The current health situation of indigenous peoples in Brazil reflects the impact of a five-century history of violence inherent in the colonial process, which resulted in depopulation, discrimination and social vulnerability¹1 Santos RV, Welch JR, Pontes AL, Garnelo L, Cardoso AM, Coimbra Jr. CEA. Health of indigenous peoples in Brazil: inequities and the uneven trajectory of public policies. In: McQueen D, organizador. Oxford Research Encyclopedias of Global Public Health. Oxford: Oxford University Press; 2022. p. 1-33.. Racism and violence of all kinds, loss of territories and environmental degradation are a feature of the daily lives of indigenous peoples.

In the late 1990s, the “National Policy for the Health Care of Indigenous Peoples” was implemented within the scope of the Unified Health System (SUS). Although it contributed to important improvements in some health indicators, after almost two decades the coverage and impacts of the Indigenous Health Care Subsystem (SasiSUS) continue to be woefully insufficient¹1 Santos RV, Welch JR, Pontes AL, Garnelo L, Cardoso AM, Coimbra Jr. CEA. Health of indigenous peoples in Brazil: inequities and the uneven trajectory of public policies. In: McQueen D, organizador. Oxford Research Encyclopedias of Global Public Health. Oxford: Oxford University Press; 2022. p. 1-33..

For decades, indigenous protagonism and participation have been fundamental in the creation of public health policies in Brazil²2 Articulação dos Povos Indígenas do Brasil (APIB). Retrospectiva 2023: Direitos indígenas não se negociam [Internet]. 2023 [acessado 2024 jul 01]. Disponível em: https://apiboficial.org/2023/12/27/retrospectiva-2023-direitos-indigenas-nao-se-negociam/.
https://apiboficial.org/2023/12/27/retro... ^,33 Coletivo Vozes Indígenas na Saúde Coletiva, organizador. Vozes indígenas na produção do conhecimento: para um diálogo com a saúde coletiva. São Paulo: Hucitec Editora; 2022.. In recent times, this protagonism has manifested itself in an unprecedented way, with indigenous leaders occupying key positions in the recently created Ministry of Indigenous Peoples, in the National Foundation for Indigenous Peoples (currently known as FUNAI) and the Secretariat of Indigenous Health (SESAI), of the Ministry of Health, among others.

In the academic sphere, affirmative action efforts have resulted in a greater, albeit still incipient, indigenous presence in public health events and institutions, which calls for greater incentives in postgraduate programs and specific strategies to enhance their participation in academic life³3 Coletivo Vozes Indígenas na Saúde Coletiva, organizador. Vozes indígenas na produção do conhecimento: para um diálogo com a saúde coletiva. São Paulo: Hucitec Editora; 2022..

Although the 1988 Constitution explicitly recognized the State’s responsibility to guarantee the rights of indigenous peoples, which was also reflected in the proposal for a “National Policy for the Health Care of Indigenous Peoples”, serious humanitarian and health crises persist in various regions of the country, as exemplified by the Yanomami situation²2 Articulação dos Povos Indígenas do Brasil (APIB). Retrospectiva 2023: Direitos indígenas não se negociam [Internet]. 2023 [acessado 2024 jul 01]. Disponível em: https://apiboficial.org/2023/12/27/retrospectiva-2023-direitos-indigenas-nao-se-negociam/.
https://apiboficial.org/2023/12/27/retro... . In an acute and critical way, this situation combines and exacerbates problems such as the invasion of indigenous territories, environmental destruction, mining and environmental contamination, food and nutritional crises, as well as exposure to violence, and healthcare that falls far short of meeting current needs.

We are living in extremely challenging times. After the important advances in guaranteeing indigenous rights in the 1988 Constitution, which followed more than two decades of military rule, and after a significant phase of creation and implementation of public policies in various areas, including health, especially in the 1990s and the first decade of the 21st century, the current scenario presents risks of relapse in the guarantee of rights on many fronts²2 Articulação dos Povos Indígenas do Brasil (APIB). Retrospectiva 2023: Direitos indígenas não se negociam [Internet]. 2023 [acessado 2024 jul 01]. Disponível em: https://apiboficial.org/2023/12/27/retrospectiva-2023-direitos-indigenas-nao-se-negociam/.
https://apiboficial.org/2023/12/27/retro... .

This thematic issue of Ciência & Saúde Coletiva (C&SC), the first of the journal dedicated to the topic, brings together reflections and analyses on the contemporary scenarios and challenges in the field of the health of indigenous peoples. Altogether, there are more than two dozen texts by both indigenous and non-indigenous authors from institutions throughout the country, as well as foreign researchers, which highlights the diversity of methodological and thematic perspectives.

Acknowledgements

The publication of this thematic issue was supported by the project entitled “The development of actions to improve the Indigenous Health Care Subsystem (SasiSUS)” (VPAAPS/FIOCRUZ - TED 60-2023).

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