22 November 2020 ‒ On 16 November with approximately 2000 virtual delegates in attendance, WHO’s Regional Director for the Eastern Mediterranean Dr Ahmed Al-Mandhari took part in the World Innovation Summit for Health (WISH) in a panel discussion on healthy dry cities. He highlighted the fact that the Eastern Mediterranean Region was home to many of the world’s most water-stressed countries and shared innovative examples of how public health was being protected in those countries of the Region that had adopted best practices. He discussed the public health challenges being faced by dry cities in which the problem of water scarcity was becoming increasingly severe and widespread as a result of climate change and the over-exploitation of available water sources due to increasing demand.

The Eastern Mediterranean Healthy Cities Programme has to date registered 92 cities and 29 villages in 15 countries. Cities and villages are accredited once they have implemented the 80 best practice standards according to the practitioner's guide to building a healthy city. A set of indicators has also been developed to measure the population’s access to basic needs, such as food, water, sanitation, income, a safe environment and adequate housing, and to promote the rational use of water and ensure good management of water resources. Without reliable access to safe drinking-water and adequate sanitation cities can neither be healthy nor sustainable. Dr Al Mandhari shared success stories from countries of the Region that had implemented the Healthy Cities Programme to strengthen urban governance. He said that the best practices adopted by implementing cities had revealed policy coherence for health, reduced health inequities, and promoted innovative economic and sociocultural interventions leading to environmental sustainability for a positive impact on health. Their experiences had demonstrated how multisectoral platforms could incentivize and catalyze systematic approaches to promote health and well-being.

In response to questions from the moderator and delegates Dr Al-Mandhari provided details about the two main challenges related to water affecting the sustainability of urban settlements ‒ lack of access to safe water and sanitation and increasing water-related disasters such as floods and droughts. These problems had serious consequences for human health and well-being and led to health problems such as noncommunicable diseases, diarrhoea, malaria, and cholera outbreaks, exacerbated by a lack of proper facilities in many instances, especially during the COVID-19 pandemic. Service outages had placed great stress on expensive network and distribution infrastructure and led to lack of adherence to hygiene protocols.

He said that those who suffered the most from water-related challenges were the urban poor, often living in slum areas or informal settlements following rapid urban growth, and these people lacked access to safe drinking-water, adequate sanitation, health services and employment. All of this had short- and long-term effects on economic growth resulting in poverty and aggravating tensions within and between communities. It also put significant pressure on public health, education and environmental services.

He concluded by highlighting the importance of generating data, engaging the community in promoting a more efficient use of water and implementing educational programmes in schools and listed a number of strategies and action plans that had been developed by WHO to support countries address the challenges, including the “WHO global strategy on health, environment and climate change (2019‒2030)”, the “WHO water, sanitation and hygiene strategy (2018–2025)”, the “Regional strategy and framework for action on health and the environment (2014–2019)”, and the “Arab strategy on health and the environment (2017‒2030)”.

Mr Erion Veliaj, Mayor of Tirana, Albania, said that Tirana, like many cities, was dealing with an ageing water infrastructure combined with urban expansion and in spite of challenges water management systems were being improved to ensure sustainable access.

His Excellency Mr Abdulla bin Abdulaziz bin Turki Al Subaie, the Minister of Municipality and Environment of Qatar, discussed a series of changes implemented by the Ministry to address the health challenges posed by the dry, hot climate of Qatar.

Dr Maitreyi Bordia Das, Practice Manager, Urban, Resilience and Land of the World Bank, explained that the World Bank looked at issues around equity and inclusion and said policy-makers considered these issues in the context of protecting health in water-scarce areas.

Professor Howard Frumkin, Professor Emeritus, University of Washington, elaborated on the key strategies that cities had adopted to combat increasing climate change-related hazards.

Moderator

Kirsty Wark

WHO

Dr Ahmed Al-Mandhari, WHO Regional Director for the Eastern Mediterranean

Panel members

His Excellency Mr Abdulla bin Abdulaziz bin Turki Al Subaie, Minister of Municipality and Environment, Qatar
Dr Maitreyi Bordia Das, Practice Manager, Urban, Resilience and Land, the World Bank

The World Bank

Professor Howard Frumkin, Professor Emeritus, University of Washington
Mr Erion Veliaj, Mayor of Tirana, Albania