 To start the discussion, perhaps I could just summarize what I perceive to be the key points that the speakers have made so far. I think it's a very interesting point, distinction between density and overcrowding, that density is not necessarily a bad thing. After all, Hong Kong apparently is ranked top in the global health indicators and it's very dense. Overcrowding, if you don't have the matching health services, is bad for health. So the two are not the same. But we can think about density. I mean, is it okay? Is there a minimum personal living space beyond which, this is the point Professor Yip made earlier, beyond which we have bad health. Then the issue of poverty and how it's necessary to get data and map your city to identify where the problem areas are and then investigate what it is that makes it have bad outcomes and do something about it. The absolutely necessary need to provide adequate health services. You can plan all you like but if you do not have the health services to match your city and the population, you're not going to get good outcomes. And this is the topic of adequacy of health services and accessibility. And then finally, the option in a new city to design, make use of natural resources and really design for healthy living with the steps and so on. So perhaps I would like to invite comments from the audience now about these topics. I'd like to ask our first two speakers to comment a little more on the issue of HIV AIDS in cities. I'm putting mind by this because I recently went to a, I guess I can only call it a debate between the Clinton Health Initiative and the London School of Economics BIOS program in which the Clinton Health Initiative stressed the importance of local community organization in dealing with problems of HIV AIDS in Africa. And the London School of Economics group said that this was ineffective, that HIV AIDS was something that doesn't have a local focus. It's not really an urban problem, it's a national or in the case of Africa a transnational problem and that focusing on local community health work essentially is going to prove ineffective. And I would just be curious if our first two speakers have any reaction to this debate. Would Gora Maboup talk about that first and then Warren? Despite my presentation did not really address HIV AIDS, I can say that based on previous research, HIV AIDS, there is many studies showing it is more important in slum area in many African countries than in rural area. Sure, it can be a national problem because if you take the case of South Africa where long time the president was overlooked the existence of HIV AIDS, you can say at the political level is a national problem. And many countries in Africa made success in HIV AIDS. It was part of the top priority at the national level. It's the case of Uganda, the case of Senegal, if you look at it at the level, yes. But let us not overlook local authorities that are playing a big role in HIV AIDS. Therefore I will not say it is only at the national level. You have to look at it at the local level. And there is program anyway HIV AIDS at the local level. Perhaps I could ask Katherine Keobobu Jongi also from Nairobi to comment as well before Ron Smith. I think my comment would be that it's quite frustrating to listen to such propositions from, I would say a major player in the fight against HIV AIDS because community health workers don't operate in a vacuum. They operate in a system that functions. If you have community health workers and you don't have enough nurses, you don't have enough doctors, you don't have drugs, drugs are out of stock, it's very frustrating because the whole system has to function. And in my view a system that functions will deal with HIV, will deal with diabetes, will deal with diarrhea, will deal with everything. And so I think the tragedy of the last decade and I think a missed opportunity in Africa has been the such huge focus on vertical systems that have created parallel systems that are unmanageable and unsustainable with the same health workforce. So in my view if I had the opportunity I would suggest that you need to strengthen the system that's going to serve everybody and in my view that system will solve the HIV problem and it will solve all health problems of everybody rather than of a disease. Thank you. Just to note that in South Africa the highest HIV AIDS incidence and prevalence rates are found in slums in urban areas and there's been a lot of work looking at why that is and part of the findings suggests that because in slums you have this lack of security of tenure and high degrees of overcrowding and lots of like in-migration and out-migration, you get this very unstable social condition that sort of facilitates the growth and spread of HIV AIDS in slums. Coming back to the question of density and health of the city, in case of density I'd like to emphasize the distinction between private and public spaces. So in some sense a territory may be very densely populated but maybe quite well off because of accessible public spaces. So I think that makes a lot of difference and for example as we had in many cities public spaces are not easily accessible because of fear of physical violence. The second thing is in question of health, I'd like to turn to question of communicable and non-communicable diseases because in some sense the idea is that better hygiene and public health measures can cover communicable diseases but not non-communicable diseases. So that also makes different when we're talking about healthy environment and facilities is to actually distinguish between the two, especially of the importance of epidemic control and hygiene in stopping the spread of communicable diseases. In terms of locating problems within the city, this just highlights how important it is to map a particular disease, a particular problem. But my question is do governments actually take any notice? Are there quite enlightened governments where they actually act on these findings of inequality and actually this information shaped their health and social care policies? Would anybody like to comment