Building healthy, thriving cities: A conversation between C40 and Novo Nordisk

Elin Jäger (EJ): At Novo Nordisk, we know that tackling chronic diseases requires looking beyond treatment to the everyday factors that shape people’s health. That’s why we focus on prevention as well as care, and why we work not just with patients, but with the communities where people live, work and grow, addressing the real barriers faced in making health choices. 

Over the last decade, we’ve learned how central cities are to this work. Our Cities for Better Health programme now brings together more than 50 cities worldwide. We work with local leaders, community groups, and residents to tackle the things that actually affect people’s daily health: Can they safely walk or bike in their neighbourhood? Can they afford fresh, healthy food? These aren’t abstract problems—they’re shaped by the streets, parks, and shops around us. And with half the world living in cities now, this is where we need to focus.

Our partnership with C40 grew from this belief. From climate resilience to social inequality, cities face many overlapping challenges that can’t be solved in isolation. By linking efforts across sectors, we help cities achieve more impact with the same resources. 

A good example is the Green and Thriving Neighbourhoods programme, which Novo Nordisk’s partnership with C40 supports. The programme helps cities to create low-carbon, people-centred neighbourhoods with access to healthy food, green spaces and safe, active transport. The programme brings health and climate goals together – building places where people can live well and sustainably. This shared vision unites Novo Nordisk and C40 around a common goal: healthier, more sustainable cities for everyone.

EJ: Too often, good ideas fail because they’re designed without the people they’re meant to help. Real progress begins by listening – understanding how people live, the barriers they face, and what matters most to them. We believe lasting solutions are built through partnership: bringing residents, city leaders and experts together to co-create neighbourhoods that reflect local needs and realities.

When communities have a say in how their spaces are built and improved, the results last. Streets feel safer, green spaces grow, and healthy food is easier to find. It’s especially important that underserved communities help lead this process – they know the barriers others might miss and help make solutions fairer for everyone. That’s why all our programmes are created and run together with communities at the centre, turning shared ideas into action.

EJ: Building on what we’ve learned from working hand-in-hand with communities, the clearest lesson is that design only delivers lasting change when people are part of the process.  When residents help shape neighbourhood design, the results reflect local needs, and people are more likely to use and care for those spaces. It’s how design turns into daily habits.

But design alone doesn’t change behaviour. It needs to be paired with community engagement and local programmes that give people the confidence and support to make new habits stick. In Bogotá, for example, the Cycle for Better Health initiative combines new cycling infrastructure with programmes that help residents build the skills and confidence needed to use it. This balance between physical design and community engagement ensures that revitalised spaces reach their potential for both health and sustainability. 

EJ: Preventing chronic disease in cities starts with local action. Each year, Cities for Better Health runs an innovation challenge to find and support community-led ideas that make neighbourhoods healthier and more inclusive. In 2024, we teamed up with C40 to launch the Healthy Cities Challenge – a global call for local projects that create greener, fairer and healthier urban spaces.

The three winning projects, from Buenos Aires, Nairobi and Rio de Janeiro, show what local leadership can achieve. In Buenos Aires, Asociación Sustentar, a community group, is working with local businesses to expand a weekly market and make healthy, sustainable food easier to access. In Nairobi, the GoDown Arts Centre, which is leading the Dunga Road Renewal project, is turning a busy street corridor into a safe, lively place for walking, cycling and social connection. And in Rio, the Oswaldo Cruz Urban Lab, an initiative by the Faculty of Architecture and Urbanism at the Federal University of Rio de Janeiro, is bringing the 15-minute city to life – creating a community where most daily needs can be met within a short walk or bike ride.

For other mayors, the message is clear: progress starts in the neighbourhoods where people live. By working with communities, listening to local voices and supporting ideas from the ground up, cities can build environments that promote health, equity and sustainability for the long term.

EJ: Equity has always been part of Novo Nordisk’s purpose. From our early work to make insulin accessible to those who need it most, to tackling barriers to care in low-resource settings, we’ve focused on reaching people who are often left behind. That same commitment shapes how we work with partners today – promoting prevention and strengthening health systems in communities most at risk.

Making progress also means learning and adapting. Through initiatives like the Childhood Obesity Prevention Initiative from Cities for Better Health, we focus on prevention in underserved urban areas – combining community engagement, health education and local capacity-building to create lasting change. Across all partnerships, we adjust based on evidence and feedback, building local ownership and steady progress toward healthier, more equitable cities.

EJ: Investing in healthy neighbourhoods is one of the smartest choices a city or country can make. Evidence from the World Health Organisation shows that prevention pays off – every dollar invested can return sevenfold through longer, healthier and more productive lives.¹ These benefits come not just from lower healthcare costs, but from stronger local economies and more resilient communities.

Most chronic diseases are preventable. Tackling their root causes (poor diet, physical inactivity and environmental risks) saves lives, reduces costs and eases pressure on health systems.^2,3 When cities design spaces that make healthy living the easy choice, with safe places to be active and access to nutritious food, they improve everyday life. This is why Novo Nordisk has a stake in prevention: when health systems aren’t overwhelmed by preventable diseases, they have more resources to ensure patients who need our treatments can get them.

Healthy neighbourhoods aren’t just good social policy – they’re sound economics. By investing in health, equity and sustainability together, cities create communities that attract talent, boost productivity and deliver lasting savings. In short, investing in people’s health builds stronger communities and stronger economies.

EJ: Cities are where we can make the biggest difference for health and climate resilience.  Already, more than half of the world’s population lives in urban areas, and that number is expected to increase to 70% by 2050. And even more striking is the fact that by 2030, an estimated 60% of city residents will be under 18.  This gives us a real chance to create environments where young people grow up with healthy and sustainable habits from an early age. More than half of the world’s population already lives in cities, a figure projected to reach 70% by 2050.⁴ With an estimated 60% of urban residents under 18 by 2030, cities provide a powerful setting to shape environments that support healthy, sustainable living from an early age. 

Local design choices matter. When cities make room for walking and cycling, improve access to nutritious food and create greener public spaces, they deliver real co-benefits – preventing disease, cutting emissions and strengthening communities. City leaders are already showing what’s possible. They’re close to residents, quick to act and willing to take bold steps on prevention through policy and investment. Cities are proving grounds for innovation – places to test, adapt and scale what works. 

That’s why Novo Nordisk engages at the city level. We invest locally to show that prevention works – and to build the evidence and momentum needed for broader change. By partnering with mayors, communities and global networks like C40 and Cities for Better Health, we help demonstrate what’s possible on the ground and use those lessons to influence how health systems and investments evolve nationally and globally. Local action is where global change begins.