ONE UN - Strengthening Health Outcomes Through Sustainable Housing Policies a Multisectoral Dialogue on Housing and Health (WUF13)

So good afternoon, Excellencies, dear mayors, if we have in the room, we never know, dear colleagues, but we know that we have them online, so it's a real pleasure to welcome you to this one UN event, strengthening health outcomes through sustainable housing policies, a multicultural dialogue on housing and health.
My name is Natalie Rubble.
I am WHO's technical E on urban health.
Housing and health has always been at the very core of my work.
Actually, I started in WHO through the work on housing and health.
Being here at the World Urban Forum with all of you that will contribute to this session, but also who will be participating from the audience and will be listening is a really a privilege.
We still have a small group here, but I know that there are a lot of people who are connected remotely and will also be listening to the recording.
I also know that colleagues will be joining as we go.
I suggest that we start.
Um, I don't want to scare you with this and there is no need really to go into the real details.
But what I wanted to show is that housing health and well being are actually co determinants both of human and ecosystems health and well being.
The impact goes far beyond living conditions.
So we look at affordability of location, access to services, environmental quality, biodiversity.
What you see on this slide is just a diagram and this has been produced several years ago by one of the key professors we have been working with when we developed the housing and health guidelines, and I'll explain in a minute that explains a bit the pathway between the social determinants the housing features, the health hazards, and then the health outcomes.
In other words, we very much know that the socio demographic factors, including actually age, sex, ethnicity, disability, and economic factors including wealth, income, and power are actually going to have an extremely important impact on what people can afford in type of housing.
It's going to be impacting the type and the quality of the houses, but also it's going to be impacting the costs that are associated with housing as heating, water, and maintenance costs.
If we go one step further, this will have a key impact on the housing features that our housing will have.
I want to stop here because when we talk about housing, we are not talking about just the roof that we have on top of us.
Housing is really the build environment, so it's the indoor environment, but it's also the immediate housing environment that people are living in.
It's really in the context, in the urban context or In general, the city context, the neighborhood context in which this dwelling is located.
But there is another dimension which is extremely important, that it's housing is not only physical, it's also about the people who live in those houses and in their neighborhood.
It's really a construction between all these factors.
So There are a number of housing features like accessibility, insulation, energy, space that actually can become a health hazard and by default then can impact health.
Again, I just want to pause here because when we talk about health, we do not only think about physical health.
We definitely think also about the mental health impacts that housing and housing structures have.
These factors, therefore, are important for health, but in follow up, I would say, or in conjunction, they also shape education outcomes, economic productivity, and broader social equity.
As urbanization accelerates, housing challenges are definitely intensifying across cities.
So Um, so coming from a WHO health perspective, and again, these are just some examples of what we as an organization have been doing because I'm representing WHO, so I could have actually populated this slide with all the work that all our assistance agencies have been working, but I just wanted to use this to show different entry points.
In the sense that WHO in 2018 has recognized that actually we needed to provide normative guidance to countries as what are actually standards that need to be, you know, followed, achieved in order to protect health and promote health and well being.
In 2018, WHO produced the first housing guidelines.
WHO is a normative organization, we traditionally developed clinical guidelines.
This was the first one that was looking at very specific sector.
This is why quite innovative because even the methodology that was used was more about instead of using clinical knowledge, clinical evidence, it was looking at public health evidence.
This was the first guidelines.
But what is interesting and which is connecting us all is the other examples where actually we have been looking at housing in the context of climate change mitigation.
Housing is a key sector in the context of energy efficiency, of climate mitigation and adaptation, but also urban planning for resilience and health.
Where within the urban planning context, housing plays a very crucial role.
But also, we often talk about non communicable diseases.
You see idea of fraudulent slip because I was already going one step further.
Very often we associate nowadays housing to issues like indoor air pollution, for example, or other diseases.
But we do see that actually in many countries and in particular in urban environments, actually housing housing interventions can be used as a key interventions to protect from vector borne diseases that actually are emerging again in the urban context.
Last but not least, as I was saying in the beginning, housing is a real social intervention because crowding is impacting health.
If we are living in a crowded space, this will have an impact, for example, on the transmission of diseases, tuberculosis or others.
But nobody chooses by himself or herself to live in a crowded house.
It's a consequence.
It's a social housing is a social issue.
In other terms, for us, housing is really at the interface between environmental, social, and almost economic commercial determinants of health.
By looking at all these evidence, actually, you will see that in the discussions here, every single organization that is represented today, but also beyond because we couldn't have all the sister agency here is actually doing essential work to be addressing the housing agenda and therefore having an impact on health.
Maybe just to conclude about the objectives that we have for this session is to really see where there is the opportunity to invest in share solutions.
It's an opportunity, actually, housing for a one UN collaboration.
It requires coordinated approach and it's bringing several agencies together, UNEC, UNEP, UN Habitat, UNICEF, UN DRR, and WHO and we all really aim of aligning housing policies, social inclusion, inclusion, and sustainability and we do hope that at the end, we will have some ideas for how to go ahead with actionable one UN solutions for better health outcomes.
So with this, just to briefly give you a bit of an update of where we're going to go with this session, we have divided it in three parts.
We will have two panels and then concluding remarks.
The first is really to look at building a shared narrative.
Then we will have two presentations, and then we will actually hear how the work that WHO and other agencies are doing on the ground is actually implemented.
While in the first panel, we have UN agencies speaking, in the second one, we will have partners that are actually working in translating that work on the ground being speaking to us.
So with no further delay, I would like to kick start immediately the very first panel where we're going to be looking for building a shared narrative, and we have the honor to have with us as a first speaker, Gurna Ro.
Gura, she is the Sectoral Transition section chief at UNEP, and she will be really addressing issues around environmental quality, climate mitigation and adaptation, and resource efficiency.
And so Guara over to you to tell us from your mandate, from the work that you are doing, where do you see housing policies that are mostly strongly affecting health and how are you addressing this? Over to you.
Thank you so much, Natalie.
I think it's great to have this session in a way to realign again on these topics.
