Amazonia in Dispute: COP30, structural contradictions and impacts on Brazil’s Unified Health System

Abstract

The 30th Conference of the Parties to the United Nations Framework Convention on Climate Change (COP30) brings to the fore strategies to be adopted by Brazil’s Unified Health System (SUS) in the context of mass gatherings and intensified human mobility. The Amazon emerges as a contested territory, where global interests collide with local health needs. Grounded in the Social Determination of Health and a critical Global South perspective, this theoretical–reflective essay problematizes how power relations and economic interests shape investment priorities, perpetuate structural health exclusion and constrain environmental sustainability, territorialized health surveillance and democratic co-management. The essay is organized into two axes: (1) the Unified Health System in the face of mass gatherings and its structural contradictions; and (2) challenges of financing, sustainability, and territorialized surveillance amid global demands, local needs and climate crises. The hosting of COP30, in the Amazon, similar to previous megaevents, tends to reproduce a logic of interventions geared toward international visibility and disconnected from historical demands, revealing a confrontation between two antagonistic projects: The perpetuation of a colonial-extractive logic and the construction of alternatives grounded in health justice.