Rejecting both uncritical enthusiasm and technological panic, she sees AI not as a threat to academia, but as a mirror reflecting long-standing issues: gaps in methodological training, unresolved questions of authorship, and a culture that still treats scientific integrity as a bureaucratic protocol rather than a core value.

The arrival of AI tools in everyday research has prompted organizations such as the Brazilian National Council for Scientific & Technological Development (CNPq) to publish unprecedented regulatory guidelines—a sign that the technology is already part of academic practice and demands clear governance standards.

For Scussel, the greatest risk is not the technology itself, but researchers who delegate essentially intellectual tasks to machines.

In this interview with Science Arena, she explains how to select AI tools critically, why cross-validation is nonnegotiable, and what separates responsible AI use from careless application.

Science Arena — What are the biggest practical challenges researchers face when using AI without compromising the quality of their work?

Fernanda Scussel – AI has highlighted fundamental problems in academia that already existed but were neglected, such as questions of authorship, authenticity, and weaknesses in how research methodology is taught in Brazil.

The challenge is not only using the tool ethically, but also examining academic culture as a whole.

The focus needs to shift away from the technology itself and back to the research process. In other words, AI should be viewed as a tool for specific stages of research—not as a magical solution capable of writing dissertations or reading papers on its own. 

Many researchers feel overwhelmed by the sheer number of tools available. What criteria do you use to determine what is actually useful?

The main criterion is suitability for the task. Researchers should first define the problem they need to solve and only then choose the technology. Another important factor is testing: I recommend exploring no more than three or four tools and focusing on the one you feel most comfortable using.

Good results come from making the most of a specific tool, because consistent use enables machine learning and allows the model to better understand the user’s needs over time.

What validation strategies are paramount to ensure that a tool is trustworthy?

We need to understand that AI platforms are companies, and they contain what I call a “flattering element” designed to encourage engagement—they want to please you.

That means researchers must develop their own validation criteria. One crucial strategy is cross-checking, to verify whether what the AI claims actually matches what the author of a paper wrote.

Another critical error is delegating essential tasks, such as reading, to the machine. Use AI to accelerate the process—for example, to help navigate a complex text—but never relinquish intellectual responsibility for the content.

How do you stay up to date and distinguish genuine innovation from mere hype?

You need to be very careful with hype because it creates an environment of anxiety. If you are already using a tool that delivers reliable and satisfactory results, there is no need to migrate to the “tool of the week” simply because of external pressure.

Maintaining focus on a single tool also strengthens the machine-learning process I mentioned earlier and reduces the anxiety of constantly chasing the next technique.

As a professor, I test many different options, but for most researchers, the ideal approach is to tune out the noise and concentrate on what works for their own process.

What are the most common mistakes people make when using these tools?

The first is not knowing how to create an effective prompt. You need to know how to “direct” the AI—that is, provide context and establish limits.

The second is the lack of interaction: many people simply copy and paste the first response they receive, which results in generic writing and increases the risk of plagiarism.

Finally, there is a lack of technical understanding, such as ignoring the “context window,” which can lead to hallucinations when too much information is inserted at once.

How to structure an effective prompt for scientific research

What are the greatest opportunities AI offers today for democratizing Brazilian science?

AI has practically eliminated the English-language barrier, for example, and to me that has been a major breakthrough. Researchers not fluent in English can now understand complex texts and participate in classes on a more equal footing.

In your view, what are the next steps for this technology?

We now need to focus on training educators so they are better prepared to incorporate these tools into their own practices and teach students how to use them correctly.

We need to discuss all of this responsibly and without taboo. AI is here to stay, and therefore it deserves serious attention and a thoughtful approach.

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Physician and researcher Beatriz Barreto-Duarte, from the Clinical and Translational Research Laboratory at the Oswaldo Cruz Foundation (FIOCRUZ) in Bahia, describes this scenario not only as an interviewee, but also as an author. In an article published in the journal PLOS Global Public Health, coauthored with other researchers, Barreto-Duarte outlined the challenges faced by physician-scientists in low- and middle-income countries—a category that includes Brazil.

Among the obstacles identified are lengthy and demanding training pathways, systems that prioritize prestige-based medicine over evidence-based medicine, and financial disincentives for those pursuing dual careers. In an interview with Science Arena, she further discussed these issues.

Short-term grants, unstable careers

In Brazil, many physician-scientists still rely on grants with limited durations and uncertain prospects for renewal. This instability undermines the continuity needed to carry out research with the depth it demands.

For Barreto-Duarte, the equation is simple: without protected time—dedicated periods reserved for research and free from clinical obligations—it is impossible to produce quality science in a sustainable manner.