When the guidelines on housing and health were adopted, I still was working with UN Economic Commission for Europe.
I was secretary to Committee on housing.
I think that already at that time, it was very exciting document.
I'm always thinking about it now and I was thinking, what we can do about it in my new capacity.
At UNP, I'm at the climate change division and I'm leading the section which is working on building, schooling, energy, and also the subnational climate action.
But also, I think it's much more at UNEP, what we're doing is we're also hosting Secretariat to partnerships, wider partnerships, and then helping them to implement on ground any normative work.
I'm also secretary head of the Secretariat of the Global Alliance for Building Construction, which is now around 400 organizations where we have 70 governments, we have sub national governments.
We have actually 38% of membership of the globalized building construction is private sector, but also have architects, experts.
So in this community, we are working on a regular basis, on normative basis about the buildings.
Of course, in buildings, we are looking, first of all, from climate, environmental perspective because we are UNEP.
And also because the buildings construction accounting for 34% of the global energy rates C two emissions and 32% of the energy use.
So given that it's a high impact sector for C two emissions, you know, we're definitely working together with our members to reduce C two emissions from the sector, but also at the same time, of course, and this is where I think we do need to connect much closer with you going forward, uh, because of the exactly health dimension, because this is where people live in those 70% of the buildings, which is residential.
And specifically, for instance, and cooling and building program, we're working on the extreme heat and actually, it's already where all our UN agencies are engaged because there was a Secretary-General call on extreme heat and we all aligned already and we're also hosting the Secretariat of the Cool Coalition which is 330 members, which is working on addressing extreme heat through both first of all, passive cooling, but also active cooling.
And for the cities, we also have BA heat implementation drive, which is, you know, helping cities to develop heat assessment, heat action plans to procurements.
Strategically, so this is the direction where we're coming from at UNEP and UNEP as a Secretariat of the Global Alliance of Building Construction and as a Secretariat of the cool Coalition.
So looking also addressing, for instance, the extreme heat, and this is where we are very happy to work with as agencies, Of course, in our work, this technical work is very important.
Under the Global Alliance or cool Coalition, we also have working groups of experts on building materials, for instance, what where you can use better building materials.
We have working groups on finance on data, very technical work, which I will not overload you with this now, but just to say that UNP is a science based organization.
We produce lots of science documents.
So on building sector decarbonization, on the sustainable cooling, we are producing multiple annual flagship reports with lots of data.
We actually launched just two days ago the global status report, our annual global status report on buildings and construction, which speaks about trends of decarbonization of the building sector globally.
So science is very important.
But of course, we know that in all this work in improving housing conditions, the political will is important and over the global Alliance for Building Construction, it was also established a Intergonmental Committee on buildings and Intergovernmental Council on Building and climate.
Actually, it was established here in Baku and at Cop 29.
Last year, it specifically launched Bilm call for action on sustainable housing, which is saying that affordability and sustainability including health should go together.
I just want to say, Natalie also that from UP side, we do have this Blem call for action as a important political document where the government 70 governments who are part of the ICBC, they already in a way reaffirmed the importance of the health as a part of the sustainable housing.
We definitely as a part of the future realignment, we will be very happy to go to you know, based on this important political statement from the countries.
In terms of our priorities priorities for the future, we just had our Lausan Buildings and construction Summit, which was organized together with Aqua Fedrac de Plinique Lausanne, which has a very good laboratory on materials, so they're working on this low carbon cement.
But they're a member of the global ABC and this is where we actually also discussed a lot about where we're going strategically.
I would like just maybe to mention what are the three strategic directions that we're going for.
We had a very good discussion on Bos housing and urban development, and and we really see that integrated approach looking at both environmental, economic and social aspects is the way forward.
But Lausanne building Summit, which actually brought 500 participants from around 70 countries, we agreed that amongst the three strategic priorities, and we cannot do everything, so we really trying to focus on the three topics.
First of all, we would like to focus on the thermal performance and passive cooling heating.
Of course, for us, working mostly in developing low income and middle income countries, extreme heat and addressing cooling is important.
This is where the cooling is not an issue of just fluctuates, it's an issue of health and dignity and this is where we're working with many of you already, but maybe this is where we could really strengthen our cooperation.
We are really promoting the passive cooling, which as in the previous session, we had Mumbai metropolitan government speaking on our B cool program, where we're doing very simple solutions like white roofs, urban design, nature based solutions, which you can do in informal settlements and where we know that in India over 90% of the buildings are built informally, the same in many other countries.
So this is definitely a like shading ventilation, roofs is one of our priorities for the future.
Terminal performance, passive cooling, this will be the first priority.
Secondly, we're working very actively on materials.
Of course, cement, steel, other materials still remain to be major source of carbon emissions.
But we're working through our working groups, but also through the technical assistance projects and better design to promote, of course, biomaterials, but also not everywhere you can use the wooden construction.
Low carbon cement and maybe sufficiency.
One of the working group we have is sufficiency.
How you can build with less materials more like using modular construction, for instance.
This is definitely one of the approaches that we can use and I think this is also have very good implication for more healthy housing.
Because you can actually design it the way that it's already healthy.
And the third approach where we're also connecting a lot with other union agencies and first of all, re habitat is urban planning, but also connecting to the rest of infrastructure, how we connected to transport, water, energy, sanitation, green spaces.
And yeah, just to demonstrate to you, maybe just a couple of examples, for instance, in India, in Odia, which are now building low carbon housing.
So we using the low carbon materials, the greening approaches, but also engaging the local community, philanthropies, local architects, and we're doing many other UN agencies together.
So it would be important for us to join with other UN agency, both on normative basis, but also on the very concrete technical implementation basis.
Thank you.
Thank you very much, Guana.
Maybe if I could just pose on two aspects.
The first is, and I'm using the example of cold like insulation in particular, is that it shows very well how a built environment intervention is actually a key social intervention.
When we look at energy poverty, energy poverty is actually impacting how people heat, how people cook, very often resulting in the use of solid fuels, which is creating a huge indoor air pollution burden.
But in a health impact, but at the same time, who's going to go and fetch the words? Very often it's young girls.
