 Thank you. It's an honor and a pleasure to be speaking here before you. I'll share about health inequities in Indian cities and also about some approaches that have worked. Here are six messages about inequalities. In India's urbanizing economy, affluence and deprivation are juxtaposed. While on the one hand, cities are glittering, opulence grows along with deprivation, poverty and inequality. There are two examples. 50% of Mumbai's population lives on 6% of land and this 50% contributes to the economy in many ways because without them, Mumbai wouldn't be the city that it is. In Delhi, the municipal corporation of Delhi, in an official communication informed that water supply for planned colonies is 225 liters per capita per day, whereas it is 50 liters per capita per day for listed slums. This is official information provided by them. So the government actually is acknowledging the inequity that they are perpetrating on purpose. And all this despite the fact that urban poor contribute measurably towards India's economic growth. Between 60 to 90% of urban poor are involved in the informal sector and the urban sector contributes 60% to 70% of the country's GDP. These are nutrition inequalities. There are a few other countries and I just left them there and removed so that some of you can see. But what this shows is that chronic under nutrition, which is a very important indicator of deprivation, multifaceted deprivation is about 53.8% among the lowest or the poorest quartile based on the wealth index. And in the next higher quartile, it is 43%. So if you count these children, there are about 12 million children under five in the lowest two quartiles of urban India who are chronically undenourished. Why are they important? They will form the bulk of the informal sector workforce in the next 15 years. This is another form of disparity in living space. We have had a lot of discussion around density. This is an indicator which Gora used in a slightly different way. Here we try to see if how these indicators vary. And we tried to assess more than five persons per sleeping room. This is an indicator available for many countries in the demographic health surveys and we found that in the lowest quartile in India, nearly 50% families had more than five persons per sleeping room. Now, why is this important? We did some more analysis and we found that chronic undenutrition among children less than five years in households with more than five persons per sleeping room is 1.4 times higher than households with less than four persons per sleeping room. And if we were to make it three, this would be two twice as high. We just didn't do the next level of math. Tuberculosis prevalence, which was referred to in the Hong Kong presentation just before me, living in houses with more than five persons is twice as high as those in four persons per sleeping room. So this tells us that if public health interventions which are multi-sectoral have to be focused, where will you target your efforts? Now, these are three slides from eight cities of India. Four of them are mega cities and four are medium-sized cities. And we see that there are disparities on the toilet front. This is the indicator for no toilets. And the city called Merritt is the worst off where nearly 50% households in the poorest quartile have no toilets. The green bar is for slump. In this particular study, we had pushed the India DHS to do an over-sampling of urban areas so that this level of analysis was possible. This is not possible for other countries unless there have been instances where the capital city has been over sampled or automatically gets over sampled in some countries because it is so large. Infant mortality rates also show a disparity across different parts of the city. I'm not going into the details, but what we see is that it is worse off in the small city, Merritt, and it is quite bad in Delhi also. Under nutrition, we again see a differential and here we find that even in Chennai, which is otherwise better off on several other facets, under nutrition is quite high among the lowest quartile. But the slums are far better, so that will bring me to another slide about the difference between what is designated as slum and what doesn't get designated. Why are we talking about all this? The urban vulnerable segment or the slum forms the fastest-growing segment of India's population and of the population of almost all developing countries. And I was just noting data which tells us that India has 100 million officially designated poor people. The official poverty line has now acknowledged that there are 100 million poor. As per the 1.25 US dollar, it will be 158 million urban poor. 90 to 95% of future urban growth is going to happen in countries like India, less developed countries. And likewise, about 97% of the growth of urban vulnerable populations or slum populations or non-affluent populations, whichever way we want to describe them, is also likely to happen in similar scenarios in other countries. This is the issue of slums being officially listed or not listed by the civic authorities. Our organization did this study in several cities. Here is data from five cities which tells us that approximately 30 to 35% of the slums were not listed. There was a big study conducted by the Ministry of Statistics of the Government of India down below, which showed that 49% of slums in India were not part of official lists. We see that the slums which are in official lists have better access to some of the important determinants of health. This is another type of inequality which I wanted to bring to attention, particularly because in this meeting I am realizing that we are discussing mostly about large cities. What is