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Belfast Healthy Cities

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Healthy Cities 21st Century

World Health Organization International Healthy Cities Conference 1-4 October, Belfast, Northern Ireland

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The WHO International Healthy Cities Conference opened on 1 October 2018 in Belfast, Northern Ireland, United Kingdom, bringing together more than 500 delegates from 60 countries and over 200 cities. While the Conference takes place every 5 years, this year’s event has particular significance – it celebrates 30 years of Healthy Cities as a global movement and looks ahead to the next phase of work for the WHO European Healthy Cities Network.

Participants have gathered for a 4-day programme with multiple sessions under the overarching theme of “Changing cities to change the world”, recognizing that urban centres have a vital role to play in sustainable development.

Day 1 summary

Conference delegates immediately set to work on Monday morning at the WHO European Healthy Cities Network business meeting, where voting members of the Network discussed preparations for the next phase of work.

The political vision and proposed goals of this phase align fully with WHO’s 13th General Programme of Work, the Health 2020 policy framework and the Sustainable Development Goals (SDGs). A series of 8 concurrent side events followed the meeting and highlighted examples of successful healthy city initiatives, ranging from health-promoting schools for children to technology to support active and healthy ageing.

The afternoon plenary session opened with a powerful recital of the poem “Confidence” by Mr Colin Dardis, written to mark the 70th anniversary of the United Kingdom’s National Health Service and to pay homage to the ideal of universal health coverage.

The Deputy Lord Mayor of Belfast, Councillor Emmet McDonough-Brown, warmly welcomed participants, noting in his remarks that Belfast was the 11th city to join the Network in 1988 and has been a key member ever since.

The plenary continued with a focus on primary health care, making links to the 40th anniversary of the Declaration of Alma-Ata on primary health care. The Declaration will be commemorated during an upcoming global conference in Astana, Kazakhstan.

Keynote speakers included Professor John Ashton, Senior Adviser to the Network, and Dr Bente Mikkelsen, Director of the Division of Noncommunicable Diseases (NCDs) and Promoting Health through the Life-course at WHO/Europe.

Professor Ashton reflected on how far the Network has come in its 30 years thanks to continued support across political parties, which was core to the founding of the movement. There are currently national networks in more than 30 countries, and the movement is still expanding: Kyrgyzstan recently established the first national healthy cities network in central Asia.

Dr Mikkelsen made the case for why cities should prioritize actions and investments designed to fight the rising epidemic of NCDs. The WHO European Region is rife with inequities in the area of NCDs and mental health. There is a pressing need for local action to address this growing burden through political commitment and broad stakeholder engagement.

In a joint session, the chief medical officers of Northern Ireland and Scotland and deputy chief medical officers of England and Wales, United Kingdom, reflected on the challenges that lead to unhealthy cities and provided ideas for how to support cities in tackling these challenges. They underscored the importance of community engagement to design effective solutions.

The first plenary concluded with presentations from representatives of both Astana and Almaty, Kazakhstan, showcasing those cities’ efforts to improve health and well-being. The Deputy Mayor of Almaty invited delegates to attend the next WHO Healthy Cities Summit of Mayors, to be held in Almaty on 23–24 October.

The day closed with 8 parallel sessions sharing good practices of multisectoral strategies for urban health, followed by a welcome reception hosted at Queen’s University Belfast.

Day 2 summary

Councillor Deirdre Hargey, Lord Mayor of Belfast, opened the second day of the Conference by expressing her hope that city leaders will have the chance to engage with counterparts from around the world and to benefit from the experience the Network has to offer. A vibrant interlude of Irish dancing by Celtic Storm provided a memorable and energetic start to the day, which continued with a welcome from Dr Michael McBride, Chief Medical Officer of Northern Ireland.

In her opening speech on behalf of WHO, Dr Piroska Östlin, Director of the Division of Policy and Governance for Health and Well-being at WHO/Europe, noted that the Network must use the experience gained over the past 30 years to expand the healthy cities movement further throughout the world. Innovative and transformative approaches are at the heart of the movement, and these will be crucial to achieving the SDGs, using health as a cross-cutting platform.

Chair of the Network’s Political Vision Group, Cllr Tony Fitzgerald, Cork and Ms Monika Kosinska, WHO Regional Focal Point for the Network, reflected on the Copenhagen Consensus, adopted by city leaders in February 2018, and its 6 Ps: peace, planet, place, people, participation and prosperity. These will form the basis for the Network’s next phase of work, based on the broad principles of building an equitable, healthy and sustainable future for all.

Ms Kosinska also presented the draft Belfast Charter*, which outlines the actions that cities will need to undertake in order to implement the political vision laid out in the Copenhagen Consensus. The draft Charter is currently open for comments, with the aim of adopting a final version at the close of the Conference on Thursday.

Dr Agis Tsouros, International Adviser for Global Healthy Cities, emphasized that the agenda and priorities of the healthy cities movement have always been consistent with the big issues now embedded within the United Nations 2030 Agenda for Sustainable Development. He encouraged cities to “grab the big issues” and seize the opportunity to put in place credible and evidence-based urban health policies.

In keynote speeches, Dr Brandon Hamber, Professor at the International Conflict Research Institute of Ulster University (Northern Ireland, United Kingdom), and Dr Ilona Kickbusch, Director of the Global Health Centre of the Graduate Institute (Switzerland), explored the relationship of health within development and security, peace and participation.

