Special Session - Pulse of healthy homes (WUF13)

So I'm inviting everybody who is just coming into the room to join us in the front.
Come in.
Don't be shy.
Very good.
Excellencies, honorable mayors, dear colleagues, a very warm welcome to the special session on the pulse of healthy homes.
My name is Natalie Rebel.
I am WHO's technical lead on urban health and I have the real honor to moderate this session today.
Actually, over the last years and since I began working in WHO, housing has been really at the heart of my work.
It's a real passion.
I'm extremely honored to be here.
Housing is a critical determinant of health.
It is increasingly shaped by demographic shifts, by urbanization, by climate change.
Unsafe or poor housing quality directly impacts health.
We have seen it that increases the risk of injuries, for example, or the exposure to air pollution that has an impact on respiratory health.
Indoor environmental risks matter everywhere, extreme temperature, overcrowding, non communicable diseases, communicable diseases, you name it.
And more importantly, is that housing insecurity and affordability issues create stress, impact mental health, and impact the quality of the houses that we are living in.
So the lack of accessibility isolates vulnerable groups.
You can see by these introductory words that poor housing is a key pathway to health, but also to health inequalities.
It's actually linking social and environmental determinants.
It's really bringing these two risk factors together.
So today, we are extremely pleased to have you here and to discuss housing and house.
I'm honored that with together with ministers, city leaders, public health experts, and grassroots voices, we will be able to explore, first of all, what we know, who should do, but also more importantly, what and how.
With this, I would like to hand over to Anna Claudia Rosbach, Executive Director, UN Habitat, who will deliver her opening remarks.
Excellencies, honorable guests, distinguished delegates, and dear friends.
Kash Kal Missens, everyone.
It is a privilege to welcome you to this special session on the Pulse of Healthy Homes.
I would like to thank the World Health Organization for its strong collaboration and co organization of this session and to warmly thank all distinguished speakers and participants contributing to today's discussion.
Housing is far more than shelter.
It touches every aspect of people's lives, health, safety, opportunity, resilience, and dignity.
And that is precisely why the housing crisis, which affects nearly 2.8 billion people who lack access to adequate housing, including the over 1 billion living in informal settlements and slums, has become one of the defining challenges of our time.
UN habitats strategic plan for 2026 2029 is grounded in a fundamental principle.
Adequate housing can change the trajectory of people's lives.
Through it, we are expanding access to housing, land, and basic services, especially for people in informal settlements and communities facing displacement, climate impacts, and humanitarian crisis.
But we cannot do this alone.
We are deepening our commitment with the WHO, and we need to work with urban planners, health professionals, epidemiologists, investment banks, and above all, communities themselves.
The pace of urbanization is accelerating.
The urgency has never been greater, but we must do this right.
Health and dignity are not an afterthought.
They must be built in from the start.
The links between poor housing and poor health outcomes are well established.
We have the tools and in many cases, the willingness to act.
Yet too often, knowledge stops at the door of policy.
This forum gives us something rare, the chance to be in the same room as the people who can make a change.
Let us not leave here, having only shared what we know, forge the partnerships, make the commitments, live with a name, an action, and a next step.
And as you do, hold on to this question.
What is the one decision you can take that brings healthy homes within reach of those who need it most? I look forward to hearing what emerges from this room today.
Please continue to count on us as a trusted partner in advancing this agenda.
Thank you.
Thank you very much, Executive Director, and as Anna Claudia, doctor Tedros also regrets not to be here with us.
At the same moment as we are gathering, WHO is hosting the World Health Assembly in Geneva, so unfortunately, he could not join, but he really wanted to speak to you and address his welcome as well.
Doctor Tedros.
Excellencies, mayors, Under Secretary-General Rosbach, dear colleagues and friends.
The world is changing rapidly.
Urbanization, demographic shifts, and climate change are placing unprecedented pressure on housing.
By 2030 3 billion people will need access to adequate housing.
By 2050, the number of people aged 60 and over will have doubled.
Housing is not simply a roof over our heads.
It's a fundamental determinant of health.
Safe and healthy homes, save lives, prevent diseases, and support well being throughout life.
Housing is also vital for people displaced by conflict and climate related disasters for whom stable shelter is essential for protection, dignity, recovery, and long term health.
Yet poor housing conditions drive inequality.
Low income communities face unsafe structures, overcrowding, poor air quality, and limited access to energy, water, heating, and clean cooking.
The COVID 19 pandemic exposed these vulnerabilities as overcrowding, increased transmission, and economic shock pushed millions towards homelessness and energy poverty.
A healthy, dignified home is the foundation of a more resilient society.
For almost two decades, WHO has been working with UN Habitat to embed health and safety in housing policy and practice.
Today, I'm pleased to announce that we are strengthening our partnership with a new memorandum of understanding.
Thank you all for your commitment to healthy housing and a healthier, safer, fairer world.
I thank you.
Thank you very much, doctor Tedros.
Actually, as doctor Tedros was addressing the member states at the World Health Assembly, I know that in his speech to the member states, he has been acknowledging the importance of cities in addressing public health and has been actually acknowledging all the work that has been done across the regions at the very local level.
Thank you, doctor Tedros.
So with this opening remark, I think we need to go and work and have some discussions ongoing.
And the next part of the session will be organized into two parts.
We have a first part, we will be discussing the what and the who should be addressing housing and house.
Then we will move to how are we actually implementing that? How will I actually be able to be successful? So I would like to invite the first panelists who would actually address the issues, what do we know and who must act? I would like to invite doctor Amina Gharib Fakim, doctor Carlos Dora, doctor Jose Tuniga, and doctor Linda Loyd just to join me here on the panel.
Please.
I think you have perfect.
You have microphones behind you.
I would like to start with doctor Amina Gharib Fakim who is a scientist, but what is very important for our discussions today, she's actually a former president of Mauritius, so she hands on knows what needs to be done.
Doctor Amina, you have been working at the frontier of science.
You have a led a nation.
You now chair one of the world's leading climate adaptation organization.
Could you tell us what has been the single biggest obstacle to translating evidence on housing and health into policy? In particular, when we talk about reaching the most vulnerable and what has made it move? Thank you very much.
Thank you, Madam Moderator.
First of all, I'd like to again acknowledge the, the active participation of the Islamic Gjavi International Center for this partnership with the UN Habitat and Wolf 13.
I will start very quickly on the second component, which is health.
Ever since we became independent in 1968, health was perceived to be a priority for the country and health was perceived to be an investment in the people.
It was never considered an expense and it became free for all ever since 1968, and everybody has access to primary health care for free.
Of course, the private sector is also there where people can access private medicine.
But nonetheless, for the vulnerable people, they can easily access the public healthcare.
When this was made possible, we found a net decrease in infectious diseases in some of the very, very small what we consider smaller diseases that affect, of course, our space.
Now, when it comes to the housing, I know Mauritius, we actually live in a tropical region.
We are subjected to cyclos every year.
Interestingly, one of the biggest cyclo to hit us was 1960.
Since then, I can say we have been ahead of the curve where the building transformation happened ever since then.
We became more climate resilient ever since this started.
What I can say is that when these two features came together, we found a net diminution in many of the diseases that precise doctor Charges was referring to in terms of transmission and in terms of vector boorne diseases with ulgibilities considerably.
So we managed to create a home, we managed to create a space for all those through these two pillars, which of course, health and safety of the home, which is there at least at the modicum.
Having said this, it is not 100%.
There are still people who are vulnerable and I saw that first time when I was in office when there was, of course, a very bad flooding, you see these mothers who are desperate to see a house, a home for their children especially.
We still have the challenges, but I think we have managed to find some of the solutions through precisely investing in our people in our space.
Thank you very much.
Maybe if I can pick on one of the aspects.
You've mentioned the link to climate change, to resilience.
I mean, when we talk about housing and we look at what is impacting the hat in that context, we've seen that there is and you've been working quite a lot and looking on how biodiversity, you know, medicinal plants, but also the relationship between nature and human health.
We confront that when we are in our habitat.
Could you maybe speak a little bit what does a truly healthy home look like when we talk about an ecosystem that is good for our health? I would be controversial here.
I will say that one of the thing that we have to increasingly stop saying is humans are going to save nature.
Nature doesn't need us.
Nature has been here for over 5 billion years, and I think we are very expandable species on this planet.
