Improving Lives in Sub-Saharan Cities A Laboratory in Global Urban Development Millennium Cities Initiative Earth Institute | Columbia University I Improving Lives in Sub-Saharan Cities A Laboratory in Global Urban Development Millennium Cities Initiative Earth Institute | Columbia University Improving Lives in Sub-Saharan Cities: A Laboratory in Global Urban Development COLUMBIA UNIVERSITY IN THE CITY OF NEW YORK Millennium Cities Initiative, The Earth Institute EDITORS Dr. Susan M. Blaustein (Director) Lorian Viola (Operations Manager) PREPARED BY Mary Everette Cann Lindsay Jones Copyright©2015, The Trustees of Columbia University in the City of New York. All rights reserved. No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or information storage or retrieval, without advance written permission from the publisher. PUBLISHED BY Millennium Cities Initiative Columbia University in the City of New York Printed in the United States of America. ISBN: 978-0-692-45047-5 II ACKNOWLEDGEMENTS MCI would like to thank Earth Institute Director Jeffrey D. Sachs, for giving supporters on so many valuable projects, including, AfrikaVerein, Airtel – life through our Initiative to his vision to strengthen regional development Ghana, Carter Ledyard Milburn LLP, Cravath Swain & Moore LLP, DLA and to improve urban resilience, viability and sustainability. Piper, We would also like to thank the Earth Institute’s administrative team, from Executive Director Steven B. Cohen, through many departments Ericsson, GlaxoSmithKline, Johnson & Johnson, Kohn Pedersen Fox and outposts, including the MDG Centre for West and Central Africa, the Associates and KPMG; and our academic partners, including the Aharon Columbia Global Center in Nairobi and the Center for National Health Ofri International Training Center, Ben Gurion University, Kwame Development in Ethiopia, for enabling the Millennium Cities Initiative to function and to prosper. MCI would like to thank in particular the Millennium Villages Project, Urban Design Lab and the Center for Sustainable Urban Nkrumah University of Science and Technology, Maseno University, The Development, and, elsewhere within the University, the Office of the General Sackler Institute, University of Ghana – Legon, Los Gatos High School and Counsel and the Columbia University Business School, Columbia Center the dozens of African and American schools that have collaborated to train for Sustainable International Investment, Graduate School of Architecture, today’s teachers and tomorrow’s leaders. Planning and Preservation, Mailman School of Public Health, School of Engineering and Applied Sciences, School of General Studies, School of MCI’s effectiveness and reputation have grown in large measure thanks International and Public Affairs and Teachers College, for their expertise to our expert leadership in the field; three of our finest development and for the loan of their high-minded students. Founding MCI Co-Director practitioners deserve special recognition for their courage, patience and Dr. Karl P. Sauvant, of the Columbia Center for Sustainable International devotion: Ms. Abenaa Akuamoa-Boateng, in Kumasi; Ms. Beldina Opiyo- Investment, and former Senior Investment Advisors Joerg Simon and Dr. Omolo, in Kisumu; and Mr. Joe Melara, in Accra. In New York, two superb Karin Millett are responsible for formulating and leading MCI’s private and dedicated operations managers, Mr. Paulo Cunha and Ms. Lorian Viola, sector development portfolio, to bring job-generating investment to the have enabled MCI to thrive and to excel. Millennium Cities. We would like to express our gratitude to the members of MCI’s Advisory Beyond Columbia University, MCI would like especially to express our Board, for their service and their brilliant contributions: Ms. Pam Allyn and gratitude to our partners in the Millennium Cities, including the mayors Ms. Sarah Costa, Prof. Yasmine Ergas, Ms. Connie Evans, Mr. Steven Kass, and municipal governments, educators and students, medical practitioners, Dr. Geeta Mehta, Ms. Doris Mpoumou, Dr. Nawal Nour and Dr. Funmi city planners and water/sanitation specialists, local non-governmental and Olapade, Mr. Gary Schwartz and Prof. Deborah Tolman, and to MCI’s many community-based organizations, slum dwellers’ and business associations, generous individuals, foundations and firms that have funded our work in Accra and Kumasi, Ghana; Akure and Kaduna, Nigeria; Bamako and over these last nine years. Segou, Mali; Blantyre, Malawi; Kisumu, Kenya; Louga, Senegal; Mekelle, Ethiopia; and Tabora, Tanzania, and to the relevant state governments and MCI would like to thank Dr. Guido Schmidt-Traub, for his invaluable initial national ministries in each