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course—has been suggested as a major cause of increased disease transmission risk. 49 At the same time, megacities create global population-mixing effects, and this makes traditional local-level approaches for disease surveillance, response, and public communication much less effective. 50 People who live in transitional or periurban areas interact with residents of the densely populated urban cores where they work, and with users of public transportation systems, airports, and seaports. Combined with the global transmission belt of increased worldwide air and sea travel, and greater connectivity across the planet, this creates pathways for the extremely rapid global spread of infectious or exotic diseases—something that was seen in recent pandemic influenza episodes and in cases of bird flu. 51
    The food security effects of coastal urbanization are equally severe. Increased pollution from growing coastal cities depletes fish stocks. Fisheries that were once key sources of food for coastal towns begin to collapse under the pressure of unchecked population growth, bringing increased pollution and overfishing. This is particularly severe in low-income countries, where coastal megacities lack effective wastewater treatment systems, so enormous amounts of raw sewage flow directly into rivers and the sea. At the beginning of the twenty-first century, for example, Pakistan’s largest coastal city, Karachi, generated a million cubic meters of sewage every day, creating a massive amount of coastal pollution. 52 Karachi (discussed in Chapter 2 ) has the largest fishing fleet in Pakistan, mainly comprising small boats that operate close to the coast, so increased coastal pollution prompted by urban growth could put a serious dent in Pakistan’s fisheries and in the livelihoods and diets of Karachi’s inhabitants. 53
    Onshore, meanwhile, the newly urbanized areas that surround an older city core absorb territory that was once occupied by farmland, market gardens, and orchards. As slums and unplanned housing developments expand into this space, the distance between a city’s population and the food sources on which it depends increases significantly. Food has to be produced farther away and transported over ever-greater distances, increasing transportation and refrigeration costs, raising fuel usage, exacerbating pollution and traffic problems, and creating “food deserts” in urban areas. In a more general sense, “as societies urbanize and modernize, so their populations become ever-more dependent on complex, distanciated systems . . . to sustain life (water, waste, food, medicine, goods, commodities, energy, communications, transport, and so on).” 54 Food insecurity resulting from urban expansion is thus just one facet of a pervasive urban problem: reliance on complex infrastructure subsystems with many moving parts, all of which have to work together for society to function, and which require stable economic and political conditions.
    Local armed groups can exert a chokehold on these systems, including a city’s food supply, by preying on the transportation flows that connect the city to its hinterland: setting up illegal checkpoints, robbing travelers, or extorting protection money from farmers who need the road to get their food to market. In Kenya’s capital, Nairobi, for example, gangs such as Mungiki have exploited their location astride the city’s food transportation routes (as well as their relationships with figures in the Kenyan political elite) to prey on the matatus —the brightly colored, privately owned minibuses that connect outlying suburbs with downtown areas—extorting as much as 1 . 1 billion Kenyan shillings (US$ 13 million) per year from transport operators. 55 Nairobi’s population is 3 . 5 million today, and it’s expected to reach 8 million by 2025 , with more than half the city’s inhabitants crammed into only 1 percent of its