Health systems in the Amazon need to be reimagined for a more sustainable future

Historically, public policy has treated the Brazilian Amazon as a vast natural resource for economic exploitation 1 and an "empty demographic space" ripe for occupation. 2 Based on this framing, development projects have had profound social-environmental and cultural impacts on Amazonian ecosystems.They have overwhelmed the age-old interactions between traditional peoples and managed nature, 3 pushed indigenous and traditional communities to the fringes of urban centres, 4 and imposed systemic violence.This has led to a loss of biodiversity and socio-diversity and undermined "buen vivir" principles, which conceptualise wellbeing through community based autonomy, the rights of nature, and social justice, while challenging dominant principles of development and individualism. 5Amazonian indigenous peoples hold a holistic and interconnected view of health and illness.They value the balance between society and nature. 6 7They believe that diseases like malaria and covid-19 are not only biological phenomena, but also the outcome of imbalances-rooted in the actions and power of the "white man" intertwined with spells, spiritual disturbances, and protective factors linked to shamanic practices.