important to understand is that medium-sized and smaller cities suffer worse. They do not have adequate services infrastructure. And the number of these cities in the world is huge. So if we look at the total population in the mega cities of the world and we look at the total urban population in the medium and smaller sized cities, this would far outnumber. So that's why they are also important. Now I'll share five approaches which I've worked. The first approach is mapping. This is the map of Merritt which was having the tallest red bars. These are the listed slums in Merritt. And the red ones are the unlisted slums in Merritt. So if we did not do this entire exercise, we would have missed these. And this is the total picture. So we found that plotting, especially mapping the vulnerable populations on a city map is a very effective tool. It just opens up the eyes of administrators, civic authorities. This is an example from one of the wards of Mumbai where again we did a very similar exercise. And here we have also shown the health facilities. So we can see which part of that city the health facilities are adequate and in which parts they are not adequate. This is neighborhood mapping. This is also very powerful. This is done by community groups themselves. It helps them, the community groups themselves ensure that no family is left out from lists which are used for housing, for food subsidy and other entitlements. Because typically what the civic authorities do when they will resettle a slum is that they will say that this slum had 200 families so here is the amount for 200 families irrespective of whether the slum actually had 280 families. And who will be the 80 who will be left out? The most voiceless. The second thing it does is it tracks access to health care. Immunization, antenatal care, HIV testing. It also helps identifying and providing linkage for the recent migrants. We had heard yesterday that recent migrants who have come to the city maybe one year ago they usually do not have a good understanding of what is available for them. This is another example of how communities draw maps and the different colors here are the different parts of the slum that have been taken charge of by the slum dwellers. The second approach which I wanted to share which actually came up from whatever I have heard and learned during this meeting is that coordinated urban planning and design is crucial and there are three points here. Sensitive social equity oriented child and gender friendly urban planning can help reduce disparities. Multidisciplinary well-being teams, urban well-being teams, like a team that is sitting in this room right now has an important role and this meeting is playing that role. Planning and design keeping the most powerless neighborhoods in mind will be helpful. If we reach the most powerless, during that course we will end up reaching slightly less powerless people automatically. This is a community organization. This is approach three which I wanted to share with you. Trained slum groups enhance access to healthcare as well as to other services. Institution building and negotiation capacity building at the community level helps them address determinants of health. How do they do that? They do that through formal petitions to authorities for various services. They do that through persistent negotiation. That's an important skill which people have to learn to be able to do it. Collective representation to the authorities. Actually 20 women, 50 women going to the civic authorities in person and using legal tools. India has two legal tools which are commonly used. One of them is called the right to information act and another is called the public hearing. These are also tools that we have taught them how to use. There are examples of how NGOs or private players have partnered with the public sector to increase or expand healthcare. This is one hospital in Assam. This is a health center in many states of the country. This is using whatever is available. So in urban areas, telephones are available, these tuk-tuk's are available, and so if we utilize whatever is available and develop systems, develop skills, we can increase access. This is my last slide. What can we do? Four messages. On the research front, and maybe some of you will get upset with me, 50% of the resources for action to reduce inequalities in cities. The focus on realities. Urban poor constitute the most rapidly growing segment of the population. So if research takes this into account, the research design automatically will help this. And action research, if it involves enablement of vulnerable populations that will directly help the population, it will also propel such research and future. On the policy front, what I have felt is that many countries have good policies. Usually the policy think tank is reasonably good. It takes good advice. There's a very important need to translate that into expeditious and undiluted results. There's a lot of dilution which happens from the policy until it reaches where it's supposed to reach. The third message is that if we have coordinated collaborative research and action, which is what I think this type of meeting will lead us towards, that will be very helpful. Everybody has emphasized that. I've learned a lot certainly from this meeting. And this is something which I wanted to leave everyone with. Make the invisible, visible, facilitate empowerment and skill building of those with weak voice and little power. Before I leave, I just wish to acknowledge the work of all colleagues, community stakeholders, stakeholders at national state, and from all of you from whom I've learned enormously during the course of these two days. Thank you very much.