What we have to do is really find our space in the ecosystem that we live in.
That starts with a proper respect of our environment, proper respect in our biodiversity, learn to go back to our traditional practices, which I found the magic when I was working on medicinal plants.
There's so much solutions within that space that we can use to alleviate the poverty and, of course, non access to medical care.
Now, to come back to the ecosystem, we have seen in such a distant past, the impact of nature and of course, vector borne diseases, which happen, of course, through climate change, which are of course increasing the impact.
So we really have to go back and relook at our approach to nature and ensure that we don't keep cutting the branch, which is keeping all us together on this planet because at the end of the day, biodiversity underpins life on Earth and sooner we realize that whatever we're doing, we are impacting our own livelihoods, our own future, I think we'll start thinking twice about how we treat nature.
If you were to give monetary value to what nature gives us every year, I will go back to the findings of Amchan when he said that nature gives us for free, $100 trillion worth of goods and services that we take for granted and we are very happy destroying it every day.
And these goods and services happen to be clean water, clean air, food, everything you name it, that survival depends on.
Let us go back to basics.
Let us go back to the values that we have instilled in us through generations and say that we are not going to dominate nature, but we're going to respect her.
Thank you very much.
We will be moving to our second panelist, doctor Carlos Dora.
Doctor Carlos Dora is a medical doctor, he's an epidemiologist and he actually has been working, I think his whole life on the health impacts of public policies in urban development, looking at very key sectors like housing, transportation and has been working in the UN system in international environment and today he's representing the International Society for Urban Health.
So doctor Dora, the evidence is linking housing conditions to physical and mental health.
I think this is very important to stress it at this point, and this evidence has been building up for quite some time.
However, I think that we're still not moving housing at the center of the health policy.
Is there a piece of evidence that we are missing that we would need to produce in order to make policymakers move? Thank you, Natalie.
As a doctor, first, we know the evidence that convinces to prescribe something is produced by epidemiology in general is linear.
You have risk factors, and then you analyze the various risk factors have to identify which one is causing the diseases.
The other ones are considered confounding factors or modifying factors.
Then once you find the reason behind the disease, you make a prescription and the person goes to the pharmacy, right? Now, with the housing, we have a completely different story, which is one, there are many risks and many opportunities which are associated with housing.
You mentioned some of them, air pollution due to using dirty fuels or lack of access to green areas or to sustainable transport or to blue areas, to the sea or to lakes, or you have lack of access to food the insulation issue in terms of climate change, the need for resilience to disasters.
There's a whole host of risks and opportunities which are associated with housing that if you want to really benefit a population, then you have to take them all into account.
It's not good to have a linear thinking and thinking the traditional way of medicine goes to pharmacy and then get treated and get evaluated.
In addition to that, when you're doing that kind of intervention, you're not treating one individual, you're treating with their community.
You're treating the household, all of the members, but you're also treating the people who are the intervention affects the people who lived around that.
You know that if you have a polluting fuel within the home, all your neighbors will be affected.
So there's a need to look at that as a group.
Third, when you look at that as a group, you'll have the opportunity to make interventions which you can add the benefits and not the cost or the side effects.
You really model for looking at the interventions in housing is fundamentally different from looking at the intervention of an individual.
So within that, we have to have the pletora group of risks, the populations which are affected, and then the models of change, the theories of change that will allow you to understand what causes what and how they relate between each other.
Because if you don't do that, then you're missing the point and the costs are the communities we're going to serve.
So we do have to estimate the co benefits or climate, but also to look at what we're missing.
Because if you're saying, well, this intervention is very good, let's do that.
That's not enough.
You have to look at the range of interventions and see what are the overall benefits in order to have the balance of risks and benefits.
Thank you very much.
This makes me think about also the way that we define housing in the sense that when we look at housing, it is important that we see housing not only as the physical structure, but also as the social construct of the people who live in the house, but also the environment that is around the house and how you use it.
It's the community.
I think it resonates very well.
If I may just ask a follow up question because we were looking about also how to measure, how to use the information.
We know that urban health data tends to be aggregated, pardon me, at the city level, which is actually masking very strong deep inequities within cities.
This is something that we are facing.
How do we get the right evidence in front of the right decision makers at the right scale? Because again, it's about what arguments do we want to give in order to make sure that actions are going to be taken.
So I think there's also very much a core part of the difference between understanding what the risks are, understanding what the inequalities are in describing them, which is, of course, as important as a starting point.
But then using the evidence to take action, which requires a complete different mindset.
You have to have this theory of change in the understanding of what processes lead to ill health or to good health, both of them or to externalities which are negative or positive.
But you have to understand input the evidence in the shape that can be understood by the actors who can do something about it.
So for that, you need to understand who those actors are.
What are their priorities? What are the incentives that you could be having so they would take notice of the kind of evidence which you're doing which you're developing.
Second, you need to understand context.
You need to understand what this information is going around.
Or what are the opportunities which have been used interventions have been used by the community or have been tried and didn't work.
To go without understanding of that context is very dangerous.
It really is missing the opportunity of engaging with the voices, with the experience, and with the history of that community.
Last, you have to understand which are the policy making processes which are at stake and which you can use? Are there laws? Are there opportunities for budget? Are there different planning processes that you can contribute to interfere in the way that you have to shape your evidence, it has to be usable to those processes as well.
It's not evidence, evidence for what and for whom and in which conditions.
And that's a role that what I do, I considered in what we call health impact assessments, which do consider the risk assessment, but do consider also the actors, the processes, and the policy opportunities that exist.
I think I would call that a complete health impact assessment.
Thank you.
Thank you very much, doctor Dora.
Actually, you are pointing to one very important issue is about being at the heart of where the policies are taken, being in contact of where actually actually takes place, understanding the needs.
With this, I would like to move to our third panelist, doctor Jose Zuniga, who is the President and Chief Executive Officer of Fast Track Cities.
Which is a network of cities who traditionally have been advancing the response to HIV, communicable and non communicable diseases, but has been also expanding its mandate.
In line of what we just heard and in line of your experience in working with fast track cities, can you share how actually cities that have been committing politically interact with data that they can accelerate responses to health crisis? Can you tell us what it takes to apply those frameworks? How do we use the experience that you have seen happening but translated to the housing and health agenda? Can you share any insights? Sure.
Thank you, and it's an honor to be here.
Thank you to UN Habitat and WHO for their partnership around Fast Frack Cities.
Perhaps a little context first.
Fast Frack Cities was launched in 2014 with 26 initial cities committing to accelerate their responses to HIV, TB, and viral hepatitis.
Today, we're at over 600 cities around the world, in every region of the world.
In 2024, as Natalie noted, we expanded our remit on the ten year anniversary of Fast Track Cities to other communicable diseases, NCDs and the health impacts of climate change because HIV, TB, viral hepatitis did not live in isolation, and neither do all of these other disease conditions and the impacts of climate change.
And in that respect, the secret sauce, if you will, for Fast Track Cities includes sustained political commitment.
So ensuring that elected officials, city council, and as important, the planning councils within cities are committed year it through in the goals of the Fast Track Cities Part Declaration.
The second one is community ownership.
Too many times we rely on politicians exclusively to deliver on the mandate of these types of urban health initiatives.
Without community engagement and ownership, the accountability that's required to ensure that political appointees or elected officials actually do what they pledge to do in signing declarations is moot.
The other is the importance of data informed action.
If we don't understand the gaps, if we don't know where they lie, it's very difficult to create and develop and implement strategies and interventions or even allocate resources specific to where the needs are greatest and I'll cite one example.
In the city of Paris for a very long time before the initiative was launched in that city, The public health department was spending money across the entire city on prevention interventions.
When they started mapping out where the key populations were actually residing, we understood that there were specific Arldisment where these resources should be prioritized.
And so in that sense, the ability to take data, action it, put resource behind it, and measure the impact over time was successful for Paris to achieve double digit percentage point increases across the indicators were established for Fast Track cities, and that's the other important piece.
Without metrics, People can sign a declaration.
I commit to ending HIV in my city, but you have to prove it.
You have to be able to demonstrate that you're moving the needle and that requires targets, that requires indicators.
For us in HIV, it was 909090 initially, 90% of people living with HIV on knowing nurse status, 90% on treatment, and 90% achieving viral suppression.
Achieving viral suppression and untable viral load means that a person living with HIV cannot sexually transmit HIV to their sexual partner.
