Urbanisation implies both a social phenomenon as well as a physical transformation of landscapes. Indeed, this is one of the most powerful, irreversible and visible anthropogenic forces on earth. Climate change is expected to exacerbate the risks and vulnerabilities of urban systems, which will definitely threaten urban well-being and growth.

Vulnerable region

It is evident that the Asia-Pacific region is home to many who are at risk due to growing impacts of climate change. Historically, more people have been affected by floods, droughts and storms in this region than anywhere else in the world. Statistics show that 83 percent of all people affected by droughts, 97 percent of all affected by flood and 92 percent of all affected by storms from 1960-2007 resided in East Asia, the Pacific and South Asia.

While everyone is vulnerable to climate-induced risks, the most affected are in low-income groups with little adaptive capacity. Among them, old people, children and women are most vulnerable. In this context, reducing vulnerabilities and increasing resilience to help people cope with the health effects of climate change should be a high priority in developing countries. At the same time, innovative approaches should be explored to protect the most vulnerable in families and communities.

Urban health

One worrying fact is that the urban population is still increasing. More than half of the world’s population lives in urban areas and more than 90 percent of the future population is likely to live in the cities, mainly in poor developing countries. More importantly, urbanisation is a leading 21st century trend, which will have a significant impact on health.

According to the World Health Organisation (WHO), over 70 percent of the world’s population will live in cities by 2050. Therefore, some key factors influencing urban health include governance, population, natural and built environment, socio-economic development, nutrition and food security.

Most cities in deveoloping countries have limited access to adequate and clean water resources. As a result, the risks of communicable diseases will increase in both rural and urban areas. Likewise, greater rainfall, combined with warmer temperatures, is likely to make clean water and adequate sanitation more complex and costly, and expand vectors for waterborne diseases, including malaria and dengue fever.

So despite some tangible opportunities, cities can bring in new challenges for better health. Over the decades, cities have been facing increasing threats of infectious diseases like HIV and AIDS, tuberculosis, pneumonia and diarrhoea. In addition, the trend of non-communicable diseases like asthma, heart disease, cancer and diabetes are also on the rise. These unintended consequences are most likely to increase the costs of healthcare in cities.  

Burdened and overwhelmed by the problems associated with urban growth, cities like Kathmandu are increasingly vulnerable to air pollution. The increasing expansion of roads and on-going construction of large buildings will have tremendous impacts on human health. Moreover, city life is further worsened by poor housing and living conditions in slum areas.

Case of Kathmandu

An absence of a sustainable approach to solid waste management in cities is also a pressing issue that calls for immediate action. While there are emerging needs for environmental laws with proper enforcements, community education in cities on environmental issues is urgently required to raise public awareness.

For example, the recent Bagmati River Cleaning Campaign is an innovative effort. Under the leadership by Chief Secretary Leela Mani Paudyal, this campaign gained much popularity with support from the Kathmandu Metropolitan City, Ministries of Urban Development, Environment, Local Development and civil society.

Additionally, the challenges of urban road safety are ever alarming. With increased urbanisation, road fatalities are expected to become the fifth leading cause of death across the globe by 2030, according to WHO. These vehicles not only emit greenhouse gases but also cause fatalities.

The grand challenge for the coming decades will be to transform the ways we think about people and the environment in the cities in order to transition towards a brighter and sustainable future.

Bhandari is with Nutrition and Food Security Secretariat, National Planning Commission