Paper short abstract:

In this paper, we comparatively examine how in the context of cancer genetics and technological innovations for the diagnosis and treatment of cancer in Brazil old inequalities in accessing prevention, diagnosis and treatment persist and intersect with emerging new inequalities.

Paper long abstract:

While there are now studies in the UK context examining how biomedical innovations are bringing about transformations in cancer patienthood (Kerr and Cunningham Burley 2015), how they are unevenly integrated across different fields of medical research and clinical practice and in the co-ordination of care giving (Bourret et al 2011, Day et al 2017, Kerr et al 2019), we know much less about these dynamics in the low income and emerging economies in the Global South. In this paper, we comparatively examine two related fields in cancer research and health care in Brazil; cancer genetics and technological innovations for the diagnosis and treatment of cancer. Based on an ethnographic research carried out in public and private cancer or cancer genetic centers in the north east and south east of the country we examine how in this context old inequalities in accessing prevention, diagnosis and treatment persist and intersect with emerging new inequalities. We argue that this is a situation that both reflects and informs how biomedical innovations are being incorporated into the Brazilian health system. We pay particular attention to how in Brazil judicialisation has emerged has emerged as a response to inequities in accessing cancer health resources whilst also posing an ethical challenge to care giving. We also examine how stratified patienthood in this context is less a product of global efforts to 'personalise' medicine and more an outcome of dynamic, often disjunctured social relations between the clinic, research and care.