Health sector involvement in federal environmental licensing and malaria control in the Brazilian Amazon: a retrospective observational study

The mining (20.3%) and power generation (19.1%) sectors had the highest proportions of cases that resulted in a process being opened. The follow-up period exhibited variability over time, reaching a peak of 28.9% in 2014 and subsequently declining, with a figure of 6.7% recorded in 2018. While 70.0% of the projects under scrutiny resulted in a case being initiated at the MoH within a year, 8.6% required a period of up to three years, and a case was documented that exhibited a 16-year interval between the initiation of proceedings at Ibama and at the MoH.

The findings suggest that most projects on Amazon region are progressing without the necessary involvement of the health sector, thereby increasing the risk of adverse impacts on malaria control measures. It is imperative to enhance the systematic and timely involvement of the MoH in environmental licensing processes to ensure that development is aligned with the overarching objective of eliminating malaria in Brazil.