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Empowering our cities to fight the pandemics of the future

Members of the Cities that Work council come together to delineate the critical challenges that need to be addressed to equip our cities to withstand pandemics.

Cities accomplish many wonderful things – they enable people to exchange ideas, goods and services, and many other forms of collaboration. However, the fact that they serve as international and national gateways, coupled with the close proximity between people, means they are also fertile ground for contagion. Of the last thirty pandemics in world history, four have occurred in the last thirty years and the majority of them have begun in cities.

On 10th June, the Cities that Work Council came together to discuss evidence and experience on the city-level response to COVID-19. The overarching message was clear: the ability of cities to respond to the current pandemic has greatly exposed the inequalities across the world. Our cities, particularly across Africa which is the fastest urbanising continent, need to be better equipped to deal with future pandemics, and for that, we urgently need to confront the most critical roadblocks.

Video highlights from the Cities that Work council discussion

First, access to water and sanitation is the most fundamental investment to prevent COVID-19 and improve the health of our cities

Handwashing with soap is perhaps the most important measure to control the transmission of COVID-19. Yet, weaknesses in water, sanitation and hygiene infrastructure, particularly in urban areas, put millions of lives at risk to the ongoing pandemic, not to mention other still-wide-spread infectious diseases such as cholera. In Harare, for example, even some of the most affluent neighbourhoods have not had access to running water in about 10 to 12 years. The situation is much worse in low-income areas.

Over recent years, several African governments have made serious efforts to implement emergency WASH solutions. For example, across West Africa, leaders have installed plastic water containers, nicknamed “Veronica buckets”, in strategic urban locations as a simple, low-cost and effective way to allow safe handwashing despite the absence of running water. However, larger temporary solutions such as boreholes and tanks, although vital now, often have unintended consequences and can lock the city into unfavourable land-use patterns for many years to come. Rather, for long-term liveability in our cities, investments in well-planned, permanent infrastructure is necessary, and requires global support.

Although necessary, the lesson we have learnt from examples the world over is that purely infrastructure-led solutions are rarely sufficient. Even though New York built the Croton Aqueduct in 1842, the 1849 cholera outbreak led to more deaths than the one in 1832. Death rates remained high because connection fees to the aqueduct were expensive, and just as in sub-Saharan Africa today, many poorer individuals cannot pay for costly new water systems. Therefore, over and above the structural challenges, there are systemic problems that cannot be solved overnight. They require consideration of how other softer elements around behaviour change, communication and incentives can be used to encourage improved sanitation behaviours, which will be imperative not only for COVID-19, but for ensuring improved liveability in cities going forward.

Second, we need to design our cities to be more liveable going forward, so that the benefits of density outweigh the costs

From cities where data is available, such as in US, Brazil and India, there seems to be a clear relationship between density and the prevalence of COVID-19. However, density alone does not necessarily lead to a greater number of deaths. Across the globe, many highly dense cities such as Hong Kong and Singapore (initially) have avoided high mortality rates. In New York City, the proximity of citizens to services and ability to work from home in the most dense wealthier areas meant infection did not translate to deaths, whereas in the less dense poorer areas it did.

The long-run solution is therefore not to reduce density, but rather, managing density more effectively. Apart from investing in the necessary health and water infrastructure, this can be done in a number of ways; including building regulations and land-use zoning, as well as incorporating parks and green open spaces into urban design. In African cities, the former are usually already too stringent which drives up the cost of construction, and rather require the city government to be able to coordinate and enforce.

We should also be careful not to forget that informal settlements, although sites of overcrowding and therefore potentially high-risk areas for contagion, are also crucial safety nets for the poor. They are needed more than ever in light of the economic shock that has accompanied COVID-19. We need to ensure that our public policies are supporting the informal sector by, for example, removing restrictions to ensure it can absorb as many people as possible.

Third, devolved decision-making is essential in adapting to local conditions, but needs to be met with the requisite finances  

This pandemic is an event that has created radical uncertainty. Apart from ‘no-regret’ policies such as investments in WASH infrastructure, the right answer at this stage to “what should we do?” is “we don’t know”. The costs and benefits of different measures taken will vary across location and through time, and there is no model yet that can tell us the answer. Instead, we need to learn as we go – we need to experiment, evaluate, monitor, and adapt.

Good quality data is therefore very important. Without it, targeting additional services and support to people who need it the most is much harder, as is weighing up the trade-offs of different policy options. In some cities, like Nairobi, researchers are already using phone surveys to fill in knowledge gaps on population attitudes and practices. The City of Cape Town is using live data from funeral homes to assess high-risk areas in light of stretched testing capacity and the associated delays in official statistics. For many other cities, the capacity to collect and use data might not exist and requires targeted assistance. The IGC is therefore supporting data collection on the economic impact of COVID-19 in a number of African and South Asian countries, with more detailed real-time analysis in some countries, like Sierra Leone.

Communication is key to ensuring compliance, placing emphasis not only on what the message is, but who the messenger is. Therefore, critically, information not only needs to be devolved to the local level to support city governments in taking decisions, but also fed to community leaders. These leaders are often best placed to tailor public communication in building a strong and uniting narrative.

To support decision-making at the local level, many cities rely heavily on fiscal transfers from the national governments. Whilst now is a critical time to maintain or expand these transfers, many cities are seeing the reverse. In Cape Town, for example, large and unprecedented expenditure items are being pushed down onto the city, at the same time as local revenues are drastically declining. In Accra, some revenues dropped to zero during the lockdown, and have only resumed to around 35% of expected revenue since then.

In Freetown, the City Council is working to avoid the situation where they do not have the finances to deliver the services that residents so desperately need, by reforming and expanding the property tax system. Although contested by some, the new tax system is far more equitable: more closely linking the rates to property value and widening the base so that everyone contributes rather than just 50% of the population as it was previously the case. Cities which undertake such reforms will be in a better position to finance recovery from this pandemic and withstand similar shocks in the future.

Global investment in the infrastructure and institutions of African cities is essential for a more resilient future

The pandemic has created a policy juncture to undertake reforms which help in building cities that work. Given the clear evidence that urban form matters for the spread of pandemics, we need to reflect on what has gone wrong with our cities. The gap in urban infrastructure in Africa’s cities has put it at an enormous disadvantage, threatening not only these cities themselves, but also the world at large. COVID-19 is a stark reminder that a disease starting thousands of miles away can impact us all, and the global community needs to start thinking seriously about investing in the infrastructure and local institutions that will overcome this inequality and ensure that developing cities are more liveable and resilient in the future.

While there is still much that is unknown, we hope to explore some of the relationships between COVID-19 and cities in more depth through this blog series. Future pieces will delve more in-depth into topics such as public transport, WASH, urban density, restarting economies, municipal finance and city decision-making under uncertainty, amongst others. We hope that you will join us in this learning journey, as we try to shed light on some of the most fundamental questions city leaders are facing at present.

This blog is based on a conversation within the Cities that Work council and is the first in a series of blogs exploring topics on cities and the ongoing COVID-19 pandemic. 

Disclaimer: The views expressed in this post are those of the authors based on their experience and on prior research and do not necessarily reflect the views of the IGC.

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