Cities on the Forefront of COVID-19 Response – Experiences From Athens, Bogota and Kampala
Cyclists in Bogota take advantage of car-free roads

Third in a series – Cities are major drivers of public health and the COVID-19 pandemic has brought increasing and urgent necessity for effective, innovative leadership and collaboration within and between cities.

“The COVID-19 pandemic has upended lives around the globe and nowhere has the impact of this virus been more evident than in urban areas, home to more than 50 percent of the world’s population,” said Dr Tedros Adhanom Ghebreyesus, WHO Director-General, at the COVID-19 and Beyond: Cities on the Front Lines of a Healthier Future event on Thursday. “Many [cities] have fought back, with people and leaders uniting to suppress the virus and save both lives and livelihoods.” 

The event on Thursday, co-sponsored by Partnership for Healthy Cities, WHO, Bloomberg Philanthropies, and Vital Strategies, highlighted and celebrated the critical leadership provided by mayors and city governments. The event followed the release of a portfolio of case studies exhibiting efforts by urban leaders to develop a course of action to combat the pandemic, and occurred ahead of the upcoming World Cities Day on October 31. 

“Mayors and other urban leaders around the world have risen to the challenge of responding to COVID-19 and continue to make incredibly difficult decisions to protect people’s health, while maintaining economic stability and social cohesion,” said José Luis Castro, President of Vital Strategies. “City leaders entered the COVID-19 era in many cases without a playbook. They have nevertheless mounted a remarkable pandemic response.” 

The mayors of Bogota, Colombia, Athens, Greece, and Kampala, Uganda shared their experiences tackling the unique challenges facing their cities and populations. The mayors – who Dr Tedros referred to as urban health champions – detailed their actions to impose lockdowns, provide support to vulnerable communities, and implement forward looking health policies. 

Bogota, Colombia
Bogota also expanded its bike network during the national lockdown for healthy, safe transport.

Controlling the spread of the pandemic and increasing the capacity of the health system was prioritized early on with a six week lockdown in Bogota, implemented by the city government and Mayor Claudia López. The national lockdown in Colombia was promoted by the collaboration between 500 mayors, including López, to institute city-wide lockdowns. 

The rapid response by city leadership enabled the health system capacity to double between April and August, from 935 intensive healthcare units to 2,200, and from 200 tests per day to 15,000. 

In order to deal with the economic hardship and rising poverty levels that accompanied the lockdown, the city government collaborated with the national government to provide cash transfers to more than 700,000 families. This network of income and social support has been incorporated into Bogota’s long-term development plan to assist with social and economic recovery. 

Investment in small businesses, which delivers 60 percent of employment in the city, kept them in business and contributed to reducing unemployment from 26% in July to 19% in August. 

“I think we have an incredible opportunity during this pandemic, and then afterwards, to change things definitively for the better for cities. To improve sustainable mobility and to leave in place the social contract for women, for youth, for poor families,” said Mayor López. 

Athens, Greece
Staff from Hellenic Liver Patients Association
“Prometheus” in Athens delivers essential supplies to vulnerable community members.

The city government of Athens, led by Mayor Kostas Bakoyannis, took strategic actions to prioritize disenfranchised people who were vulnerable to the health and economic effects of the pandemic. The pandemic is not only a health issue, but a huge socioeconomic issue also, said Mayor Bakoyannis. 

The pandemic reveals and exacerbates existing inequalities and structural injustices. To address these inequalities and those at high risk, shelters were set up for homeless Athenians and those struggling with drug addiction, providing protection and medical attention. 

A system, Health at Home Plus, was established to deliver food, medicine, and aid to the homes of tens of thousands of residents during the lockdown. The system has continued until today, providing services and meeting needs of the population. 

“[Local authorities’] strength is working bottom up and our true power is in the street,” said Mayor Bakoyannis. “In order to be able to respond to the needs of the city, we understood that the city organization had to change. That’s why for us the pandemic was also an opportunity to move forward with long overdue reforms. It was a catalyst.”

Kampala, Uganda
Kampala Capital City Authority staff provide food relief and healthcare aid.

Kampala, one of the most densely populated cities in Uganda, has had 37% of total COVID-19 cases reported in the country. While the city-wide lockdown implemented in March slowed transmission of the virus, it also brought numerous challenges for workers relying on daily jobs to survive. 

The leaders of the Kampala government established a food distribution system to assist residents during the lockdown. A stimulus package was introduced to support small businesses and address some of the economic challenges. 

“As leaders, at times we need to take firm decisions regardless of the consequences,” said Deputy Mayor Doreen Nyanjura. “And we have seen this work in Uganda, where some attempts even had to involve the police because they are looking at saving the lives of our citizens.

“We need to unite as leaders with our citizens.”

The collaboration between the city government and national government hasn’t run smoothly during the COVID-19 pandemic, Deputy Mayor Nyanjura noted. The efforts of local authorities were constrained by the lack of funding from the national government. As a result, the city government has faced increased pressure to support medical teams, increase the capacity of health systems, and educate and empower the public with a limited budget. 

Advice For Other City Leaders

The three mayors provided advice for leaders of cities currently dealing with effectively tackling the pandemic and meeting the needs of residents: 

“We prioritized facts, science, and truth over politics and partisanship. We placed expertise over populism. It worked. It worked on a national level and it worked on a city level” to get cooperation from citizens for the lockdown and for compliance with pandemic prevention measures, said Mayor Bakoyannos. 

“Follow the facts and science. I think it’s amazing that in the 21st century we’re still seeing this debate in some very prominent democracies about science…follow the facts and tell people the truth [about] the risks that they are facing,” said Mayor López. “As long as we have science, leadership, decisions, and assertiveness…we will learn how to save lives.”

“Unite and take firm decisions, and consider the lives of those that [the government] represents,” said Deputy Mayor Nyanjura. “We need to unite with our citizens, we need to unite with our technical team…[and] with the government.”

Image Credits: Climate and Clean Air Coalition , Fernanda Lanzagorta, OPS Columbia, Partnership for Healthy Cities, Partnership for Healthy Cities.

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