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Increasing urbanization in the Asia and Pacific region is leading to a rapid increase in the number of megacities. A major concern is the issue of sustainable transport. This article describes the procedures used and results of a multi‐economy foresight study of sustainable transport in megacities of the Asia‐Pacific region. Key issues and policy actions needed are identified.

The Asia‐Pacific Co‐operation (APEC) region, which comprises 21 developed and developing economies, is expected to become predominantly urban by 2020 with at least 15 cities exceeding 10 million inhabitants. Whether such megacities will be “healthy” in the sense of physical, mental and social wellbeing is critical to the future of the region. A modified scenario creation technique has been used in this study of APEC megacities to 2020. Fifteen key issues have been identified and these can be grouped using the concept of cities as living organisms. A healthy megacity is one which reduces its resource inputs and waste outputs, whilst simultaneously improving the quality of life for its inhabitants. The study concludes that healthy megacities are possible if appropriate policy actions are taken.