“We must recognize the physician-scientist as a strategic figure, with transition grants and genuine integration between universities, hospitals, and the National Health System (SUS),” she says.

How other countries have addressed the issue

In contrast to the situation in Brazil, Barreto-Duarte points to countries where physician-scientists receive strong institutional support. In the United Kingdom, the National Institute for Health Research (NIHR) funds professionals at different stages of their careers within the healthcare system itself, helping ensure that scientific production remains closely connected to patients’ real needs. 

Examples can also be found in low- and middle-income countries. The Latin American Network for Health Research Education (LANEHR) focuses on training regional leaders in research and medicine, while the Consortium for Advanced Research Training in Africa (CARTA) provides African scientists with mentorship, training, and institutional support.

International initiatives supporting physician-scientists

“When a country creates the infrastructure, stability, and incentives for physicians to continue conducting research within the public healthcare system, the investment becomes cost-effective in the medium and long term,” argues Barreto-Duarte.

To read the full article on the challenges facing physician-scientists in Brazil, see the interview with Beatriz Barreto-Duarte in Science Arena.

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Prôa was born in São José dos Campos, São Paulo State, and earned a degree in molecular sciences from the University of São Paulo (USP). She also trained as a mezzo-soprano singer at the Academy of the São Paulo Symphony Orchestra (OSESP), where she first began combining her love of music and science. 

At Einstein, Prôa has focused on developing solutions for Brazil’s public healthcare system (SUS), especially disease-screening algorithms and models that combine climate and health data to predict how environmental changes impact vulnerable populations. 

In this interview with Science Arena, she discusses her route into international academia, data biases in artificial intelligence (AI), and what science still needs to do to better connect with the general public. 

The first chords 

With experience in mathematics and neuroscience, Prôa joined Einstein Hospital Israelita—while still an undergraduate in molecular sciences at USP—to study dystonia, a neurological condition common among musicians. 

The overlap between disciplines was no accident: from the very start, she sought to explain the brain through mathematical models—she had an almost philosophical drive to translate emotions and perceptions into equations. 

Music was never merely a backdrop in that journey. While studying for her degree in molecular sciences, Prôa was also a professional singer and mezzo-soprano with OSESP. 

While observing an orchestra in Germany, she gained insights that would later become central to her mathematical models.

 It was also at Einstein that she discovered a new direction for her work: understanding the direct impact of scientific research on public health. Working first with neuroimaging and later with AI applied to medical imaging, she realized she could shorten the distance between research and real life. 

“I fell in love with seeing science reach people,” she says. 

Since then, her work has focused on developing solutions for Brazil’s public health system (SUS), including disease-screening algorithms and models that combine climate and health data to predict the impacts of environmental changes on vulnerable populations. 

Going global 

Prôa’s international career was not something she planned since childhood. It emerged, she says, from her active desire to understand the global academic system. 

In 2022, she began a PhD in theoretical neuroscience at Columbia University, New York. After completing her second year—at which point the program automatically grants a master’s degree—she took a one-year leave of absence to pursue a master’s in public health at Harvard. She completed the program in May 2025 and resumed her doctoral studies at Columbia the following semester. 

The decision, seemingly unconventional at first glance, stemmed from a realization Prôa had during her PhD. While working on projects for SUS, she noticed that the results had a more tangible and immediate impact than her original line of research involving mathematical models of the brain. 

The shift was not between fields, but between scales: from the laboratory to the healthcare system. To ensure she could maintain the same technical quality in this new area, she concluded that she needed training in public health and strategic management. Harvard provided exactly that. 

A turning point came in 2021, before she had even started her PhD, when she joined the Próxima Initiative, a Yale University mentoring program for young scientists in the biomedical sciences. 

For a year, Prôa was mentored by a Yale neuroscience PhD student who guided her through the application process, from understanding the international academic system to the emotional challenge of writing a personal statement. 

At Columbia, she found herself as the only student in her class from outside the elite circles of American higher education, which further motivated her to participate in mentoring programs. 

One of the biggest challenges was writing her personal statement, an essay in which candidates have to present themselves confidently. Prôa says she had to overcome what she describes as a “Brazilian culture of humility,” as well as impostor syndrome, both of which made it difficult for her to talk confidently about her accomplishments. 

Her discomfort with self-promotion, which she believes is something cultural rather than individual, eventually became the basis for a separate communication project. 

With over 30,000 Instagram followers, Prôa now advises young researchers interested in studying abroad, sharing what she has learned about international applications, interdisciplinarity, and academic careers.

The initiative took shape during her master’s degree at Harvard, where she worked as a science communicator for the institution. The response has been especially positive among Brazilian students who do not have access to structured support networks. 