This has huge implications on the educational development and the chances.
You see that a topic that is very much related to the construction to the building actually has huge implications across other developmental impacts.
The second one, which I think Guario mentioned is extremely important is that, you know, The best way, if I like to say to move this agenda forward is not necessarily to have all this included in the health agenda, is the other way around is having health in all the declaration, in all the commitments that you have been mentioning.
As soon as health is there is a key vehicle.
We need to make sure that the other sector, the housing sector are becoming, if I could say, the public health implementers.
I think these are very good examples for us to look at.
Thank you very much.
I would like then to move to the next agency who has been working on this area, which is UNICEF.
Taking an example from a vulnerable populations perspective, looking at basic services for very specific population groups.
Unfortunately, our colleague, Abhid Solomon, who is the environmental health lead in UNICEF could not be with us, but we have a recorded message.
If I can kindly ask colleagues from the IT to play it, thank you very much.
Hello, greetings.
I apologize for not being with you in person today, but I hope with the help of this recording, we can share UNICEF's message on the issue on this very important issue of housing and children.
Well, a child's home isn't just a building, it is the entire universe.
But when that home is not there or is unsafe, it fractures their health, their growth, and their peace of mind.
No child should have to battle toxic air, unsafe water, or extreme heat in the one place that's meant to protect them.
Those are heavy burdens for small shareholders.
A safe home isn't a luxury.
It is a lifeline.
The sanctuary every child needs to survive, grow, and truly thrive.
A child is not a small adult.
They're small, they're developing bodies, breathe more air, they absorb the world far more deeply than we ever will.
From their womb through adolescence, they are beautifully fragile.
When they're exposed to unsafe living conditions are surrounded by environmental hazards, the damage can last a lifetime.
We cannot protect children with the policies that we built for adults.
Therefore, we must design our world through their eyes because their entire future depends on it.
When we think of housing, we must look at three dimensions, access to safe housing, adequate living conditions, and environmental hazards around them, including climate change.
Together, they shape the world across the life course from the developing fetus to their adolescence, impacting their lifelong health, their learning, and their earning potential.
So let's look at the first dimension.
A safe home is a luxury for millions of children, those that cannot simply afford them.
This is driven by poverty, by conflicts, by broken systems, families being crushed, forcing innocent children into slums, into displacement, and the cold reality of homelessness.
When a child's foundation is this unstable, their education stalls, their security shatters, and they are trapped in a cycle of vulnerability.
We aren't just failing to build walls.
We actually fail here to protect their future.
Well, let's look at the second dimension.
We have a situation where globally, over 1.5 billion people survive in crumbling inadequate housing.
Behind that staggering number are millions of children lacking the absolute bare essentials.
We talk about clean water, safe energy, a sturdy roof.
Without these basic shields, a home becomes a breeding ground for disease and injury.
If you don't fix this foundation, we condemn an entire generation to lifelong developmental harm.
Then we have the third dimension, the environmental side.
Well, inside and outside their doors are children are surrounded by invisible enemies.
They are breathing toxic air, traffic, smog, and burning waste.
They're poisoned by lead, choked by mold, and forced to play in contaminated soil.
As the climate fractures, they endure extreme heat and terrifying floods, all while stripped of safe green spaces to just be children.
Housing is not just about shelter.
It is really a public health crisis we are talking about, a matter of equity and a fundamental child's right.
But we can't change the story.
We must fairly expand access to affordable homes, fortifying them with clean water, with pure air, with climate protection.
It is time to rewrite our policies, integrating children's health directly into urban planning and building resilient cities from the ground up.
Above all, we must champion the most vulnerable forgotten communities because giving a child safe housing doesn't just protect their bodies.
It shatters inequality.
It unlocks their infinite potential.
Finally, I would like you to have a look at the Children's Environmental Health collaborative that UNICEF is putting together with partners.
We are uniting over 60 global partners.
You have the tools, the policies, the data, and the learnings to protect children.
Join it to contribute to build the safe world children deserve.
Thank you very much.
Thank you very much, Apte who unfortunately could not be with us today.
I think that one important or two important takeaways that I have from his presentations is first of all, when he was showing the diagram on the impact on housing conditions on the health of the children, showing that the outcomes are manifolded.
You have the direct, I would say, health impact, but you have the manifolded social impact that goes with that.
Then there is another issue that he mentioned and maybe we can elaborate on later is the role of the sectors like urban housing, but also the role of the health sector itself.
Because the health sector actually has also a role to play.
For those who have been maybe had the opportunity to listen to some of our conversations previously, there is one example that I give very often, is that there are countries that actually have managed to combine interventions in the house and the health system.
Doctors, for example, when they see a patient that children in particular that come again and again and again with the same disease, the same symptoms, actually they understand that probably the cause is within their housing environment, and they pair actually with environmental specialists who go and make an assessment of the house and this act is actually covered by the health insurance.
Why we are here really promoting the role of the non health sector, housing and planning, et cetera, also the health sector has really a key role to play.
Today is a journey.
We are addressing housing really in its totality and it's a huge pleasure to be joining forces with the colleagues from our WHO country office here in Azerbijan.
We have today Tarana Aliyev.
This is correct pronunciation, who is actually working on disability and rehabilitation.
I think the perspective of the work in the country office on really looking at inclusive housing for health, disability inclusion, assistive technologies also and how they go hand in hand is extremely important.
Taran over to you.
Thank you, Natalie, for the introduction and dear participants, dear all.
I'm really glad and it's a pleasure for me to be here and to contribute to that dialogue one UN dialogue on housing and health.
The focus that I will be trying to bring is very important and often under address dimension, which is about how access disability inclusion and assistive technologies together act as drivers of resilient and equitable urban development.
So from the perspective of World Health Organization, when we are thinking about health and the topic is health and housing, let's just remind our own selves that health is not just about being alive and health is not the absence of diseases.
Today, World Health Organization is recognizing As an indicator of health, which is functioning.
When we are talking about functioning, we need to keep in mind access, we talk about participation, we talk about inclusion.
