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Malaria is increasing in Indigenous and artisanal mining areas in the Brazilian Amazon

Nature Medicine volume 29, pages 762–764 (2023)Cite this article

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In 2015, Brazil received the Malaria Champions of the Americas Award from the Pan American Health Organization. That same year, the National Malaria Control Program (NMCP) launched a plan to eliminate Plasmodium falciparum1. One year later, Brazil recorded the lowest number of malaria cases in 37 years (about 143,000), 99.9% of which were in the Amazon region. This trend suffered a setback in 2017, when around 231,000 cases were reported. Although no single reason explains the increase, Brazil was facing an economic crisis, austerity measures imposed limits on health spending, and other emergencies such as Zika virus and Chikungunya virus shifted the focus away from malaria2. In 2019, when President Bolsonaro started his four-year term, major changes in the Ministry of Health affected malaria control. The NMCP was merged into a division that also oversaw 35 neglected diseases, all technical advisory groups were eliminated and there was no support to develop a strategic plan for malaria elimination. Despite this unfavorable situation, in 2022 Brazil launched an elimination plan to achieve zero malaria in four phases: first, reduce cases to <68,000 by 2025; second, eliminate P. falciparum malaria and deaths due to malaria by 2030; third, achieve zero cases and deaths by 2035; and fourth, prevent the reintroduction of malaria from 2035 onward3.

Deforestation and artisanal mining also contribute to other problems: an increase in respiratory conditions as PM2.5 particles are emitted from forest fires; malnutrition due to contamination of water and food with mercury used in artisanal mining; infectious and neurological diseases associated with mercury poisoning; and violence, especially homicide and rape. All of these effects are now impacting the Yanomami people, who are facing severe malnutrition, the worst ever reported among Indigenous communities in the Americas, with malaria also widespread4 (Fig. 1b). The Yanomami Indigenous land is the largest in Brazil, spans two states (Roraima and Amazonas) and borders Venezuela. It also contains the third-largest area of artisanal mining in Indigenous lands and the largest number of airstrips (75), 34% of which are within 5 km of a mining area, according to Mapbiomas (https://mapbiomas.org/) (Fig. 1a). Despite several reports and alerts sent to the Federal Prosecutor’s Office, the National Indigenous People Foundation (Funai) and the Army, it would appear that President Bolsonaro did not take action to prevent what now became a humanitarian crisis5.

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Fig. 1: Protected areas, airstrips and malaria in the Brazilian Amazon.

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Acknowledgements

We thank N. Arisco, J. Ponmattam and S. Kim for help with data curation and image editing.

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  1. Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA

    Marcia C. Castro

  2. Secretaria de Vigilância em Saúde e Ambiente, Ministério da Saúde, Brasília, Brazil

    Cassio Peterka

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  1. Marcia C. Castro
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Correspondence to Marcia C. Castro.

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Castro, M.C., Peterka, C. Malaria is increasing in Indigenous and artisanal mining areas in the Brazilian Amazon. Nat Med 29, 762–764 (2023). https://doi.org/10.1038/s41591-023-02280-0

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