That is an important message to convey a message of hope, a message that the stigmatizes HIV, which takes me to my next point.
You need a hook.
And what is that hook? For me, within the framework of trying to push pull this through into housing, it is that a healthy home is also a healthy neighborhood, a healthy community.
And in that respect, we're really happy about engaging in this space in a more broad way, because we've been engaged in it for quite a long time.
The reality is that as we started this work in HIV 11 years ago, we looked at the data and saw that amongst people living with HIV who were marginally housed or homeless, you saw double digit percent, a percentage point higher level of age related mortality.
If you could house these people and provide the stability required for them to be able to adhere to the therapy and as important, have the shelter that's needed, we see success.
I could go into greater detail about this, but those are the basic elements along with ensuring that equity is at the center of our work that have made Fast Track stay successful.
Thank you very much.
Fast Track cities, you rely on an extremely large network of 600 and plus cities.
I think that within that network, the understanding that housing conditions are inseparable from the disease outcome, this is the basis of which you have been working on.
I just very briefly, if we could follow up, if you could just share with us what you think about the cost of treating housing as a social issue, how much this has been at the core of the work of the Fast Track cities compared to or maybe in addition, if I could say, to the investment in the public health infrastructure as one of the priorities identified by the network.
I would say that sadly, the work around housing is a small percentage of where cities focus their energy.
And that is something we're trying to correct obviously through our partnership with UN habitat, with WHO, with housing organizations in key countries because in most countries, we have a critical mass of fast track cities that if they prioritize in a specific agenda, they can have national impact on epidemic, on social determinants of health.
And so in that respect, there's a great deal more work to be done But it also starts within the context of urban development.
I'll tell you that I was shocked walking around the urban expo over the last day and a half.
I stopped by several booths to talk and say, basically, I'm here representing the healthcare sector and without exception, in most booths, well, without exception, honestly, I was told, we don't do health here.
We'll refer you to the Ministry of Health, we'll refer you to the Department of Health.
Well, we need to change that dynamic.
Nothing in urban development or in improving the lives of people who lives in cities, municipalities and formal settlements can be achieved without addressing health more broadly.
In that respect, I think there's a great deal of work to be done, and we need to get to it.
Thank you very much.
As we have been moving in the discussions, we have heard about the need of contextualizing our information, contextualizing all the actions, and also of making sure that we evaluate the community needs and also to understand better the social and ecological context in which we are collecting the data, interpreting it, but then implementing our intervention.
I would like then to hand over to our last panelist of this first round, doctor Linda Loyd, who is the Lancet Commissioner on Deng and other arboviral diseases, Lancet Commission.
And so I would like to focus specifically on some of the areas you have been working on for many, many years, and in particular dengue and arbivru diseases which are absolutely fundamentally linked to housing and neighborhood conditions.
So if we talk about stagnant water, inadequate drainage, overcrowding, I would like to ask you, what does this disease burden tell us about what a healthy home actually must include? So give us the wisdom of what we need to do.
Thank you, doctor Robo.
Eight years ago, doctor Margaret Chan, the WHO Director General 2007-2017, said gaps in health outcomes are not a matter of fate.
They are indicators of policy failure.
We can see policy failures across the globe that have resulted in the inequitable distribution of public infrastructure, leaving tens of millions of people at very high risk of denue and other arbivral diseases transmitted by the 80s of Gypsy mosquito.
Because they live in neighborhoods that are undervalued and ignored by broader society.
We know and we definitely have the evidence for what a healthy urban home must include, reliable, consistent piped water into the home.
If that's not available, a sealed container that prevents mosquito entry through which water can be collected, stored, and safely accessed by the homeowner.
House screening and self closing doors to prevent the mosquito from entering into the home.
Cross ventilation in the home to reduce the human odors that actually attract the mosquito into our house, and weekly trash collection services to eliminate the multiple small and medium sized containers that are generated within the household, but also get tossed into our neighborhoods because there is no trash collection services.
These containers become mosquito breeding sites that affect everybody.
There is actually very exciting evidence that was published just last month with very impressive reductions in rates of malaria, respiratory infections, and diarrheal diseases in children living in healthy star homes that took place in Tanzania.
Not only were the children in these star homes healthier three years later, but they were also taller than children living in a traditional house.
Why do we fail to act on evidence? Well, programs are oftentimes reactive and it's very difficult for them to become proactive to address an issue that's coming down the road.
It's not our responsibility.
Sometimes we don't even know how to put the evidence into practice in our daily jobs, and we may also feel apathetic because we feel we can't influence decision making.
But in spite of this, I do believe that we can have an impact on reducing disease transmission and creating healthy homes and neighborhoods if we use community engagement as a social justice in how we do our job every day, not just me as a social scientist, but all of us.
Community engagement allows us to build bridges with our partners.
The communities that are most um that live in underserved areas with a lack of infrastructure and healthy homes, our partners within the health sector.
Local government, the municipality and urban planners are all groups that we should be working with every day hand in hand.
A strength of community engagement is that it is a continuous process, not an event and not an activity.
By doing this, we evolve as our work with our partners evolve and the solutions that we identify evolve.
Thank you very much.
I would like to pick up on two things.
The first one is that a lot of the interventions that you have been mentioning that are particularly relevant to address Denger Abo viruses and other diseases are actually and we talked about this relevant for addressing other risk factors.
It's just to say that when we talk about the core benefits, when we talk about finding those interventions that have the biggest impact, this is extremely important.
Absolutely.
The second thing that I would like to pick on is about obviously the climate change context because climate change is expanding the range of vector borne diseases.
Que to you is how urgent is the window for cities to act on housing as a climate health intervention? A we treating it with that urgency that we actually require? Well, I would say no.
Dengue is one of the fastest growing infectious diseases.
There's been over a 400% increase in dengue incidence over the past 20 years.
I would say no, there's been no urgency.
For years it was thought that the appropriate and efficient use of vector control tools would actually reduce or eliminate disease transmission.
We know that's not true.
The only way we're actually going to reduce disease transmission in light of climate change and a lack of public infrastructure is by changing how we deal with this issue.
So this is actually the issue that the Lands Commission of which I am a member, has been working on for these past few years.
If the key risk factors for dengue and other arbor viral diseases are overcrowded housing as noted in the first question, that with inadequate water supply, poor management of water distribution systems, inadequate solid waste management, and a lack of trash collection services, how can the health sector have any impact when not one of those items is actually the responsibility of the health sector? Those are the responsibility of local government and cities.
We think and we believe it is critical that cities and local government acknowledge and accept that a core component of urban planning is actually mosquito control.
And that with mosquito control comes a responsibility of local government to ensure the equitable distribution of public infrastructure.
We also believe that local government is very well placed to take on this responsibility because local government knows its area.
They can make the connections and convene the partners that are essential if we are to resolve and help reduce dengue and other arbor viral diseases as the ever growing minutes that they are.
Because as doctor Chan noted, differences in health outcomes are generally the result of our policy failures and so we can actually make a change in how we do our work and address that.
Thank you very much.
Thank you very much.
I don't know if you agree with me, but I think that after listening to all our panelists, I think that there is no doubt that healthy housing is not the knowledge problem.
I think we are all on the same page that we have the evidence that housing has an impact, housing conditions have an impact on health.
We know what to do.
We have heard of a lot of examples based on methodologies to be used, policies, processes to be used.
However, I think that we all agree that still there is a need to be done.
Something is still missing in order to go one step further.
Can I ask all our panelists, what is the one governance change that would unlock everything else from your perspective? Maybe I can start with doctor Jose Zuniga over it.
It's very difficult to narrow it down to one.
But for me, after this conference or forum, it's breaking down the silos.
They exist at global level, national, and municipal level to the extent that we are unaware of what each is doing and so by breaking down the silos and creating the type of diagonal and other partnerships, we can the high tide can lift all boats at once rather than looking specifically at one issue at a time.
Thank you very much.
Maybe, doctor Amin Arif Fakim, can I hand over to you because we have been speaking about the importance of acting locally, about taking decisions at the local level, understanding what is needed.
But this needs to happen in the national context.
It happens not on its own.
From your experience, also coming from a national context, what is the one thing that would make a change? You know, governments are elected on principles of promoting better quality of life for the citizens, amongst other things.
