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The article by Costa e Silva et al. addresses a timely theme and an interesting proposal at a time when Brazil has adopted an ultraliberal and essentially anachronistic path, coinciding with Donald Trump’s protectionist turnaround in the world’s greatest power. Brazil’s option since August 2016 has drastically reduced funding for teaching and research, preaching a broader role for the market in these areas. The article discusses the inherent risks in public-private partnerships (PPPs) in public health projects, including scientific and technological ones, resulting from conflicts of interest with private corporations. PPPs have been proposed as a veritable panacea in these neoliberal times, for both healthcare services and scientific and technological development. I propose to debate the following aspects: (1) the nature of public-private relations in general; (2) the notion of risk; (3) corporations’ characteristics; and (4) the different roles of corporations and the state in relation to scientific and technological development. All these issues are situated in a moving terrain, loaded with ideologies, often irreducible and thus recommending caution. As for public-private relations, Polanyi 1 called them a dual movement, or the conflict between the two main opposed principles in capitalist society, namely economic liberalism versus society’s self-protection. Corporate interests can be associated with the former principle and public health with the latter. In this sense, which tends to prevail, collaboration or competition? Although the article does not define risk, it does propose a hierarchy of risks resulting from PPPs: “possible; possible with caveats; and impossible”. The logic is similar to that of epidemiological scales that aim to measure “risk factors” for the occurrence of adverse events. Risk is an important notion for various fields of knowledge like environmental sciences and economics, among others. In economics, while the market ideology extolls entrepreneurs’ purported risk-taking tendency, proposed as the true motor force for development, the literature highlights “risk aversion” in investors, who tend to choose the less risky option in the face of two alternative paths with similar possibilities of gain 2. In finance, “risk aversion” led to the existence of powerful agencies like Fitch Ratings, Moody’s, and Standard & Poor’s, which classify risks in products, financial agents, and even countries, the latter scored hierarchically according to their capacity to pay off their public debts. The crisis of 2008-2009 immediately comes to mind, when such agencies failed miserably. For example, they were giving Lehman Brothers an A rating until the bank broke on September 15, 2008, dragging down the entire Wall Street, European, and Japanese financial markets with it 3. As for the third issue, the nature of corporations, this resulted from a process of social construction that gave them an identity as “legal persons”, similar to “physical persons”. An essential element in this construction was the separation between investors or shareholders and the professional corporate administrators. The former enjoyed limited liability, were only accountable for the money they invested, and could not be penalized for occasional malfeasance by the corporations. The idea was assimilated by trade codes in all the capitalist countries, together with the “bottom line principle”, according to which the administrators’ first and foremost obligation is to pursue profit to benefit the 1 Paulo Henrique de Almeida Rodrigues

Dificuldades para a classificação dos riscos das parcerias público-privadas na área da saúde pública