Science without a pedestal

When discussing AI—a central theme of her current work—Prôa is careful to avoid blind enthusiasm. For her, the importance of the technology lies less in its technical sophistication and more in what people are using it for. 

In a country marked by inequality, this means ensuring diagnostic algorithms work across different patient populations. 

“When you train a model using data from only one group, it will not work for others,” she explains. She also stresses that academia needs to learn to engage with the general public, to welcome questions and step down from the pedestal that distances knowledge from the public. 

For those just starting out, her advice is straightforward: “Don’t be afraid to ask questions—there are no stupid ones. And perhaps most importantly, recognize that science is neither a solitary nor a linear path. Results alone are not enough. Science involves communication, human relationships, and politics. Having a support network makes a huge difference.”

How to apply to universities abroad 

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Besides boosting Brazil’s science, technology, and innovation ecosystem, the program also aims to expand the country’s capacity to conduct clinical trials. The objective is to make the country a strategic benchmark in the development of health technologies. 

The initiative also strengthens decentralized clinical trials (DCT)—featured in a 2024 report by Science Arena—whose goal is to expand patient access to studies evaluating the safety and efficacy of new medications and disease therapies.

To this end, the new policy establishes five main pillars: 

• Digital transformation;
• Social participation;
• Regulatory convergence with international standards;

• Alignment with innovation policies; 
• Expansion of access across all regions;

The pillars are aimed at integrating research and innovation with the needs of Brazil’s public health system (SUS), as well as reducing regional inequalities in access to clinical trials.

The program consolidates the Brazilian Clinical Research Network (RBPClin) by providing accreditation for research centers, specialized professional training, and greater integration between the Brazilian Health Regulatory Agency (ANVISA), ethics committees, and research institutions, in order to accelerate processes and accentuate governance in the sector.

RBPClin was established by the Ministry of Health in 2022 as a coordination and advisory body aimed at strengthening clinical research in Brazil. 

Devised after public consultation, with contributions from universities, hospitals, corporations, and civil society organizations, the PPClin advocates bolstering areas such as transparency, monitoring, and technological innovation in order to widen public access to new healthcare solutions.

Regulatory challenges

One of the gaps for expanding population access to clinical trials in a more diverse manner lies in regulation, which requires continuous advancement to ensure that Brazil’s population diversity is represented in these studies. 

PPClin represents an important step toward more patient-centered clinical trials in Brazil by institutionally incorporating principles that, until recently, were fragmented in the legislation.

One of the main advances is in the explicit inclusion of “social engagement and participant-centric research” as a guiding principle, signaling a shift in the model: from research organized primarily around centers and sponsors to a more experience-led approach, focused on access and the real needs of volunteers.

The emphasis on regional equity and reducing inequalities may also favor the expansion of multicenter networks, as well as the partial decentralization of trial phases and greater reach of studies, bringing clinical research closer to the realities of the Brazilian population.

Health strategy

The ordinance also seeks to boost Ministry of Health cooperation in the areas of Science, Technology, Innovation, and Education, building on a broader strategy that links investments in vaccine production with messenger RNA technology, biotechnology, and strategic medications, such as the expansion of domestic insulin production.

In this context, strengthening clinical research is seen as a key element in reducing technological dependence on other countries, increasing the country’s capacity to respond to future health emergencies, and consolidating a more robust scientific infrastructure.

In addition to the accreditation of research centers in line with international standards and the training of specialized professionals, the strategy includes the implementation of digital platforms for the monitoring, integration, and sharing of scientific data.

The program provides for rapid-response mechanisms for research in critical situations such as epidemics and emerging health crises, as well as mechanisms for avoiding bottlenecks observed in recent times, leaving Brazil better prepared to develop faster scientific responses to potential public health emergencies.

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According to Brainer, the biggest challenge faced by scientists today is strategic: understanding which tool is best suited to each stage of the research process and how to get the most out of them without compromising scientific integrity.

To help researchers navigate this rapidly expanding ecosystem, Science Arena compiled a list of the main tools recommended by Brainer, including details of their main functions, strengths, and weaknesses. See below:

CONSENSUS

Link: https://consensus.app/ 

Key function: Literature searches, focusing on direct, accurate, evidence-based results.

Strengths: The platform has partnered with major scientific publishers (such as Wiley, Sage, ACS, and others). As a result, it can extract data from papers in their entirety, rather than just the abstracts. It also provides the exact page number and a link to the source article, significantly reducing the risk of hallucinations or data manipulation.

Weakness: Because it depends on publishing partnerships, Consensus’s search is limited to specific databases, potentially excluding important titles.

CORE

Link: https://core.ac.uk/

Key function: Indexing open access scientific literature. 

Strengths: CORE is a free platform that aggregates data from repositories around the world. It is particularly useful for conducting broad literature searches, focusing on the latest developments in open-access publications.