I think there has come a time now when citizens increasingly have to demand that these people, the politicians distill the political will to precisely make available resources where they are needed.
And increasingly we find that those who are most vulnerable, they are precisely going to go down further because there's going to be no resources available to local communities at various levels.
So it is time to demand more accountability and more distribution of that wealth so that those who really need it must have it.
As we've done it because even we are very small country, but we made sure that from the very beginning in terms of key decision in ensuring that health education, for example, among the pillars for social improvement, they were there free for everyone.
It's possible to do it, but we need to demand more accountability.
Thank you very much.
Okay.
Doctor Dora, what shall we do? I can tell you what I'm doing.
I'm following my nose and trying to apply this experience that I've had over the years in many places.
But I think you have to be able to listen to listen to specific actors in the public space because the justice system can do certain things that other people cannot, but they cannot do things that people who are running transportation systems, for example, can.
I think we have to develop this ability to listen and to tell the good from the bad in terms of the misinformation that goes, let's say, battles that try to capture the public space.
Listening mechanisms which are plural and can respond to specific groups needs.
I think it is something that we could do as a group that does know about these issues and cares about these issues.
I think it's a promising avenue.
Thank you very much.
Last but not least, doctor Lloyd, I'll just repeat that the governance change that we believe is necessary and it's a big one is that mosquito control must be led by cities and local government, not the health sector.
Health sector provides a supporting role, but local government must take responsibility for eliminating mosquito breeding habitats and limiting human mosquito contact through, as I said before, better urban infrastructure that is equitably distributed, better water and trash management, sustained community engagement, especially with those living in communities that are most affected by poor urban infrastructure and requiring housing designs, urban planners that actually promote healthy homes.
Thank you.
Thank you very much.
Thanks to all our panelists.
They have, first of all, reinforced the knowledge that we have that actually housing and health is extremely interlinked.
But it's not only an environmental issue, it is a social issue.
It needs to be seen in a local context.
It does require collaboration between the different scales of government, but it can only work if we hear actually the voices of those most concerned.
Apologies.
Again, I think one important message that came across is that actually we know what is happening.
We actually have quite a bit of experience of how actually to address and there are certainly some mechanisms that need to be put in place in order to make it then translated into action.
Before we close this panel, I would like to just very briefly turn actually to you, the audience.
You have heard that housing is a key determinant of health.
In your daily work, in your daily context, whatever profession you are representing today, can I ask you we don't really have time for a question if I may, but I just wanted to prompt you to maybe those of you that in your daily work have been actually working Between housing and health, how many of you are actually taking health into their considerations? How much is it embedded in your daily work? How much do you discuss it during your work? Can I please waive? It's also a way of doing physical activity.
Thank you very much.
So Can I say that more can be done? I see many hands that have been raised, but I think that we would like to see everybody being waving and actually waving very heavily to see when we talk about housing, we actually take into consideration the health impact and we actually look at in terms of equality and equity.
With this, I would like to thank the first panel.
We have another panel and we will continue the discussion.
Thank you very much, inviting you to take a seat.
Thank you.
Thank you.
Thanks.
So we want to keep you active, right? We want to keep you stunned.
So before we move to the second panel, I would like to introduce you to Kan Chan Kim, who defines himself as an artivist and you will understand why.
Over the last half an hour, 45 minutes, we have been discussing about a lot of the housing risks.
We have been talking about materials that are dangerous to our health and our housing environment.
We have been discussing about challenges that we face in our urban in our city environment.
So what we want to see is that actually all those challenges, all those maybe dangerous elements that we are facing can be actually translated into something positive, into something nice.
So we very much, we are very happy to have Kan Chan Kim with us.
He is from Mauritius, and you will see how he will be translating all those factors that we have been seeing as dangerous in something extremely beautiful.
So over to you.
Thank you.
So while we wait, I am sure that after this performance, whenever we will go back to our houses, to our environment, we won't see the environment anymore as it was.
We will be inspired by the transformation power.
This is music.
These are instruments I need coverage like this and important.
In the Vers Island, pollution is becoming a great problem in the site is nearly full and pollution plus passage and it creates a lot of flash floods to inspire the young generations to make a positive change, I conduct workshops for children.
And this song I perform is what I composed just because we were.
So struggling the train traditional Chico America is made from a sugarcane.
And we need some drugs.
So I've got drugs with, I think plastic bottle.
This is the best drug with our type.
He does.
Damian ukuati bus on Saltivil Unzic On Saltivil Salte Pole Salt Pari Salt Patio Salt P Salt Pari Sal Patiss Paulo Thank you.
So apart from promoting, like, upcycling, like, trusty music also aims to make music art accessible to all, like, without costing a lot of money and also to inspire other creative solutions to make this world a better place.
So thank you, everyone.
Thank you.
Thank you very much, Akan, for this performance and thanks for this testimony of resilience, creativity, and community engagement.
Thanks for bringing in the young, the adolescents, the kids to be producing, discovering with you this way of hope.
Thank you very much.
So before we move to our second panel, I just wanted to continue our discussions about how to best contextualize the work that we are addressing on housing and house.
I think that the discussions earlier today have clearly shown that housing needs to be seen in a much broader context.
Housing and mobility, for example, are extremely interlinked.
We need to make sure that people that are living in houses are actually connected to the outside world, that they can go to work, that they can see friends, they can do shopping.
So with this, I would like to hand over to Jean Tote, who is the United Nations Secretary-General Special Envoy for road safety, and we have the pleasure that he's addressing the audience with a few words.
Can we have the sound? Excellencies, ladies and gentlemen, colleagues.
This Yird World Urban Forum comes at a critical moment.
By 2050, nearly 70% of the world population will live in urban areas.
This means adding around 2.5 billion people to our cities in less than 25 years.
This will place major pressure on housing, infrastructure, public services, and mobility systems.
The challenge is not only where people will live, but whether they can move safely once they are there.
Today we are not ready.
Sustainable urban development is not possible if families risk their lives simply by stepping outside their homes.
Every year, road crashes kill 1.2 million people and injure another 50 million.
They are the leading cause of death for young people age five to 29.
They cost the global economy $3.6 trillion, around 3% of global GDP.
This is what I call a sudden pandemic and it is completely preventable.
We know the major causes speeding, impaired driving, and the failure to use helmet, seat belts, and trail restraints.
A pedestrian hit at 30 kilometers an hour has about a 10% chance of dying at 50 kilometers an hour, the risk rise to as much as 80%.
Unsafe mobility causes harm beyond crashes.
Car dominated streets reduce physical activity, increase air pollution, and bring trauma to families and communities.
The solutions are clear.
Effective policies, stronger compliance, and sales investment.
In Azerbjan, progress is being made.
Road deaths decreased by almost 10% 2024-2025.
This is not by accident.
It is a result of consistent enforcement, new public transport, and a clear national road safety plan.
But even here, one third of drivers and passengers killed in the first quarter of 2026 were not wearing seat belts.
More must be done.
This is why I'm calling for every government and city to take concrete action on three commitment by the end of 2026.
Set default urban speed limits of 30 kilometers an hour on all streets where people live, work, and play, mandate and enforce helmet use for all micro mobility and two wheel vehicle users.
Adopt a vision zero strategy with clear target to address road fatalities and injuries.
The choice to properly address the silent pandemic on our roads is not technical.
It is more.
This July member states will meet in New York for the UN high level meeting on road safety.
I'm counting on concrete to announce concrete achievement and clear results.
Government, cities, industry, civil society, and international organizations all have a role to play in safe urban mobility.
At the UN Secretary-General Special Evo for road safety, I'm working with global celebrities and the advertising company CDO to bring road safety messages to more than thousand cities across 80 countries.
This cama raises awareness, but it must be supported by stronger local commitment.
I close with a simple message.
Healthy neighborhoods are not only a result of quality and affordable housing.
Safe mobility is at the core of sustainable, inclusive, and healthy cities.
I hope everybody will understand that we need to wake up this sudden edemy and I'm really counting on you.
Thank you.
Thank you very much.
Again, one key message that housing needs to be seen in the context of where it is placed and we need to make sure that accessibility to the housing and from the housing is in short.
With this, we're moving to our second panel, and we will be continuing our journey in discussing of what works and we would even go gear up one gear up, we're going to say, how can we scale up the work? I'm inviting our panelists Kamala Kamilevan, Ilka Portikiwi, doctor Sebastian Van Hark, doctor Gassan Abdullah Aotman, and doctor Ana Valiev, please join me on stage.
