From healthy city projects to healthy cities

This paper discusses experience to date with the formulation and implementation of Healthy City projects in the South. After describing the origin of the Healthy Cities movement and what constitutes a Healthy City project, it reviews the experience of Healthy City initiatives in Fayoum (Egypt), Quetta (Pakistan) and Campinas (Brazil). It then discusses the roles of three critical stakeholders: international agencies (and how their support should facilitate local action rather than dictate it); local government staff and politicians (and the difficulties in getting their sustained support); and citizens and grassroots organizations. It ends by discussing how the real success of any Healthy City project is when it ceases to be a project, because the system it set up to ensure that health issues are given priority, to involve all stakeholders and to ensure that all sectors recognize that their role in healthy cities becomes part of the structure of local governance.