National Health System

Brazil is home to a wide spectrum of traditional, complementary and Indigenous medical systems (TCIM), shaped by the ancestral knowledge of more than 300 Indigenous peoples, Afro-Brazilian communities and local rural populations. Practices such as pajelança, benzimento, the use of sacred plants and herbal medicine continue to play a vital role in community health and cultural resilience.

Brazil integrates TCIM into its Unified Health System (SUS) through national policies such as the National Policy on Integrative and Complementary Practices (PNPIC) and the National Policy for the Health Care of Indigenous Peoples (PNASPI). Recognized traditional and complementary health practitioners include community therapists, traditional midwives, Indigenous health agents and spiritual healers, particularly within the Indigenous Health Care Subsystem (SASI-SUS).

Within SUS, Traditional, Complementary and Integrative Medicine (TCIM) is recognized and implemented through a set of public policies designed to promote cultural diversity, value popular knowledge and respect traditional, complementary and integrative care practices.

Key national policies that support and implement TCIM include: the National Policy for the Health Care of Indigenous Peoples; the National Policy for the Comprehensive Health of Roma Populations; the National Policy for the Comprehensive Health of Rural, Forest and Water Populations; the National Policy on Popular Education in Health; the National Policy for the Comprehensive Health of the Black Population; the National Policy and Programme on Medicinal Plants and Herbal Medicines; and the National Policy on Integrative and Complementary Practices in SUS. Understanding the interfaces and distinctions among these policies is essential for strengthening their implementation at the local level.

The National Policy on Integrative and Complementary Practices (PNPIC), established by Ordinance GM/MS No. 971 of 3 May 2006 and expanded by Ordinances GM/MS No. 849/2017 and No. 702/2018, incorporates into SUS practices that were already widely used in municipal health services across Brazil. According to its guidelines, the policy must be implemented through multiprofessional approaches, involving different categories of SUS health professionals depending on the level of care in which the practices are offered. Thus, Integrative and Complementary Health Practices (PICS) are delivered by SUS health professionals in accordance with their legal responsibilities and specific competencies.

At the local level, community-based and traditional knowledge – such as ancestral quilombola medicine – coexists with PICS and supports the promotion of healthy environments and comprehensive care. Although these knowledge systems are highly relevant for community health, they are not considered PICS, as they are not delivered by SUS health professionals but by social actors recognized through other policies directed at traditional populations.

Professional Regulation and Training in TCIM

Professional regulation and training in Traditional, Complementary and Integrative Medicine (TCIM) in Brazil are essential for consolidating and strengthening these practices within SUS.

Currently, Integrative and Complementary Health Practices (PICS) are offered by professionals from various health fields, in accordance with their legal competencies and professional guidelines. However, the specific regulation of professions associated with TCIM is still developing and presents several challenges.

Some practices—such as acupuncture, homeopathy, herbal medicine and anthroposophic medicine—have specific resolutions and regulations issued by professional councils, including the Federal Council of Medicine (CFM), the Federal Nursing Council (COFEN), the Federal Council of Physiotherapy and Occupational Therapy (COFFITO), and the Federal Pharmacy Council (CFF). These councils recognize and regulate the work of professionals in these areas within their respective categories.

Other community-based and traditional practices—such as prayers, benzimentos, traditional midwifery, root-healing practices and pajelança—are not regulated by professional councils but are recognized through public policies directed at traditional populations and popular knowledge. These practices form an important field for intercultural dialogue with SUS, especially in Indigenous, quilombola and rural territories.

Regarding training, many public and private universities have begun incorporating TCIM content into undergraduate and postgraduate programs, particularly in medicine, nursing, physiotherapy, psychology and pharmacy. In addition, the Ministry of Health promotes continuing education and training courses for SUS professionals through Distance Education (EaD/SUS) and partnerships with educational institutions and state and municipal health departments.

However, gaps remain in systematic training and the regulation of specific professions linked to integrative practices, representing a challenge for the qualified expansion of TCIM within SUS and for strengthening research and scientific production in the field.

In Brazil, health professions are regulated by federal laws approved by the National Congress. Each profession has specific legislation defining its exclusive scope of practice and establishing its professional regulatory council. Physicians, nurses, physiotherapists, pharmacists and others have their activities supervised by these councils, which issue resolutions in line with professional legislation. Through these resolutions, practices such as Traditional Chinese Medicine, homeopathy, osteopathy and other PICS are formally recognized within these health professions.

Other practitioners – such as naturopaths, holistic therapists and yoga instructors – are classified as occupations by the Ministry of Labour and Employment, which recognizes their professional activities.

Training requirements for PICS vary according to the complexity of each practice, ranging from graduate and undergraduate programs to technical courses and non-accredited short courses.

Information on the Health System, Access and Integration of TCIM in Brazil

The provision of Integrative and Complementary Health Practices (PICS) within SUS reached 9 million participants in 2024, with 54% of services delivered in Primary Health Care and 46% in medium- and high-complexity care.

In Primary Health Care, more than 20,000 health units offer PICS, while more than 4,000 facilities provide these services in medium- and high-complexity care, including mental health services, specialized centers and hospitals.

The most widely offered practices are those of Traditional Chinese Medicine—mainly acupuncture, auriculotherapy and Chinese body practices—which account for approximately 64% of all PICS services. Other frequently offered modalities include meditation, yoga, massage and herbal medicine.