Urbanization and Slums Infectious Diseases in the Built Environment: Proceedings of a Workshop (2018) / Chapter Skim
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2 Perspectives on the Prevention and Control of Infectious Diseases in an Urban and Interconnected World
2 Perspectives on the Prevention and Control of Infectious Diseases in an Urban and Interconnected World
Pages 5-16
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From page 5... ...
A local perspective that highlighted the role of slums in global disease transmission was offered by Alex Ezeh, former executive director of the African Population and Health Research Center in Kenya. POTENTIAL CHALLENGES AND OPPORTUNITIES AT THE GLOBAL LEVEL The SDGs came into force as a nonbinding international agreement in 2016, consisting of 17 global goals that span 169 specific targets to be 1 The 2030 Agenda for Sustainable Development is available at www.un.org/sustainable development/development-agenda (accessed January 11, 2018)
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From page 6... ...
For example, new activities aimed at setting priorities for improving the urban environment are orga 2 The 17 SDGs include no poverty; zero hunger; good health and well-being; quality educa tion; gender equality; clean water and sanitation; affordable and clean energy; decent work and economic growth; industry, innovation, and infrastructure; reduced inequalities; sustainable cities and communities; responsible consumption and production; climate action; life below water; life on land; peace, justice, and strong institutions; and partnerships for the goals. 3 Established in 2000, the MDGs were a set of eight international development goals with targets to be achieved by 2015.
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From page 7... ...
Specifically, Dye reported that the United Nations Human Settlements Programme (UN-Habitat) reviewed 5,000 initiatives from 140 countries to identify best practices for developing the urban environment, and set forth priorities, including slum upgrading; water, sanitation, and hygiene services; housing; urban governance; urban planning; and urban economy.
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From page 8... ...
Sustainable Systems for Health Dye reported that the profile of health in the development sphere is on the rise, which is a legacy of the MDG era being propelled in the SDG era. Discussions taking place at the highest levels of international organizations are being mirrored at the level of many national governments, he said, and health matters are increasingly considered matters for the whole of government and not just the ministry of health.
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From page 9... ...
Years ago, he remarked, urbanization was not even considered a factor, despite observations that there was no leishmaniasis in settlements on the edge of towns, where people lived in different types of housing than areas affected by the disease. Today, it is well established that good housing engenders multiple health benefits and is part of the solution for leishmaniasis and other issues, said Dye, because poor-quality housing and neglected peridomestic environments are risks for vector-borne and other illnesses.
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From page 10... ...
"Health is better, but inequality is greater too: that is an urban dilemma we need to resolve," said Dye. Despite media attention to mounting income inequality worldwide, he remarked, WHO statistics suggest that health equality is steadily improving and that the health gap is slowly narrowing between poor and rich people in low- and middle-income countries.
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From page 11... ...
Although it can be useful to summarize national averages on statistics, said Dye, it is also important to analyze the data in a more detailed, disaggregated way to understand more about who is being left behind -- that is, the poorest people in the lowest quintile. Achieving universal health coverage will require more sophisticated measurements and analyses of statistics to understand where the disadvantages lie, he said, and to understand the determinants of socioeconomic circumstances.
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From page 12... ...
The challenges faced by people living in slums are tantamount to the challenges of the shared physical and social environments in which they live, remarked Ezeh. The importance of space to people living in slums was underscored by a recent series in The Lancet on slum health (Ezeh et al., 2017; Lilford et al., 2017)
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From page 13... ...
However, he noted that current estimates and statistics about slums in low- and middle-income countries are derived from UN-Habitat data, which do not characterize slums as specific places. He explained that the following criteria are used to identify people living in slums instead: groups of people or households that lack access to safe water, sanitation, and other infrastructure; people who have insecure tenure within the urban space; and people living in high-density settings (defined as three or more people in the same sleeping room)
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From page 14... ...
Ezeh explained that many of the health risks faced by slum residents are driven by their environments, such as overcrowding, poor garbage disposal, poor toilet facilities, lack of affordable clean water, and poor drainage. These are constant features within slums in many low- and middle-income countries, he noted.
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From page 15... ...
He added that the difference in mortality rates in slums versus nonslum urban areas is much larger than the difference in the mortality rates between urban and rural areas. However, he cautioned that these estimates and indicators of health outcomes in urban areas may be based on data that do not accurately capture slum communities or represent how their health outcomes are distinct from the broader urban setting.
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From page 16... ...
16 URBANIZATION AND SLUMS Ezeh predicted that slums will emerge as the major nexus between the urban and rural, between the formal and informal, and between the local and global. Given that the slums of low- and middle-income countries are the birthplace of many global epidemics, he maintained, slum health cannot continue to be ignored if efforts to control disease and infection on the global front are to succeed.
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