Africa, Asia Cities Growing Faster Than Health Systems Can Cope – Experts

…Call for urgent strengthening of resilient urban health systems

Rapid urban population growth across Africa and Asia is projected to increase by nearly 90 per cent over the next two decades, raising urgent concerns over the capacity of existing health systems to cope with expanding disease burdens and service demands.

This warning was issued by the CHORUS Urban Health Consortium, a research think tank that has been active for over six years in Bangladesh, Ghana, Nepal and Nigeria, as it called for the urgent strengthening of resilient urban health systems across the two continents.

In a statement made available to LEADERSHIP, the consortium noted that cities in Africa and Asia are expanding faster than their health systems can effectively respond, leading to growing gaps in access, quality and coordination of healthcare services, particularly for vulnerable urban populations.

To address these challenges, the consortium, in partnership with the University of Ghana’s School of Public Health and the International Society for Urban Health, is set to host a high-level Evidence-to-Policy Forum in Accra.

The forum, scheduled for January 29 and 30, 2026, at the University of Ghana’s Legon Campus, will bring together researchers, policymakers, city officials and health managers to exchange research findings on urban health and explore policy solutions for rapidly growing cities.

Co-Director of the Consortium, Professor Helen Elsey, highlighted systemic weaknesses in urban primary healthcare, noting that the proliferation of uncoordinated public, private and non-governmental clinics, alongside pharmacies, has resulted in fragmented service delivery and uneven quality of care.

She said these challenges have contributed to poor health outcomes, particularly in maternal and child health, as well as the rising burden of non-communicable diseases such as hypertension, diabetes and cancer.

According to Elsey, high costs, limited availability and poor accessibility of both public and private healthcare services have reinforced the continued reliance on informal providers, including traditional birth attendants and drug vendors, in many urban communities.

Another Co-Director of the Consortium, Associate Professor Bassey Ebenso, stressed that improving urban health systems cannot be separated from addressing underlying social and economic factors.

He identified critical issues such as unreliable electricity, poor road infrastructure, inadequate water and sanitation, air pollution, transportation challenges and social norms that increase health risks as key drivers of poor urban health outcomes.

Together with the Consortium’s Chief Executive Officer, Professor Irene Agyepong, Ebenso called on political leaders in Africa and Asia to formally acknowledge the scale of urban health challenges and mobilise coordinated, multisectoral responses at both city and national levels.

Presenting country-level research findings at the Accra forum, lead investigators from the four participating countries highlighted practical interventions being implemented to address urban health system gaps.

Professor Genevieve Aryeetey of the University of Ghana explained how CHORUS is working with Ghana’s Community-based Health Planning and Services (CHPS) programme to improve access to quality healthcare and health information for the urban poor.

In Nigeria, Professor Obinna Onwujekwe of the Health Policy Research Group at the University of Nigeria reported progress in integrating informal health providers into the formal health system through the establishment of an Urban Health Unit within the Enugu State Ministry of Health.

Similarly, Professor Rumana Huque of the ARK Foundation in Bangladesh and Dr. Sushil Baral of HERD International in Nepal shared advances in linking pharmacies and non-governmental clinics with government primary healthcare services to improve the management of diabetes and hypertension.

The consortium noted that its research, covering areas such as climate change, school health, sexual and reproductive health, health data systems and multisectoral collaboration, has generated a growing body of evidence to inform urban health policy.

The Accra Evidence-to-Policy Forum is expected to convene researchers, policymakers, media professionals and global health stakeholders from Africa and Asia, with the aim of consolidating efforts toward sustainable urban health programmes, stronger policy impact and a forward-looking urban health research agenda across both continents.