Background Many of the Millennium Development Goals - in health, environmental sustainability, poverty reduction and enhanced international development assistance- will not be met despite improvements in some areas. As we now consider the Post-2015 development agenda for Africa, many believe that it is best to tackle the poverty and health problems where they are growing fastest – in the cities. UN-Habitat estimates that sub-Saharan African cities have over 166 million slum dwellers most of who work in the informal sector where they simply do not earn enough to afford decent shelter and services. What does sustainability mean for such cities and townspeople?

Objectives Ideally, well managed cities should promote good health and well-being; but poverty and slum conditions pose a serious public health challenge to Nigeria's rapidly expanding urban population. Unfortunately, the current pattern of government spending on the health sector tends to favor the better-off in society who are the main users of available curative health services. Many government officials and planners still see the urban poor and the slums in which they live as evidence of the failure of official policy, and therefore something to be removed through misguided policies of forced eviction and other forms of repression. The main policy challenge is how best to reach the poor, and decrease the inequalities in access to health care; how to promote the growth of more inclusive and humane cities by reviewing discriminatory laws and codes which inhibit the access of the poor to affordable land, healthcare and housing security; how to forestall the growth and spread of slums, and ensure that the existing ones are upgraded; how poverty which leads to slum conditions can be alleviated and reversed; how to integrate health concerns into planning and development policies in cities, and keep the health impact of these policies constantly in view.

Methods The paper draws from archival sources and social science literature on poverty and urban health in Africa. It also draws insights from the work of several UN and other international organizations, as well as my personal experience and contact with the urban poor in Nigeria and other African countries.

Result Current research suggest that the path to urban peace, health and sustainability in Africa lies in building more inclusive and socially equitable cities “where everyone, regardless of their economic means, gender, age, ethnic origin or religion are enabled and empowered to participate productively in the social, economic and political opportunities that cities offer”.

Conclusion The concluding section stress the need for appropriate and well targeted urban health and other social interventions by state and local authorities, the international development community, the private and civil society organizations and the urban poor themselves in a collaborative effort to build safer, healthier and more equitable cities.