São Paulo’s local migrant health policy

between resilience and fragmentation

Autori

DOI:

https://doi.org/10.1590/1980-85852503880003316

Parole chiave:

international migration, local policy, migrant health, Unified Health System (SUS), governance

Abstract

The city of Sao Paulo (Brazil) has historically been an important migration destination, for both national and international migrants. The city shelters an estimated 376 thousand foreigners and has set up an agenda of policies targeting this population over the last decade, aiming to cope with ever-evolving mobility dynamics and vulnerable groups. This article examines São Paulo as a relevant case of a local government having devised specific policies aiming to include its migrant population in public services, especially within healthcare, at its primary care segment. The Brazilian Unified Health System (SUS) leaves room for strategies to promote the health of several demographics, including international migrants. Findings indicate that São Paulo’s local migration policy has achieved institutional stability and international recognition but remains constrained by fragmented governance, limited intersectoral coordination, and insufficient prioritization of migrant health. The study argues that...

Biografia autore

  • Jameson Vinícius Martins da Silva, Global Health and Sustainability (School of Public Health), University of São Paulo (USP), São Paulo - SP, Brazil

    Postdoctoral Fellow at the Federal University of São Paulo’s Medical School (EPM/Unifesp). PhD in Global Health and Sustainability at the School of Public Health, University of São Paulo (FSP-USP). This article derives from a PhD project supported by the São Paulo Research Foundation (FAPESP, Brazil), grant no.

Riferimenti bibliografici

ABUBAKAR, Ibrahim; ALDRIDGE, Robert W.; DEVAKUMAR, Delan; ORCUTT, Miriam; BURNS, Rachel; BARRETO, Mauricio L.; DHAVAN, Poonam; FOUAD, Fouad M.; GROCE, Nora; GUO, Yan; HARGREAVES, Sally; KNIPPER, Michael; MIRANDA, Jaime; MADISE, Nyovani; KUMAR, Bernadette; MOSCA, Davide; MCGOVERN, Terry; RUBENSTEIN, Leonard; SAMMONDS, Peter; SAWYER, Susan M.; SHEIKH, Kabir; TOLLMAN, Stephen; SPIEGEL, Paul; ZIMMERMAN, Cathy. The UCL-Lancet Commission on Migration and Health: the health of a world on the move. The Lancet, v. 392, n. 10164, p. 2606-2654, 2018. DOI: https://doi.org/10.1016/S0140-6736(18)32114-7

» https://doi.org/10.1016/S0140-6736(18)32114-7

ACNUR. I relatório cidades solidárias Brasil: proteção e integração de pessoas refugiadas no plano local. Brasília: Agência da ONU para Refugiados - ACNUR, 2022.

AGUIAR, Marcia; MOTA, André. O Programa Saúde da Família no bairro do Bom Retiro, SP, Brasil: a comunicação entre bolivianos e trabalhadores de saúde. Interface, v. 18, n. 50, p. 493-506, 2014. DOI: https://doi.org/10.1590/1807-57622013.0040

» https://doi.org/10.1590/1807-57622013.0040

AHOUGA, Younes. The local turn in migration management: the IOM and the engagement of local authorities. Journal of Ethnic and Migration Studies, v. 44, n. 9, p. 1523-1540, 2017. DOI: https://doi.org/10.1080/1369183X.2017.1368371

» https://doi.org/10.1080/1369183X.2017.1368371

AMRITH, Megha. Pathways to urban citizenship for low-income migrants in São Paulo. Citizenship Studies, v. 19, n. 6-7, 2015. DOI: https://doi.org/10.1080/13621025.2015.1023260

» https://doi.org/10.1080/13621025.2015.1023260

BIRN, Anne-Emanuelle; PILLAY, Yogan, HOLTZ, Timothy H. Textbook of Global Health Oxford: Oxford University Press, 2017.