Thank you.
Good to see you.
We are picking from where we left and we are going to be continuing discussing of how can we really make impact.
I would like to start with Camila Camileva, who is the Director General of the Global Cities Hub and by training, she's international lawyer and a multilateral diplomacy expert.
Camelia Well, we know what works.
We have heard it.
City level action on healthy housing is possible, but it requires actually financing structures that most cities don't really have yet.
What innovative models are emerging from your experience, and in particular, what governance conditions need to be in place in order to scale them up? Thank you very much for giving me the floor and welcome to everyone, and thank you, Natalie.
I will reply to your question quite concretely because when we speak about local and regional governments, we get immediately super concrete and I was listening to the first panel about this and believe it or not, some mayors are watching on TV because we are online and I received comments for the first panel, which I will try to quote.
I'm speaking also about who must act or who must be seen, who must be afforded to act.
Housing and health began as profoundly local concerns raised first by municipalities and the link can be traced back to the earliest urban settlement across civilizations.
Once housing became semi permanent and populations concentrated, health immediately became a public concern.
One reply to the coming on my WhatsApp to the first panel was local governments are dealing with health.
It's not that they're not dealing with health, but very often this comes from above.
If you have received an explanation in the exposition, we are not dealing with health, that means sometimes that municipalities are not actually entitled in the governance.
They don't have budgets, they don't have competencies to deal with health, but they wish to deal with health precisely related to housing.
Because poor design, inadequate services, and unsafe living conditions produced direct and visible consequences in the residences.
The first responses to those have always come from local governments.
As a result, national and international housing policy has historically been shaped by local experience and innovation.
So this brings me also to this WHO, World Health Organization Housing and Health Guidelines, which are dated, if I'm not mistaken, from 2018 and maybe it's a moment now after these discussions to redo them with much more participation from local and regional governments.
It's not a critic, obviously, you're smiling, but this is just a suggestion from the global City Cope.
Cities remain on the front line of implementation, but they often lack the governance frameworks, financing structures and capacity needed to act and scale.
This is actually the heart of your question.
From the global cities Hub in Geneva, as you know, we sit in the middle of the so called international Geneva, more than 40 organization around us there.
You have N habitat, you have WHO and still people as we see in these organizations even governments are working in siloss.
When it comes on the local level on the city level, these silos as previous speakers have said, must be actually overcame because responsibility for housing, health, climate, and infrastructure remain divided across policy silos and levels of government.
Speaking about this very concrete problem of dang that came in the first panel, a mayor from a city where the temperature is more than 40 degrees, more than nine months per year is b in Pakistan and our friend working with us.
He just said that the supply of water is the problem because some people store their waters in open containers because they cannot afford new water tanks to store their water.
So this brings you immediately to what a local government in a safe housing must actually think about.
He must think about the revenues of the people living in this city.
Obviously, he doesn't have money or resources to support families to buy new container.
So it has to be a kind of integrated interoperability approach for a problem to get to save the livelihood, for example, from pandemic and gangs.
Innovative financing models are indeed emerging, Natalie.
To reply to your question, we are seeing increased use of blended finance, public private partnerships, and initiatives such as the Davos Ba Cultural Alliance, which is a big alliance that promotes a more holistic vision of the built environment.
New approaches are also linking housing policy with climate finance, for example.
But these models only succeed under specific governance conditions.
First, health outcomes must be explicitly embedded into zoning laws, building codes, and housing strategy.
Second, housing policy must be integrated with transport, as we heard from an Tot, health, climate, and urban planning system.
Third, cities need robust data system to monitor progress, anticipate needs, and guide decision making.
Finally, strong multi level coordination is essential to align local action with national and international frameworks.
Concrete example can be found in Geneva where the GNLc system uses water drawn from the lake of Geneva at a stable temperature to provide renewable heating and cooling.
It demonstrates how housing, public health, and climate resilience can be addressed simultaneously through innovative infrastructure.
Now, this costs money, but also possibilities of finding financing Also and have creative solutions for less money.
The very last conclusion of this is that innovative financing can support niche or complementary projects, but relying primarily on individual access to credit, philanthropy, or isolated project based innovation has repeatedly proven insufficient for the scale of global housing needs.
National governments must therefore provide sustained support for housing over time while local governments must pursue political solutions on land and property taxation that allow them to supplement national transfers and invest adequately.
Thank you.
Thank you very much.
Actually, you saw me smiling when you were mentioning the housing and health guidelines because I had the pleasure to be the WHO officer in charge working on those housing and housing and health guidelines.
I think I just got a homework to do, so it will be with pleasure.
We need to move on, but maybe I'll come back a little bit later to you.
But I would really like to move back, if I could say, to the voice of the cities and we have the pleasure of having Deputy Mayor of Tempo, Finland with us, Ilka Portki and he is the Deputy Mayor for urban environment.
And I would like to ask you whether you could share with us some of your experiences in particular as regards to the concrete investments that your city has been doing in housing quality as a public health intervention.
We wanted to ask whether you could run us through one example, one program that you have been implementing and what did it take politically actually, but also financially to implement this program.
Thank you.
Thank you for inviting me here.
It's a pleasure to be here.
Finland is the ninth time happiest country in the world, so I guess we are doing at least something right.
Our most important lesson in Tara has been that healthy housing is not only about the apartment itself, it's about the whole living environment around people everyday life.
A concrete example is how we have guided urban growth along sustainable public transport, especially our tramway corridor.
Around 90% of our new housing in Tamp is planned along this new tram corridor.
The goal is that people can read schools, services, jobs, culture, green areas, and public transport easily in their daily life.
For us, healthy housing also means reducing segregation.
We try to build neighborhoods but different income groups and life situations instead of separating people into different areas of the city.
From a long term social sustainability perspective, it is important that children from different backgrounds can grow up and go to school together.
In the same neighborhood that strengthens social cohesion, trust, and resilience.
Politically, this requires long term commitment and sometimes difficult discussions.
Urban insensitive mobility changes and infill development can create concerns among residents.
Financially, it res major investments in public transportation, public spaces, streets, parks, and services before the full benefits are visible.
We measure success through multiple indicators, access to services and public transport, housing production, resident satisfaction, mobility pattern, climate impact, and broader well being indicators.
But some of the most important results are long term and difficult to measure immediately, reduced segregation, stronger communities, and healthier everyday lives.
Thank you very much.
Maybe as a follow up, we do know that Nordic housing standards are held up to be one of the most efficient standards and be considered as a global benchmark.
However, we also know that it's not always easy to make them transferable.
Maybe from your perspective, what do you think is generally transferable from your experience, but also what might be some of the challenges that other countries, both within the region and beyond would be facing.
I have to be honest, the nordic model cannot be simply copied to everywhere, as you mentioned, Peanut has relatively strong local government, high institutional trust, planning capacity, and welfare structures.
Those are important reasons why many nordic solutions work.
But I believe some of these principles are transferable almost everywhere.
First, housing should not be planned separately from mobility, services, public space, and nature.
Healthy comes homes are connected to healthy neighborhoods.
Second, prevention matters.
It is far better and more humane to prevent segregation, exclusion, and poor living conditions than try to repair those problems afterwards.
Third, cities should not try to create mixed neighborhoods instead of separating people by income or background.
Social cohesion does not happen automatically.
Cities must actively create environments where people from different walks of life share schools, public spaces, and daily experience.
Finally, cities should listen carefully to residents and local communities.
Technical planning alone is not enough.
People need to feel safe, included, and connected to their environment.
I would not say that cities should copy tamper, but I do think many cities can adapt the same human centered thinking.
How do we build urban environments that support health, dignity, trust, and everyday quality of life? Thank you very much for these insights and maybe just to pick on one aspect and move on with the conversation is that what is important is also that cities have the opportunities to exchange with each other, learn from each other.
This brings us to our next panelist and to doctor Sebastian Van Hoch who is the founder of healthy Cities.
I would like to start with one of the statements that I think healthy cities does in arguing that the city itself is actually a tool for health.
And so building on that, I wanted to ask you when cities come and want to join your work with you, is the health argument and the housing and health argument already there or is it something that you need very slowly to be getting out of the conversation and also the commitment? Thank you, Nat.
Yes.