The necessity of co-creating solutions and bolstering civic engagement in urban life was a thread throughout the plenary session. Dr Hamber quoted the American-Canadian author Ms Jane Jacobs to illustrate the importance of participation and ownership: “Cities have the capability of providing something for everybody, only because, and only when, they are created by everybody.”

The afternoon allowed participants to delve further into the themes of environment and health, peace, and urban design through 16 separate parallel sessions. The day concluded with a civic reception hosted by the Belfast City Council in the iconic Belfast City Hall.

Day 3 summary

Staying true to the principles of a healthy city, the day started with the opportunity for participants and delegates to join an early morning run or a brisk walking tour of Belfast. The day’s morning plenary session then focused on transformative approaches for environment and health.

Dr Janez Potočnik, Co-chair of the United Nations Environment Programme (UNEP) International Resource Panel, gave a fascinating keynote speech. Calling for a new paradigm of the circular economy, he warned that we have a once-in-a-lifetime opportunity to shift the expected path of urbanization in a more environmentally sustainable and socially just direction.

Trade-offs among various Sustainable Development Goals (SDGs) are unavoidable, Dr Potočnik continued, because they are dependent on natural resources, but focusing on sustainable consumption and production is the best way to mitigate trade-offs and create more efficient synergies. A circular economy should be seen as part of the societal and cultural transformation needed to sustain humanity, with benefits for both the environment and health.

Mr Victor Everhardt, Deputy Mayor of Utrecht, delivered a second keynote speech, underscoring that creating a healthy city is a long-term commitment. He offered pioneering examples from his city, such as electrically powered boats that make deliveries throughout the city’s canal network, approaches to remove cars from public spaces, and initiatives to improve and expand bicycle paths and bicycle parking throughout the city.

The keynote speakers were then joined for a panel discussion by Ms Brigit Staatsen of the National Institute of Public Health and the Environment (the Netherlands); Professor Jonathan Patz of the Global Health Institute at the University of Wisconsin–Madison (United States of America); and Tom Andrews of Sustainable Food Cities (United Kingdom).

The panellists explored how we can encourage better connections to exchange experience, with a focus on addressing the environment and health, increasing active transport, reducing emissions and energy use, and ensuring healthy and sustainable diets. While we need to connect local policies to global policies and contexts to enhance cross-policy coherence, this should not stop local leaders and cities from taking action now.

Participants then had the rest of the morning to join one of 18 site visits across the city of Belfast to gain first-hand experience and insight into actual projects that are making Belfast a healthier, more sustainable city to live in.

The day closed with 2 blocks of parallel sessions – 16 in total – covering a broad range of topics from sustainable communities, to equity and inclusion, to environment and health. In the evening, a dinner for the delegation of mayors and politicians was hosted by the Lord Mayor of Belfast at the beautiful Malone House.

Day 4 summary

The final day of the Conference opened with a performance by the Harmony Choir, a project that brings together 10 school choirs from Belfast North. The morning plenary session focused on the theme of food and food systems, and their critical role in health, well-being, community resilience and tackling inequalities.

Mr Geoff Tansey, curator of the Food Systems Academy (United Kingdom), emphasized how food systems should deliver safe, sustainable and sufficient diets for all. He explained that the marketing of unhealthy foods is harming our health and well-being, and noted that the 4 main threats to the world (and food systems) are climate destabilization, increasing inequality, competition over resources and global militarization.

Coming together across cultures and borders to build happier and healthy cities can help counter these trends. Mr Tansey encouraged city leaders to look beyond technical innovation to social, economic, institutional and legal innovation to find ways to create sustainable and equitable food systems.

The afternoon saw more parallel sessions as well as a meeting of universities. The group explored the development of an open partnership of universities that would cooperate with the Network and provide scientific and practical support.

The final plenary and business session of the Conference took place in the afternoon, when the Belfast Charter was officially adopted. The election of representatives of cities and national healthy cities networks to the advisory committee for the next phase was also announced.

Professor Selma Sogoric, Coordinator of the Croatian National Healthy Cities Network, received an award for the poster she developed with colleagues for the Conference – one of dozens of posters that were on display throughout the week. Creative notes – visual representations from throughout the Conference – were also presented in this final session.

Dr Franklin Apfel, Managing Director of World Health Communication Associates, moderated a discussion looking to the future with the former and current WHO regional focal points for the Network, Dr Agis Tsouros and Ms Monika Kosinska, respectively.

They provided insight into what Phase VII holds for the Network. Ms Kosinska noted that the conditions for the Network are ideal as the world focuses on achieving the SDGs. “The word is spreading,” she said in closing remarks. “The work of the cities of the Network is turning heads around the world. The time for Healthy Cities is now.”

The Conference concluded with a farewell from Ms Suzanne Wylie, Chief Executive of Belfast City Council, and a performance by the Belfast Here 4 U Choir. Delegates joined the Choir in a song commissioned for the event, with lyrics by Ms Inge Kristiansen, Healthy City coordinator in Horsens, Denmark and sung to the tune of Ode to Joy.

Belfast Healthy Cities would like to thank the Board of Directors, Conference Steering Group, Sub-Committee groups, partners and funders for their commitment and dedication in making the conference such a successful event.  Special thanks to Public Health Agency, Northern Ireland Housing Executive and Belfast Health and Social Care Trust for their important contribution.

*The Belfast Charter is available here

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