BRANCO-PEREIRA, Alexandre. O refúgio do trauma. notas etnográficas sobre trauma, racismo e temporalidades do sofrimento em um serviço de saúde mental para refugiados. REMHU: Revista Interdisciplinar da Mobilidade Humana, v. 26, n. 53, p. 79-97, 2018. DOI: https://doi.org/10.1590/1980-85852503880005306

» https://doi.org/10.1590/1980-85852503880005306

BRANCO-PEREIRA, Alexandre. Tensions between universality and equity in the access of racialized immigrants to the SUS in the metropolis of São Paulo during the Covid-19 pandemic. Vibrant, v. 20, 2023.

BRAUN, Virginia; CLARKE, Victoria. Using thematic analysis in psychology. Qualitative Research in Psychology, v. 3, n. 2, p. 77-101, 2006. DOI: https://doi.org/10.1191/1478088706qp063oa

» https://doi.org/10.1191/1478088706qp063oa

CARNEIRO JUNIOR, Nivaldo; AITH, Fernando; SILVA, Rubens Antonio da; WANDERLEY, Dalva Maril Velloso; LUNA, Expedito José; SHIKANAI-YASUDA, Maria Aparecida. Access and right to health for Bolivian migrants in a Brazilian metropolis. Saúde e Sociedade, v. 31, n. 3, 2022. DOI: https://doi.org/10.1590/S0104-12902022210761

» https://doi.org/10.1590/S0104-12902022210761

CAVALCANTI, Leonardo; OLIVEIRA, Tadeu; SILVA, Bianca G. Imigração e refúgio no Brasil: retratos da década de 2010. Brasília: OBMigra, 2021.

DELVINO, Nicola. European cities and migrants with irregular status: municipal initiatives for the inclusion of irregular migrants in the provision of services. Oxford: Center of Migration Policy and Society (COMPAS), 2017.

FAUSTINO, Deivison Mendes; OLIVEIRA, Leila Maria. Xeno-racismo ou xenofobia racializada? Problematizando a hospitalidade seletiva aos estrangeiros no Brasil. REMHU: Revista Interdisciplinar da Mobilidade Humana, v. 29, n. 63, p. 193-210, 2021.

FILOMENO, Felipe Amin. Theories of local immigration policy. In: FILOMENO, Felipe Amin. Politics of Citizenship and Migration Springer International Publishing, 2017.

FONSECA, Elize Massard; NATTRASS, Nicoli; LAZARO, Lira Luz B.; BASTOS, Francisco Inácio. Political discourse, denialism and leadership failure in Brazil's response to Covid-19. Global Public Health, v. 16, n. 8-9, p. 1251-1266, 2021. DOI: https://doi.org/10.1080/17441692.2021.1945123

» https://doi.org/10.1080/17441692.2021.1945123

FREITAS, Patrícia Tavares. Migrações internacionais e cidadania local: um estudo sobre a formação de um novo domínio de agência na cidade de São Paulo. In: BAENINGER, Rosana; PERES, Roberta; FERNANDES, Duval; SILVA, Sidney Antonio; ASSIS, Gláucia; CASTRO; Maria da Consolação; COTINGUIBA, Marília (org.). Imigração haitiana no Brasil Jundiaí: Paco Editorial, 2016, p. 427-450.

GAETA, Rosana Magalhães; SILVEIRA JUNIOR, Clóvis; OLIVEIRA, Gisele Lopes de; LEITE, André de Santa Cruz; OROZCO, Yury Puello; FERREIRA, Fernanda Ranña; SANTOS, Maria Cristina dos. A implantação da política municipal de saúde para imigrantes e refugiados na cidade de São Paulo/SP. In: PADILHA, Alexandre; FLORENCIO, Alexandre de Souza Ramos; BASSICHETTO, Kátia Cristina; AMARAL, Marcia Aparecida do (orgs.). Inovação e Direito à Saúde na cidade de São Paulo (2013-2016) Brasília: PAHO/WHO, 2017, p. 39-52. Disponível em: http://iris.paho.org/xmlui/bitstream/handle/123456789/34091/OPASBRA17011-por.pdf?sequence=5&isAllowed=y

» http://iris.paho.org/xmlui/bitstream/handle/123456789/34091/OPASBRA17011-por.pdf?sequence=5&isAllowed=y

GEIGER, Martin; PÉCOUD, Antoine. International Organisations and the Politics of Migration London: Routledge, 2015.

