Abstract
The percentage of the world's population living in urban areas will increase from 50% in 2008 to 70% (4.9 billion) in 2025. Crowded urban areas in developing and industrialized countries are uniquely vulnerable to public health crises and face daunting challenges in surveillance, response, and public communication. The revised International Health Regulations require all countries to have core surveillance and response capacity by 2012. Innovative approaches are needed because traditional local-level strategies may not be easily scalable upward to meet the needs of huge, densely populated cities, especially in developing countries. The responses of Mexico City and New York City to the initial appearance of influenza A pandemic (H1N1) 2009 virus during spring 2009 illustrate some of the new challenges and creative response strategies that will increasingly be needed in cities worldwide.
Highlights
This report outlines the issues discussed at an international technical consultation on “Cities and Public Health Crises” held in Lyon, France, on [29-30] October 2008
The International Health Regulations require countries to strengthen their capacity for surveillance of and response to disease outbreaks and other public health emergencies both at national level and at state or city level too
Participants in the Lyon consultation concluded that, in today’s largely urban and interconnected world, infectious disease outbreaks and other public health emergencies pose a real threat to large cities but that with a good understanding of the specific issues posed by urban settings, and appropriate preparation from municipal and national stakeholders, that threat can be mitigated
Summary
The designations employed and the presentation of the material in this publication do not imply the expression of any opinion whatsoever on the part of the World Health Organization concerning the legal status of any country, territory, city or area or of its authorities, or concerning the delimitation of its frontiers or boundaries. The mention of specific companies or of certain manufacturers’ products does not imply that they are endorsed or recommended by the World Health Organization in preference to others of a similar nature that are not mentioned. All reasonable precautions have been taken by the World Health Organization to verify the information contained in this publication. The published material is being distributed without warranty of any kind, either expressed or implied. In no event shall the World Health Organization be liable for damages arising from its use. 2 - Background 7 The growth of cities 7 The vulnerability of cities 8 Slums 8 Crime and violence 9 Natural disasters 9 Infectious diseases in cities 9 The speed of infection 9 Imported infections 10 Foodborne diseases 10 Infections that originate in the city Nuclear and chemical accidents The International Health Regulations 11
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