Urbanization- An Emerging Humanitarian Disaster

In 2008, the proportion of the world's population living in urban areas crossed the 50% mark. The current rates of urbanization suggest that in China, 870 million people — more than half the population — will be living in cities within less than a decade, and the capital of Botswana, Gaborone, will grow from 186,000 to 500,000 inhabitants by 2020.1 Most observers believe that essentially all population growth from now on will be in cities: the urban population is projected to grow to 4.9 billion by 2030, increasing by 1.6 billion while the rural population shrinks by 28 million.1
This transition is happening chaotically, resulting in a disorganized urban landscape. Although many expect urbanization to mean an improved quality of life, this rising tide does not lift all boats, and many poor people are rapidly being absorbed into urban slums. Urbanization, in fact, is a health hazard for certain vulnerable populations, and this demographic shift threatens to create a humanitarian disaster. The threat comes both in the form of rising rates of endemic disease and a greater potential for epidemics and even pandemics. To protect global health, governments and international agencies need to make commensurate shifts in planning and programs, basing all changes on solid epidemiologic and operational research.

Global health: Urbanization—An emerging humanitarian disaster, The New England Journal of Medicine, August 20, 2009. (Free full text)