Functioning is a core.
If we are talking about housing today, how housing that people are provided with that cities make available for people promotes that functioning of people.
This is a crucial issues that we are trying to understand, we are trying to explore.
According to WHO's housing and health guidelines, yes, house is not a physical shelter.
House should have so many features such as the protection from environmental risks.
It should provide people with adequate space.
It should be accessible.
Accessibility needs to be there.
All these features are not optional.
All those features determine whether people are going to live quality life, whether they are going to have that appropriate well being, and whether they are going to be included and integrated into the society.
So yes, we are living in the world where global demographic and epidemiological changes are taking place.
Today, cities grow, populations age.
Today we are observing the increased prevalence of non communicable diseases.
Number of people with disabilities are increasing.
We are absorbing the increased prevalence of chronic health conditions that people are living with, and all those people are going to experience some functional limitations, functional difficulties, and at the same time, they are going to spend more time at home.
Now we are approaching the home as something that is going to determine the independence of those people, social inclusion of those people, well being of those people.
A perspective that we can approach is climate change.
And then home and house is going to be the place that is going to protect people from extreme weather, from exposure to heat, from exposure to cold.
Again, these features are not optional and these features are showing us that housing today is becoming a public health necessity that needs to be addressed.
So people with disabilities inclusion and functioning, these are the terms that I'm going to use throughout my speech.
And when we are talking about people with disabilities, we need to understand that more than 1 billion of people in the world live with different forms of disabilities.
They have limited functioning abilities.
Now we are talking about assistive technologies.
Assistive technologies are simple devices that are going to help people to be independent with their mobility, and mobility devices, vision aids, hearing aids, communication aids that are going to help people to be independent and have dignity in life, but at the same time, assistive technology that is going to enable that functioning of people.
It's not possible without accessible housing.
Accessible housing and assistive technology, they are mutually reinforcing each other.
We cannot talk about functioning if people are not provided with accessible housing and if people do not have access to assistive technology.
What is the solution? Simple housing design features would be a great solution.
If we are talking about step free entrances, if we are talking about wide doorways, if we are talking about safe bathrooms, accessible bathrooms, safe flooring, and some other very simple features that would make it possible for people with functional limitations, freely use assistive technologies that are enabling their functioning.
So despite strong evidence that is coming from Board health organizations that inaccessible housing is going to increase the risk of preventable injuries.
It's going to increase social dependency of people.
We have the evidence that Accessible housing is going to promote independence, is going to promote functioning, and it's going to prevent people from injuries that can take place in unaccessible housing.
Despite all those strong evidences, implementation gaps exist remain, unfortunately.
Today we are observing that accessibility is considered apart from housing design and urban development, but we want to see that be integrated, accessibility issues integrated into housing design and urban development.
So it's a complicated issue that needs to be approached from different side and today we need to say that probably one UN approach is going to bring that clear value to that with the complimentary mandates that different UN agencies have.
We can move from fragmented actions to the integrated urban solutions that are going to help to make housing accessible, cities accessible, and if we want to have cities that are not going to leave anyone behind, so we need to unite our mandates, our knowledge, expertise, and evidences to make cities and housing accessible and available for everyone.
Thank you.
Thank you.
Thank you very much.
Here you can also see some of the work that has been done specifically in Azerbijan and we are happy to share any information that is required.
Thank you very much.
We have another few minutes maybe to take the advantage of having the panelists with us.
Maybe I'll just deviate from my script because we are a small group.
Maybe if there is one question from the floor, we have time for one, but if there is one question from the floor, if anybody has a question to our two panelists.
Yes, please.
You have your microphone.
Thank you for the brilliant session.
As a mom, I have questions about education for special need babies because in Azerbijan we had innovative for disability child.
If you had three groups of disability, you can't go to the school.
Yes, you haven't this access.
You need to go to the light group of disability.
And only if you had this position, you can go to the school.
But how many schools had access assistive technology for babies with disability? It's my question because it's social isolated.
It's not about house isolated because toilet electricity and water, it's good opportunity for us, but we need more Thank you.
Apologies.
Thank you very much.
I think the obvious panelists to respond.
Thank you.
Thank you for the quite important questions that you are posting today where the schools are providing those assistive technologies for children in the field of education.
Unfortunately, for now, in education system, we don't have schools that are providing assistive technologies, mainly children with disabilities.
They have to come to the school with their own assistive products that are going to assist them in school environment and how schools are accessible or not.
Also, I don't think that I will be having those positive response to that question, unfortunately.
But as a world health organization in the country, we are working on the issues of access to assistive technology and we are trying to bring different ministeres, Minister of Health, Minister of Labor and social Protection, Minister of Education together to have this joint national action plan of making assistive technology available in different sectors by opening the door to all children to go to the school and get educated.
Thank you.
Thank you very much.
I'm inviting you maybe to have follow up conversations with the colleague, if you don't mind, just to make sure that we can stick to our agenda.
We're coming to an end of this first panel and maybe just two reflections and I don't know if you agree with me.
The first one is that whatever entry point we take, if it's from a disability perspective, it's from an energy perspective, et cetera There is one important element that we need to look at.
It's also the life course approach.
Because actually whatever approach we take, we'll have to make sure that it is going to be adequate.
As the people change in life and the needs that they will change.
We have a lot of houses that are there, but they will have a lot of houses that will have to be built.
This is, I think, an important principles.
The other just takeaway is that I think that there are more and more shared entry points, and I think services, location, environment, and quality are one, but I think that still there is more that can be done.
Still there is some fragmentation that I think that we collectively can overcome.
This would be my first takeaway.
I don't know if you agree to this.
Yes, absolutely.
Thank you very much.
Thanks to Gara, thanks to Ap, who wasn't here and thanks to Tarana.
I thank you very much, big applause.
Inviting the panelists to go on the seats and changing the panels.
I am inviting Lisa to join us, Doris and also our colleague Lipsia to come onstage, and then I will introduce you.
Apologies.
I was doing some housekeeping before we can continue with our discussions.
