More than half of the world’s population now live in cities, and by the year 2050, urban populations are expected to comprise more than 75% of all people (UNFP, 2007). The health of the world’s people is therefore increasingly a matter of urban health. However, urban growth, especially in sub-Saharan Africa has occurred mainly in informal settlements and other areas of “concentrated disadvantage” (Vlahov et al 2007) such as inner city areas and the city periphery, with the prospect of increasing burdens of ill health and rising inequities.

The purpose of this paper is to outline the urbanization process in Africa, and to describe some of the environment and health implications of rapid urban growth in a selection of African cities. Much of the paper is based on case studies of ten cities, specially prepared for this purpose. The paper is divided into four main sections.

The toxic effects of lead have been known for centuries. Its many useful properties gave rise to a dramatic escalation of lead use around the time of the industrial revolution, when lead poisoning was common amongst workers in the smelting, painting, plumbing, printing and other industries. With the advent of motor vehicles early in the 20th century, and the use of lead in petrol, environmental lead contamination increased substantially.

The Healthy Cities movement has its origins in the recognition that health is determined much less by health services than by social, environmental and economic factors, as originally pointed out by McKeown.2 Observations of this kind gave rise to the now well-established concepts of Health Promotion and Primary Health Care and policies such as WHO’s Health for All.