Learning from Brazil's Exemplary Progress in Advance Warning and Response

In Brazil, climate change is exacerbating poverty and inequality—from extreme weather events such as droughts, wildfires, and floods to public health emergencies such as respiratory infections dengue, yellow fever, and Zika outbreaks.1 Over the past two decades, threats like these have helped drive steady improvements in advance warning and response (AW&R). As part of its extensive public universal health system established over 35 years ago, the Sistema Único de Saúde (SUS), Brazil operates a nationwide network of surveillance units, situation rooms, and data‐driven tools that monitor infectious diseases with epidemic potential, zoonotic threats, and disasters in near real time.

Exemplars in Global Health chose Brazil as an Exemplar country in AW&R because it:

• Established a nationwide network for risk analysis, emergency notification, and coordinated response across federal, state, and municipal levels.

• Built predictive platforms that combine epidemiological, laboratory, and meteorological and environmental data to generate alerts that policymakers and global health partners can act on.

• Anchored surveillance and response in the public universal health system's legal, governance, and financing framework, with sustained funding across federal, state, and municipal levels that supports routine operations and can scale during emergencies.

• Implemented a decentralized monitoring and evaluation system that tracks performance using standardized indicators, enabling continuous assessment and improvement across all levels of the health system.

Key lessons that peer countries can learn from Brazil’s experience with AW&R systems include:

• Nationwide coordination—underpinned by clearly defined roles, protocols, and data flows across all levels—enables national guidance to translate into rapid, locally tailored action during emergencies.

• Integrated data systems connect primary care, laboratory, vaccination, hospitalization, mortality, and climate and environmental data, enabling comprehensive analysis and informed public health decision making.

• Constitutionally mandated minimum public health spending provides a more durable funding base than temporary emergency funding mechanisms.

• Early warning platforms that rely on data models can be sustained through partnerships between public health agencies, universities, and technical institutes, which provide complementary, specialized data science and modeling capacity.