Urban Governance for Health and Wellbeing

Rapid and unplanned urbanization is one of the major ecological and human challenges of the 21^st century. UN Habitat predicts that by 2050, over 70% of the world population will be living in cities, with an even faster growth pace in low- and middle-income countries. The inability of current urban infrastructure to cope with increasing demand for public services leads to adverse health and social impacts. While cities offer many opportunities for employment and access to better public services that can generate health, they also pose major health risks. Deficiencies in strategic urban planning and in addressing social determinants of health, such as employment, income and housing, often result in social inequalities, poverty, crime, environmental hazards and unmet needs of vulnerable populations, significantly affecting their health and well-being. Additionally, these deficiencies are larger in poor peri-urban settings such as informal settlements which are often overcrowded, lack basic services such as safe water and sanitation, and are the focus of the re-emergence of infectious diseases such as tuberculosis.

The COVID-19 crisis has put city governments and urban communities at the frontline of responding to the pandemic and building back better. Cities planned along separation lines have been disproportionately affected, with unequal opportunities of access to essential resources (housing, employment, water and sanitation, and urban infrastructure) required for a healthy life. COVID-19 is however also an opportunity to generate innovative solutions to initiate long-term urban resilience to health shocks.

Initiated by Switzerland and building on good practices made in the WHO European Region, a new global initiative strives to promoting good urban governance for health through the empowerment of city authorities and leaders, multisectoral action, and participatory urban planning with active involvement of communities. Swiss institutions championing urban planning and civic engagement for better living environments will play a key role in the initiative (e.g. Geneva City Hub, cantonal urban planning and zoning services, Swiss Federal Office for Spatial Development).

In a first phase, the program will target 5 cities: Douala (Cameroon), Khulna (Bangladesh), Tunis (Tunisia), and the two Latin American cities Bogota (Colombia) and Mexico City (Mexico), since Latin America has been heavily affected by the COVID-19 pandemic. The additional credit approved by the Federal Council for WHO’s work in Latin America will be used for supporting Mexico and Colombia. 

1.    Institutional and policy frameworks for good urban governance for health and wellbeing are developed at local, national, regional and global levels.

2.    Capabilities and evidence for urban health governance are strengthened for local and national governments.

3.    Local leaders and communities have jointly addressed health and wellbeing needs and priorities through participative processes and social innovation.

Principaux résultats attendus:  

1. A framework on good urban governance
for health and wellbeing is developed, adopted,
and applied by selected cities.

2. Urban governance assessment tools/instruments
are developed and adapted by selected countries/cities.

3. Case examples on models of joint planning
mechanisms that include community engagement
and multisectoral work between citizens and local
authorities, are documented and disseminated.

4. Global, regional and national networks of local
leaders/mayors on urban governance for health
and wellbeing are mobilized.

5. Urban Health Laboratory in Latin America to
produce evidence on effectives of good urban
governance are set up.

6. Capacity building and exchange of experiences
between cities, including communities and local
actors of each selected city (e.g. urban health equity,
health impact assessment), is provided and takes place.

Principaux résultats antérieurs:  

The inception phase succeeded to:

1. Select 5 cities using specific criteria, including commitments from their mayors to addressing urban governance.

2. Develop preliminary city profiles for the 5 selected cities, through rapid situation analyses on existing urban governance schemes.

3. Identify initial priorities for the 5 cities, with a common core of priorities.

4. Identify key stakeholders to engage in the program for each city.

5. Produce an outline of an action framework on urban governance for health and wellbeing, including related principles and strategies.

6. Finalize a WHO institutional model on Healthy Cities.