HAYDU, Marcelo; INOUE, Silvia V.; SILVEIRA, Cássio; MARTIN, Denise. Therapeutic itineraries of Congolese refugees in the city of São Paulo. Global Public Health, v. 15, 2020. DOI: https://doi.org/10.1080/17441692.2020.1714071

» https://doi.org/10.1080/17441692.2020.1714071

IOM. International Organization for Migration. World Migration Report 2015: Migrants and Cities - New Partnerships to Manage Mobility. Genebra: IOM, 2015. Disponível em: https://publications.iom.int/books/world-migration-report-2015-migrants-and-cities-new-partnerships-manage-mobility

» https://publications.iom.int/books/world-migration-report-2015-migrants-and-cities-new-partnerships-manage-mobility

______. COVID-19 and the State of Global Mobility in 2021 Genebra: IOM, 2021. Disponível em: https://publications.iom.int/books/covid-19-and-state-global-mobility-2021

» https://publications.iom.int/books/covid-19-and-state-global-mobility-2021

IPPDH. Instituto de Políticas Públicas em Direitos Humanos do Mercosul. Migrantes regionais na cidade de São Paulo: direitos sociais e políticas públicas. Buenos Aires: IPPDH, 2017. Disponível em: https://www.ippdh.mercosur.int/wp-content/uploads/2017/01/Migrantes-regionales-en-San-Pablo_PT.pdf

» https://www.ippdh.mercosur.int/wp-content/uploads/2017/01/Migrantes-regionales-en-San-Pablo_PT.pdf

KORNEEV, Oleg. International Organizations as Global Migration Governors: the World Bank in Central Asia. Global Governance, v. 23, n. 3, p. 403-421, 2017.

LABONTÉ, Ronald; STUCKLER, David. The rise of neoliberalism: how bad economics imperils health and what to do about it. Journal of Epidemiology and Community Health, v. 70, n. 3, p. 312-318, 2016. Disponível em: https://doi.org/10.1136/jech-2015-206295

» https://doi.org/10.1136/jech-2015-206295

LOSCO, Luiza Nogueira; GEMMA, Sandra Francisca B. Primary Health Care for Bolivian Immigrants in Brazil. Interface, v. 25, e200477, 2021. DOI: https://doi.org/10.1590/interface.200477

» https://doi.org/10.1590/interface.200477

MARTIN, Denise; GOLDBERG, Alejandro; SILVEIRA, Cássio. Immigration, refuge and health: sociocultural analysis in perspective. Saúde e Sociedade, v. 27, n. 1, p. 26-36, 2018. DOI: https://doi.org/10.1590/S0104-12902018170870

» https://doi.org/10.1590/S0104-12902018170870

MARTIN, Denise; INOUE, Silvia Regina Viodres; SILVEIRA, Cássio. Health care for international migrants in São Paulo, Brazil: access and universality in the context of the Covid-19 pandemic. International Latin American Studies Review, v. 29, p. 49-68, 2022.

MORAES, Ana Luisa Z. Crimigração: a relação entre política migratória e política criminal no Brasil. São Paulo: IBCCRIM, 2016.

