ISEE-301 Introduction: India, a country with the population of more then one billion is facing major challenges due to rapid urbanization. If the present growth rate continues, by 2026, the total urban population will increase to 506 million from the present figure of 285 million. The population migration from rural to urban areas will contribute the largest share. The authors argue that if no major realistic steps are taken with immediate effect, it will not be long before millions of people face a huge burden of health hazards. Aim: This paper attempts to analyse the current infrastructure, government planning and future policy, and health hazards in Indian urban areas, and to predict future trends with regard to disease burden. Methods: Air pollution, lack of water, sanitation and drainage facilities, vehicular accident, lifestyle disease and mental stress are considered to be the major threats to the health of the urban population. Extensive analyses of reports of census, health information and policy, pollution, urban development, natural resource management along with several research documents have been done. Based on past trends, the future status of urban infrastructure and health outcomes are predicted. The present socio-cultural-political and ecological dimensions from regional, national, and global perspectives are also incorporated in order to make realistic predictions for the coming decades. Results: The present average per capita generation of solid waste and waste water will increase two fold or more in the next two decades, due to changing patterns of life style. Hence, the total per day generation of waste will increase four to five folds during the same period. The present requirement for land for solid waste disposal will increase five to six folds. But due to scarce land resources and the rising population, there will be a severe crisis in solid waste management. The waste water treatment capacity of existing systems will not be able to cope the situation. The medium and smaller towns, not generating major revenue, will face more severe problems due to regional disparity. Global warming and unsustainable irrigation, will lead to a severe shortage of water in rivers and aquifers. The total number of vehicles will increase by six to ten times and poor urban infrastructure will lead to high road accidents and air pollution related health hazards, which will increase by ten to fifteen times. The recent trend of more migration of women will continue, and more vulnerable factors will be entcountered. Growing privatisation and structural adjustments will lead to more inequalities and the poor will bear the brunt, ultimately. Discussion: Considering the present trend, it is estimated that the existing water and vector borne diseases will remain the dominant cause of morbidity and mortality. On the other hand, malignancies, HIV/AIDS, and lifestyle and stress related diseases would emerge as major new challenges. •Complete analysis will be available within a month.
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