host country. support in envisioning this project and in establishing our partnerships with counterparts across the United Nations, and Ms. Chandrika Bahadur, Prof. No less important have been MCI’s longstanding and immensely rewarding Patricia Culligan, Ms. Ashley Hufft, Profs. Cheryl Palm, Richard Plunz and partnerships with the Governments of Finland and Israel; our NGO Pedro Sanchez, Mr. Edward A. Silver and Dr. Sonia Ehrlich Sachs, for their collaborators AmeriCares, CORDAID, Cure Cervical Cancer, CyberSmart enduring moral support and encouragement. Africa, Girls2Women, Himalayan Cataract Project, International Society of Ultrasound in Obstetrics and Gynecology, KNOCK Foundation, LitWorld, And finally, MCI would like to dedicate this volume to the approximately Millennium Promise, the Mount Carmel Training Center, Mums for Mums, eight million people of the Millennium Cities, who have welcomed us with Physicians for Peace and the World Agroforestry Center; the multilateral open hearts. As you are reminded here of many of our sincere efforts in agencies with which we have worked the most closely, including Cities your communities over many years, we hope you find that MCI has made a Alliance, United Nations Children’s Fund, UN Development Programme, contribution in setting your beautiful, resourceful cities firmly on the path UN Environment Programme, UN-HABITAT, UN Industrial Development to sustainable development. Organization, UN Office for Project Services, the World Bank; our corporate III TABLE OF CONTENTS Acknowledgements ............................................................................................................................................... III Introduction ..............................................................................................................................................................1 Education ..................................................................................................................................................................12 Gender ......................................................................................................................................................................32 Health ........................................................................................................................................................................52 Private Sector Development ...................................................................................................................................74 Urban Ecosystems ...................................................................................................................................................94 Conclusion ............................................................................................................................................................ 124 V 1MCI was founded by Earth Institute Director Jeffrey D. Sachs, together with then-MCI Co-Directors Susan M. Blaustein and Karl P. Sauvant. Dr. Guido Schmidt-Traub, then Policy Advisor and Associate Director of the United Nations Millennium Project, now Executive Director of the UN Sustainable Development Solutions Network, supported and assisted in the creation of the Initiative. 2Developed by the United Nations in 1990 and embraced in 2005 by the member states, the MDGs consist of eight quantifiable Goals, each comprised of multiple targets, all aimed at eradicating extreme poverty worldwide. Specifically, the MDGs include: 1) Eradicating Extreme Hunger and Poverty; 2) Achieving Universal Primary Education; 3) Promoting Gender Equality and the Empowerment of Women; 4) Reducing Child Mortality; 5) Improving Maternal Health; 6) Combating HIV/AIDS, TB and Malaria; 7) Ensuring Environmental Sustainability; and 8) Forging Global Partnerships for Development. While there has been tremendous progress worldwide in nearly all of these areas, increasingly severe environmental stressors, unchecked population growth and the failure of the international community to meet its commitments to support the poorest countries in this monumental effort have conspired to keep well over a billion people trapped in extreme poverty. The subsequent set of measurable targets, the Sustainable Development Goals, have been designed to pick up where the MDGs have left off, relying even more heavily on MDG 8’s call for “global partnerships for development” as the world forum in which practical solutions for addressing poverty and its myriad devastating consequences can be devised, tested and scaled by some of the world’s finest minds, hopefully leading to truly transformational and lasting change. 3The Millennium Villages Project (MVP), a pilot