Robert M. Buckley

Thirty Years of World Bank Shelter Lending: What Have We Learned?

By reviewing the Banks experience with shelter lending, this paper seeks to address the question of whether the Bank has helped developing countries deal with the inevitable problems that arise with urbanization, particularly problems with the provision of shelter. It reviews the Banks performance, with a focus on identifying lessons learned so that current demands can be more effectively addressed. In contrast to earlier studies, however, this review focuses more on how the changing policy environment has affected the structure of Bank assistance, rather than on how Bank assistance has affected the policy environment. This perspective is taken for two reasons. First, in recent years, benevolent changes in the policy environment are helping to ensure that better shelter conditions are provided to the poor in rapidly growing cities. However, despite the generally improved environment, some serious and often long-standing obstacles are impeding and, in some places, preventing progress. The emphasis on the policy environment allows the Bank to give greater weight to these constraints. Second, Bank shelter assistance is no longer an experimental program, as it was when the first review took place. Shelter assistance is now a mature sector, with 278 loans (including International Finance Corporation [IFC] loans). As a result, this review devotes considerably more attention to the outcomes of the Banks shelter projects than did the earlier studies. Conclusions about shelter lending are by no means completely positive, however. In particular, while the nature of the lending has evolved to embrace the private sector more fully, it has also moved away from the poverty orientation that was for many years the core focus. If the Bank is to make a meaningful contribution to the Millennium Development Goal of affecting the lives of 100 million slum dwellers, this trend will have to change.

Roundtable on Urban Living Environment Research (RULER)

For 18 months in 2009–2010, the Rockefeller Foundation provided support to establish the Roundtable on Urban Living Environment Research (RULER). Composed of leading experts in population health measurement from a variety of disciplines, sectors, and continents, RULER met for the purpose of reviewing existing methods of measurement for urban health in the context of recent reports from UN agencies on health inequities in urban settings. The audience for this report was identified as international, national, and local governing bodies; civil society; and donor agencies. The goal of the report was to identify gaps in measurement that must be filled in order to assess and evaluate population health in urban settings, especially in informal settlements (or slums) in low- and middle-income countries. Care must be taken to integrate recommendations with existing platforms (e.g., Health Metrics Network, the Institute for Health Metrics and Evaluation) that could incorporate, mature, and sustain efforts to address these gaps and promote effective data for healthy urban management. RULER noted that these existing platforms focus primarily on health outcomes and systems, mainly at the national level. Although substantial reviews of health outcomes and health service measures had been conducted elsewhere, such reviews covered these in an aggregate and perhaps misleading way. For example, some spatial aspects of health inequities, such as those pointed to in the 2008 report from the WHO’s Commission on the Social Determinants of Health, received limited attention. If RULER were to focus on health inequities in the urban environment, access to disaggregated data was a priority. RULER observed that some urban health metrics were already available, if not always appreciated and utilized in ongoing efforts (e.g., census data with granular data on households, water, and sanitation but with little attention paid to the spatial dimensions of these data). Other less obvious elements had not exploited the gains realized in spatial measurement technology and techniques (e.g., defining geographic and social urban informal settlement boundaries, classification of population-based amenities and hazards, and innovative spatial measurement of local governance for health). In summary, the RULER team identified three major areas for enhancing measurement to motivate action for urban health—namely, disaggregation of geographic areas for intra-urban risk assessment and action, measures for both social environment and governance, and measures for a better understanding of the implications of the physical (e.g., climate) and built environment for health. The challenge of addressing these elements in resource-poor settings was acknowledged, as was the intensely political nature of urban health metrics. The RULER team went further to identify existing global health metrics structures that could serve as platforms for more granular metrics specific for urban settings.

Real Estate Regulations in Accra: Some Macroeconomic Consequences?

Ghana has been one of the most rapidly growing economies in sub-Saharan Africa. This growth has been aided by Ghanas improving policy environment. In light of this, the paper addresses the question of why, given its higher level of per capita income and relatively strong growth, the housing conditions of the poor in Accra are considerably worse than those in a number of other African cities with lower incomes. There are not many data available to answer this question, so the method is indirect and takes two approaches. First, a variant of the monocentric city model is used to calculate Accras housing supply elasticity relative to those of other similarly sized African cities. The model suggests that housing supply responsiveness is considerably lower in Accra, a result consistent with the observed higher housing costs. Secondly, a number of traditional housing demand and reduced-form equations are estimated for Accra and the other cities. This allows the formation of a quantitative judgment about Accras housing supply elasticity. Taken together, the two approaches indicate that lower-income families in Accra have such poor housing conditions because the market is extremely unresponsive to demand. The welfare costs of current housing and land policies are considerable. The results suggest that making Accras real estate market more responsive would go a long way towards improving the effectiveness of the broader policy environment. It would also no doubt improve the housing conditions of the poor and help to reduce the citys expanding footprint.

Discontent with the World Bank's excursion into economic geography: lions and butterflies once more?

The World Bank s 2009 Reshaping Economic Geography has had overwhelmingly negative reviews by geographers. Why are they so unhappy with the Bank s excursion into economic geography? One answer is that they have some valid criticisms. Another explanation, one that we think is important, is that some of their criticisms are not valid. We think that this problem arises because of cross disciplinary problems, filled with ―venom and incomprehension. We attempt to put what we think are misunderstandings to the side to clarify the most effective criticisms. If this can be done, perhaps the Bank s foray into economic geography could be more usefully engaged by geographers and others Robert M. Buckley Graduate Program in International Affairs The New School The Rockefeller Foundation, New York rbuckley@rockfound.org Thomas D. Buckley Department of Geography George Washington University Geocommons, Arlington, VA buckley.tom@gmail.com

No data, no problem, no action: addressing urban health inequity in the 21st century.