MORAES, Maria Cecilia L.; ARAÚJO, Linda Concita N.; CAMARGO, Climene. Black immigrants in São Paulo-Brazil: sociodemographic profile, reason for coming, embracement and health. Revista da Escola de Enfermagem da USP, v. 57, e20220448, 2023. DOI: https://doi.org/10.1590/1980-220X-REEUSP-2022-0448en

» https://doi.org/10.1590/1980-220X-REEUSP-2022-0448en

MOULIN, Carolina; MAGALHÃES, Bruno. Operation shelter as humanitarian infrastructure: material and normative renderings of Venezuelan migration in Brazil. Citizenship Studies, v. 24, n. 5, p. 642-662, 2020. DOI: https://doi.org/10.1080/13621025.2020.1784643

» https://doi.org/10.1080/13621025.2020.1784643

MOULIN, Carolina; THOMAZ, Diana. The tactical politics of "humanitarian" immigration: negotiating status, enacting mobility. Citizenship Studies, v. 20, n. 5, p. 595-609, 2016. DOI: https://doi.org/10.1080/13621025.2016.1182679

» https://doi.org/10.1080/13621025.2016.1182679

OCKE-REIS, Carlos Octávio; BENEVIDES, Rodrigo; FUNCIA, Francisco; MELO, Mariana. Evolução do piso federal em saúde: 2013-2020 Brasília: IPEA, 2023. (Disoc: Nota Técnica, 109). DOI: http://dx.doi.org/10.38116/ntdisoc109-port

» http://dx.doi.org/10.38116/ntdisoc109-port

ORTEGA, Francisca; ORSINI, Michael. Governing Covid-19 without government in Brazil: ignorance, neoliberal authoritarianism, and the collapse of public health leadership. Global Public Health, v. 15, n. 9, p. 1257-1277, 2020. DOI: https://doi.org/10.1080/17441692.2020.1795223

» https://doi.org/10.1080/17441692.2020.1795223

PAIM, Jairnilson Silva. Sistema Único de Saúde (SUS) aos 30 anos. Ciência & Saúde Coletiva, v. 23, n. 6, p. 1723-1728, 2018. DOI: https://doi.org/10.1590/1413-81232018236.09172018

» https://doi.org/10.1590/1413-81232018236.09172018

PATARRA, Neide; BAENINGER, Rosana. Mobilidade espacial da população no Mercosul: metrópoles e fronteiras. Revista Brasileira de Ciências Sociais, v. 21, n. 60, p. 83-102, 2006. DOI: https://doi.org/10.1590/S0102-69092006000100005

» https://doi.org/10.1590/S0102-69092006000100005

PÉCOUD, Antoine. États-nations, mobilité et citoyenneté dans le discours international sur les migrations. Raisons politiques, v. 2, n. 54, p. 67-85, 2014. DOI: https://doi.org/10.3917/rai.054.0067

» https://doi.org/10.3917/rai.054.0067

______. Depoliticising Migration Basingstoke: Palgrave Macmillan, 2015. DOI: https://doi.org/10.1057/9781137445933

» https://doi.org/10.1057/9781137445933

PREFEITURA DE SÃO PAULO. Relatório de Entregas de Gestão 2017-2020. Coordenação de Políticas para Imigrantes e Promoção do Trabalho Decente. São Paulo: SMDHC, 2021. Disponível em: https://www.prefeitura.sp.gov.br/cidade/secretarias/upload/direitos_humanos/Imigrantes%20-%20Entregas%20de%20Gest%C3%A3o%202017-2020_VF.pdf

» https://www.prefeitura.sp.gov.br/cidade/secretarias/upload/direitos_humanos/Imigrantes%20-%20Entregas%20de%20Gest%C3%A3o%202017-2020_VF.pdf

______. 1º Plano Municipal de Políticas para Imigrantes 2021-2024 São Paulo: CPMigTD, 2021. Disponível em: https://drive.prefeitura.sp.gov.br/cidade/secretarias/upload/direitos_humanos/MIGRANTES/PUBLICACOES/Plano%20Municipal_Produto%20Final_Atualizado_02.pdf

» https://drive.prefeitura.sp.gov.br/cidade/secretarias/upload/direitos_humanos/MIGRANTES/PUBLICACOES/Plano%20Municipal_Produto%20Final_Atualizado_02.pdf

PRICE, Jonathan; SPENCER, Sarah. City-level responses to migrant families with restricted access to welfare benefits: a European pilot study. Oxford: Center on Migration, Policy and Society (COMPAS), 2014.

