São Paulo’s local migrant health policy: between resilience and fragmentation

Abstract The city of Sao Paulo (Brazil) has historically been an important migration destination, for both national and international migrants. The city shelters an estimated 376 thousand foreigners and has set up an agenda of policies targeting this population over the last decade, aiming to cope with ever-evolving mobility dynamics and vulnerable groups. This article examines São Paulo as a relevant case of a local government having devised specific policies aiming to include its migrant population in public services, especially within healthcare, at its primary care segment. The Brazilian Unified Health System (SUS) leaves room for strategies to promote the health of several demographics, including international migrants. Findings indicate that São Paulo’s local migration policy has achieved institutional stability and international recognition but remains constrained by fragmented governance, limited intersectoral coordination, and insufficient prioritization of migrant health. The study argues that without structural reforms and stronger national and international support, local initiatives alone cannot fully ensure this population's right to health.