A confession. As much as I would hate to be without my iPad or laptop and can barely remember how we got by before the internet opened access to a mind-boggling range of material I still like to read and hoard hard copies of important documents. Over two decades I have built a significant collection of reports, strategies and reviews. I couldn’t call it a library (it lacks much in terms of organisation) but it’s a resource where I can find a great deal of what was happening around drug policies and allied fields during the 1990’s and into the 21^st century. In terms of external validation, I have had many individuals and agencies come to me for assistance, including central government, who had somehow lost copies of their own policy documents while switching to digital formats.

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What an excellent event the City Health 2018 conference proved to be. The seventh edition since the inaugural event at the Guildhall in the City of London in 2012 each subsequent has added to the knowledge and breadth which makes this such a fascinating and unique undertaking. The city of Odesa were great hosts and combined with the tremendous efforts of the organisers nearly 250 participants from over 20 countries gathered to discuss how we can develop healthy responses during this period of unprecedented change and challenge.

It was a great pleasure to meet so many people committed to improving urban health and be exposed to so many examples of great work. There were also some incredibly stimulating and thoughtful presentations and inputs, not just from speakers but also members of the audience. While I can’t pretend the travelling (especially the rather tight transfer times) were anything other than tiring City Health has done a wonderful job of recharging my batteries and energising me to consider how I can make use of what I have learned in Odesa and apply it and share it with colleagues in London. It certainly reminded me that many colleagues around the world face a level of challenge in delivering evidence-based approaches that some of us struggle to imagine. Also, this blog will continue, not least because 2019 will see two City Health events!

The first of these will see City Health hosted by Liverpool John Moores University on 22 March. Liverpool is not just a city with an important maritime history or being famous as being the home of The Beatles, it also enjoys a long influential history of innovation around public health, having been the first city in England to appoint a Medical Officer of Health in the mid-19^th century. More recently it has also been at the forefront of developments relating to harm reduction in relation to drug use and has led much of the work in trying to improve safety in the night time economy. Get the date in your calendar now. The other City Health event is to be held in Australia in September. While exact dates are yet to be confirmed this will be a great opportunity to take City Health beyond the confines of Europe and engage with a broader range of cities. Australia has, of course, often led global developments in terms of pragmatic and humane responses to problems associated with drug use. Though in terms of the current position relating to tobacco harm reduction it perhaps reminds us that no country has a monopoly on wisdom, or that previous victories mean there are not further battles to be fought in helping our most vulnerable communities. I very much hope you are able to participate or engage in one or other of these events.

Let me return to the recent conference in Odesa. The quality of speakers and presentations was outstanding. Reflecting the ethos of City Health, the presentations are already available via the website but in addition many were filmed, and these will be added in the coming weeks. Some of the issues which caught my attention will be flagged in forthcoming blogs, but I must mention David Wilson, the World Bank’s Global HIV/AIDS Program Director, who delivered the Alison Chesney and Eddie Kiloran Memorial lecture. He provided a global and historic overview of current health challenges, highlighting the great gains achieved by improved nutrition, sanitation, vaccination and antibiotics. He then raised the question that given this why are we so many societies and individuals experiencing such anxiety? He then highlighted examples where drug and alcohol use coupled with rises in heart disease were seeing declines in health expectancy. Looking to the future he outlined the challenges posed by the current technological revolution and suggested we all need to start looking at the current and future challenges in health rather than continuing to fight the battles of the past. That poses a considerable challenge for us all.

We are now just days from the 2018 City Health conference, where those attending will be the guests of the Alliance for Public Health (Ukraine), AFEW International (Netherlands), and the city of Odesa in association with Knowledge Action Change. Seven years ago, I had the pleasure to host the first of these events. It is a testament to the growing interest in how we make our cities better, heathier places to live- as well as the hard work of the organisers- that City Health has not only continued as an annual opportunity to hear and debate from a wide range of experts and commentators, but is now also a year round network where research, news and views are shared on a weekly basis. It’s been a pleasure to contribute to this process. For me, it’s been an enjoyable opportunity to reflect on a wide range of topics and share my thoughts with you. Many thanks to those who have responded, I apologise for having been London and substance misuse centric, but the last six months have helped broaden my knowledge beyond those confines!

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The main summer holiday season is coming to an end in London.  Traditionally, August is a quiet time where we catch up on long overdue administrative tasks and discuss potential collaborations for the coming months.   However, with City Health in Odesa less than two weeks away, I find myself in a reflective mood.   The last few months have seen a range of health stories in the media. Some got barely five minutes of interest, others generated coverage on television, and debate online.  What, I have been considering, are the actual impacts on our populations of this media interest?  People are exhorted to stop smoking, eat healthier, avoid sugar, drink less (if any) alcohol, be more active, avoid too much sun, and practice safe sex. No doubt there were also a few other topics that slipped passed me. How effective is this kind of advice?

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