As we were announcing in the beginning, this second part is really aiming at moving from policy to practice and really to put the cities in the countries at the forefront where action is actually being implemented and to really have the narrative.
The segment aims to demonstrate how UN mandates that we know we all have with our respective agencies, they do translate on the ground and coordination pardon matters more than everything.
So we have today representations from the work that agencies are doing, but actually firsthand, not from necessarily the agencies themselves.
The overall question that we are asking our panelists is from their perspective, how are the priorities and the guidances that are received from the UN and other international partners on housing in particular, how are they translated into practice and where the stronger cross sector coordination actually make the biggest difference? And I would like to start by introducing Lisa Rossi.
She works in the Sectoral Green Cities team and in the European Bank for Reconstruction and Development.
And she will be covering really the housing multisectoral heat and risk governance and investment part with a specific focus on human and ecosystem health and well being.
So Liza over to you for telling us what to do.
Telling us what to do better.
Thank you very much, Natalia and it's a pleasure to be here.
And Let me just take a step back and frame how the BRD considers physical climate risks in its investment.
We assess all of our operations all of our projects from a physical climate risk perspective and we try and ensure that Within the project design, we mitigate to the extent possible in an ex ante context, the risks that are identified during our due diligence.
This comes when we engage with an actual project.
We have parallel streams that are more upstream, let's say, on action planning, and this is where we engage with clients that are both from the private and the public sector in identifying green investments and green policies.
Now, when it comes to the built environment and housing specifically, and I'm very glad, Natalie that you already introduced housing as part of a wider system, an urban system, rather than just a building in isolation, what we do is, yes, we consider the building in its context rather than a standalone construction.
And we're going towards that direction in our approach.
This is something that we're doing both in retrofits of housing or in new building development, including social infrastructure and housing, embracing a preventative approach.
So what can we do? What can we integrate from the design and planning stage already to mitigate the risk? And coming to the, um, how we adopt guidance that is developed from partner institutions.
I'm very glad to be here and being able to say that there's an important toolkit and framework that we have I supported UNDR in developing BNDR and partners by giving a bit of our perspective from the Multilateral Development Bank position on extreme heat risk governance.
This toolkit has been, I believe, very important already in defining some of our activities, very recently, engaging with clients on matters of governance of extreme heat resilience.
We've been working with the City of Timswara in Romania on this, for instance, and we're also, looking at engaging with partner financial institutions in the countries where we work in raising the awareness also within the financial sector, and how they can integrate extreme heat considerations.
And About the toolkit, how has this been helping us in defining our activities? It's an extremely important tool to ensure that the stakeholders that are engaged in investment and planning are empowered to take the right decisions at the right time when it comes to HIT risk consideration and integrating those in their investments and plans.
It also equips them with the relevant knowledge and evidence to make an investment case that integrates extreme heat resilience considerations.
Just to sum up, the guidance from partner organizations, in this case, particularly from you and DRR, has been extremely valuable in shaping and helping us engaging with our clients on the topic.
Thank you very much, Liza.
I think that this is an extremely important aspect about how to make sure that we identify the best entry points from the financing perspective.
What argument, if I could almost like to have to be provided to motivate the investments, the financial investments and the support.
Considering also that when we talk about housing, we are talking about multiple structures.
Housing can be a public house, can be a private house, can actually be a social house.
Actually, when we look at the financing schemes and how to support this, this has very nuanced facets and it's important to be able to translate that technical guidance, if I could say, and then the financing mechanism.
I'm sure that we can maybe open up the discussion afterwards.
Thanks again, Lisa.
I would like to hand over to Doris Andoni.
She's an independent expert on housing from Albania.
But I think importantly for our discussion today is that she's actually the former chair of the U NEC Committee on Urban Development, housing, and Land Management.
And if you allow me a personal note, I'm very pleased to see Doris again of the many years where we have been connecting in Geneva and so she will be representing the area of land use, governance, regulatory frameworks, and affordability.
Doris, the floor is yours and I'm handing over this to you.
Thank you.
Thank you, Natalie, and it's also a pleasure for me to meet you, but to meet also many other people that I know, but also that I don't know, but we have been in panels discussing on topics that bring us together.
Um I And you mentioned that because I wanted to say why I'm here, I've been engaged in housing since 30 years.
My first years of my professional experience was an architect, which is very much connected to housing because as architect, I've been working for architecture of the buildings and housing.
But from the housing policy perspective is much more wider than just an architecture.
I feel that I have enriched my professional background with what I have been doing during these last 30 years.
I have a presentation You can.
Yes.
I prepared a few slides.
The first one, I apologize.
This is an old fashioned format, but I'm still using.
I don't know if anyone has used it or is using this format.
But for me, it has been very helpful because it generates a lot of discussion, the part down of the main problem, generate a lot of discussion and brainstorming with my staff, with my students, and also with stakeholders on which are the major problems affecting affordable housing and this is where we work, what we should do to address these problems.
But what I bring to politicians for making an argument to reform housing to improve housing conditions are the effects of not doing, of not working on housing affordability and adequacy.
What are the effects are deteriorated public health or improve public health if we want safety safety risks, education, can be improved because if we improve conditions in the schools by the children go back to house and they don't have conditions where to study and where to warm up, they don't perform well and so on.
This is why I brought this and we usually link housing and health mostly by our experience, but also by indicators, by reports, by important documents that different organization produce.
But I think that I it comes also for us at least for me that I've been working with housing policies in my country, but also consulting in different countries.
For me, it is very much important the contact that we have and what you get from the people and from the real life experiences from real life.
I want to mention one of them which has card in my memory and I cannot take it out.
It was a single mother, with living with a son of adult son 18-19-years-old that was suffering of, depression and because of moving all the time from one apartment to the other, his conditions were deteriorating.
It didn't help even the solution that the local government gave to them through the housing bonus, we call it, it's a subsidy for rental market.
It didn't help this family because they were living in a city in south of Albania, very touristic one, which is, um, almost dead during winter, during nine months.
But when summer comes in three months, it became overpopulated.
Their contract was interrupted and they had to find a new apartment.
It was something that has stressed the family and deteriorated the conditions of her son.
