Abstract
INTRODUCTION: Urbanization presents growing public health challenges worldwide, particularly in the Eastern Mediterranean Region (EMR) where rapid urban growth coincides with conflict, migration, and health disparities. The WHO Healthy City Programme (HCP), launched in the 1990s, addresses these through multisectoral urban health initiatives. AIM: This narrative review examines the HCP's global implementation, with focused analysis of the EMR context. METHODS: A comprehensive literature search was conducted using PubMed, Scopus, and Web of Science, supplemented by WHO and UN documents. Key terms included "Healthy City" and "Urban Health." Only English-language documents addressing HCP implementation were included. RESULTS: The HCP has expanded to all six WHO regions, with 35 cities certified in the EMR by 2019. The programme emphasizes equity, emergency preparedness and community participation in this region. Implementation challenges include weak institutionalization, limited inter-sectoral collaboration, and inadequate documentation. The paper specifically notes these barriers in the EMR context, along with the need for better monitoring systems. Successful examples from the region demonstrate the programme's alignment with Sustainable Development Goals. CONCLUSION: Scaling the HCP in the EMR requires stronger governance frameworks and systematic evaluation. The programme's multisectoral approach remains crucial for addressing urban health challenges, but requires sustained political commitment and adapted strategies for regional implementation.