Nairobi, 27 July 2020 - A webinar held on the topic of health and equity through multi-level governance gathered over 50 participants in a lively debate with urban managers, health experts, academia and governance practitioners as part of the COVID-19 Urban Thinkers Campus Series session organised by the UN-Habitat Policy, Legislation and Governance Section.

“Coordination between the national, subnational and local governments is the first step of an effective response” declared Shipra Narang Suri, Chief of the Urban Practices Branch at UN-Habitat while setting the tone of the session.  She emphasized that horizontal cooperation between sectoral institutions and non-state actors such as civil societies, community-based and faith-based organizations as well as the private sector is key for building trust, ownership and sustainability. Narang Suri stated that the fallout from the pandemic will lead to many new norms once cities start bouncing back and moving towards the recovery path: “the scale, duration and intensity of COVID-19 has fuelled the urgency to revamp our health systems and adapt our city governance principles, approaches and frameworks”.

This discussion is part of the UN-Habitat work for developing a Guide which aims to provide national governments, local authorities, policy makers and other interested actors, a sound tool for improving health equity through multi-level governance. Indeed, it is worth noting that last year governance was defined by UN-Habitat as a driver of change for sustainable urbanization within its Strategic Plan 2020-2023, emphasising the need to strengthen urban governance through sound institutions and mechanisms which provide predictability and coherence in urban development plans to enable social inclusion; sustained, inclusive and sustainable economic growth; and environmental protection.

Some of the key insights shared by the webinar speakers are highlighted below:

Remy Sietchiping, Chief of the Policy, Legislation and Governance Section, UN-Habitat, focussed on the important role that national, sub-national and local governments play in territorial development and health crisis management in his opening remarks. He noted that strengthening urban governance with sound institutions and mechanisms provides predictability and coherence in urban development plans to enable social inclusion; sustained, inclusive and sustainable economic growth; and health equity. He highlighted the subsidiary dimension of multi-level governance as key for collective action to reduce urban inequalities.  

Dr Marc Ho, Technical Officer at WHO Health Emergencies Programme, provided some lessons learnt from COVID-19 in emergency preparedness including the importance of coordination, community engagement and trust, as well as the essential public health functions such as contract tracing, isolation and quarantine. He highlighted the normative work undertaken by WHO to guide cities in strengthening their preparedness for COVID-19 and beyond. Finally, he stressed four key areas of focus for city governments: a) coordinated local plans in preparation for effective responses to health risks and impacts; b) risk and crisis communication and community engagement that encourage compliance with measures; c) contextually appropriate approaches to public health measures, especially physical distancing, hand hygiene and respiratory etiquette; and d) access to health care services for COVID-19 and the continuation of essential services.

Professor David Everatt, Head of Wits School of Governance, stated that urban governance is a dynamic two-way process between the elected representatives and the electorate in the sense that, the former have delegated authority to make decisions (on behalf of the latter), while the latter call for equitable application of power and accountable decision-making from the former. He also noted that civil society actors have played a major role in providing health and essential services to the poor and marginalized communities during this health crisis. In as much as this is commendable, this has not only exposed the impunity within formal institutions, but also detracted the civil society entities from their watchdog and advocacy roles to demand for better and inclusive governance.  In his final remarks, he stressed the need for urban governance processes to be participatory, consensus oriented, accountable, transparent, responsive, effective, efficient, equitable and inclusive, so that cities can build back better and address blatant inequalities.

Xavier Tiana Casablanca, Head of International Relations at the Àrea Metropolitana de Barcelona, presented the metropolitan demographic dynamics in Barcelona as well as an overview of the health implications for AMB’s delivery of its key mandates in the areas of mobility and transport, solid waste management and use of public space. He mentioned that the institution has implemented four key governance arrangements to give citizens more rights and health safety guarantees prompted by the COVID-19 pandemic focussing on a) more bicycle and pedestrian footpaths; b) flexible work environment modalities; c) public transport as an essential service; and d) clean and health environment to reduce health risks and vulnerabilities.

Marco Felipe Chacón, Executive Director of the Colombian Association of Metropolitan Areas –a key institutional actor for strengthening the dialogue between metropolitan institution and the national government– made clear how metropolitan institutions have shown a transcendental role in addressing the pandemic. They have configured themselves to implement solutions that transcend local jurisdictions and political-administrative municipal boundaries and, the urban-rural continuum. He explained that in Colombia the six existing metropolitan institutions have worked with municipal and regional governments to implement virus mitigation measures such as those related to the use of public transport. Also, in these places metropolitan councils have been installed for risk management and to strengthen health systems. In some metropolises the pandemic has been declared a common public matter through the respective administrative acts.

Article by UN-Habitat
Photo credits: Community members in Mathare slum, Nairobi, Kenya during COVID-19 - May 2020. @UN-Habitat/Kirsten Milhahn