Urbanising lessons: Is Delhi listening?

Whatever their political leanings may be, the residents of India’s capital agree on one thing. New Delhi’s air is foul. You may argue about how bad it is or whether it is the worst in the world, but no one in this megacity doubts that the air is not fit to breathe.

Now even the India Meteorological Department tells you officially that the city’s air quality has nosedived to “very poor” levels. The reasons are familiar — the onset of winter means particulate matter, a major pollutant, stays closer to the ground. Then there is pre-Diwali traffic and smoke from burning crop stubble in farms all over Punjab, Haryana and western Uttar Pradesh. Cumulatively, the fires of hell have been unleashed, and people cannot breathe without falling ill.

The problem is not confined to Delhi. More and more Indian cities have very poor air quality, adding to the load of respiratory and cardio-vascular illnesses in the country.

These are local issues. But they also resonate globally as happened last week at a convention of cities — Habitat III, held in Quito. Around 45,000 delegates — including at least 200 city mayors and 140 national delegations — attended the conference in the breathtakingly beautiful capital of Ecuador, among the first World Cultural Heritage Sites declared by Unesco.

Formally known as the United Nations Conference on Housing and Sustainable Urban Development, Habitat III was the third in a series that began in 1976 to “reinvigorate” the global political commitment to the sustainable development of towns, cities and other human settlements, both rural and urban. The process has led to what is referred to as the New Urban Agenda (NUA). At the conclusion of the Quito Summit, UN member states adopted this agenda, a set of global guidelines for sustainable urban development.

The NUA recognises the diverse challenges posed by rapid urbanisation. But it still leaves crucial gaps. Health advocates at Quito said health had been mentioned 25 times in the NUA but there was not sufficient awareness among city planners about its pivotal role in city development strategies.

At Quito, the World Health Organisation, which has been playing an active role in mainstreaming health in the NUA, drew attention to one of its new documents which explicitly states that “the most important asset of any city is the health of its citizens”.

Which gets one back to the foul air in Indian cities and other factors that affect our health. Those who shrug off global conventions as talkathons should read the WHO’s new report “Health as the Pulse of the New Urban Agenda”. The 43-page report makes a powerful case for integrating health into urban planning, investments and policy decisions. “Health is essential for fostering good livelihoods, building a productive workforce and vibrant communities, enabling mobility, promoting social interaction and protecting vulnerable populations,” it notes.

Good health is a goal in itself. But the WHO report also makes the economic case for investments in good health — cities with clean air, energy-efficient infrastructure and widely accessible green spaces can attract more investment and businesses, create more jobs and offer more opportunity to people from all walks of life. What city planners do actually affect our health in many ways. Take the case of lifestyle diseases such as heart diseases, stroke, cancer and respiratory ailments. The number of such cases is going up sharply across the country.

The main risk factors for such diseases are tobacco use, excessive alcohol consumption, physical inactivity, poor diet, exposure to air pollution and chronic stress. All of these are directly influenced by urban design and policies. For example, lack of access to public transport and safe spaces for walking and cycling increasing reliance on private motorised transport which in turn leads to more sedentary behaviour and enhances exposure to air pollution.

Some city planners have begun to realise the benefits of investing in health. For example, Rajshahi in neighbouring Bangladesh which once had dangerously high levels of particulate matter in its air dramatically improved its air quality by replacing old brick kilns with cleaner and more effective kilns, using battery-powered electric auto-rickshaws, planting green strips, paving sidewalks to reduce dust and promoting pedestrian areas.

Delhi is the only city in the world where the indiscipline of drivers forced the authorities to dismantle its only bus rapid transit (BRT) corridor. In contrast, Mexico City has created five high-quality BRTs serving almost one million passengers a day — 10 per cent of whom switched from driving personal vehicles. The reduction in vehicular pollution eliminated an average of 6,100 work loss days, says the WHO report. The city has also developed the EcoBici bike-sharing programme with 100,000 members and 10 million trips per year.

India has its National Urban Health Mission and the Union health ministry has proposed a new integrated framework for managing air pollution that prioritises tracking peoples’ actual exposure to dangerous pollutants. This needs to be implemented soonest and in many cities.

Building healthy cities is not rocket science. But as the many examples that were discussed at Quito showed, it requires political will. Politically sensitive leaders also realise that while talking about cities, it is important to factor in slums and informal settlements. Slums are part of almost every city in the developing world. Many slums don’t have toilets, electricity, water and sanitation — sometimes not even paved roads. All this takes a toll on the health of people.

The discussions at Quito are important for India. More than 377 million Indians are city-dwellers, according to the 2011 census. That may be a relatively low rate of urbanisation, but it still translates into one of the highest urban populations anywhere in the world.

India now explicitly recognises the role and importance of urbanisation and cities in the process of its socio-economic transformation. The country’s urban areas contribute close to 60 per cent of gross domestic product. The Narendra Modi government envisions “smart cities” as one of the prime drivers of future growth. But it must not forget that a smart city will deliver smart outcomes only if its inhabitants are not weighed down by ill health.