Read the Conversation
Conversation highlights:
- Brazil has expanded its telehealth network from 10 centers to 63 centers, now serving 53% of Brazilian municipalities with digital health services.
- The Ministry of Health secured representation on Brazil's National AI Council, positioning healthcare as a priority in the country's artificial intelligence strategy.
- The SUS Innovation Laboratory received over 900 project submissions in its latest call, demonstrating strong private sector engagement in public health innovation.
- Brazil is implementing a unified health identifier system across 400+ information systems to create integrated patient records spanning public and private care.
- The country is developing clinical protocols for telehealth across multiple specialties based on real-world implementation experience.
- Brazil's 'AI for the good of all' national strategy emphasizes digital sovereignty while maintaining international cooperation through BRICS, G20, and WHO partnerships.
EF: It’s been two years since our last conversation. How do you assess Brazil's progress in digital health transformation, and what are your current priorities?
AEH: Brazil's digital health transformation is part of a comprehensive federal government digitalization strategy that extends far beyond healthcare alone. We now have a national AI plan, a digital government strategy from the Management and Innovation Ministry, and a national cybersecurity framework, all formalized through federal legislation. These initiatives provide the foundation for our intersectoral approach to health system digitalization.
A significant development has been the evolution of our National Authority for Data Protection into a full agency with expanded jurisdiction covering both data protection and AI regulation. The Ministry of Health now holds representation on the national council supporting this agency, a critical advancement that ensures healthcare perspectives inform Brazil's AI governance framework.
Regarding the Digital SUS programme specifically, we're seeing substantial progress across states and municipalities in implementing electronic health records, improving information systems analytics, and expanding telehealth services. Our telehealth network has grown dramatically from 10 centers when we began in 2023 to 63 centers today, serving 53% of the 5,517 Brazilian municipalities.
We're also developing informational models and minimum datasets to ensure telehealth interoperability, with our systems now using specific codes to differentiate between tele-consultancy, tele-screening, tele-diagnosis, and other modalities. Additionally, we're creating clinical protocols for telehealth across different specialties based on our implementation experience to ensure quality and maximize telehealth's potential.
EF: The SUS Innovation Laboratory recently opened a new call for projects. What has been the response, and how do you manage this scale of innovation?
AEH: The response has been remarkable. Our call for new projects and partners concluded with over 900 project submissions, a strong indicator of Brazil's vibrant health innovation ecosystem. This volume demonstrates significant private sector and academic interest in collaborating with our public health system.
Now comes the critical evaluation phase, where we'll assess these projects against our criteria to determine which ones align with our strategic priorities and can be effectively incorporated into the laboratory. The challenge isn't just selecting the right projects, but ensuring we can support them adequately given our operational constraints.
Managing innovation at this scale requires strategic focus and partnership. We work extensively with universities, researchers, and specialists who understand the value of contributing to national-scale health policy development. Our approach is inherently collaborative because Brazil's health system operates across three government levels, federal, state, and municipal, with 26 states and our federal district requiring coordinated implementation.
We have monthly councils where all stakeholders discuss and agree on initiatives before implementation. Additionally, our National Health Council provides social oversight, with equitable representation from government, health professionals, and citizens. Every new policy must be submitted and approved through this council, ensuring broad stakeholder buy-in.
The reality is that we must prioritize ruthlessly. There are many initiatives we'd like to pursue, but we focus on those with the greatest potential impact across our universal health system serving over 200 million Brazilians.
EF: With Brazil's BRICS presidency emphasizing AI in health and your new role on the National AI Council, how is Brazil positioning itself for global leadership in healthcare AI?
AEH: Brazil is strategically positioning itself as a leader in responsible AI development through our principle of 'AI for the good of all', a philosophy that emphasizes both digital sovereignty and international cooperation. This approach distinguishes us in the global AI landscape.
We actively participate in multiple international forums beyond BRICS, including the Global Digital Health Partnership with 42–43 countries, primarily from the Global North, as well as WHO-coordinated initiatives. We also engage in the Latin American Network for Digital Health (RACSEL), under the leadership of the Pan American Health Organization, strengthening regional collaboration and knowledge exchange. During our BRICS presidency, we organized seminars on AI and data governance, and our G20 leadership resulted in collaborative documents and guidelines with participating countries.