If we consider that 75% of your health is the environment where you live, then housing is very important and the city is a tool for health.
Maybe a bit of background.
I worked in water and climate before and we did big investment programs and we found that the biggest impact was actually on health.
We thought why not actually build a city for health.
Starting from there, how does the housing come in? Um, well, we have a healthy city generator.
We have a tool where we begin all the urban determinants and how they affect health.
Housing is one of them, others are mobility, greening, and so on.
So we can actually calculate what the impact is of each determinant on health.
And this is very important because you ask when cities approach us, what they want, they often know that health is important, that the urban development, the housing is important for health, but they don't really know what to do, they want to act, basically.
And we kind of bridge that gap from what they know to actual action.
So if we assess an area, urban area or a city, how healthy it is, we pinpoint to what they should focus on.
And we can assess urban development plans.
We can see which one has the highest positive health impact to give an example of that, I want to thank you and habitat because we did a lot of work for over 50 to 100 cities in Europe.
We hadn't really tested in other cities.
They said, what you do is unique.
Can you please try the global south as well.
We ran a program together and went up to cities in Africa, Asia, South America, and so on.
We found actually it is also very relevant to do this where also housing comes in.
Now we upgraded our methodology to also include those elements such as informal settlements and these things, security, also to consider those.
Thank everyone habitat on that.
Thank you very much.
Maybe just to go one step further and actually bridging to the conversations that we had earlier on the data.
Within the city network that you are leading, you have been developing a tool which is called a healthy cities generator that has the objective of integrating health into urban planning in a very measurable way.
So the question I wanted to ask is, what does it tell us about the evidence that sometimes is not enough by itself, right? That sometimes you need to have not only the evidence, but you also need to have the better data, pardon me, the frameworks that go with it, but also the political permissions to act actually on what has been identified? So how have you been using actually these mechanisms to enhance activities? Now, we actually see that it really can drive action.
The program I referred to before, they invite us to work with the city of Bangkok to review a plan they had, and we could actually show that the plan they were proposing could increase life expectancy by two months on average for everyone and to reduce health care costs by 20%.
Now that's a very strong driver to actually invest in such a plan.
So The planning was being done, but if you come with such analysis, it really can mobilize investment.
One place where we did it in Europe in the United Kingdom, in Bradford, it's one of the first cities that work with us, the seventh largest city in Northern England and they mobilized $250 million for the project based on our analysis that they brought together show that if they pedestrianize, you invest in green and in the housing there, what that would bring.
Then the United Kingdom government said, if you do this, then we can actually fund this.
That's something very strong if we can show not just research.
I'm also a researcher myself, not just research, we actually show if you this and you say, this will be the impact.
We can really get political support.
In this case, actually it's the city in the United Kingdom with the highest minority population.
They help with implementation.
Little small pocket parks being built and maintained by people living in such a neighborhood.
We got political support, public support, and mobilize money basically based on proper analysis and dealing with these people.
I have colleagues who are urban planners, Cia my colleagues in the room she's an architect.
Um, they can then actually provide specific ideas on how they can improve the design of such places to make it healthier.
Thank you very much.
In the conversations that we had so far, we have been coming from the scientific perspective, from the policy making perspective, the city networks, and we had a lot of discussions about health, but a little bit less yet about the medical sector, I would like to say on how it engages actually in this discussion.
I'm very happy to give the floor to doctor Gassan Abdullah Atman, who is a consultant in pediatric is a consultant, respirologist, and intensivist, a medical doctor and the founder of CO Otter Community.
You have made a rare journey, I would like to say.
You have come from pediatric intensive care, I would almost say to intensive neighborhood health.
We would like to ask you what the ICUs at the hospital that you have been observing could actually not fix and that needs to be fixed actually at the street level, at the neighborhood level, at the housing level.
Thank you so much, doctor Rubel, for inviting me.
It's a pleasure to be here.
My journey, as you explained it, started off as a physician sub specialist who deals with chronic and acute phases of illness.
I've seen kids at their vulnerable state in a hospital and clinic and ICU settings.
Treating them all the therapeutic interventions that we used was aimed at stabilizing and then restoring their physiological state, and then bringing them back to their factory that creates the disease.
So I realized this fact that these kids were not victims of a disease, but rather they're victims or the outcome of a poorly designed urban spaces that is restrictive to their development.
We could intervene with therapeutic treatments, medicine, per se, but These will not treat the ongoing restrictive the development that the children requires.
The children require ecosystems that surrounds them, that provides them intricately with all the nurturing soil that they need for their growth, for development, whether it's cognitive, societal, and as well as social development.
These are actually the determinants of disease I would say reverse engineering determinants of health that we are neglecting.
These kids will go in quietly developing this kind of disease and then come to us again and again and we restore them and put them back.
So apparently, I was one of the children in my clinic, they triggered this to me and they made me realize that the play spaces in their neighborhoods were not safe, they're not encouraging, they're not for play or even engagement with their peers.
I started to start that journey.
The first five years were learning a lot about the intersecting disciplinaries of urban development.
Then the five years was targeted to develop this prototype model, which has been successfully done hand in hand with the children and the neighbors of the neighborhood that I live in.
Thank you very much.
Because you have been so exposed to the conditions of children, particularly due to the living conditions that they were exposed, being at the indoor air quality, being at the unsafe environment around their house, Would it be possible to share a little bit more of Beta based on your observations, what the impacts were or are on their health, but also in terms of development, what does it mean? Based on this, how should a healthy home look like in order to avoid this? Let's define a healthy home first.
Healthy homes are not places where children just survive.
These are places where children thrive as well.
And they're not constrained to the walls and the structure where the family unit lives, but rather it's the neighborhood, the streets, the public spaces, the garden specifically, and the areas where the children meet with other kids.
Children's disease starts because of air quality, the heat stress, because these unsafe streets which children are not allowed to go to so all these environments are restrictive and constraining kids from doing their basic important explorative play and also develop socially and create mindsets where they can understand what is wrong and what is right for their health.
And if we teach these kids how to engage with adults as well, that means that we are raising the level of social integration within the community.
All of these were not found there.
And coming from Kuwait, which is the most or one of the hottest countries in the world, heat stress is one of the issues that we face.
You'll be surprised when you unleash the chains that is created by the restrictive environments and let the children faculties of creativity, curiosity, and critical thinking move.
I was surprised on how innovative these children and youngsters were in trying to combat the main factor that prevented them to go out outdoor.
That was by itself was one of the very fundamental reasons why I think health comes by the child themselves, children tailoring their environment once they are allowed to experience it.
Thank you very much.
This highlights one additional important point that we maybe did not yet address in its full impact.
It's about the link about the health and development.
A child which is healthy in the home, who can read, who can learn, do the exercises, go to school will definitely have stronger and more lasting development chances.
The linkages between health and development obviously is extremely narrow.
Thank you very much.
I would like to move to the example that we are facing here.
We are in Macho.
We are in a city that is undergoing very rapid urban transformation.
I'm sure that the city has been experiences similar tensions that we have been discussing between development, the housing quality, and the public health impacts.
I wanted to ask doctor Anna Valiev who is associate professor of the other university, just to share your experience about what cities in transitions actually need to prioritize.
Well, thank you very much for your questions.
You were already just staying here for a couple of more days and see the real example of how the city transformed from being one of the post Soviet or post communistic cities to become more cities of the developing south.
But what would I say that what the countries should prioritize is that the experience of Azerbijan that we had in the last 30 years showed that we always try to find out some example.
So whenever we became independent, we tried to look at the certain type of developmental models to emulate and to follow up on that model.
One of the emulation model was most of the time Dubai.
Why Dubai? Because Dubai was a fastest growing city.
It within 30 years, it became one of the major, I would say global city and that's why the model of Dubai was not only attractive for Baku specifically, but also for many cities of the former Soviet Union Republics.
Well, it turned out that Dubai model or any other model that we try to emulate London or just a Prague or Warsaw or something doesn't work in our environment, not because we cannot do it, but because the local pecularity is absolutely different.
After so many years of trying to emulate this grandiose buildings, constructions, image buildings, buildings, huge constructions, facilities, we turned into the to finding some identity inside the city.
Thinking about the more something authentic.
That's why whenever you see right now in the city, you will see the diversity of the buildings.
You can see the skyscrapers, you can see this really fantastic buildings.
