Mega cities: infrastructure deficits and the implications for public health

The process of globalisation has resulted in the accelerated growth and functional diversification of many large cities of the developing world (the so called mega cities). While this development has created opportunities for economic growth and improvement in the standard of living (at least for some) it has also presented significant planning challenges for those government-based authorities charged with the responsibility of providing basic infrastructure and services. Bangalore, the capital of Karnataka state in southern India, is an example of a mega city struggling to cope with a range of challenges resulting from the city’s integration into the global economy. These challenges include coping with the consequences of rapid urbanisation – access to clean water and sanitation services and the manner in which these impact on public health. A range of responses, initiated by governments, non-government organisations (NGOs), and community-based (often self-help) associations, have been implemented to address these concerns. The effectiveness of these responses is largely determined by the degree to which they address the underlying dynamics of change and the extent to which they empower local communities to take ownership of the decision-making processes that ultimately impact on the quality of their lives. It is clear that effective governance and the transparency and accountability of decision-making processes are essential if lasting solutions are to be found to the challenges facing developing cities such as Bangalore.