Rapid, unplanned urbanization is one of the major ecological and human challenges of the 21st century. UN Habitat predicts that, by 2050, nearly 70% of the world’s population will be living in cities, with disproportionate urban growth in low- and middle-income countries. While cities offer opportunities for employment and access to better public services, they also pose major health risks. Good local governance is critical for achieving the 2030 Agenda, and countries must strive to ensure that their cities are creating and improving their physical and social environments and their community resources to enable people to support each other and to develop to their maximum potential.

The World Health Organization (WHO) has identified health promotion in urban and local settings as critical to achieving the Sustainable Development Goals (SDGs) and health equity. The Initiative is expected to contribute to achievement of SDG targets 3 and 11 and the Triple Billion Targets of the WHO 13th General Programme of Work 2019–2025 by addressing key issues in urban health, including social, environmental and economic determinants, and promoting healthier lives for individuals and communities in cities. The WHO and UN Habitat 2016 Global report on urban health concluded that good urban governance – notably the role of city governments and strong leardership – is key to ensuring health equity and the health and well-being of their citizens.

Building on good practices in the WHO Healthy Cities programme, WHO is collaborating with the Swiss Agency for Development and Cooperation to promote good local urban governance for health and well-being through civic engagement and multisectoral coordination within the Initiative on Urban Governance for Health and Well-being (2020–2028). In the first phase of the Initiative, WHO is working with five cities: Bogota (Colombia), Douala (Cameroon), Mexico City (Mexico), Khulna (Bangladesh), and Tunis (Tunisia). The mayors of these five cities have committed themselves to increasing current mechanisms for participatory urban governance to address priorities, such as through stronger multisectoral collaboration, community engagement, and promotion of social innovations and dialogue at local levels.