The health and environmental crisis on Yanomami Territory (Roraima State, Brazil) is the most evident expression of the urgency to debate the future of the planet’s biodiverse regions. The gold rush financed by dominant economic forces produces rapid social and environmental degradation, in which mining activity kills forests and rivers, as well as their inhabitants. The immediate withdrawal of over 20,000 prospectors operating in the region is necessary to stop the immediate danger, but it is only the first step. It is necessary to foster technical-scientific debates on the relationship between health, environment, and economy to build a perspective of future in which the forest remains and that respects its population ¹1. Codeço CT, Dal’Asta AP, Rorato AC, Lana RM, Neves TC, Andreazzi CS, et al. Epidemiology, biodiversity, and technological trajectories in the Brazilian Amazon: from malaria to COVID-19. Front Public Health 2021; 9:647754.. The future of the Amazon is the future of Brazil and of the planet. For this future to exist, it is essential to develop an economy that recognizes the value of the biome as a maintainer of the planetary climate and human and environmental health. However, it conflicts with the economy based on the intensive extraction of resources for immediate gain by commodities that results in deforestation, land accumulation, and homogeneous production landscapes. The conflict occurs between economic models that emerge in contrasting modes of relationship and interaction with nature, performed by different actors, local and global, in arrangements that lead to a greater or lesser social and environmental vulnerability ¹1. Codeço CT, Dal’Asta AP, Rorato AC, Lana RM, Neves TC, Andreazzi CS, et al. Epidemiology, biodiversity, and technological trajectories in the Brazilian Amazon: from malaria to COVID-19. Front Public Health 2021; 9:647754.. Locally, the conflict threatens food security and quality of life associated with historically constructed environmental and cultural wealth, resulting in forced population displacement, malnutrition, violence, poverty, endemic diseases, social inequities, and environmental contamination ²2. Viana RL, Freitas CM, Giatti LL. Saúde ambiental e desenvolvimento na Amazônia legal: indicadores socioeconômicos, ambientais e sanitários, desafios e perspectiva. Saúde Soc 2016; 25:233-46..

This vast and urgent subject is also complex because the Amazon challenges us to have views different than traditional and hegemonic ones. Its aquatic, humid, warm, and of fickle lands nature, inhabited by populations with different lifestyles, demands unorthodox technological solutions of sanitation, supplies, assistance, urbanization, locomotion, and health promotion ³3. Garnelo L. Especificidades e desafios das políticas públicas de saúde na Amazônia. Cad Saúde Pública 2019; 35:e00220519.. Its vast borderline with several countries with different languages, cultures, health policies, and problems demands specific actions. Its large territory, transformed by the substitution of diversity by the homogenization of production modes, results in new health risks that must be recognized. The impacts of big constructions and intensive environmental transformations need to be assessed in a comprehensive and timely manner. The interaction of many health risks that result in syndemics needs to be treated in an integrated manner.

This year, CSP inaugurates a Thematic Section that seeks, based on different disciplinary approaches, to contribute to a conjuncture analysis of the Amazon and think about its future from a health perspective. We have much to contribute to this debate, with a complex view on health in the Amazon and its social, economic, cultural, and environmental determinants, which expand the discussion and deconstruct the hegemonic view that “the forest is a source of poverty and disease” and that “the hotter the sicker”, as well as other perspectives simplifying the relationship between humans and the environment ⁴4. Carlson CJ, Albery GF, Merow C, Trisos CH, Zipfel CM, Eskew EA, et al. Climate change increases cross-species viral transmission risk. Nature 2022; 607:555-62.. This cycle of reflection begins in March, 2023, and readers are invited to discuss the topics in the comments session.

Belém (Pará State, Brazil) is a candidate to host COP 30 in 2025. May this exercise of reflection serve as a contribution of the Amazon to planetary health.

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