In the late 1980's the World Health Organization coined the concept of a healthy city. Its purpose was to view public health from a broader, more holistic viewpoint, including social, political, environmental and cultural aspects. (WHO 2000 “Strengthening Healthy City Projects in the South-East Asian Region”)

The WHO characteristics of a healthy city are:

• A balance between man-made and natural environment
• Basic needs met for all city people (food, shelter, income safety and education)
• Effective and efficient waste and drainage management
• Absence of communicable diseases
• Inter-sectoral coordinated action programs
• Decisions involve communities and the public
• Where a balanced economy status exists
• Reasonable population density
• Political commitment to people's health and quality of life
• Where city authorities/citizens recognise health effects on town planning

Unfortunately, few cities measure up to these principles of a “healthy city”. With half of the world’s population now estimated to be living in an urban environment, most of them in Asia, helping cities to become “healthier” is becoming an urgent priority.

Urbanisation is a consequence of, and also a prerequisite for, economic development, a sign of potential for a nation and its people.

However, about 90% of city growth occurs in the developing world where societies and people are less prepared for the increase in population.

Because the planning process is not inclusive, or because the economic status of residents is imbalanced, or because infrastructure is not expanded to meet the basic needs of all, or for many other reasons, many cities in Asia would be considered “unhealthy”.

The challenges of urban poverty

Urbanisation is by no means a new phenomenon, but the rapid urbanisation that is taking place today is.
Some striking predictions have been made for urbanisation in Asia Pacific over the next two decades.

For instance, by 2025 nearly three-quarters of the population of the Philippines will live in urban areas. Around two-thirds of Indonesia’s population – over 178 million people – will be urban citizens. India will have half a billion city-dwellers.

And finally, by 2025 the total urban population of Asia Pacific countries where World Vision has a presence will increase by over 700 million (UN Population Division, ‘World Urbanization Prospects: The 2007 Revision’).

Shelter is the most visible issue of urban poverty. Because of the struggle to find or afford housing, a large proportion of new arrivals to the city often move to areas where land ownership is not enforced and build their own makeshift accommodation.

Out of the three billion people who are living in urban areas today, one billion live in slums. UN-HABITAT estimate that the slum population will likely double over the next 30 years and they will be living in the slums in cities that are bigger than any of the current cities (Oxfam 2006 “Urban poverty and Development in the 21st Century”).

In many Asian cities 30-40% of the population are already living in slum areas and the percentage of poverty is as high as 40% of the population.

However, urban poverty has many dimensions, including inadequate or unstable incomes, lack of access to basic services, public infrastructure or safety nets, poor protection of rights and weak political voice or influence.

In urban areas measuring poverty is more complex than simply using the traditional US$1 a day benchmark. The urban poor are likely to have a higher income, as they are often earning daily wages, and basic services and infrastructure are usually in place.

However, it is the higher cost of accessing these basic services that differentiates urban poverty from rural poverty (ESCAP ”Facing the Challenges of Urbanization and Urban Poverty in Asia and the Pacific” 2007).

In most cities, US$1 per day would not be enough to pay rent, access clean water, transport, health care, education, and other essentials.

The consequences of this new urbanisation presents challenges for organisations like World Vision who have been working to reduce poverty and promote positive development for people in the developing world for decades.