It indicates a very direct connection of housing condition, in this case, security of tenure.
And mental health.
You Natalie mentioned that the impact of housing is not only physical health, but I think that is very much important and it is not very much analyzed or brought into international discussions.
The issue of security of tenure in the rental market.
It is much more discussed for informal settlements, but not so much in that.
Now to come back to your question, and how we use these international documents is that There are a number of documents that very important documents that link at the UN level that link housing and health.
I would like to mention the general comments, number four and seven of the International Convention of the Committee on Convention on economic, social, and cultural rights that define, which are the seven elements that define the right to adequate housing, which are directly linked to health and the other one very important on which we are discussing these days are the SDGs, and for my work, SDG 11, but also SDG three, SDG three is related to health, SDG 11 is related to housing.
However, I have to be honest to say that I have been working with SDG 11, but not with SDG three.
I see here that they stand a bit like the skene lines that they don't interact with each other.
I've been working also with other UNECE documents.
I cannot mention the guidelines on health and this is a big problem for me for myself when we were introducing amendments to the law on social housing and I was looking for recommendations from our Ministry of Health and Institute for public health.
If they had some guidelines on a on health issues related to condition of housing, we didn't get any response because we wanted to develop the sub legal acts on standards.
At that time, the guideline on housing and health was not yet there because it was 2018.
And we have been working in UNEC with different other documents, very important one like ministerial commitments on affordable.
And one thing that I wanted to highlight, Geneva UN Charter on sustainable housing was adopted in 2015.
And is very broad.
It covers all the spectrum of housing as intersectorial linkages with a lot of other aspects.
But just a small curiosity that the work for preparation of this charter started since 2010, at the time, I was in my first mandate as chair of the committee, working with Secretariat for developing this policy paper and The title of this policy paper was affordable, Hey, and ecological housing, which means that since the inception of the charter, the health issue was inside, but then the title became more general as sustainable housing, which cover many other issues.
So tell me if I overdo with my timing.
Yeah, just stop me because 1 minute.
Other documents, country profiles, which reflects all these political guidelines that are at the UNEC level into country level.
The most recent one culture profile that we have produced are for Albania, Armenia Steel draft and for Montenegro.
All the major guidelines that are included in the Geneva UN Charter in the ministerial commitments, which is also an important document that is updated each four to five years anytime that the ministerial is held.
Housing 2030 also that was developed with UN Habitat and housing Europe, they all contain elements that link housing with health.
All these are reflected also in the country profiles.
I just want to mention what I have done in my work in Albania.
When we were preparing the revision of the law on social housing, Um, I have insisted to include in the law the elements of the right to adequate housing, affordability, adequacy, and with the adequacy, all the elements that define an adequate housing, space, location, quality of materials, and these are then translated into standards.
SDG 11 also is included into the legislation as definition in the Albanian context, and it means inadequate neighborhoods.
This is related with programs that contribute to improvement of the inadequate neighborhood.
Also what is most important is framed into the budgeting The midterm budgeting that you cannot escape, you have to provide and you have to report also based on this format.
These are some of the international documents that I have been using from my own perspective, but also as representing also UNECE in different activities.
If time allows, I can be more precise.
Yeah.
Thank you very much, Doris.
Maybe if you agree, we'll just move on and then we will have a bit of time maybe for some follow up and then maybe this can be used.
Before moving on, first of all, again, thanks a lot, Doris.
I would just maybe want to pose on three issues.
The first is starting from the end, the regulatory part, which is the fundamental one because this is the issue about producing guidance, and I'm speaking now as the example of WHO, which is it's a normative guidance in terms of science, but it's not a legislative.
The issue is how those recommendations, how those are actually translated into regulations, norms and standards that are being enforced.
I think the experience and the challenges also to do this is very important.
The second thing that I wanted to pick up is about you speaking about how the different SDGs are related.
I just wanted to use the example, which I think is showing that we are going slowly, slowly in the right direction, is that if you look at the SDGs, if you look at SDG seven on energy, well, there is one which is on household air pollution, which is owned by WHO and there is an SDG 11 on the ambient air pollution, which is also owned by WHO.
Now, the interesting bit is not that it's WHO owning it.
The interesting bit is that they are understood as health indicators.
So the level of pollution is actually understood as something to measure actually, the conditions in which people live and how we are doing in terms of health.
This intersection of how to use, this is extremely important.
Then the last point which is then bringing me down to our next speaker is about what you were mentioning about the participation, being understanding the needs of the population.
Sometimes there are some, you know, policies that might not be helpful because in a given context, they will not be applicable or they actually don't meet the needs of the populations.
This leads obviously very, very well to the contribution that we will be having from Dips Rai, who is a sectorial young Gamechr.
She is representing the city of tn, tn municipality and she is a project intern for the young Gamechanger projects that UN Habitat has been implementing and WHO has been one of the implementing partners for some of the work.
She will be really sharing the view of an integrated housing policy, urban planning, informal settlement, but really from the community perspective.
Psica, please the floor is yours and you have the little tickets.
Good afternoon, everyone.
My name is psiga Rai.
I'm from an Gm Geng, India.
So Journey is not a data point.
It's where I live.
I'm 24-years-old, but I know where I can be performed.
I knew in Journey, it is a midside city of Odessa, about 20 kilometers from Wbansa.
My messages today is simple.
In city like Journey, house Urban Hill are not separated Iu.
They are same Issus.
So let me know we did about it.
In 2023, part of Young Game Changer Initiative, we can do more survey, more awareness, more health camp in journey.
But now the results are in our screens.
The result is told about all the people's SEMs belongs.
So what we can do, we can start door to door camping.
Then we can ask question, how does people are feelings? So they are connecting housing and health sewing together every day, planning failure becoming health failures.
So that is our.
Why assessment becomes more important step? Because we carry public space as not about only for peoples, public space are only used for accessible omens and safe omens, because in outy there has been no cameras, no street light, no traffics, so there has been more rever end point.
Thank you.
Thank you very much.
From my perspective, there are two very important issues that have been mentioned in your presentation.