Weakness: By design, CORE does not search paid-access journals or articles protected by paywalls.

OPEN EVIDENCE

Link: https://www.openevidence.com/ 

Key function: Searching for high-impact medical literature.

Strengths: The tool is extremely thorough and reliable for the medical and biomedical fields, targeting the databases of established journals, such as The New England Journal of Medicine (NEJM) and The Journal of the American Medical Association (JAMA). 

Weakness: By focusing on specialized databases, the scope of the results is limited, potentially excluding important journals or fields.

SCISPACE

Link: https://scispace.com/ 

Key function: Supporting academic writing with citation optimization and reference management.

Strengths: Authors can select a section of their text and ask the tool for a source within its database that supports the claim. The platform has a direct interface with Zotero and Mendeley, two popular reference management tools, and can automatically format tables and citations in more than 2,600 styles, including Vancouver and AMA. It can also be used to adjust the tone of a text, to make it more persuasive, pragmatic, or conversational, for example.

Weakness: Over-reliance on rewriting features can weaken the text’s originality and the author’s voice.

PERPLEXITY AI

Link: https://www.perplexity.ai/ 

Key function: Connecting ideas and cross-referencing data from different scientific articles.

Strengths: Perplexity performs advanced methodological correlations by cross-referencing author data and multiple articles, quickly creating complex theoretical overviews.

Weakness: João Brainer issues a strong warning about data privacy. The platform’s integrated browser collects user reading and browsing data in real time. For scientists working with patents, business ideas, or unpublished theses, this can create risks related to information leaks and loss of intellectual property before publication.

Popular Large Language Models (LLMs)

Key function: Preliminary screening, organizing ideas, and refining manuscripts.

Strengths: Each of the most popular large language models (LLMs) offers its own advantage in the research process: Brainer highlights Claude as the most rigorous and refined model for dealing with the density of purely academic texts; Gemini excels at searching for references online and providing links for fact-checking; and ChatGPT is especially useful for identifying trends and gaps in the literature.

Weaknesses: Because they are designed for general purposes, LLMs function based on linguistic probability. This means that when asked to process data without contextual limitations, there is a greater risk of hallucinations. They require detailed and exhaustive input; poorly worded or superficial prompts tend to lead to inaccurate and irrelevant responses.

Number one tip: combine tools and build a PDF database

Brainer’s main practical recommendation is not to expect any single tool to solve every aspect of a research project. It takes some effort to achieve consistent results. 

“You can combine the broad searches of PubMed AI CORE with the more in-depth refinement provided by Consensus and the reference management of SciSpace,” says the expert.

“You should also create your own archive of PDFs you have collected,” advises the researcher.

Brainer predicts that in response to the current flood of AI-generated papers, major journals will begin requiring authors to submit the original source files they consulted, both for auditing purposes and to ensure scientific integrity.

Watch the full discussion with João Brainer below:

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In its early years, the group focused on evaluating the quality of services dedicated to psychological distress. Over time, other issues gained prominence, including studies examining the profile of people seeking help through mental health services—young people included.

Kantorski notes that psychological distress in this age group has increased in recent years, particularly during the COVID-19 pandemic. This observation prompted the expansion of research examining the intersection between mental health and youth.

A study published in 2024 analyzed the mental health of 329 female university students during remote learning. Using questionnaires and standardized models to measure levels of distress, Kantorski and her coauthors concluded that 85% of the sample showed some level of depression, 24% had high levels of anxiety, and 25% reported suicidal ideation.

Pandemic worsened psychological distress among young people

The harmful effects of the COVID-19 pandemic on the mental health of young Brazilians are also addressed in a report on mental health produced by Agenda Jovem FIOCRUZ, an initiative of the Oswaldo Cruz Foundation (FIOCRUZ) that runs projects focused on the challenges facing Brazilian youth.

In the report, the authors state that the pandemic increased levels of psychological distress in the Brazilian population as a whole, but that the effects were felt particularly strongly by young people “because this stage of life is marked by intense sociability and circulation.”

The study examined mental health data available through Brazil’s Unified Health System (SUS), focusing on information related to hospitalizations, mortality, and healthcare services provided to people between 15 and 29 years of age across Brazil.

André Sobrinho, coordinator of the initiative, argues that surveys such as this provide insight into the worsening mental health of young Brazilians. 

A central focus of the survey was analyzing young people’s mental health in relation to factors such as gender, race, and region of residence. Considering these aspects led researchers to conclude that mental health problems and the search for specialized support vary depending on young people’s sociodemographic profile.

One example is the difference between men and women: men have a hospitalization rate 57% higher than women, a figure described in the Agenda Jovem FIOCRUZ report as “substantially higher.”