REIS, Rossana Rocha. A política do Brasil para as migrações internacionais. Contexto Internacional, v. 33, n. 1, p. 47-69, 2011. DOI: https://doi.org/10.1590/S0102-85292011000100003

» https://doi.org/10.1590/S0102-85292011000100003

SILVA, Jameson Vinícius M. A tensão entre o nacional e o local no âmbito das políticas migratórias: o acesso dos migrantes aos serviços de saúde nas cidades de São Paulo e Barcelona. Dissertação (Mestrado em Ciências Sociais), Universidade de São Paulo, São Paulo, 2017.

SILVA, Jailson de Souza e; FERNANDES, Fernando Lannes; BARBOSA, Jorge Luiz. Haitian migration and structural racism in Brazil. In: CRAWLEY, Heaven; TEYE, Joseph Kofi (orgs.). The Palgrave Handbook of South-South Migration and Inequality Cham: Palgrave Macmillan, 2023, p. 413-434. DOI: https://doi.org/10.1007/978-3-031-39814-8_19

» https://doi.org/10.1007/978-3-031-39814-8_19

SOUZA, Beatriz. Pelos imigrantes: experiências com direitos humanos e imigração na Prefeitura de São Paulo (2013-2014). Aracê (Direitos Humanos em Revista), v. 2, n. 3, 2015.

SPENCER, Sarah. Multi-level governance of an intractable policy problem: migrants with irregular status in Europe. Journal of Ethnic and Migration Studies, v. 44, n. 12, p. 2034-2052, 2017. DOI: https://doi.org/10.1080/1369183X.2017.1341708

» https://doi.org/10.1080/1369183X.2017.1341708

STEFFENS, Isadora; MARTINS, Jameson. "Falta um Jorge": a saúde na política municipal para migrantes de São Paulo. Lua Nova, v. 98, p. 275-299, 2016. DOI: https://doi.org/10.1590/0102-6445275-299/98

» https://doi.org/10.1590/0102-6445275-299/98

STUCKLER, David; BASU, Sanjay. The Body Economic: eight experiments in economic recovery, from Iceland to Greece. London: Penguin Books, 2014.

VENTURA, Deisy; YUJRA, Veronica. Saúde de Imigrantes e Refugiados Rio de Janeiro: Editora Fiocruz, 2019.

VENTURA, Deisy; BUENO, Flávia. From global health leader to pariah: Brazil as a laboratory for 'epidemiological neoliberalism' in the face of Covid-19. Foro Internacional, v. 2, n. 244, 2021. DOI: https://doi.org/10.24201/fi.v61i2.2835

» https://doi.org/10.24201/fi.v61i2.2835

WALDMAN, Tatiana. Movimentos migratórios sob a perspectiva do direito à saúde: imigrantes bolivianas em São Paulo. Revista e Direito Sanitário, v. 12, n. 1, p. 90-114, 2011.

WIHTOL DE WENDEN, Catherine. Faut-il ouvrir les frontières? Paris: Presses de Sciences Po, 2013.

WHO. World Health Organization. Beyond the barriers: framing evidence on health system strengthening to improve the health of migrants experiencing poverty and social exclusion. Geneva: World Health Organization, 2017.

______. World report on the health of refugees and migrants Geneva: World Health Organization, 2022. Disponível em: https://www.who.int/publications/i/item/9789240054462

» https://www.who.int/publications/i/item/9789240054462

Pubblicato

2025-10-02

Come citare

Martins da Silva, J. V. (2025). São Paulo’s local migrant health policy: between resilience and fragmentation. REMHU, Revista Interdisciplinar da Mobilidade Humana, 33, e332124. https://doi.org/10.1590/1980-85852503880003316