The first is that you were speaking about housing and public spaces.
The first is that again, let's go back when we started today, that when we talk about housing, we're not talking about the wall that ends at the house, and then housing means also what is around us, around the house.
It's about the spaces that we can use to play, the infrastructure that we have to go to school, to work, et cetera So I think this notion that you have presented is extremely important.
The second which is very important is that you were speaking about the community engagement.
I mean, understanding what is needed.
Again, I can share some of the discussions that we had several years back when we were developing the WHO housing health guidelines with a number of partners.
And obviously understanding that housing and health is extremely wide, and then the big question was, but how to prioritize? Where do we start? I mean, the need of really bringing in the communities to understand what is needed in a very given context is absolutely essential, but also because the prioritization might be different in different contexts.
We can develop general standards, norms, approaches, but they need to be really put in the local context.
Thank you very much.
If you agree, I have, a bit of a follow up question to you, if you don't mind, because in the first panel, but also now in the second panel, you have been representing different approaches by different UN organizations and pieces of work.
From your experience, where do fragmented approaches in housing policy more clearly constrain actually health outcomes? Are there any examples that you can share where actually the fact that they wear different approaches actually have made health outcomes more difficult? Do you have any example? How does it look in practice? Somebody wants to start? Okay.
Yes.
I think in terms of fragmented approaches, a good example is, again, going back, I sound like a broken record now, but going back to housing as part of the urban system.
This requires coordination between different stakeholders.
It requires homeowners associations.
It requires potentially the cultural preservation institutions, the municipality to come together to ensure that the urban environment around housing blocks can respond to the needs of a healthy environment, both outdoors and indoors.
So there's a real need for coordination in terms of governance around these issues.
So this is one example and the lack of it would bring us to having a well insulated apartment building block with maybe nice ventilation systems, but then you go outside and you're locking your green spaces and your passive nature based solutions within the public realm.
So, um, It's really about the coordination of different stakeholders that are key to good urban governance.
Thanks, Bruce.
I touched a bit upon when I presented previously, that the structural fragmentation stands mostly first with data.
So Data on housing stands with Ministry of responsible for housing and health data stands with the institution of Public Health and Ministry of Public Health, and very rarely, perhaps they confront each other.
So this is first as a fragmentation that I see.
Second from my concrete work with the country profiles is that um we get in our roundtables with stakeholders from very different institution organization, but which are very much related directly to housing.
We don't have someone from public health institutions.
This is also not only for the work with the country profiles, but also when I go back to my country.
So We never had someone from Ministry of Health or the public health institution in our roundtable of discussion to discuss together the relation between housing and health issues.
And the first one is reflected also with the SDGs, as I mentioned before.
The second is because when we produce this country profile and we give recommendations, our recommendations or the study goes to Ministry of Housing.
It doesn't go to Ministry of Health, we still don't have this contact.
When I think that what we can do, if you have another question about that, I can answer now.
We cannot extend more CD profile because it's very vast, it's very wide as it covers so many housing, urban development, land management, and within, for example, housing national planning, regional, national local planning, housing the condition of housing, existing housing, energy efficiency, affordability, so many topics, and it becomes sometimes not readable for policymakers.
Perhaps it can add value not to include it into the study, but to use the country profile missions, for example, to include someone from WHO that gets together and fill in the gap that nowadays exists.
I think that this can produce a separate study, but that will be very helpful both for housing and health issues.
Thank you very much, Doris, because actually you answered the questions I wanted to ask you about how maybe to use the country profiles.
I do remember many years back and colleagues from UNIC, you may remember the environment and health reviews many years back.
At some point there was the inclusion of health.
There were environmental health performance reviews.
I think it's an interesting model and it's something that could help us overcome.
****, I don't want to put you on the spot, but if you want to share very briefly about maybe in the work that you have been experiencing, maybe some of the challenges of bringing those agendas together, that would be extremely helpful.
The example of two public space hour is most example of our success because the two public space we develop in Ewan habitan project, they are all accessible all the person because oney there is no public space.
So the two public space developed in Ewan habitan is first public space of ney.
Thank you.
Thank you.
Thank you very much.
Thanks to all our panelists.
Thanks for sharing your insights about actually the work that has been led and developed by UN agencies has been used, translated on the ground sometimes with challenges, and I think it's important to acknowledge that, but also the positive impact things a lot.
Thanks to everybody.
So if you agree, I would like to invite you maybe to take a seat in the audience, and then we will move to the last part of our session where we will be inviting colleagues from different agencies to reflect actually a little bit in concluding thoughts about what they have heard.
I would like to invite first Loretta Hiber Gerarde who is the Chief Risk Knowledge monitoring and Capacity Development branch in UNDR.
So Loretta, please.
Thank you very much.
It was really a very rich conversation.
What really struck me is that regardless of where our starting point was, whether it was children, urban housing, urban planning, sorry, whether we are tackling this from a health lens or a disaster risk lens, which is my case, the conclusion is the same.
That is housing is not a sectoral issue, it's a systems issue, and so we need systems approaches to address it.
We heard today very powerful evidence that housing is really health infrastructure.
From a DRR perspective, a house that floods or collapses or forces displacement during disaster events, it's not just a housing failure.
It's a health crisis, obviously, but it's also an economic shock which often has many years of repercussions and it's a social rupture as well.
We are seeing very stark numbers when it comes to issues around climate change and displacement, for example, with nearly 46 million new displacements this past year, and that's double what we were experiencing the last years.
Climate related disasters are accounting for about 14 million people, being made homeless every year.
That's often because the houses are not made to withstand the shocks that are coming through climate change, which is more severe flooding, which is more frequent types of hydromeological hazards in addition to the geophysical hazards such as earthquakes that we are very aware of.
So the economic case for acting now is really overwhelming and we know that it doesn't cost that much.
Research shows that the investments in climate resilient construction, they pay for themselves within two years, and yet it isn't happening at the scale that's actually needed.
And that's often because you see a lack of political will.
Even in countries that face disasters in the recovery phase, what we're seeing are homes being built in exactly the same manner.
