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Introduction <p>Urbanization presents growing public health challenges worldwide, particularly in the Eastern Mediterranean Region (EMR) where rapid urban growth coincides with conflict, migration, and health disparities. The WHO Healthy City Programme (HCP), launched in the 1990s, addresses these through multisectoral urban health initiatives. Aim: This narrative review examines the HCP’s global implementation, with focused analysis of the EMR context.</p> Methods <p>A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science, supplemented by WHO and UN documents. Key terms included “Healthy City” and “Urban Health.” Only English-language documents addressing HCP implementation were included.</p> Results <p>The HCP has expanded to all six WHO regions, with 35 cities certified in the EMR by 2019. The programme emphasizes equity, emergency preparedness and community participation in this region. Implementation challenges include weak institutionalization, limited inter-sectoral collaboration, and inadequate documentation. The paper specifically notes these barriers in the EMR context, along with the need for better monitoring systems. Successful examples from the region demonstrate the programme’s alignment with Sustainable Development Goals.</p> Conclusion <p>Scaling the HCP in the EMR requires stronger governance frameworks and systematic evaluation. The programme’s multisectoral approach remains crucial for addressing urban health challenges, but requires sustained political commitment and adapted strategies for regional implementation.</p>

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The state of the healthy city programme worldwide: a narrative review with a focus on the Eastern Mediterranean region

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年2月19日

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  • Mohammad Hossein Poorhashemi-Ardakani,
  • Jafar Sadegh Tabrizi,
  • Mohammad Saadati,
  • Mohammad Assai-Ardakani,
  • Samar Elfeky,
  • Saber Azami-Aghdash

摘要

Introduction

Urbanization presents growing public health challenges worldwide, particularly in the Eastern Mediterranean Region (EMR) where rapid urban growth coincides with conflict, migration, and health disparities. The WHO Healthy City Programme (HCP), launched in the 1990s, addresses these through multisectoral urban health initiatives. Aim: This narrative review examines the HCP’s global implementation, with focused analysis of the EMR context.

Methods

A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science, supplemented by WHO and UN documents. Key terms included “Healthy City” and “Urban Health.” Only English-language documents addressing HCP implementation were included.

Results

The HCP has expanded to all six WHO regions, with 35 cities certified in the EMR by 2019. The programme emphasizes equity, emergency preparedness and community participation in this region. Implementation challenges include weak institutionalization, limited inter-sectoral collaboration, and inadequate documentation. The paper specifically notes these barriers in the EMR context, along with the need for better monitoring systems. Successful examples from the region demonstrate the programme’s alignment with Sustainable Development Goals.

Conclusion

Scaling the HCP in the EMR requires stronger governance frameworks and systematic evaluation. The programme’s multisectoral approach remains crucial for addressing urban health challenges, but requires sustained political commitment and adapted strategies for regional implementation.