This combination of socioeconomic factors also helps explain the deterioration of mental health among young Brazilians. One of these is the labor market, marked by a high degree of job insecurity and exhausting working hours, says Sobrinho. 

Family responsibilities and difficulties continuing one’s education are other factors that may affect the mental health of young people.

Therapeutic groups show positive results

This is why it is important to listen to young people to understand their circumstances and provide services tailored to their needs, says Kantorski. One example is a paper coauthored by the researcher aimed at discussing the therapeutic outcomes of groups for adolescents at Brazil’s Psychosocial Care Centers (CAPS).

Based on observations conducted in these settings, the authors documented positive outcomes in the psychosocial rehabilitation of adolescents attending CAPS facilities, particularly regarding issues such as sexuality, family conflicts, and drug use.

According to the UFPEL professor, however, research that places young people at the center of discussions surrounding mental health still needs to become more widespread. 

“These health services need to be better prepared for young people. We need to understand their experiences to address their needs,” she says, pointing to the emergence of social media as an important difference between today’s youth and previous generations.

Australia inspires Brazilian care model

The difficulty of providing adequate mental health services is also being felt in other countries. Ian Hickie, a professor of psychiatry at the University of Sydney in Australia, has been studying the issue for years. 

As early as the 1990s, it was already evident to the researcher that there was a gap between centers dedicated to youth mental health in Australia and the delivery of effective, high-quality services for this population.

In 2006, the National Youth Mental Health Foundation, known as Headspace, was established. The Australian service was set up to build centers where primary mental health services—or gateways into the healthcare system—could be offered to young people.

According to the program’s latest official report, released in October last year, one million young people have already accessed some kind of service offered by Headspace.

But Hickie believes the model has shortcomings. “These centers are focused on physical infrastructure. The objective is to establish new clinics that create gateways to increase access to healthcare,” the specialist says.

The effectiveness of Headspace has already been examined in scientific studies. A paper published in 2023 in PLOS One analyzed data from 58,000 young people who accessed the service between 2019 and 2020.

To evaluate patient outcomes, the authors focused on self-reported psychological distress among young people, quality-of-life measures also reported by patients, and assessments made by healthcare professionals after young people accessed Headspace centers. 

The results were positive: approximately one-third of patients showed improvement in psychological distress, while half reported improvements in quality of life.

However, there are also counterarguments regarding the lack of robust evidence supporting the service. In a paper published in 2023 prior to the study featured in PLOS One, other researchers argued that published studies on Headspace lack standardization in measuring service outcomes and that, even when positive outcomes are observed, they are generally not clinically significant.

Hickie also questions the long-term relevance of programs such as Headspace. He argues that models centered on physical clinics are not scalable and are unable to address the full complexity surrounding the deterioration of young people’s mental health. 

Digital tools expand access to care

One possible solution is the adoption of digital tools. “In the digital age, young people can become active participants in monitoring their own mental health so they can access additional support,” Hickie summarizes.

The University of Sydney professor is involved in various projects using digital resources in an attempt to build high-quality mental health services dedicated to young people. One such initiative took place in Brazil through a collaboration with Pedro Pan, a psychiatrist and advisor to the graduate program in psychiatry and medical psychology at the Federal University of São Paulo (UNIFESP).

Pan had previously collaborated with a group of researchers from the University of Melbourne in Australia on a project aimed at identifying early signs of schizophrenia in young people. Years later, the physician again collaborated with Australian scientists—this time with Hickie himself.

The partnership was essential to the development of a Brazilian digital tool designed to assess young people’s mental health based on general patient data. Called Mindcheck and cofounded by Pan, the technology incorporates different aspects such as thoughts, emotions, screen time, and socio-emotional skills to conduct a digital mental health checkup.

According to the psychiatrist, tools such as these may be useful because they generate greater engagement among this age group, since “young people are already using digital media and these kinds of tools.” 

Approximately 100 assessments have already been conducted. Half took place during the platform’s development phase, while the remainder occurred during the pilot stage. “Initial data show that Mindcheck helps identify mental health risk profiles that had often not previously been recognized by young people or their families, while also helping raise awareness of important day-to-day factors such as sleep, screen use, routine, stress, and emotional well-being,” Pan summarizes.

A paper on the development of the platform and qualitative evaluations of its use is currently under review for publication in a scientific journal. In the meantime, individual examples of young people assessed using the technology illustrate Pan’s observations.

One case involved a young woman who was experiencing attention difficulties at school. The initial suspicion was a cognitive disorder, but the Mindcheck assessment suggested that the problem could be related to excessive nighttime screen use. “After reorganizing her sleep routine and reducing nocturnal screen time, there was a substantial improvement in attention and academic performance, without the need for more complex interventions,” says Pan.

