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This working paper is the product of the Living Off-Grid Food and Infrastructure Collaboration. It is designed to bring together our thinking on how infrastructure can shape the food and nutritional security of urban marginalised populations. Infrastructure assemblages include the material (physical and technological), as well as the political and systemic factors that ‘govern’ how infrastructure is developed and used. Urban food systems are made up of public and private actors, and market and governance processes that shape the cost and availability of food in different urban contexts. At the intersection of urban food systems and infrastructure assemblages lies the food and nutrition security of urban dwellers. The framing of contemporary debates and policy priorities with respect to both nutrition and infrastructure are heavily conditioned by presumptions – in favour of formality and griddedness, for example, or of the need to raise agricultural productivity – which fail to reflect the reality of marginalised communities in Southern cities. For these communities, their experience is one of hybridity, with formal and informal infrastructures and economies central to their lives and livelihoods. These hybrid arrangements are imbued with power structures and socio-political dynamics that are context specific and further condition communities’ experiences. Together, these are the factors that condition or shape the possibilities for individuals and households pursuing different food strategies. However, there is a failure to reflect this reality in the conceptualisation of infrastructure challenges, leading to unworkable solutions and policies that end up perpetuating problems. There is an urgent need to reframe problematic assumptions, starting first and foremost from the entry point of urban informal settlements in the global South. By taking food as a lens in this process, we illuminate these contexts, and how they relate to hybrid infrastructure arrangements and potential alternatives. This reformulation is vital at this critical juncture, when Southern cities need infrastructure development that meets the needs of rapidly changing demographics without locking cities and nations into unsustainable pathways.

The cost of the Covid-19 pandemic remains unknown. Lives directly lost to the disease continue to mount, while related health, livelihood and wellbeing impacts are still being felt, and the wider ramifications across society, politics and the economy are yet to fully materialise. What is known about these costs though, is that they have been unequally distributed both within and between countries. Preparedness plans proved inadequate in many settings – especially when it came to protecting those most vulnerable, including those marginalised by geography, poverty, or exclusion along the lines of religion, ethnicity or gender. The top-down, surge-style, biomedically dominated and technologically driven preparedness approach that has dominated global health thinking and which was propelled into action with Covid-19 was found wanting not only on the grounds of effectiveness, but also of social justice. This presents both a challenge and an opportunity for a convergence of the preparedness and development agendas. Drawing on a growing body of social science evidence, this report contends that securing health in the face of today’s uncertain disease threats in often unpredictable settings means making social, economic and political priorities as core to the preparedness agenda as biological and technological ones. We present here a framework for a vision of pandemic preparedness for the real world – one that accepts that context is paramount, embraces inclusivity and justice, shifts power centres and rejects simplistic, one-size-fits-all solutions.

The Covid-19 pandemic is more than a health crisis. It has worse outcomes among individuals with co-morbidities, has exposed fault lines in our societies, and amplified existing inequalities. This article draws on emerging evidence from low- and middle-income contexts to highlight how Covid-19 becomes syndemic when it interacts with local vulnerabilities. A syndemic approach provides a frame for understanding how Covid-19 is amplified when clustered with other diseases and how this clustering is facilitated by contextual and social factors that create adverse conditions. Public health responses to Covid-19 have also exacerbated these adverse conditions as many face social and economic crises as a result of some policies. These multiple challenges generate major implications for both the public health response and for broader development action: first, one size does not fit all and we must attend to local vulnerabilities; second, short-term public health response and longer-term development approaches must be integrated for improved intersectoral coordination and synergy. A synergised public health and development response will allow us to better prepare for the next pandemic.