Recently, I accompanied our minister and president to India's AI Impact Summit, where global leaders, including President Macron and UN Secretary-General António Guterres, discussed AI's trajectory. Guterres made a crucial point: AI is advancing so rapidly that no single country can address its challenges alone, and collective action is essential to harness its benefits.
While the United States and China may lead in certain AI aspects, Brazil is building robust AI and digital transformation policies with sovereignty at their core. We've established digital secretariats across multiple ministries, science and technology, communications, government, and justice, creating a comprehensive framework for AI development.
Our strength lies not necessarily in being at the absolute forefront, but in pursuing the right direction with strong foundational policies. We're developing AI capabilities while maintaining our values of universal access and social responsibility, principles that resonate globally and position Brazil as a thoughtful leader in responsible AI implementation.
EF: How do you see public-private partnerships evolving in Brazil's health system, and what partnership models work best in practice?
AEH: The SUS Innovation Laboratory represents our strategic approach to public-private partnerships, recognizing that effective healthcare delivery requires collaboration between sectors. Brazil operates the world's largest universal public health system, serving over 200 million inhabitants, but our constitution establishes that private sector participation is complementary and essential.
The reality is that Brazilian citizens often have hybrid healthcare journeys, moving between public and private facilities. For truly integrated care, we need unified health data that follows patients regardless of where they receive treatment. This is why we're building a national health data network that includes private sector data, creating a comprehensive data lake for improved care quality, continuity, and public health surveillance.
A critical breakthrough has been the implementation of a unified health identifier, using citizens’ existing federal tax number, a widely known and lifelong identifier. We are progressively integrating this identifier across our 400+ health information systems, with only 48 systems remaining to be updated.
However, overcoming fragmentation has required more than a single identifier. It has depended on a broader interoperability strategy, with the National Health Data Network (RNDS) playing a central role as the official platform for data exchange across the health system. Together, these efforts are enabling more coordinated, continuous, and patient-centered care.
Our partnership model works because it serves the citizens' benefit above all else. Whether someone receives care in a public or private facility, their electronic health record must be accessible to them and their healthcare providers. This continuity of care principle drives our integration efforts and ensures that public-private collaboration serves the ultimate goal of better health outcomes for all Brazilians.
The key is moving from fragmented, siloed approaches to integrated systems that put patient care and population health at the center of all partnerships.
EF: As we conclude, what message would you share with global health leaders about Brazil's approach to digital health transformation?
AEH: Brazil's experience demonstrates that universal health systems can successfully embrace digital transformation while maintaining their core values of equity and access. We're proving that countries don't need to choose between technological advancement and social responsibility; both can be achieved simultaneously through thoughtful policy and strategic partnerships.
Our approach emphasizes building robust foundations rather than pursuing technology for its own sake. The unified identifier system, the National Health Data Network (RNDS), as the backbone for interoperability and data exchange, comprehensive data governance frameworks, and integrated public-private partnerships together create a sustainable infrastructure for long-term success. These are not just technical achievements; they represent policy innovations that other countries can adapt to their own contexts.
I’d also highlight our commitment to international cooperation while maintaining digital sovereignty. Through BRICS, G20, and WHO partnerships, we are learning from global best practices while developing solutions that reflect Brazilian values and needs.
At the same time, our engagement in Latin America is fundamental. Through close collaboration with the Pan American Health Organization and regional initiatives such as the Latin American Network for Digital Health (RACSEL), we are strengthening shared capacities, promoting knowledge exchange, and actively contributing to the advancement of digital health across the region — a space where Brazil has also taken on a leadership role.
This balance between global engagement and national priorities offers a model for other countries navigating similar challenges.
Currently, we are implementing an ambitious project with China and the BRICS Bank to build a smart, sustainable hospital at the University of São Paulo, along with a network of 14 interoperable intensive care units nationwide. This represents our vision of high-complexity care delivered through intelligent, interconnected systems.
The message is clear: digital health transformation succeeds when it serves people first, technology second. By maintaining focus on universal access, social equity, and citizen benefit, we are building a digital health system that truly serves all Brazilians while contributing to global health knowledge and innovation.