International cooperation faces adaptation challenges

The dialogue between Pan and Hickie that resulted in Mindcheck illustrates how international collaborations can play an important role in improving mental healthcare for young people. But these partnerships also have limitations, mainly because of local differences in each region.

One way to improve these adaptations is to establish research standards across different countries, says André Sobrinho of Agenda Jovem FIOCRUZ. Thus, even if studies take local situations of psychological distress among young people into account, international collaboration and exchanges would become easier. 

“It requires a greater effort not only to build exchange networks, but also to establish global scientific and methodological parameters that can serve as a common foundation,” the researcher concludes.

How can research on young people’s mental health be improved?

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The contrast is striking: the two viruses share the same vector—the Aedes aegypti mosquito, which makes it unlikely that vector control alone explains the difference. 

Researchers have not yet reached a consensus on what caused this decline, but point to a combination of biological and epidemiological factors. 

A study by Felipe Yuji Sasazaki and colleagues from the NB3 Laboratory of Neuroimmunology at the Federal University of Santa Maria (UFSM), published in Virology Journal, examines the challenges already overcome and those that still need addressing in order to understand the virus and its long-term impacts.

The peak of the 2015 epidemic and the authorities’ response

The first infections by Zika were identified in Brazil in 2015, in samples collected that same year. The number of cases grew rapidly, and the number of children born with microcephaly increased at the same rate. 

The connection between the virus and the malformation was formally confirmed on November 28, 2015. By the end of the decade, 178,516 confirmed cases had been recorded in Brazil, according to DataSus and the Pan American Health Organization (PAHO)—the highest number in the Americas. 

In comparison, Puerto Rico, the second most affected country in the Americas, recorded fewer than 38,000 cases over the same period.

In addition to microcephaly, other clinical manifestations were identified in affected children, including auditory and visual impairments. This set of conditions led experts to adopt the term Congenital Zika Syndrome (CZS), first described in Brazil. 

Important note: CZS does not always manifest as microcephaly at birth. Neurological damage may appear later, complicating early diagnosis and suggesting that the number of cases could be higher than recorded.

Faced with this situation, the federal government declared a National Public Health Emergency on November 11, 2015, which lasted for 18 months. 

In 2016, it launched a widespread campaign against Aedes aegypti, including educational initiatives, training for healthcare professionals, and mobilization of the Armed Forces to eliminate mosquito breeding sites. 

Factors associated with the reduction in cases

The analysis identifies at least four hypotheses to explain the decline. The first involves mosquito coinfection: when Aedes aegypti carries Zika and chikungunya—or Zika and dengue—at the same time, its vector competence for transmitting Zika virus may decrease by 10%, according to a study published in the Journal of Infectious Diseases in 2021. 

Although modest in isolation, this reduction may play an important role in a multifactorial context.

The second hypothesis points to herd immunity. 

There is only one described serotype of Zika, which means that infection with any variant likely confers long-lasting immunity. With a significant portion of the population already exposed during the epidemic peak, viral circulation would naturally wane.

A third factor is structural underreporting: most Zika cases are asymptomatic or mildly symptomatic, which reduces the demand for medical care and, consequently, official reporting. Lastly, Wolbachia technology has advanced significantly. 

Outstanding questions: immunity, sylvatic cycle, and surveillance

Despite the decline, Zika has not disappeared. Between 2021 and 2023 (the most recent years with available data), Brazil recorded between 4 and 8 new cases of Zika-associated microcephaly per year. 

The study highlights unanswered scientific questions, including the exact duration of immunity acquired after infection: some studies suggest it lasts around two years, while others report reinfections within as little as six months.

One point highlighted by the authors is the role of dengue antibodies in Zika dynamics. These can both neutralize the virus and facilitate its entry into cells. 

The mechanism is known as ADE (antibody-dependent enhancement). The recent national dengue vaccination campaign may alter the population’s immunological profile and interfere with Zika transmission. The researchers recommend monitoring this effect carefully.

The article also warns of the possibility of a sylvatic cycle of Zika: one study detected viral RNA in populations of Ae. albopictus and Haemagogus leucocelaenus collected in areas with little human interference in Rio de Janeiro between 2018 and 2019, a period during which urban cases had already declined. 

This suggests that the virus may continue circulating off the radar of conventional surveillance, possibly involving non-human primates as reservoirs.

The authors recommend expanding vector surveillance, improving diagnosis, and ensuring long-term support for the families affected by CZS.

Social and diagnostic advances

In addition to vector control, Brazil has made progress on other fronts. The federal government established financial compensation for families affected by CZS through Law No. 15.156, of July 1, 2025, and in 2020 approved a lifetime benefit for affected children. 

