manner. "In these nations, projects are largely financed by the private sector, but in the case of Panama, we are still far from that happening because the State today carries the greatest burden of funding for research."

Panama excels in study against Polio

The effective execution of immunization processes, taking into account the symbiosis between the State and private companies that has led Panama to have progressive advances in health in recent decades, is largely the result of the birth of private initiatives that seek to strengthen the health sector in the country and improve the quality of life and life expectancy in the region. Entities such as the Center for Research and Clinical Studies in vaccines Cevaxin and VaxTRAILS, a boutique organization in clinical research (CRO) which offers solutions in management and monitoring processes in clinical trials of vaccines, have implemented knowledge through pillars such as research, with a view to finding innovative solutions for health in Panama, America and the world..  

The existence of private entities in Panama, such as those mentioned above, is not a mere coincidence or the result of a creative outburst in the country. It is the result of latent and historical needs that have existed in recent times in the region and in the world. As Latin America is one of the main regions in the planet with a larger and more diverse (ethnicities, races, origins, etc.) population group, the development of vaccination studies has become a route of analysis and research, thanks to the very different behavior of diseases in different population, racial and cultural subgroups. This breeding ground has fortified research and driven new campaigns, initiatives and medical studies that have reinforced the quality of life and have provided sufficient data to project and prevent diseases and illnesses in the future.

Consequently, Panama and Latin America have assumed a scientific leadership role as a source of vaccine research studies for the world. Rapid enrollment and high levels of adherence by the population have given Panama great recognition by forging research processes that increasingly include new population subgroups, generating greater health coverage, as well as a broader spectrum of data that continue to empower the country's knowledge and research. Similarly, the advances in infrastructure in the region and the growth in research reflected in the behavior of the market, have also consolidated the development of clinical studies, hand in hand with different CRO's throughout the continent.

Taking up again the unity resulting from the symbiosis between the public sector and private companies in Panama, the growth in research and the advances in public health in the last ten years have shown that working together in favor of common goals is the main way to achieve results in the short and medium term. In the first half of 2014, a group of Panamanian scientists, supported by international funds such as the Bill & Melinda Gates Foundation, led a research study on the fight for the total eradication of polio in the world. The study forged, at the time, a broad set of information, which has given rise not only to contribute to the eradication of polio, but to further investigate other diseases and pathologies that still continue to aggravate the population in Panama and the world.

Since the end of 2014, to date, this clinical research has had a great international impact, managing to be published in media such as The Lancet and has consolidated solid foundations among private companies, non-profit organizations and states. Likewise, the results obtained have been fundamental in decision-making regarding future actions in the context of immunization processes. At the same time, these results expose the scientific progress of Panama and the region, fostering a greater link with international organizations such as the WHO and the Centers for Disease Control and Prevention of the United States. The study involved researchers from the Global Research of Infectious Diseases, based in Rio de Janeiro, Brazil, the Center for Vaccinology in Ghent, Belgium, the Instituto de Pós-Graduação Carlos Chagas in Rio de Janeiro, the Center for Disease Control and Prevention in Atlanta, United States and as previously mentioned, the support and contribution of the Bill & Melinda Gates Foundation from Seattle, United States. The results achieved jointly and internationally are a faithful representation of teamwork in favor of common benefits.

A research process with social fruits

As with any disease that seeks to adapt to the different conditions found in the environment (temperature, humidity, altitude, pressure, etc.) and manage to alter the vital functioning of an organism, the need to generate a high-dose inactivated vaccine against wild poliovirus type two (attenuated) is a useful shock measure to counteract any new outbreak or variant of the virus. As a result, it was possible to identify and analyze the greater effectiveness, in terms of speed and intensity, of the high-dose inactivated vaccine, as more than 90% of the "study subjects" (boys and girls) were expected to achieve full protection from a single dose of the vaccine. On the other hand, the conventional trivalent inactivated vaccine was able to achieve full protection in 75% of the subjects.

Thanks to these results, the implementation of immunization processes through the use of the high-dose inactivated vaccine has reduced the use of oral vaccines (Sabin), which are slightly prone to induce poliovirus by vaccination. Likewise, a high percentage of protection was established with the inactivated vaccine, thus reducing vaccination through the conventional trivalent inactivated vaccine. The total eradication of poliomyelitis in the world is soon to be achieved, and this study has led to major conclusions in favor of this goal. The bureaucratic management that has been given to these public health policies in Panama, together with international alliances linked to the contribution of capital, technology and knowledge, have been preponderant factors in the process of development and construction of a Panamanian society and a world that is increasingly healthier and free of barriers that harm the quality of life.

Finally, it should be noted that this study carried out by Panamanian scientists is only a starting point to continue positioning Panama and the Cevaxin medical research center as a reference in scientific research in Latin America and the world. The world crisis caused by Covid-19 has not only affected society, but also, in cases such as Panama's, has led to an increase in the interest of young people in studying careers related to medical sciences (medicine, bacteriology, virology, biotechnology) and agribusiness.