Health technology incorporation in devoping countries: Who gains, who loses?

This work aims at studying the process of health technologies incorporation in developing countries. For this purpose, a case study regarding diagnostic imaging equipment incorporation in Brazilian health care system was conducted, with focus on variables that influence the decision-making process. The theoretical approach adopted is the one used by the Political Economy of Health, which provides concepts to discuss health as a social right, an economic good, and a sphere to accumulate capital. 
The methods used included semi-structured interviews with representatives of the main segments involved in health technology process in Brazil – industry, health care services providers, physicians, health insurance companies, government, and public regulatory agencies.
The results show that expensive diagnostic imaging equipments are incorporated mainly by the private health sector, and the decision to incorporate such equipments is determined by the relationship between industry, large service providers and physicians. At the same time, public health sector, government, public regulatory agencies and health insurance companies have little influence in the process.
The main conclusion of this work is that health technologies incorporation within health care systems of developing countries does not follow any criteria based upon health needs of the population, which means that this process helps to strengthen, increasingly, health as an economic good as well as a space to accumulate capital. In other words, the absence of regulation to incorporate such technologies helps to increase the levels of access inequality within health care systems of these countries, which weakens the aspect of health as a social right.