The public health system also offers medical follow-up for pregnant women with suspected Zika virus infection.

In the field of diagnostics, considerable progress has been made since 2015. Multiplex kits for the simultaneous detection of Zika, dengue, and chikungunya have been developed in Brazil and distributed to the 27 Central Public Health Laboratories (LACEN), which has increased the capacity for laboratory confirmation across all regions of the country. 

The main challenge currently is the cross-reactivity between Zika and other flaviviruses circulating in Brazil, especially dengue, which compromises the specificity of serological tests.

Factors associated with the decline in Zika cases in Brazil

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Although nearly every human cell contains the same DNA, each expresses a specific combination of genes, producing different proteins and carrying out distinct functions in the body. 

Since 2010, advances in single-cell sequencing technology have made it possible to map the cellular diversity of human tissues with unprecedented precision. In 2016, a global consortium called the Human Cell Atlas began using the technique to catalog all the cells in the human body, establishing a molecular reference map of healthy cells.

Studies of single cells revealed a much greater heterogeneity than previously thought. Even single tissues carry distinct cellular subpopulations that are morphologically identical but perform specialized functions.

The project, featured in a 2024 Science Arena report, uses single-cell RNA sequencing to identify gene expression patterns, thereby classifying cells by molecular affinity rather than solely by traditional anatomical criteria. 

Accessible data

Conceived as an open science initiative, the project makes its data freely available to scientists and physicians worldwide, establishing an international collaborative infrastructure that covers bioinformatics, cell biology, and translational medicine.

By 2024, the consortium comprised thousands of researchers from over a hundred countries, including Brazil, where molecular biologist Patricia Severino, one of the project’s representatives in Latin America, leads the project at Einstein Hospital Israelita, focusing on cancer biology.

“Collaboration among Latin American researchers has yielded strong results, including the so-called Single Cell Notebooks, which aim to democratize access to training in single-cell analysis and spatial transcriptomics through free multilingual educational materials available on an open and reusable platform, contributing at a global scale,” says Severino.

This scientific collaboration resulted in an article, published in Nature Genetics in May of this year, describing how reducing language and technology barriers improves global capacity building and fosters more inclusive and equitable genome research. 

Working together

Across various countries, this collaborative network has strengthened scientific capabilities not only by expanding sample collection, but also by training teams in sequencing, computational analysis, and biomedical innovation. 

As a result, the project faces new challenges related to the storage, standardization, and processing of massive volumes of biological data. 

According to Severino, the Atlas’s primary scientific value lies in creating a reference map to offer insight into physiological cellular states and use comparisons to detect changes associated with diseases.

Advances in the research are expected to lead to increasingly precise molecular diagnoses and the identification of new therapeutic targets, paving the way for personalized treatments, including a better understanding of metastasis and breakthroughs in the treatment of neglected infectious and tropical diseases. 

Biomedical impact 

During the COVID-19 pandemic, data from the Human Cell Atlas helped identify cells expressing the ACE2 receptor, contributing to research on infection mechanisms and highlighting potential treatments.

The project has also strengthened scientific capabilities in regions such as Latin America and Asia, not only by expanding sample collection, but also by training teams in sequencing, computational analysis, and biomedical innovation.

However, its greatest potential lies in redefining our understanding of the human body from the perspective of cellular and molecular diversity, with profound implications for biomedical research, diagnostics, and personalized therapies.

Since 2025, the Atlas has been working in partnership with UNESCO to promote open science and improve access to the benefits of genomics on a global scale.

“At the cellular level, we already understand why some patients or populations resist certain treatments,” Severino points out. This shows that the data generated by the project are already being used for practical applications, she says. 

“There are no clinical trials yet, but the accumulated knowledge could also be used for that type of development.”

Although genetic diversity has been a concern since the early stages, the consortium now has a group dedicated to equity and diversity to ensure that diverse populations are studied using data that reflect their specific genetic backgrounds, something that is often lacking in Latin America. 

Computational studies

After characterizing healthy cells, the Atlas researchers are now seeking to understand why morphologically similar cells behave differently in different parts of the same tissue—a question considered fundamental to the development of new treatments and medications. 

Virtual cells—AI-assisted computational models that simulate the functioning of real cells—are being used with the data generated so far to identify patterns that traditional analysis techniques have missed. 

“Virtual cells allow us to analyze large volumes of biological data and study how genes contribute to disease without needing to conduct so many laboratory experiments, which can greatly reduce the cost and time needed to develop new drugs,” says the Einstein researcher, who believes that the ecosystem surrounding this technology will make precision medicine even more precise.

