By Brazil Stock Guide — Brazil’s Health Ministry has cleared the way for one of the country’s largest hospital public-private partnerships to be financed on a significant scale through the capital markets, authorizing the company behind Belo Horizonte’s Padre Eustáquio Hospital Complex, known as HoPE, to issue up to R$1.12 billion in tax-incentivized and infrastructure debentures.
The decision, published Monday in Brazil’s Official Gazette, classified the project as a priority investment in public and free healthcare. In practical terms, that allows up to 90% of the R$1.247 billion in capex recognized for the financing framework to be funded through those instruments.
HoPE is not the first healthcare project to qualify for tax-incentivized debenture financing. The Health Ministry established specific rules for public healthcare projects in late 2025, and other projects have since received similar approvals.
What stands out in the Minas Gerais project is its scale. The R$1.122 billion issuance ceiling puts the capital markets at the core of the financing structure for a large hospital complex that will be fully dedicated to Brazil’s Unified Health System, or SUS.
The project was structured as a 30-year PPP by the Minas Gerais state government. The concession was auctioned at B3, Brazil’s stock exchange, in São Paulo on September 19, 2025, and was won by the Saúde HoPE consortium, formed by Integra Brasil, Oncomed and B2U Participações.
The consortium offered an annual availability payment of R$286 million, representing a 13.03% discount to the maximum R$328.9 million allowed under the tender. Opy Health Care and Construcap also submitted bids.
At the time of the auction, B3 said the concession had an estimated net present value of R$2.4 billion and would require approximately R$1.74 billion in infrastructure and equipment investment over the 30-year concession period.
The Health Ministry order published this week uses a more specific financing base, recognizing R$1.247 billion of project capex as eligible for the debenture structure and allowing issuance of up to 90% of that amount.
The size of the hospital itself helps put the investment into perspective. HoPE will have 532 beds, including 110 intensive-care beds, as well as more than 60 outpatient consultation rooms and 13 operating rooms.
The complex will bring together five major areas of care: oncology, infectious diseases, pediatrics, hematology, and maternity and women’s health, in addition to a new Central Public Health Laboratory for Minas Gerais, known as Lacen-MG.
The new hospital will absorb services currently provided by the Alberto Cavalcanti, Eduardo de Menezes and Infantil João Paulo II hospitals, as well as the Odete Valadares Maternity Hospital. Officials expect the project to increase the number of available beds by 28% compared with the existing facilities.
The state government estimates HoPE will be able to provide more than 200,000 specialist consultations a year, an increase of more than 45%, along with around 30,000 hospital admissions annually, roughly 60% above the capacity of the facilities it will replace.
The complex is also expected to offer services that are currently unavailable or more limited in the state network, including pediatric surgery, pediatric oncology, onco-hematology and bone-marrow transplants.
The new Lacen laboratory is expected to perform more than 1.5 million tests a year related to notifiable diseases, as well as more than 375,000 public-health and sanitary analyses, according to project estimates.
Although HoPE is being built and operated under a PPP, it will remain a public hospital. Care will be 100% provided through SUS, while clinical and medical management will remain under the responsibility of the Minas Gerais state government and its hospital foundation, Fhemig.
The private concessionaire will be responsible for construction, equipment, maintenance, infrastructure operations and non-clinical support services. Physicians, nurses, clinical decisions and direct patient care will remain under public management.
The concession is operated by SPE HOPE S.A., created by the winning consortium. Integra Brasil operates in social-infrastructure PPPs, Oncomed has experience in hospital and oncology services, while B2U Participações is owned by Ultra Engenharia e Construções and BII Investimentos Imobiliários.
The ability to raise up to R$1.12 billion through tax-incentivized and infrastructure debentures gives the project a new financial dimension.
Such instruments have long been used in sectors including energy, toll roads and sanitation, and are now beginning to gain more ground in healthcare infrastructure, particularly in PPPs backed by long-term contracts and predictable public-sector payments.
Under the ministry’s order, the project company may use the proceeds for future expenditures or to reimburse eligible project-related costs and debt. The issuance may take place within five years.
If the project later receives funding directly from the federal government or from federally managed resources, the maximum debenture issuance will have to be reduced by the corresponding amount.
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