Advancing and integrating climate and health policies in Brazil: Insights from national policy stakeholders

Introduction: Climate change poses increasingly severe risks to human health, exacerbating social inequalities and placing additional pressure on the overall resilience of health systems, particularly in Brazil's Unified Health System (SUS). These intersections remain poorly explored in Brazilian national policy agendas. This study presents perspectives from national stakeholders on the current integration of climate and health policies, ideals for integration, barriers to achieving ideals, opportunities, and strategies for overcoming barriers and advancing integration. Materials and Methods: This article synthesizes findings from an investigation of Brazil's climate-health policy landscape based on 33 semi-structured interviews that underwent a qualitative content analysis. Results: Stakeholders perceive a lack of coordination between the climate and health sectors in Brazil, fragmented governance, limited dedicated funding, and a low prioritization of health in climate agendas (and vice versa). Nonetheless, ongoing revisions to national climate plans, the SUS´s national reach, the momentum of COP30, and well-informed civil society pressure create openings for policy integration. Key barriers include silos, political polarization, short-term political cycles, and the absence of systematic data. Promising strategies include improved communication, embedding health co-benefits in sectoral policies, improving funding, and promoting community-based resilience. Participants recognize the need to align policies, but identified multiple barriers, including institutional inertia, vested interests, and a lack of prioritization of these agendas. Strengthening intersectoral governance, advocacy, and social pressure, reducing silos, expanding research, education, and communication on the climate-health nexus, and amplifying risk perception are vital to advancing this agenda. Conclusion: There is a consensus that climate and health policies in Brazil are poorly integrated, forgoing crucial mutual benefits. Promising opportunities and strategies for integration include coordinated governance, evidence-based policymaking, persistent advocacy, and targeted communication efforts.