In one study now in its final stages, the Latin American team is building a cellular map of gene-expression profiles for healthy immune cells from diverse Indigenous and mixed-ancestry populations in the Americas. The results are set to be published in the second half of 2026.

The Atlas also organizes its work around “biological networks,” progressively releasing preliminary datasets, continuously updated as new donors and populations are added.

Annotations of cell types and states are improved over time, while the use of AI-based data harmonization is on the rise.

After a decade of research, the Human Cell Atlas will hold its annual meeting in Boston, USA, in June, focusing on the impact of its studies on global health and medicine, and emphasizing how scientists and physicians can use AI to benefit patients worldwide.

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The data compiled by the study show that careers outside academia are now the norm, not the exception. In the USA and Canada, only 20 to 25% of PhD holders obtain tenure-track positions—university roles that place researchers on a formal path toward permanent job security. 

Rates vary across Europe: 31% in the Netherlands, 19% in the UK, and 9.5% in Italy work in academia. In Australia, around 42% of PhD holders work in higher education, a comparatively high proportion but still the minority.

Non-academic careers: a documented gap

There is a recurring pattern in studies on career choices: many begin their PhD programs intending to pursue an academic career, but their intentions shift throughout their training. 

Stability, salary, and work-life balance attract individuals to the non-academic market, while intellectual autonomy and an interest in basic research keep them in academia.

These are some of the findings from “PhD graduates pursuing careers beyond academia: a scoping review,” by Isabelle Skakni and colleagues, published in the journal Higher Education Research & Development. 

The study is based on publications from 2000 to 2021, predominantly representing studies from North America and Europe, with emphasis on the USA (37%), the UK (17%), and Australia (13%). It is a delimitation of both the study and the field it maps.

In Brazil, the new National Graduate Studies Plan (PNPG) highlights the employability of master’s and PhD graduates as one of its challenges, due to the mismatch that still exists between academia and the labor market. 

The PNPG recommends building bridges with other professional environments (academia–non-academic productive sector, academia–society, academia–cultural institutions, and academia–basic education relationships) and the creation of indicators that assess the impact of graduate education on the non-academic productive sector.

The findings from the review help explain why this bridge is difficult to build.

What employers think (and what changes after hiring)

Only 16% of the studies include employers as the investigated population. While they value the analytical skills of the PhD holders, they express skepticism about whether the choice of a non-academic career is genuine or the result of a lack of alternatives.

Another finding is the change in perception after experience: organizations that had never had PhD holders on their staff tend to be more resistant to hiring them. Those that have report greater satisfaction and a willingness to hire them again.

The discussion points to a cultural gap rather than an institutional gap. Career support programs exist. 

The authors classify them into three types: supplementary (optional workshops and online resources alongside the PhD program), immersive (internships, short-term research, and mentorship programs), and transformative (career development integrated into the PhD curriculum itself). The literature on the effectiveness of these initiatives, however, is scarce.

What the studies agree on is that leaving academia is still seen, in many contexts, as a failure. Changing this perception within universities, the authors argue, is necessary for any other reform to succeed.

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Physician and researcher Beatriz Barreto-Duarte of the Clinical and Translational Research Laboratory at the Oswaldo Cruz Foundation (FIOCRUZ) in Bahia has observed this pattern throughout her career. In an interview with Science Arena, she contextualized the problem: “We still treat physician-scientists as exceptions, rather than an essential part of the healthcare system.”

When prestige supersedes evidence

According to Barreto-Duarte, medicine becomes guided by hierarchies when clinical or policy decisions are based on the reputation of the speaker, rather than the robustness of the scientific evidence. The result is that practices without scientific backing remain in place, anchored only in tradition.

“This culture allows outdated practices to persist simply because ‘that is how it has always been done,’ creating an environment where asking questions is seen as disrespectful,” she explains.

The burden of tradition over innovation

Physician-scientists are uniquely positioned to translate research findings into improvements in patient care. But when the work environment prioritizes tradition, presenting new proposals, even when based on solid evidence, can be a frustrating exercise.

The burden is even greater for women, as Barreto-Duarte explained to Science Arena.

“I believe that authority and experience are extremely valuable, but they need to go hand in hand with continuous learning and a commitment to evidence,” she emphasizes.

Why this drives talent away from the system

For Barreto-Duarte, the hierarchical model has a serious side effect: it pushes the professionals most capable of contributing to innovation away from the public system. When they cannot find space for evidence-based proposals, physician-scientists seek more receptive environments—usually outside the public sector and often outside Brazil.

The problem, therefore, is not only cultural. It is also structural. A system that fails to recognize the value of evidence as a basis for decision-making loses human capital that took decades to train.

Click here to read Science Arena’s full interview with Beatriz Barreto-Duarte on the career challenges faced by physician-scientists in Brazil.

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