Rapid urbanisation in low- and middle-income countries is having a significant impact on the health and wellbeing on the world’s population. Healthcare services in growing cities are struggling, and are already swamped with ongoing challenges like infectious diseases. They have limited time or resources to tackle chronic diseases like high blood pressure, which are often without symptoms early on, yet can cause long-term damage.

An Urban Health in Africa Dialogue was co-hosted in Cape Town by the Academy of Science of South Africa (ASSAf), the Novartis Foundation, the International Society for Urban health (ISUH), InterAcademy Partnership (IAP) – Health (IAP), International Council for Science (ICSU), and the University of Basel. This is the first time that an event such as this, which brings together important stakeholders together to discuss urban health, is being held in Africa.

The dialogue looked more deeply at emerging urban health challenges. Over two days, participants had the opportunity to explore the emerging frameworks between urban health and urban planning as unique sectors that require multi-disciplinary collaboration to advance common agendas. It will also examine the challenges and opportunities of pursuing these multi-disciplinary approaches.

Advancing new approaches through dialogue

The first day’s agenda focused on research, education, policy and capacity building. It was punctuated by two panel sessions, one focused on frameworks for advancing urban health, the other on creating health in African cities – with a goal of setting the vision for a multisector approach.

Positioning the challenges and opportunities of achieving health and well-being for all with current trends in urbanization – while keeping in mind the importance of global international agendas like the Sustainable Development Goals (SDGs), climate change and the Habitat 3 New Urban Agenda – is also critical.

“Input from diverse scientific disciplines are integral to inform policy, research and practice to meet emerging urban health challenges,” according to Roseanne Diab, Executive Officer of the Academy of Science of South Africa, one of the co-hosts of the event. 

“It will be important to translate these global agendas to local agendas to form the basis for policy, research and implementation action at a regional, national and municipal level,” said Jo Boufford, President at The New York Academy of Medicine.

On day two, the session shifted gears and looked more pragmatically at urban health in practice by discussing examples of implementation efforts in African cities and specific efforts to pursue a multidisciplinary approach. This was done via a combination of small group discussions, case examples and panel discussions.

Urban health a particular challenge for developing countries.

For the first time in history, more than 50% of the world’s population lives in an urban area – and by 2050, it is estimated that 70% of the world’s population will be living in towns and cities. One effect of rapid urbanization is the growth of non-communicable diseases (NCDs), especially in low- and middle-income countries (LMICs). Already today, almost 75% of global NCD deaths occur in LMICs, resulting in approximately 28 million deaths every year.

In Africa in particular, the unprecedented scale and pace of urbanisation have impacted disease patterns and exacerbated critical health inequities, while posing challenges for sustainability in housing, infrastructure, basic services, food security, education, employment, safety, and natural resources, among others.  In addition, health literacy levels may also be lower than in high-income countries, so populations are less likely to engage in health seeking behaviors.

Overcoming this challenge cannot be done by one organisation alone. Public and private resources will need to come together to strengthen the system of care – and strong, effective leadership in these countries will need to lead the charge. Hedwig Kaiser, Vice President for Education at the University of Basel, noted that “one of the most critical roles of the next generation of leaders is to help develop emerging urban environments to serve the wellbeing of their citizens.”

“We believe that by bringing together global and local partners from various sectors and disciplines, we can work to address the underlying risk factors of chronic non-communicable diseases in urban settings, which often lie beyond the realm of healthcare,” said Ann Aerts, Head of the Novartis Foundation. “With their expertise in diverse fields, we hope to identify novel approaches to create robust and sustainable interventions which can have measureable impact on public health.”