But meanwhile, in the downtown, you can see the approach to the development is more authentic, just to try to bring something identity driven development versus the emulating the grandiose buildings like we see that in many developed countries.
Thank you.
Thank you very much.
I think you are pointing to something extremely important, is that although certainly it's important to have key standards, it's important to have regulations, norms.
Very often, the local context need to be taken into consideration.
We need to learn from each other, but we need also to make sure that this is applicable in a very given local context.
It might be very different culturally, but even geographically, even I would say from a climate perspective.
Maybe moving further on that, your research on youth in particular, I think they understood in Azerbijan showing that a generation that is navigating actually significant urban and social change.
I think this again brings ties together a lot of the discussions we had.
What does the quality of homes or neighborhoods of public spaces actually mean for young people? Do they see its connectedness to health and well being? A cities in your experience, in your countries generally listening to what that generation, the new generation has to say? That's a very good question to answer.
I mean, I would say partially.
Yes, of course, governments are listening, but the approach for the constructionist Azerbijan especially in the public spaces and in certain type of spaces for the young generation is a little bit different.
Most of the architects who construct the public spaces either males or they are in the older generation people.
Coming from the Soviet time of period.
They are most of them architects, not urbanists.
That's I always fight with architects because I always say that architects can build perfectly certain type of the building or something like that, but to make it lively, you need to have a urbanist.
What's the biggest challenge for us is that we still don't understand what urban urbanist is about, and we rely on all the work, whether it's a construction, whether it's a parking, whether it's a building, whatever it is, to be constructed by the architects.
Architects can do perfectly the certain type of the constructions.
Engineer, by the way, most of the architects and Azerbajan engineering construction, so they can do the perfectly from engineering perspective.
But from looking from the social perspective, from perspective of the sociology or anthropology, this is what we need to make it lively.
That's why in many cases, if you look at the at the parks or the public spaces.
Only recently we started to address the needs of the young generation.
Spaces for the entertainment, spaces for picnics, spaces for some other activities rather than to building the parks or special spaces only for old people because in our approach, the parks must be conducted only for either moms with the kids or for the older generation, not for the younger generation.
I think this slowly is changing and I think COVID from one side pushed forward that the people decided to go want to go outside and rather to sit at home and that's why there is a certain type of the push happening.
Thank you very much for sharing this experience.
I would like to pick one aspect that I think ties together different elements that have been mentioned.
I'm taking slightly my hat off the moderator, but just for 2 seconds.
But sharing experiences that we have been observing in other countries, for example, the So medical services have been working very closely with municipalities and urban planning services in the sense that even health insurances were involved.
I'm trying to be more clear.
We have countries, we have been observing countries where medical doctors were receiving patients that were definitely being sick because of the housing conditions and in order to treat them better, they were prescribing the doctors were prescribing inspections of the house in order to identify whether the conditions were caused by the environment.
The most interesting part of it is those prescriptions are being covered by the health insurance.
Suddenly, a built environment, if I could say, inspection, become a medical prescription, a medical treatment.
We have a couple of countries that have been implementing and using this approach.
But the reason why I'm using this example is because for me it ties up quite a lot of these discussions that we had today.
It's about housing is a key public health intervention.
It's almost like a medical intervention, if I may want to say, that requires the collaboration of different partners, different stakeholders are very different levels.
For this panel, I would like to ask you one collective concluding question if I may.
When going out from here in Baku, World Urban Forum, What is the one concrete commitment that in facing, in policy pardoning of financing or community engagement, you would recommend every city should have.
You would like them to see committed by leaving the gate over there with that one committing to making sure that houses are built and maintained in a way that is preventing disease and promoting health? Can I start with you? Thank you.
I love this question.
Our cities are ever changing, I would like to call upon you and myself that we take every opportunity to make our cities healthier.
If you make an investment, if you change every time your city is changing, use it as an opportunity to promote health.
That's my goal and you're investing every day, use that opportunity.
Thank you very much.
Aida.
Thank you very much, Natalie.
One conclusion to me would be that city leaders need to consult with the residents.
But I just wanted actually to mention that what we think, what I think is one thing.
But amazingly, we have a real time exercise to reply to you by more than 50 mayors.
These are the mayors that participated last year to the United Nations Bom of Mayors held in Geneva in 2025.
So if I may reply to your question out of this outcome documents of the Forum of Mayors, which last year actually combined the SDG related to health with a high level ministerial meeting in housing.
These two combinations made the present mayors in the meeting adopt the outcome document.
The recommendations, these are real time mayors who say this is that they call for housing to be treated as a human rights I wouldn't have bet on this to be honest as an outcome of 50 bets, but this is the result consultable on the website.
They call for housing to be treated as a human right, emphasizing affordability, quality, accessibility, and non discrimination.
They advocate for land policies that prioritize community needs over purely market driven approaches in order to reduce spatial inequalities.
They also stress the importance of climate resilient and climate adaptive housing, including direct access to funding for local resilience initiatives.
And these principles are to be respected universally all over the world.
One thing, interoperability and consulting and including local governments and their residents in all the decision making.
Thank you.
Thank you very much.
I.
Well, first of all, your city has to have a long term vision where the city is going and has to be like 20 years and you have to listen guys like Sebastian and his company, what's the best for your city and stick to that commitment.
Thank you very much, miss Sam.
Well, I think at ensuring that city level urban planning policies and urban health should not be separate conversations and it should be spoken about children or child centered urban design should be inclusive and considered as a preventative public health infrastructure.
The key issue of mobilizing this is through by proper community engagement and inclusive design with the community, and so not for the community, but with the community.
Thank you.
Thank you for the questions.
I will just wrap up what my colleagues said before.
I would say that decision making from the community level, that should be one of the most important, not at the end, but right from the beginning.
The decision making, how to construct the parks, how to construct the neighborhoods, how to construct child inclusive.
This decision should come not from the public officials or the architects, I usually say or urbanists or some, it should come from the communities.
They should tell us what kind of park, what kind of the neighborhood they need, not us giving them already preexisting parks.
Thanks.
Thank you very much.
Thanks to all our panelists.
Actually, I think it has been the most disciplined panels ever.
We are on time, almost ahead of time.
We have been always calculating a little bit of buffer because you never know and everybody has been sticking to the time.
Actually, we have a little bit of time left and we have been followed actually online for quite a number of participants.
It's very nice to see that beyond these four walls, I would like to say the interest into housing in house is growing.
So I'm deviating a little bit of protocol.
I'm going a little bit wild.
It's end of the afternoon.
People need to move to react.
So we have a couple of people still in the room following us and standing in there for the phone.
Can I maybe look at you colleagues in the room? If you have any question to this panelists or if you have even any experience that you would like to share, or maybe even better, a commitment that you want to take when you step out from the gate, from the World Urban Forum and saying, I want to take the housing and Health agenda further.
We have time for a few interventions, so I think that there is an intervention here in the front.
If we may have can the minor come up Thank you.
Can you introduce yourself? Apologies, sir.
Hi.
Hello.
My name is Rafa Basov.
I'm from Synergy Partnership with Marketing and PR agency.
I like Mr.
Val's approach about the difference of the urbanistic projects and architectural projects.
I would like to get his insights of feedback doctor Vali, what do you think about seabreeze and White City? These the two big urbanistic projects realized in Baku.
Do you think that this is the urbanistic project with all these social, how do you call it, living components or it's just nice architectural style projects with the stone buildings, roads, and et cetera? Thank you.
Can I just to explain a little bit about the project that maybe for those who don't know, we understand better.
Thank you.
Sure.
Absolutely.
You can just see that in this podiums all over the Baku expo, there's a nice, luxurious apartments in the seabreeze, white city where the prices are competitively higher than average all over the Baku.
The question was whether it's a good project? Yes, it's a fantastic project, it's a great project, but whether it's a socially inclusive and whether it's going to bring different strata of the people into this neighborhoods, that's the biggest question because the pricing is not into the average of Azerbijani to buy from that perspective because the per square meters is extremely high.
That's what I would say I wouldn't say this city, these places are socially inclusive from the gender perspective, from the income perspective, and from the various other perspectives.
Because of the pricing is destroying this inclusivity.
Thank you very much.
Can I just one follow up question.
In these projects that we have seen, how much is the health impact assessment taking into consideration? Health impact assessment is it part of the planning, we know, but also how much is it done? But also, are there any plans in this new development projects to measure afterwards what it has changed in terms of well being and health of the residents? Well, honestly, we don't have so far health risk monitoring system.
