Urban Health in Practice: Lessons from City Leaders

Urban health challenges are rarely solved by a single department, discipline, or city acting alone. Progress comes through collaboration across sectors, across cities, and across very different local contexts. At the International Conference on Urban Health (ICUH), held in Wellington, New Zealand in November, this idea took centre stage. City officials, practitioners, researchers, and global partners worked side by side to share what is working, what is failing, and what cities need to do next. ICUH created a space that showed, in very practical ways, how collaboration can accelerate action on the health challenges cities are already facing.

The City of Cape Town delegates attended ICUH both to learn and to share. We were invited to reflect on our experience in the urban health space, including our intersectoral governance approach and the work supported through the Partnership for Healthy Cities. This work has strengthened how we use evidence, convene partners, and translate policy into city-level action, while also connecting us to a global network of cities navigating similar pressures.

At the same time, ICUH provided space to speak openly about our greatest challenges: climate-related health risks, deteriorating air quality, and unhealthy food environments. These are complex, systemic problems that no city can solve on its own.

One of the clearest messages from ICUH was that urban health is gaining visibility, but local government responses vary widely. Across cities, there is a growing number of projects, pilots, and initiatives focused on addressing the urban determinants of health. This momentum matters. Yet most cities are still operating through fragmented, project-based approaches, without the connected governance structures needed to sustain impact. Embedding health into planning, budgeting, and delivery across departments remains the exception rather than the norm.

For city leaders, this gap between ambition and institutional reality is now one of the biggest barriers to progress. In response to this, the World Health Organization has recently released strategic guidance on urban health. This guidance provides a practical framework for local governments to integrate health into urban governance, planning, and policy delivery across sectors. ICUH also reinforced how much faster cities move when they work through networks rather than in isolation. Conference sessions revealed strong similarities in the challenges cities face and in the approaches they are testing, creating opportunities for peer learning. The next step is to build on these opportunities through sustained collaboration.

Global networks such as the Partnership for Healthy Cities play a critical role supporting structured city-to-city engagement, targeted technical input, catalytic financial resources, and program stewardship grounded in evidence. The City of Cape Town’s work on healthier food environments is a good example of the kind of practice that resonated at ICUH: an intersectoral, policy and evidence-informed approach that leverages partners and champions within an overarching governance structure.

ICUH also reinforced the importance of evidence that is designed for use. The conference surfaced practical approaches to governance, data use, and implementation that can be applied directly within the City of Cape Town’s own systems, particularly in areas such as climate and health integration, air quality monitoring, and food environment policy.  These examples will be utilised in the City of Cape Town’s work using spatial health, climate and other social determinant data to support health policy implementation.

Just as importantly, ICUH opened ongoing opportunities for partnership, strengthening existing relationships with organisations such as WHO and Vital Strategies, while connecting the city to a broader community of practice committed to applied urban health. I left ICUH with a strong sense of belonging to a community of practitioners ready to support one another in advancing shared urban health ambitions.

What ICUH ultimately made clear is that cities are no longer peripheral to the global health agenda; they are central to it. As climate risks intensify and urban inequities deepen, the ability of cities to lead, collaborate, and learn from one another will increasingly shape health outcomes. Strong governance, shared evidence, and trusted partnerships are what allow cities to move forward together.

For city leaders, the message is clear: recognize your role in creating healthier communities. The time to act is now, and it starts with investing in the relationships that make urban health action possible.