Key Stakeholder Message: Prof. Dr. Md Iqbal Alam Khan

Prof. Dr. Md Iqbal Alam Khan
Dept of Development Studies, DIU

Urban health equity is inextricably linked to long-term municipal resilience, economic competitiveness and social cohesion, and this is especially true in the current context of rapid, unplanned urbanization across the Global South and emerging economies, which give us a clear call to action.

Empirical field studies indicate that social, spatial and economic dimensions constitute the major drivers of the health burden of the metropolitan centers, highlighting that residents of informal settlements and peri-urban peripheries experience high exposure to contaminated water sources, lack of sanitation, industrial emissions and high concentrations of heat in urban areas. At the same time, weak governance and ongoing under-investment in localized primary healthcare systems increase the dual burden of disease, spreading both preventable communicable diseases into outbreaks, and high chronic non-communicable diseases prevalence (e.g. cardiovascular diseases, respiratory diseases) which lead to catastrophic out-of-pocket health expenses among vulnerable households. A 'Health in All Policies' (HiAP) approach is needed as a transformative paradigm for how the health sector works across city systems, challenging the current fragmented, and sectoral approach, and must now be institutionalized by key stakeholders in city systems, in municipal governments, in urban planning commissions, in ministries of health, civil society organizations, and international development financing institutions if this vicious circle of poverty and disease is to be broken. This systemic change requires three strategic commitments: all municipal zoning, housing regeneration, transportation and industrial infrastructure projects must include comprehensive Health Impact Assessments (HIAs) that are legally binding; primary healthcare centers and communities must have decentralized digitally enabled primary healthcare centers, with the presence of community health workers in the informal settlements, and must be overseen by institutionalized multi-sectoral oversight councils with access to real-time, open-access GIS disease surveillance and environmental monitoring platforms. Inclusive developmental financing and meaningful linkage of metropolitan spatial planning with public health priorities can help make cities more resilient, health promoting and productive and help build a strong economic base for the whole urban population.