BACKGROUND:
The Amazon is the world’s largest tropical forest and vital to climate and health1. The forest is under threat from models of land use that ignore the forest biodiversity potential, are inefficient and exclude indigenous knowledge. Nearly 20% of the forest has been deforested by extensive agriculture and industrial mining and poisoned with mercury by illegal gold mining. The stewardship of Indigenous and traditional communities are the strongest defense of the forest, their cosmologies recognise the rights of nature, and their sustainable livelihoods preserve biodiversity and carbon sinks. Yet hey are few, dispersed, and disproportionately affected by environmental degradation and structural racism. Methods and

RESULTS:
This paper reviews 40 years of Health and Happiness Project in the Tapajós River2, with innovation in integrated, climate-resilient forest development linked to primary health care in over 350 dispersed indigenous forest communities. Over 100 Heath Boats and solar-powered forest clinics and community health posts. Now serve 42 000 people across 2 million hectares, offering telemedicine, digital inclusion, education, citizen-science and socio-bio economy initiatives.

CONCLUSIONS:
This model offers viable alternatives to extractivism3. representing territories of health, citizenship and climate, of well-being, with integrated social adaptation technologies. The model could be scaled across the basin as part of a decentralized agenda for climate action with tangible local benefits that align environmental investment with social policy. Linking indigenous knowledge with forest protection, emissions reduction, food security, equity and universal health coverage can produce powerful health and climate co-benefits.