In all countries, rich and poor, the move to urban living has been both good and bad for health and has contributed to health inequities within countries (the urban–rural divide) and within cities (the social gradient). The health risks associated with accelerating urbanization in the context of other global challenges, such as climate change, food insecurity, and financial crises—especially in countries with low levels of infrastructure and health system preparedness—pose significant development challenges in the 21st century. But urbanization does not have to be negative. There is considerable global recognition that the attention to the way in which urbanization takes place provides a major opportunity not only to help economic development, but also local, national, and global health, and at the same time to address environmental concerns. Many of the authors involved in this series have written about what is required to improve urban health and health equity. A synopsis of those writings would read along the lines of “communities and cities that ensure access to basic goods such as sanitation, education, health care and social services, that are designed in ways that build social cohesion and promote good physical and psychological well-being, and that are protective of the natural environment are essential for health equity.” While today we can describe many of the features of a healthy and sustainable city, and the governance and planning processes needed to achieve these ends, there is still much to learn, especially with respect to applying these concepts in cities of low- and middle-income countries. Recognizing this, the Rockefeller Foundation provided funding for two sister projects in 2009/2010, Global Research Network for Urban Health Equity (GRNUHE) and Roundtable on Urban Living Environment Research (RULER). Each convened a network of urban experts from a variety of disciplines, sectors, and continents. GRNUHE reviewed the current knowledge in the social and environmental determinants of urban health inequities, documented what is and is not working to improve urban health equity, and identified gaps in the evidence base, thereby setting a direction for a global research agenda. All of these processes of governance, the various aspects of urban life and their outcomes in terms of health and health inequity need to be measured and monitored so that policy and program development, evaluation, and accountability are possible. It was these very issues that were of interest to RULER. RULER reviewed existing methods of measurement for urban health, aiming to identify gaps in measurement that must be filled in order to assess and evaluate population health and health equity in urban settings, especially in informal settlements (or slums) in low- and middle-income countries. In this series of papers, we report the main findings from GRNUHE and RULER. GRNUHE demonstrates how urban planning and design and urban social conditions can be good or bad for health equity depending on how they are set up, and shows some promising planning and social policies and practices from around the world. We describe how climate change mitigation and adaptation can to go hand-in-hand with efforts to achieve health equity through action in the social determinants. Drawing on examples from all continents, we highlight how different forms of governance can shape agendas, policies, and programs in ways that are inclusive and health promoting, or can perpetuate social exclusion, inequitable distribution of resources, and associated inequities in health. By outlining an integrated applied research agenda, we aim to assist researchers, policy-makers, service providers, and funding bodies/donors to better support, coordinate, and undertake action that is organized around a conceptual framework that positions health, equity, and sustainability as a central policy goal for urban management. RULER describes how existing measurement systems focus primarily on health outcomes and systems, mainly at the national level. Although substantial reviews of health outcomes and health service measures had been conducted elsewhere, such reviews covered these in an aggregate way. Relatively few countries have examined their inter- or intra-urban health inequities and even fewer do so on a regular basis. RULER observed that some urban health metrics were already available, if not always appreciated and utilized in ongoing efforts (e.g., census data with granular data on households, water, and sanitation but with little attention paid to the spatial dimensions of these data). However, in general there is a paucity of evidence on the social determinants of health and health inequities at the city level. Other, less obvious elements had not exploited the gains realized in spatial measurement technology and techniques (e.g., defining geographic and social urban informal settlement boundaries, classification of population-based amenities and hazards, and innovative spatial measurement of local governance for health). In summary, the RULER team identified three major areas for enhancing measurement to motivate action for urban health, namely, disaggregation of geographic areas for intra-urban risk assessment and action; measures for both social environment and governance; and measures for a better understanding of the implications of the physical (e.g., climate) and built environments for health. The challenge of addressing these elements in resource-poor settings was acknowledged, as was the intensely political nature of urban health metrics. Also, overcoming these challenges will be expensive, far too expensive for foundations alone. This is unambiguously a problem and is the sort of task that global health agencies such as the United Nations should systematically address. Urban development that places health equity as a central policy goal will improve health, reduce social inequity, and support communities to cope with, and avert further, global environmental change. To do this requires fine-grained measurement, multilevel monitoring systems, action on the social and environmental determinants of health and inclusive systems of governance.

Social inclusion in Mumbai: economics matters too

This paper questions the accuracy and validity of the criticisms made by Ananya Roy regarding the approach to community development of a Mumbai-based NGO, SPARC, and its partner grassroots federations in Mumbai. This includes the suggestion that the focus on sanitation rather than on land tenure is an appeal to middle-class values about cleanliness and that their support for relocating those who lived right next to the railway tracks made them agents of the state. When viewed through a demand-responsive economic perspective, SPARC’s support for community toilets was in response to what grassroots organizations asked for, and these also have high returns. Similarly, SPARC’s support for resettlement for those living alongside the railway tracks was for those who were going to be moved, and this support allowed them to have far more influence on where, when and how the resettlement took place. Here too, the high returns from faster, safer trains meant cost savings that were higher than the costs of providing good quality accommodation for those who had to move.

Climate economics: Hot in the city

Robert Buckley cautions that financial incentives alone will not fuel urban adaptation to climate change.