• Sarah Beeching

Responding to Malaria in Urban Areas

As global leaders come together in Egypt for COP27, the launch of WHO and UN Habitat’s Global Response to Malaria in Urban Areas is timely.

Climate change has provided opportunities for more diseases to spread. Urbanisation and migration are two factors that increase the risk in the future. Add to this climate change and you have the perfect recipe for major threats to global health security to emerge.

Scientists say that climate change is making over half of infectious disease worse. Bacteria thrive in warmer conditions, for example cholera is found in algae in the water, when water warms the algae multiple and the bacteria too. Climate related events like floods increase the spread of diseases such as cholera.

Disease carrying mosquitoes are on the move and thrive in warmer climates. There is now local transmission of mosquito borne disease in Europe which was unthinkable 20 years ago. If global emissions don’t fall, mosquitoes will spread further.

Animals also move when their habitats change due to the climate. This provides opportunities for viruses that would have otherwise stayed in their animal reservoirs to spill over and those diseases can then amplify into large epidemics or even pandemics.

By 2050, nearly 7 out of 10 people globally will live in cities and other urban settings. Unplanned urbanisation will likely result in a burden of disease transmitted by mosquitoes that is disproportionately high among the urban poor. Malaria, dengue, chikungunya, zika and yellow fever, are all vector-borne. These vectors are adapting to breed in urban environments. The recent spread of Anopheles stephensi in Africa is one example of how urban populations are at increased risk.

Oshun Partnership’s work on Healthy Cities, Healthy People was important in making the case that cities are uniquely positioned to understand local needs and respond rapidly to changing conditions to safeguard health. In the technical working group which prepared this report, we highlighted the need to work beyond the health sector, bringing expert partners together to implement multisectoral, health-relevant policies and public services that engage communities. The response to malaria and other vector borne disease must be an integral part of such policies and processes.

The UN Habitat / WHO framework is the first to focus on the urban context to support the control and elimination of malaria in urban environments. It provides guidance for city leaders, health programmes and urban planners as they respond to the challenges of rapid urbanisation in a targeted way. For each urban context, the strategic use of data can inform effective, tailored responses and help build resilience against the threat of malaria and other vector-borne diseases.

In urban settings, approaches that work to prevent disease transmission in rural areas may not work, or may need to occur at a smaller, more targeted scale. Consequently, the response to vector borne disease in urban areas requires data on the determinants that are unique to urban ecosystems. As urbanisation rapidly increases, there is a need for a greater focus on healthier and more resilient cities, including global political will to address the threats posed by climate change