on the more enlightened healthcare systems like the National Health Service? Maybe I have a comment. When we talk about, I'm from the Fudan University School of Public Health and I have some comment about this for the presentation. When we talk about the urban density, I think from these two presentations, I think only it is a phenomenon. In fact, it is related to the system, also related to government buildings and also capacity and they have the sources to improve the public health or not. For example, for the healthcare service and also for the infectious disease control, I think it's not only related to the urban density. If we have some sanitary equipment and also have something, it will be no problem. So I think maybe we talk about the density, I think, but we should consider the government, what is the awareness and the sources to resolve this problem. Can you hear from Mr. Adlee from Berlin and then Tony Trafford from LSE? Yes, Mr. Adlee from Berlin. I have one question and sort of comment. We have heard a lot about density and also the difference between density and overcrowding and I wish to, in the first place, ask Goram Boop maybe to comment on this. Do we in fact know enough about the difference between different regions as to how much density people tolerate and about the cultural differences? I understood that you applied your metrics to the African region, but you did not to Europe, but even within the African region, are there differences and do we have enough knowledge about the measures and metrics? Also, we heard yesterday from Libby Burton about the curvilinear relationship that she assumes between well-being and social density as opposed to a linear relationship. So do we know enough about the tolerability and acceptance to have the right measure for what we call density? Thank you. First, what I presented here, we can look at it only at the quantitative level. We did not ask a question at the household level, did you tolerate this density or not? But we can speculate. There is some countries, if you look at the case of Jordan. Jordan has low density, but the overcrowding was very high. It was not related to housing supplies. It was related to family structure. Now you can go in depth like that. Myself, I am always trying to see, can we calculate what we call relative density? Relative density is to take into consideration what you are asking for, but that requires research. I remember very well in Senegal, we said, if there is peace in the house, the house is not overcrowding. In the room, yes. But you can have a large room if there is no peace, it's overcrowding. Therefore, just to let you know the word peace relativise overcrowding. Thank you. I have a quick response to the utterest comments. From Hong Kong's experience, for a densified or dense city, to have more public space is helpful to improve the well-being. But my comments, to your comments, is that what kind of public space? That public space should be the people's friendly and people's easy participation public space. If the public space, for example, in some China cities, is a very wide area of public space, but people are certain or difficult to involve in, that public space is not helpful for the person. Okay, let's hear from Tony Travis. Thanks. I mean, it seems with a number of the issues we've discussed yesterday and today, the quality of government and the extent to which, as you say, from the chair, it's enlightened is going to be important. Because health services and public health provision are always going to need to be effective, a reasonable level of legitimacy and resourcing, and indeed a way, a capacity to research issues and then to convey and to get public support for reasonable kinds of ways of solving particular problems. However, the question that Richard Sennett and others have touched on, whether top-down or community-led bottom-up ways of delivering certain of these kind of health care services is clearly very important in all of the cities and countries that we've been discussing. So I think that an issue we haven't discussed much at this conference largely because it wasn't about governance or government is one that can never be escaped, whether we're discussing the provision of health services, public health care messages, or indeed traffic management at the core of them will be the need for some legitimacy of action by authorities that can raise resources in order to deliver effective services while with luck articulating public feeling about what needs to be done. There are two, Professor Rockwin, and then... I'd like to ask a question about Shanghai presentation. From what you presented, you gave a great focus on inputs and not so much on outcomes, and what you showed us is typical of most global cities, concentration of physicians, concentration of hospitals in the core and less so outside, and in fact your data suggests that it's a little bit more equal in Shanghai than some of the other cities in terms of inputs. But I would like to ask you about the outcomes and the health status but do you know anything if you divide up Shanghai on where the health conditions are worse? I suspect in Shanghai as elsewhere there is some evidence for what Tudor Hart called the inverse care law. You have more services for those who need them least. Now to Gene Wu's question, do governments do anything about this? I think there's a lot of evidence that governments do a lot about it and there's equal evidence that what they do doesn't have sufficient impact. But I'm wondering in the case of Shanghai, what the government may be doing about that to start with. First you may want to comment on my understanding of your presentation if I got it right, which I enjoyed very much. Actually the Shanghai government is also realized such kind of phenomena that they take initiative of developing health facilities in outskirts. For example they move some branches of hospitals in city core to the suburban urban area. So we can see this kind of trend it is helpful and it is good for the city's development. But still there are a lot of institutional obstacles, for