The Brazilian National Indigenous Health Secretariat (Sesai) reported significant advances across indigenous health services in 2025, signalling improved access to emergency care, specialised services and sanitation for communities nationwide. The Ministry of Health highlighted expanded workforce capacity, strengthened management and tangible reductions in preventable deaths in several territories.
Brazil indigenous health key initiatives and results
Sesai launched the country’s first bilingual mobile emergency service (SAMU) in Dourados, Mato Grosso do Sul, operating 24 hours and serving Guarani, Kaiowá and Terena communities. Average response times dropped from 17 minutes to eight minutes, effectively halving wait times for urgent care.
In the Yanomami territory, coordinated action with civil society partners led to the opening of a dedicated Indigenous Health Reference Centre, providing specialised care to some 10,000 people across 60 communities. Preliminary Ministry of Health data show a 27.6% reduction in overall deaths in the territory between the first half of 2023 and the same period in 2025. Deaths from malaria fell by 70%, respiratory disease deaths by 40.8% and deaths from malnutrition by 70.6%.
Sesai also opened the first hospital back-up unit for indigenous patients in Roraima in partnership with the Brazilian Hospital Services Company (Ebserh) and the Federal University of Roraima, reducing transfers to urban hospitals and supporting continuity of care within territories.
Workforce, vaccination and telehealth gains
The Secretariat moved further from the conventional contractual model by transferring management of staff in the 34 Special Indigenous Health Districts (DSEIs) to the Brazilian Agency for SUS Management Support (AgSUS). The number of physicians working in indigenous territories rose from 566 in 2024 to 716 in 2025, and 34 new public health specialists were added to strengthen epidemiological surveillance and CIEVS units.
Preventive coverage improved: by the third quarter of 2025, 87.5% of indigenous infants under one year had completed the vaccination schedule. More than 700 Indigenous Health Units gained connectivity and telessaúde services expanded to 25 DSEIs, enhancing remote diagnostics and specialist access.
Infrastructure, sanitation and governance
The Novo Programme for Economic Acceleration (Novo PAC) increased its target from 78 to 109 Indigenous Primary Health Units (UBSIs), with 51 projects under way and 35 completed across Brazil. The Secretariat also launched the National Indigenous Sanitation Programme: between January 2023 and December 2025, 510 villages received water-supply systems, 182 under the Novo PAC, reducing waterborne disease and improving living conditions.
Regulatory and clinical guidance advanced too. Sesai published the first technical manual for treating indigenous people exposed to mercury, produced with researchers, indigenous leaders and federal bodies. The Department of Indigenous Health Management issued manuals to standardise procurement, oversight and contract governance across DSEIs, and new monitoring dashboards were developed in partnership with the Federal University of Santa Catarina.
Institutional recognition followed: the Supreme Federal Court declared ADPF 709 closed, acknowledging the Union’s compliance with obligations to the SasiSUS system. Sesai also strengthened cooperation through 16 technical cooperation agreements and seven active partnership accords, while participating in four Proadi-SUS projects with leading hospitals.
Looking ahead to 2026, Sesai plans to finalise the revised National Policy for Indigenous Health, extend sanitaton and infrastructure partnerships and deepen outcomes from Proadi-SUS initiatives, aiming to consolidate the gains made in 2025 and continue expanding access to culturally appropriate, integrated care for Brazil’s indigenous peoples.
Key Takeaways:
- Brazil indigenous health recorded major service and infrastructure gains in 2025, including the country’s first bilingual SAMU in Dourados and a Yanomami reference centre.
- Mortality in the Yanomami territory fell significantly: overall deaths down 27.6%, malaria down 70%, respiratory deaths down 40.8%.
- Workforce and coverage strengthened — doctors rose from 566 to 716, vaccination completion for infants reached 87.5%, and over 700 health units gained connectivity.
- Infrastructure and sanitation expanded via the Novo PAC and a new national sanitation programme, with 510 villages benefiting from water systems.