That's why in my previous panel, I was talking about that we need to establish in Bu health risk monitoring system, but so far we don't have it.
But technically, if you talk about these neighborhoods, socially exclusive neighborhoods, health considerations into health issues take into consideration.
Thank you very much.
Any other question? I have a question here from the floor.
Can you introduce yourself, please? Hi.
My name is Christina and I'm from an Habitat working on urban house.
No, I just have a question if you ever considered mental health in some of your work because everyone was talking about health, but I haven't heard much on the depression, the anxiety that comes also from unaffordable housing and a lot of those issues that we're seeing also in Europe and other places where young people also not able to afford rent or live in those housing environments.
I'm just wondering if in your work you have addressed mental health and maybe some of the solutions you have worked on.
I have one.
We did a project in Europe in Barcelona in Spain, where we were hired to look at a program that they wanted to promote health and they had cycling lanes, walkable streets, and so on.
They basically wanted us to validate that.
But when we dove in, we found that area, the health profile of that area is actually a rich neighborhood, but stress, anxiety, depression with the highest health problems.
We said, seeing this, you have the most bang for your buck or if we change your design and we created pocket parks where people could be in green or could meet because people are very often isolated.
One of the problem with mental health is that they don't meet, they're just inside the house, that's at least in a more wealthy city.
They changed the design for better health impact considering that local characteristics.
It was actually a healthy neighborhood but not a mental health.
We'll look at mental health, mental health, physical health, but definitely mental health is an important one.
Please.
When we speak about children's development stages, we also it's part and parcel, mental health is part and parcel of these children's developing and the neural pathways are being constructed as the child grows.
And for certain, these children not exposed to the right doses of social engagement, constructive, unstructured play, outdoors and connection with nature, they are more likely to develop mental health disorders.
That's strictly by good studies, and that's why outdoor engagement and unstructured play where the child is safe but is unleashed from structure, they are actually mental health protective mechanisms.
And that's what we need to do in our neighborhoods, and the neighborhoods should have these children back to their neighbors.
I mean, together.
I mean, restilling life into the neighborhoods of these children so that they could go everywhere and still develop naturally as they should.
Thank you very much.
I just wanted to say, I don't want to put you on the spot, but I'm going to put you on the spot, but you volunteered to do so, please.
Yes.
In my city, we have this rule that every kid should have at least one hobby, if they are not affordable or not, but if they are poor family, we will afford that for them.
Every kid has at least one hobby that they want.
Thank you very much.
We still have time for a question, sharing a good example, sharing maybe an example that did not work because very often we share the good examples because it's easier, but we have to learn also from those examples that did not work well.
Is there something that anybody would like to share? Any question? If can you tell us what will happen with these 2018 WHA guidelines because you put yourself on the spot.
I agree with Crystal, the mental health really doesn't come as much as I'm not an expert, but I would also put it very much on the spot not because it's modern thing, but because now I think there is more sensibility after COVID, et cetera, Natalie, question to you.
It's putting me on the spot.
You see this? Well, as was mentioned in developed WHO guidelines in 2018, they were actually the first guidelines that we were looking at one specific sector and provided key recommendations for health in the classical WHO terminology.
So there is indeed a request from member states at the national and local level to be revising the guidelines in the terms that first of all, the evidence has been changing, it's been increasing, we have more knowledge, better knowledge, but also to maybe look at housing in its wider context because we're very much focused actually in the indoor environment of housing in the first guidelines.
So the second point is that there is a recognition that when we talk about housing as a determinant of health, we see it, as I was saying in my introduction, as really an interface between the social, the environmental, and actually even the commercial determinant of health.
Because the investments in housing, like the private investments, these are actually at the really at the at the core of financial investments and commercially.
All this to say that housing is a priority within the public health agenda of WHO and there is the idea of joining forces with UN habitat and partners to be updating the WHO housing guidelines.
Now, there is needless to say that all this goes with funds and resources, both human and financial resources.
Therefore, it is high on the agenda.
It is our priority to make sure that we try to have the funds available.
I can only say that from a WHO perspective, in particular, working in Geneva headquarters, our work to be working on normative recommendations has been put again high on the agenda.
We have been asked in headquarters to actually strengthen our work on normative recommendations and therefore it is on our agenda.
We are working to try to find the necessary funding and hopefully we will be able collectively with partners to achieve this.
Needless to say, you can rely on global City Scope for brainstorming sessions.
Thank you very much.
Colleagues, with this, I would like to really thank our panel here onstage, but also on the panel that has left the stage a little bit earlier on.
I would like to slowly move to the closing part of our special session.
Thank you very much.
And I would like to invite our colleague from the WHO country office here in Azerbijan, doctor Hand Harmanchi who is the representative of WHO, to do the closing remarks.
Hand over to you.
I think it's automatic.
It's automatic.
Do you hear me now? I don't think so.
Thank you.
Thank you very much.
I have been listening very attentively to everybody who spoke and doctor Hasan especially he reminded me of my childhood.
Allow me to share a little something that reminded me.
I understood that I realized that I was one of the lucky children globally as I was growing up in a small city.
It was a blue collar worker neighborhood, so our houses were very simple but safe and they were warm, we had water and everything.
And the best thing that I remember from those times is that we were mostly outside.
We would play outside with the kids in the neighborhood and everybody in my apartment building, they were aunts and uncles to me.
Whoever came home from school, if your mother wasn't home, You would surely find an open door to go into and safely.
We would walk to school, we would walk from school.
The parks were not some fancy places outside, they were right where we lived.
We actually played in the parks safely and played in the streets also safely.
So yeah, I think my children were not as lucky as I was, and I hope that we as the older generation now could actually make such neighborhoods for our children in the future.
Let me go now to my prepared speech.
To close this, it's only 2.5 minutes long.
Excellencies, colleagues and friends, thank you to Natalie, our moderator, and to all the speakers who have reminded us of a simple but powerful truth.
Health does not begin in healthcare facilities.
In fact, healthcare facilities get into the picture when all the other sectors have failed us and health really is deteriorating and people go to health care facilities.
Health begins in our homes.
Today, we heard clearly that a home is far more than four walls and the roof.
It's where children breathe, where families cook, where communities connect.
When those homes are unsafe, Overcrowded, cold, damp, polluted, health is the first thing that we lose.
We know what makes a healthy home.
It's clean air, safe water, good sanitation, protection from heat and cold, space, safety, and dignity.
We know the cost of failure in disease, in lost potential, and in deepening inequality.
Housing insecurity and lack of affordability are severe and growing problems worldwide, leading to homelessness, overcrowding, and lack of privacy, all of which have negative impacts on health.
As we heard multiple times in this panel today, the question is not what to do.
The question is why are we not doing it at scale? Too often the solutions are known, but they are not aligned with political will, financing, and accountability to treat healthy housing as a fundamental investment and human right in health rather than an optional social good.
The evidence is clear, housing is a frontline health intervention.
Investing in better housing is investing in prevention, resilience, and equity.
As we heard from cities, communities, and leaders today, change is possible.
It's already happening, but it's not yet happening fast enough or everywhere.
That must change.
Let me close with three calls to action.
First, governments must put healthy housing at the center of health policy, not at the margins.
This means laws, budgets, and accountability.
Second, cities must lead.
Urban leaders have the power to act where people live to design healthier neighborhoods, upgrade informal settlements, and protect the most vulnerable.
Third, we must work together across sectors, health, housing, environment, and finance.
These cannot operate in silos, as we heard here also, if we are to deliver real change.
When there are too few public institutions effectively managing, planning, and directing investment in affordable housing, large segments of disadvantaged populations are forced to live in poor quality housing, which in turn undermines their health.
Friends, colleagues, the choices we make about whole housing are choices about health.
They are choices about fairness and they are choices about the future that we want to build.
Let us leave Baku not only with ideas, but with commitments because everyone everywhere deserves a healthy home.
Let me finish with the words of my Director General, doctor Tedros.
Health is not everything, but without health, there is nothing.
Thank you very much for your attention.
Thank you very much, Honda.
A big thanks to all participants.
Thanks for joining.
Thanks for listening and contributing and a big thanks to colleagues who have been doing a marvelous job in organizing this session and guiding us through.
Thank you very much.