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Using the results of a comparative three-year research project in five metropolitan areas, this article reviews a range of practices in accessing water and sanitation by peri-urban poor residents and producers. It starts from the observation that neither centralized supply policies nor the market through, for example, large-scale profit-making enterprises are able to meet their needs. Although they are consumers insofar as they have no option but to pay market prices for water (and often for sanitation), the peri-urban poor are, in practice, sometimes regarded as citizens with basic entitlements such as the right to water. This article outlines a conceptual distinction between “policy-driven” and “needs-driven” practices in the access to peri-urban water and sanitation services. The case studies show that this access is mainly needs-driven and informal rather than the result of formal policies. The key to structural improvements in water and sanitation lies in the recognition of these practices and their articulation to the formal system under new governance regimes.

With the consolidation of democratic governments in the 1980s and 1990s, wholesale evictions of entire neighbourhoods ceased to be a solution to urban problems in Latin America. This paper discusses an example of a new generation of municipal programmes aimed at physically upgrading informal settlements while integrating them both physically and socially into the fabric of the city. In Medellín, a city with a recent history of violence and social inequality, the audacious use of well-established ski-slope aerial cable-car technology in dense and hilly low-income informal settlements was followed by major neighbourhood upgrading comprising new social housing, schools and other social infrastructure, as well as support to micro-enterprises. Although lack of mobility contributes to social inequality and poverty, the paper argues that the introduction of quick-fix highly visible transport technology on its own is unlikely to help reduce poverty. Although urban upgrading programmes and the symbolic value of cable-car systems have instilled among the local population a feeling of inclusion and integration into the 'modern' city, they can also be understood as mechanisms for the 'normalisation' of informal sectors of the city.

Rapid urbanization in the global South is adding epidemiological and nutritional challenges and increasing disease and health burdens for citizens. Greater movement of people, animals, food and trade often provides favourable grounds for the emergence of infectious diseases, including zoonoses. We conduct a rapid evidence scan to explore what is known and hypothesized about the links between urbanization and zoonosis emergence. This points to rapid demographic growth, migration and density, increased movement of people and animals, and changes in land uses as the main processes linked to the prevalence of zoonosis in the urban global South. We argue that this emerging global health challenge is also deeply connected with the urbanization of poverty and inequalities within cities. Tackling the micro-level causal relationships between urbanization and zoonosis requires urgent attention to living conditions, as well as the wider socioenvironmental transitions and structural drivers that produce and reproduce risk accumulation in urban settings.

Quantitative evidence for the risk of zoonoses and the spread of antimicrobial resistance remains lacking. Here, as part of the UrbanZoo project, we sampled Escherichia coli from humans, livestock and peri-domestic wildlife in 99 households across Nairobi, Kenya, to investigate its distribution among host species in this rapidly developing urban landscape. We performed whole-genome sequencing of 1,338 E. coli isolates and found that the diversity and sharing patterns of E. coli were heavily structured by household and strongly shaped by host type. We also found evidence for inter-household and inter-host sharing and, importantly, between humans and animals, although this occurs much less frequently. Resistome similarity was differently distributed across host and household, consistent with being driven by shared exposure to antimicrobials. Our results indicate that a large, epidemiologically structured sampling framework combined with WGS is needed to uncover strain-sharing events among different host populations in complex environments and the major contributing pathways that could ultimately drive the emergence of zoonoses and the spread of antimicrobial resistance.