In 2009, when Rio de Janeiro was awarded the Summer Games, many saw it as a validation of Brazil’s ascension on the world stage. Yet seven years later, this estimation seems to have been a bit premature, as Rio and other Brazilian cities struggle to meet the basic needs of the Olympians.
The biggest problem facing the Rio Games may not be the filthy venues for aquatic events, or even security concerns in one of the world’s highest crime cities, but basic public health. The fears of transmission of Zika virus may be overblown, given that it’s the winter in Brazil and mosquito populations will be lower, but travelers run a real risk of contracting food-borne illnesses and influenza, according to the European Center for Disease Prevention and Control.
Rio, covering an urban area of over 11 million, belongs to a class of developing world megacities that, in too many cases, have become “a breeding ground for infectious diseases,” according to researcher Carl-Johan Neiderud, including another feared mosquito-born scourge, dengue.
Dr. Seth Berkley, CEO of the vaccine alliance Gavi, points to the recent increase in the scale of densely populated urban areas, many without adequate sanitation, as turning containable illnesses like Zika and Ebola into pandemics. Dense urbanization may not have created Zika, which causes newborns to have unusually small heads, he notes, but it has accelerated its spread from a mere handful to a current tally of 1.5 million cases this year.
Outbreaks of new pandemics have become increasingly common in the developing world, where urban growth is now three times faster in low-income countries than in their higher-income counterparts. Developing country megacities already represent the majority of the world’s 29 urban areas with over 10 million residents. The United Nations predicts 16 more megacities could emerge by 2030, all but one in the developing world.
This is a problem not only for developing countries, but the health of the world. Zika, like dengue, may have proliferated in unsanitary, dense cities in the developing world, but it’s spreading to the United States. The FDA just called for Miami and Fort Lauderdale to halt blood donations due to cases discovered locally. The number of those infected is climbing in Puerto Rico as well. How long before other wet, hot parts of America — say east Texas and Louisiana – also report infections?
Why is this happening? David Heymann, head of the center on global health security at Chatham House and a professor at the London School of Hygiene and Tropical Medicine, blames our interconnected world. Even megacities in the most impoverished countriesare just an airline trip away from the rest of the world. Once a disease starts in a developing country, he says, it’s likely to find its way into more prosperous ones as well.
Historic Precedents
Cities afflicted by massive poverty have long been primary breeders of disease. Plagues and pestilences were commonplace in the earliest urban centers, from ancient Greece and Rome to Baghdad, Beijing and Cairo. Cut off often from clean water, living cheek to jowl, large cities were often assaulted, and sometimes all but emptied, by waves of infectious diseases. Rome’s sewer system may have been well ahead of its time, but the higher floors in buildings lacked plumbing hookups, which made this system less than effective in stemming disease.
Conditions got, if anything, worse when the Empire’s capital shifted to Constantinople. The largest city in the Mediterranean at the time, and one of greatest in the world, nearly half the population died from plague in the middle of the sixth century.
Much the same process occurred in the great cities of the Muslim world. Cairo, which in the 14th century had a population of 400,000, or eight times that of contemporary London, was racked by repeated epidemics that forced rulers and high officials to escape to the countryside. So great were these plagues, the Arab historian Ibn Khaldun noted, buildings and even palaces were abandoned, and “the entire inhabited world changed.”
Arguably, the industrial cities of the West provide the most compelling precursor of what is occurring in megacities today. London, in the 19th century the world’s largest city, suffered mortality rates higher than the countryside until the 1920s. Raw sewage ran down the streets of Berlin as late as the 1870s; only 8 percent of housing had toilets. Not surprisingly, as Berliners dumped their sewage into the river, there were recurrent outbreaks of cholera, typhus, and other devastating diseases. In St. Petersburg, at the dawn of the Russian Revolution, living conditions were even worse than Berlin’s; nearly half of all deaths in the city were traceable to infectious diseases.
Time To Rethink Megacities?
This sad history is repeating itself, in certain respects. We might think that city residents with access to healthcare would be healthier. In many places, that’s not the case. The average lifespan in Mumbai is 57 years, seven years short shorter then the Indian average. Gaps in life expectancy can be found in other developing world megacities, including Tehran and Cairo. “Megacity life,” notes Dr. Marc Reidl, a specialist in respiratory disease at UCLA, “is an unprecedented insult to the immune system.”
Yet despite this, some Western pundits embrace “the inexorable logic of the mega-city” as a blessing for both their residents and the planet. A recent article in Foreign Policy was bizarrely titled “In Praise of Slums,” arguing that megacities are “a force for good” because they provide more opportunities than villages.
Yet rather than accept misery common to such places, perhaps Westerners might think how to apply their past experience to solve megacities’ worst problems. It can be done. After all, Paris cleaned itself and became much healthier after Georges-Eugène Haussman’s renovation of Paris, commissioned by Napoléon III in the mid-1800s. Much can be accomplished by improving basic sanitation; in Dhaka for example, the sewer system covers barely 25 percent of the city, something that would seem strange to a denizen of imperial Rome, much less modern London or New York.
In many countries, including in the United States and Great Britain, particularly in the 20th century, health conditions improved as inner cities depopulated and more people moved to the periphery. This was one of the prime objectives of Ebenezer Howard’s bold vision for the growth of “garden cities,” which greatly influenced town planning in many parts of the high-income world.
Following Howard’s admonitions for the filthy cities of Edwardian England, perhaps we should be encouraging developing countries not to concentrate their people in megacities, but spread them out into more healthful environments. These ideas are not far-fetched. An impressive 2014 study by the McKinsey Global Institute, called “Mapping the Economic Power of Cities,” found that growth is already shifting to smaller cities.
This decentralizing process, notes Singapore-based scholar Kris Hartley, could take advantage of a growing shift of industrial and even service businesses to more rural locales, particularly in Asia. As megacities become more crowded, congested and difficult to manage, Hartley suggests, companies are finding it more convenient, less costly and, critically, better for the families to locate farther from the giant cities.
India, where some of the most impoverished megacities are located, is already experiencing a slowdown in megacity growth. The government of Prime Minister Narendra Modi has targeted small cities and villages for growth, rather than concentrating more people in larger cities.
Rather than foster the creation of unhealthy cities that incubate diseases like Zika, we in the high-income world should be looking for ways to slow the spread of pandemics that threaten millions of people, not only in the poorer countries, but also, as is plainly clear, closer to home.
This piece originally appeared in Forbes.
Joel Kotkin is executive editor of NewGeography.com. He is the Roger Hobbs Distinguished Fellow in Urban Studies at Chapman University and executive director of the Houston-based Center for Opportunity Urbanism. His newest book, The Human City: Urbanism for the rest of us, will be published in April by Agate. He is also author of The New Class Conflict, The City: A Global History, and The Next Hundred Million: America in 2050. He lives in Orange County, CA.
Photo of eco-barrier designed to prevent trash flow into Guanabara Bay in Rio de Janeiro prior to the 2016 Olympics, by Tomaz Silva/Agência Brasil [CC BY 3.0 br], via Wikimedia Commons
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