They're not being built back better.
They're not investing that additional 2% or so that costs to make them resilient.
They're not using the risk information needed to understand what are the future risks.
What they're essentially doing is they are building further risk into their societies, into their communities.
This is why I wanted to share something with you that I hope will help give this conversation some continued momentum.
UNDR has selected the theme of resilience starts at home for this year's 2026 International Day for Disaster Risk Reduction.
This is observed every year on October 13th.
This isn't an incidental choice.
We really believe that far more focus needs to be put on housing.
At the center, we need to put it at the center of global disaster risk reduction.
This is at a moment in which evidence in which the growing disaster risks from climate change, but also unplanned urbanization is really driving up disaster risk.
Housing has often been treated as downhill, downstream consequence of disaster risk.
It's not been at the forefront.
This is something that we're really trying to change.
I think collaboration between the UN is an essential component of this.
Maybe if I could just answer the question of what you asked us, is what is it that we could be doing more collectively together? These types of events, raising awareness globally in communities such as the disaster risk reduction community that has not had housing very much at the forefront of his thinking is one way to do it.
We do know that three quarters of the infrastructure that we will have in 2050 has yet to be been built.
This is really the moment to lock in this resilience.
But maybe I just focus on one other element.
It came out in today's panel, but for us, it's critically important, and that is having a common UN approach to enforcing building codes.
We feel that this is at the core, and we know through our own research that the lack of enforcement of building codes is the number one cause of high cost of disaster losses and damages.
I believe that if the UN came together very, very clearly and with a common message and common advocacy and a common approach to governments on how to ensure that building codes are developed, but also above all, respected, enforced, and the institutional capacity building to ensure that these building codes are actually put in place.
I think this would take us a long way from a DRR perspective, ensuring safer housing for everyone.
Thank you for some reflections.
Yeah.
Thank you very much, Loretta, which is really very nicely bringing the discussions together.
Thank you very much.
For concluding our session, we have the pleasure of having with us the Deputy Executive Secretary from UNIC Dimitri Marzin who will be sharing his thoughts about how a one UN alignment could actually happen.
Over to you and thank you very much for being with us.
Thank you very much.
Good afternoon, distinguished colleagues.
I think this session was about breaking silos and thinking cross sectorally and making sure that the housing and the health communities are working effectively together.
We actually did this, as you see at the 2025 edition of the Forum of Mayors, which had health as the main topic of the forum where over 60 mayors from around the world were focusing on this and we thank WHO for being there to support that conversation and in fact, to guide this conversation.
What do we take away? We need commitment at the highest level to look at housing as a complex, systemic cross sectoral issue and not just an issue that a technical body, housing committee or sometimes a department and a much bigger infrastructure ministry needs to look at.
What does it mean? It means ministers from across the board, heads of governments, deputy prime minister level officials need to be overseeing a transition in this thinking.
We made the first step in this direction with the 2025 Ministerial Declaration on housing affordability and sustainability on the margins of our housing committee, but that's not enough.
I think this forum has shown the potential of having finance ministers in the room when these discussions happen precisely along the lines of what you and Gerard just spoke about.
We have a unique chance to design the future housing, the one where most of us and our kids will live in now with resilience in mind, but also with health considerations in mind.
Secondly, we need practical policy instruments that actually underpin this cross sectoral thinking and action and that bring very importantly the health dimension into how housing and broader urban development work.
We have some good examples, some good starting points, and several were mentioned, for example, the work on within Unises committee on Urban Development, housing, and land management, the housing country profiles, the work that we've been doing together with habitat and many others to make sure that these include a health dimension.
But there is more.
Personally, I fully support your idea of using the environmental performance reviews, for example.
Very often, they become the driving force behind massive climate environment finance investments in countries.
They are in a way, a thick book full of evidence for programmatic thinking for governments in countries.
Nothing prevents us from committing to having a very strong health angle there and also connect the future of infrastructure discussion with the state of environment and the future of health discussion in each country where such an EPR is done.
Then we do have, together with WHO, such powerful instruments as the, the Transport Health and Environment Pan European Program, which looks at the future of urban transport and looks at things like active mobility.
Well, I think this is a very relevant topic to the discussion today because we need to look at cities not just as blocks of flats, we need to look at them as systems and mobility will be a critical element of that conversation.
We do have the Water and Health Protocol, which WHO and UNIC co host as well.
Again, after the COVID 19 pandemic, the understanding of water as a critical enabler of the country's resilience and society's resilience to such shocks as pandemics has become very clear.
We cannot afford future housing to be designed without accessibility to clean drinking water and sanitation in the same way as we cannot afford any houses being designed without earthquake proofing or building codes not being observed.
In this spirit, I think the tools are there We should use them.
We should make every single mission we take to a country be guided by this across agency silos, and we should encourage governments to do the same, taking a hall of government approach to the future of urban resilience with health as being a very important pillar of it.
Thank you very much for being here and I'm very happy to say that UNIC is ready to continue to be a strategic partner to WHO and all the agencies here today in this journey ahead.
Thank you.
Thank you very much, Deputy Executive Secretary.
Thanks for having been with us and disclosing remarks.
From my end, I would like, first of all, to thank all the panelists, all the colleagues across the different regions across the agencies, but also the colleagues who have been sharing with us the experiences of translating this work on the ground.
Um, I just take two, three takeaway messages.
The first is that I think that we still need to continue to see how to find those best entry points and the alignments.
But very concretely, I take two follow up actions.
I think that we should consider how to make sure that health is integrated housing profiles and reviews.
I think this is a concrete, if I could say, takeaway message.
The second very concrete takeaway that we would like to suggest is that WHO is planning, together with you and Habitat, but all the other colleagues that have been here presenting and more to be updating the housing and health guidelines.
It is still a project because obviously this requires financial and human resources, so we are, you know, planning, but there is a commitment by WHO to really scale up the work on urban house with a very specific focus on housing and housing infrastructure.
With this, I would like to thank you all.
Thanks for your contribution, and I wish you a very, very nice best of World Urban Forum.
Thank you very much.