In 2015, 54 percent of the world’s population lived in urban areas, and this figure is expected to increase to 66 percent by 2050. Three million people move to cities every week, and with the global population growing, another three billion people will need housing by 2030. The United Nations estimates that more than 90 percent of future urban population growth will be in low-and-middle-income countries (LMICs).

Long-established cities aren’t built with the infrastructure to deal with huge population growth, resulting in masses of people living in pockets of cities in sub-standard conditions. Whilst governments around the world have tried to provide innovative solutions, they haven’t always been successful. Singapore’s Housing Development Board programme has successfully built over one million units, housing 80 percent of the country’s population. But Mexico’s subsidised housing scheme in the La Trinidad suburb in Zumbango failed due to the new housing being built too far away from city centres, and crucially, didn’t offer sufficient space to live in.

In cities where governments are trying to source accommodation from within, they have multiple issues to contend with. These include traffic congestion, poor urban infrastructure, environmental degradation as well as poor basic facilities for water supply, sanitation and waste management. In fact, the biggest challenge facing today’s cities is the ability to achieve economic growth whilst providing sustainable, safe homes for its citizens. 

With masses of people living in concentrated areas, another concern is the risk of infectious diseases and pandemic outbreaks. Vaccines undoubtedly represent one of the most effective ways of eliminating some communicable diseases. However, their success and long-term impact depends on the level of supportive public policy, as well as effective communication.  Matt Zahn, MD, chair of the Infectious Diseases Society of America’s Public Health Committee, comments: “Advances in vaccine science in the 20th century were really extraordinary, and it gave us an opportunity to protect people far beyond anything we’d had in the past.” He continues, “But I think we are reaching a point where we’re running up against some basic social issues.” For example, measles was previously being managed well due to vaccines, but cases are re-emerging globally due to factors such as children not being vaccinated. 

The extent of inadequate living conditions, and the impact this has on health, is also underestimated.  Poor urban households are falling under the radar in informal settlements. A reported 3.8 billion people, in 128 countries, are at risk of mosquito-borne viruses. In countries where citizens have to pay for their healthcare, this simply isn’t a viable option for many. With the emergence of new technologies changing the way we live and work, health-focused innovations can have a huge effect on tackling and preventing infectious diseases. Technological advancements should benefit the whole of society, not just the digitally literate and digitally rich. Social enterprises that are dedicated towards helping the ultra-poor through cost-effective and usable solutions, have the power to influence health on a global scale.

In the US, a start-up company is attempting to address the challenge of inefficient and ineffective control of urban epidemics, with an all-in-one diagnostic test that can detect and report dangerous and transmissible viruses. E25Bio is a miniaturised, point-of-care, finger prick blood test that is capable of detecting infections within minutes. It is used in conjunction with a mobile phone application that can diagnose infections and advise on options for medical care. It has been designed so that anyone can use it, and is an affordable and easy-to-use piece of kit. The app also provides a vital ‘state of the nation’ overview, because all tests are geotagged in real-time, providing dispersion maps for city health officials to use during an outbreak event. 

In addition to detection, examples of preventative tools are gaining traction. The World Health Organization (WHO) states that 51 percent of urban households have low access to safe water. 2.3 billion people still don’t have basic sanitation facilities such as toilets or latrines. At least 10 percent of the world’s population is also thought to consume food irrigated by wastewater. In Mexico, a start-up company has developed affordable water disinfecting nano-silver paper filters. These are aimed at  the 2.1 billion people who earn between $2-10 per day, but their households collectively spend $20 billion on household water. The Folia Filter is an antimicrobial filter paper that is simple to use and doesn’t require electricity. Its silver nanoparticles kills bacteria and viruses, while the paper’s pore size physically filters out larger parasites. Using economies of scale with the paper manufacturing, the company is able to retail the water filters for $0.20 for 20 litres, which is only 1¢ per litre. 

Both E25Bio and Folia Water have caught attention on an international scale with their low-cost, high impact innovations and are finalists in the Global Maker Challenge for the Mohammed Bin Rashid Initiative for Global Prosperity. Innovative entrepreneurs and technologists such as these need the support of governments and its people in order to be able to make a difference on a mass scale. Technology must be given the opportunity to reach vulnerable people in cities who are in plain sight, but invisible on the healthcare radar. 

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