#UrbanHealth: Collaboration key in achieving SDGs, New Urban Agenda

Jo Boufford, president of The New York Academy of Medicine

Boufford provided the global context for the discussion on urban health in Africa by initially highlighting the most prominent public health challenges faced today and how they relate to the urban environment. They include epidemiological shifts and the rapid rise of non-communicable diseases (NCDs), the demographic shift in ageing, and climate change.

Rapid urbanisation

The most critical challenge, however, for urban health, explained Boufford, is the rate of urbanisation - it is therefore the area that requires considerable focus: "Rapid urbanisation must be at the forefront of global and national plans for achieving the SDGs and the New Urban Agenda. There's general agreement that health is critical to the economic and social development of any country, so it only stands to reason that cities, where most of the people live in most countries, have to get special attention."

Boufford believes opportunities in cities lie in the power of local government and governance, and the linking of all sectors and decision-making. This does, however, present challenges to widely accepted international development frameworks and the dominant medical model. What's required, said Boufford, is "a better understanding that medical care and the healthcare system are only one component of factors contributing to health, and it requires the health sector to partner with other disciplines and sectors in achieving health".

Multi-sectoral collaboration

While goal three of the SDGs, "Good Health and Wellbeing" remains focused on specific diseases, it also now requires focus on NCDs and the prevention thereof, allowing for multi-sectoral collaboration in areas including city design. Goal 11, "Sustainable Cities and Communities", however, does not make mention of the word 'health', noted Boufford, leaving the urban agenda a narrow one that does not promote collaboration. "This really emphasises the need to bring urban health to the forefront in the conversation on the future of cities and the future health agenda for the SDGs," she said.

The World Urban Campaign, which advised on the Habitat III process in developing the New Urban Agenda, identified 10 principles for the ideal city, one of which was a healthy city and the need to bring the importance of health, especially in the built and natural environment, into the Habitat conversation. Boufford noted that despite the efforts of the health community to increase focus on health in the final outcome document at Habitat III, the result was disappointing.

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Positive governance and city management

Density, diversity, complexity and disparities are some of the unique features of cities, she pointed out, and none individually are positive or negative - their effects are influenced by various issues, and this is where the intense demands of rapid urbanisation present a real danger. However, Boufford said, positive governance and management of cities can be the drivers of national development when they present opportunities to transform national health: "Population density in cities can facilitate delivery of development interventions and healthcare social services to large numbers of people. If planned, the built environment can include consideration of the health impact.

"Cities can facilitate healthy choices of food, exercise, social engagement, as well as maximise the resilience of its residents and, if well managed, cities can be edges of development for national economies, hubs for technological innovation, centres of positive social progress, including advancing education and empowering cities as sources of opportunity, choice and resources."

The Urban Health dialogue took place 6-7 February at the Hotel NH Cape Town, The Lord Charles in Somerset West. Click here for more info.