Over the past century, Brazil has become a hub of excellence in public health research, biomedical sciences and health technology policymaking. However, the Zika outbreak (2016) and the COVID-19 pandemic (2020) exposed critical weaknesses in its healthcare innovation system, particularly regarding the rapid production and delivery of essential technologies. This article examines the interconnected factors shaping vaccine research and development (R&D) and production capacity for neglected and re-emerging diseases in Brazil. The study is based on semi-structured interviews with 22 participants, including university professors, laboratory leaders, scientific staff, innovation managers and policymakers. Thematic analysis identified four interconnected factors: (1) the resilience of science and technology policies (S&TPs); (2) the quality of health technology programs and initiatives (HTP&I); (3) the catalytic role of health emergencies in mobilizing funding and fostering R&D capacity; and (4) the ability of data-intensive local health R&D actors to establish international collaborations. The findings reveal how Brazil's vaccine R&D and production capacity are shaped by the interaction of policy resilience, institutional capability-building and the health system. The accumulation of technological capabilities remains influenced by discontinuous funding cycles, fragmented governance and a reactive policy mode centered on crisis response rather than long-term efforts to align S&TPs and HTP&I.
