Mining and malaria in the Brazilian Amazon and in the Yanomami indigenous land.

Illegal mining expanded in the Brazilian Amazon since 2018, leading to increases in malaria among indigenous populations, particularly the Yanomami. We describe the temporal and spatial pattern of malaria and mining in indigenous lands and quantify the impact of mining on malaria among the Yanomami. We estimate that a 1% increase in the annual mining area was associated with a 24% (95% CrI: 17%, 32%) increase in monthly malaria cases in the Yanomami. Also, malaria cases in 2022 in the Yanomami were likely underreported by 83%, and an estimated excess of 102,870 malaria cases occurred from 2018 to 2023 due to increased mining activity (an additional cost to the public health system of approximately US$6.9 million). Rethinking and intensifying malaria control in Brazil is a matter of health, environmental, and indigenous justice.