City Health International

BLOG

The year is ending at a gallop.  Brexit may have pretty much paralyzed the government in Westminster but in national, regional and local administrations the wheels still turn.  Health issues still feature in the media, some, such as rough sleeping and alcohol intoxication, being seasonal fixtures.  Universities and experts continue to provide new analysis, information and fresh angles on key subjects.  This may all sound very self-evident to colleagues outside the UK, but it is reassuring, at least to me, to take a moment and remind ourselves that the earth has not stopped turning on its axis as issues over the backstop, second referendum, votes of no confidence etc. etc. dominate the news and conversation.

Last week provided a very welcome reminder of the broader world with an invitation to the launch of a new book, Collapse of the Global Order of Drugs. In the interest of openness, I should declare that I have known the editors Axel Klein and Blaine Stothard, as well as some of the contributors, for many years.  However, I can assure you that my views on the value of the book were not influenced in any way by the lavish hospitality, as this was entirely absent (not even water!).  What the evening did provide was an opportunity to reflect on the fundamental changes that have occurred across the globe in terms of drug reform and the challenge this poses for the current United Nations framework.  In the audience were a range of experts including friends, colleagues and a former boss, collectively a wealth of expertise and wisdom.

Most present were in favour of the reforms undertaken in Uruguay, the phenomena of cannabis reform happening within US states and the recently enacted changes in Canada.  Within the UK there has also been some movement around the use of medicinal derivatives of cannabis.  An increasing amount of evidence is also amassing to suggest that a number of drugs currently seen as substances of abuse may have clinical application (MDMA for example).  One of the guest speakers did sound a note of caution and asked us to consider the situation in various countries where governments were not only showing no interest in reform but were pursuing hard-line, draconian policies.  While these are likely to see increases in health-related harms (e.g. Blood Borne Virus infection rates) we should not lose sight that in many countries and cultures these policies are popular.  What to us in that room is a powerful evidence base which combines human rights, health-based approaches, pragmatism and clear benefits is to others socially corrosive defeatism that leaves the vulnerable abandoned to their fate.  The latter view is not one I hold but it’s foolish to ignore opposing views.   One element of the support for drug reform that does stand out for me is that many supportive of the moves to legalise cannabis are hostile to proposals that would reduce the harm associated with the use of nicotine.  We shall see how this apparent contradiction develops.

Now one attribute I am blessed with is contraryism.  Some would say that I am just unnecessarily argumentative (this may also be true) but I can see various sides of most contentious issues.  It was a useful skill as a civil servant when preparing briefs for parliamentary debates. It can help advance a cause or position as it allows for approaches beyond the butting of heads with opponents, which rarely changes minds and often leads to deeper entrenchment of opposing views.  And its just not people with opposing views we need to engage better with.  I have often seen those who should be allies arguing amongst themselves over matters of degree, often based on an internal philosophy or approach that doesn’t adequately value the role of others.  Where this is compounded by competition for scarce resources be these financial, political or staff, its recipe which normally hinders or prevents initiatives and delivery.    This has often afflicted projects which aim to reduce harm in Night Time Economy settings.  The priorities and demands of law enforcement, licensed venues, public health, emergency departments, local authorities, partygoers and residents can all appear an overwhelming mix.  However, we have example that with the right mechanisms in place, mutual respect and a willingness to work with others and maybe try something a bit different that real and demonstrable improvements are possible.

So, my Christmas suggestion is that we all make the effort to engage with colleagues from differing fields and backgrounds. Challenge our own understanding and biases, how do they look to those outside our particular silo?  Maybe even reach out and engage with opposing views, you don’t need to engage in twitter warfare (at least not over the season of goodwill), just improve your understanding of how other views are sustained.   Who knows it may lead to some new allies and fresh advances. 

For those celebrating Christmas I wish you a fantastic time. If you get any holiday, I hope you enjoy it.  To all of my best wishes and thanks for being part of City Health International.

Wednesday, April 01, 2020
Everything is changed. COVID-19 and responses to it have seen dramatic and fundamental changes to how life is lived around the globe. International travel has come to a near complete halt, much of the world is under some form of lock down with businesses, schools, shops, pubs and cafes shut. Our economic and social reality is now unrecognisable from that of only weeks ago.
Tuesday, March 10, 2020
Clearly the current health focus is strongly centred on Covid- 19 and related issues, as it has been for the past few weeks. It is a demanding situation for politicians, officials, and indeed all of us, especially those working in our healthcare system. One of the major challenges we face is increasing understanding and encouraging changes in behaviour, while also avoiding panic and overreaction. Trusted and accurate information is clearly essential, both for those who have a key role and for the general public. We are certainly seeing more of England’s Chief Medical Officer and Chief Scientific Adviser in the media than usual. In the current situation, politicians are not only keen to hear from experts, but also happy to let them step into the spotlight. While we still see sensationalist headlines, there are also visible benefits of this approach, with more measured and informed elements within the media coverage- though this is less evident on the outer reaches of the online universe. Before I move on to other topics, let us reflect on the significant additional pressures being placed on our frontline health providers. They deserve our gratitude and, in many instances, much improved terms and conditions. Let’s hope that when this coronavirus issue passes the staff that so many rely on are not overlooked.
Monday, February 10, 2020
Public health is front and centre of the media currently, with concerns about the coronavirus outbreak, which was first identified in the Chinese city of Wuhan, splashed across almost every front page. With confirmed cases now reported in numerous countries across the world, we face the possibility of a pandemic. As several experts and commentators have pointed out, in our modern, highly interconnected world no epidemic remains a local concern. This, of course, makes for frightening headlines- which, in turn, calls for calm and informed responses.
Wednesday, January 15, 2020
So here we are: 2020. Let me start by wishing all of you the very best for the year ahead. I have, occasionally, been accused of an inclination toward cynicism and a failure to look on the bright side of things. So, for my first blog of the year, at least, I am going to be determinedly upbeat. You can judge for yourself how long it lasts. This sense of optimism is influenced by the fact that the end of 2019 saw some positive signs in the world of substance misuse. While it was something of a mad scramble against time, we managed to pull together a high quality and well-supported pan-London Christmas alcohol campaign. I am very grateful to colleagues who delivered the key elements of this work and to everyone who supported it. Some, in fact, went well beyond the call of duty to engage with our colleagues in the blue light services. Although we will not have any data in terms of its reach and impact for some months (I will update you), what I can confidently say is that many individuals and organisations liked the messaging and tone. I like to think it is helping contribute to Londoners having a more considered and healthier relationship with alcohol, though there is a way to go yet!

Previous

CITY HEALTH INTERNATIONAL EVENTS

CHI Melbourne 2019

Read more

CHI Liverpool 2019

Read more

CHI Odessa 2018

Read more

CHI Basel 2017

Read more

CHI London 2016

Read more

CHI Barcelona 2015

Read more

CHI Amsterdam 2014

Read More

CHI Glasgow 2013

Read More

CHI London 2012

Read More

City Health International
Founded in 2012 City Health International is a network of individuals and organisations engaged in the study of and response to structural health issues and health behaviours in the urban environment.
For the first time in history the majority of the world’s population now live in urban environments and the proportion continues to grow. As national governments struggle to deal with the pressures and demands of growing urban populations against a backdrop of financial deficits and uncertainty, it is increasingly left to those working at a city level to provide the leadership and support needed to tackle key health issues.