example migrants. We all realized such kind of problems but it is difficult to change. Yes, the problems of access seem absolutely overwhelming from what you described because precisely of the migrants and that seems to be something that could be improved if nothing is done. What do you expect will be done about this? That's because the population of migrants increase faster and faster, more and more, so there are more demandings. And those kind of demandings accumulated to some point it will be changed. I'm afraid we have time for only two more questions. First perhaps you could speak and then Jorgen and Eskimoza. And then we can continue our discussion over lunch. This is a question actually prompt by Philip's presentation about the London Olympics and it's addressed to the two Chinese cities Shanghai and Chongqing. Taking the examples of the practice in London, I just want to say in terms of the post-Mega event management like the exposition in Shanghai, what sort of measures and policy has been put to place to promote the living standard and the quality of the post-event site of the exposition in Shanghai. And for the matter, you know, in the case of Chongqing as well, we understand from the presentation that that has been a well-consulted effort to promote the CBD commercial development. And we understand that Chongqing being the four largest municipalities in the country, there is a very important dimension about this rule interface with the rapid urban transformation. And in that context, how is the Chongqing government trying to address the issues in terms of addressing a proper balance between the urban and then of the rural context in terms of the living quality in particular in terms of health services? Personally, I do not think I believe that such kind of big event like the Olympics have very significant or effective impacts through people's health because I think if the public finance to put such kind of fund to the social medical system or improve the community healthcare system, it might be much better improve the life life expectancy than the Olympics. But I do think that the Olympic program big events have some good impacts, positive effects impacts to people's health. And it is of course to make a wise treatment options of post big events to use such kind of facilities open to the public might be good for improve people's well-being. Last comment from Jürgen. Thank you. Jürgen, Denmark. I would like to raise the issue on rental, rental in African poor settings, settlement renting. I think, I mean, to my own experience, there's a huge variations whether the people are renting or not renting. And if they're renting conditions in principle at least are much, much worse, much worse. Those are ones who have visited Kibera and Mathara Valley in Nairobi. We know this extremely poor conditions, very, very poor health conditions. So my question is to Mr. Kora Emburo from UN Habitat. You showed very impressive correlations on overcrowding and health. But have you ever tried to correlate health and rental, whether these are rental settlements or settlements dominated by renters or not? I mean, I like your method for on peace in the house. It's not necessarily a question of overcrowding, not overcrowding. I think, however, as we know from South Africa, my one on Smith and Edgar can confirm this, many of the informal settlements in South Africa are dominated by shack lords. If you're dominated by a shack lord, you cannot have peace in the house. So it's, I think these issues on rental, not rental are really crucial issues. And if you recall my presentation yesterday on Maputo, Mozambique, this is the reason that relatively speaking, Maputo is doing far, far better. Thank you. Thank you. I think you say rental, but you add the rental in the slum area. But if you take rental just at the city level, we cannot say owners are better off than rental. We did a study related to security of tenure. And this study is showing very clear. This is in Addis Aviva. Households who are renting feel more secure than households who are out, who consider themselves as owners because this is related to title deed. Yes, because you are in a house, you say you own the house, but when the question related to documentation was asked, it was very clear they do not have document. And we asked the question, are you exposed to any fear to be evicted? And owners were more likely to say yes, but rental now. But let come now to the slum area. Slum area, if you take Kibera, most of the people are renters. Therefore, we cannot talk about differential because that's their condition. That's their condition. Therefore, we cannot at that level compare even rental and owners. The answer is there is, frankly, there is no linear relationship between rental and living conditions. And you will be very surprised there are owners in a house who's renting the best place to get more money than others in their quarters. And this will observe in a study in Indonesia in 1995. I have the report here. Okay, thank you. Would Warren Smith also like to have the final comment before we break up? Yeah, I think I agree that I think a lot of servers have found that tenants are worse off than their own occupiers. But I just wanted to pick up on the other comments about density because density issues are very different at different scales. Because in Cape Town, for example, there are some areas are overcrowded and that those issues need to be addressed. The city as a whole is too, the density is too low, it's too sprawling, it's too fragmented. So in Cape Town, we actually need to densify and compact the city and integrate land users and socioeconomic groups. So it's very important to, like, separate out issues of density at different scales. Because density at the neighborhood scale and density at a city-wide scale, two completely different issues with two completely different dynamics. All right, I think we'll finish here. I'd like to thank all the speakers and all the audience for participation. We're continuing with this theme after lunch, focusing more on the psychological aspects of health.