This year’s City Health International was back to not-so-humble beginnings from when it first started in 2012, at the historic Guildhall in London. The programme was varied and had some engaging speakers prompting some interesting debate from the audience. Among the usual message from attending these types of conferences, to close the gap between academics and policy makers, and to better facilitate inclusion of advocates and affected populations into the policy process, there were some very interesting additional insights.


The conference had many esteemed presenters and the presentations are available online. They are worth having a read through and video will also be available.


There were 2 presentations that I will highlight. The first was from a vaper activist, Luc van Daele. Vaping has been a controversial phenomenon for a number of reasons; although considered by some to be an effective harm reduction measure to help people who struggle with nicotine dependence via tobacco smoking, it has been subjected to much of the same restrictions and public denouncement as that of tobacco industry. Members of the public have been noted to be personally offended by the passive smoke and by the people who tend to use vaping as an alternative to or alongside smoking. Vaping has developed a niche subculture among smokers with a range of websites, forums and groups that share information about this activity. Many policy makers have tried to hastily implement harsh restrictions on the tools used for vaping, often ignoring the crucial differences between tobacco smoking and vaping. Users have developed modifications to the available equipment and can even try to create their own liquids at home. These hacks have been developed to enable users to get more smoke, and to also be more ‘safe’ in terms of the way they refill and the type of liquid they can use. However, the fact that such hacks have to be made often arises from the poor quality or standard of available tools for vaping, and many users would argue it is due to ill-conceived policies. The liquid itself is yet to have better regulations to ensure that long term use is not harmful due to untested chemicals. Users have often been demonised and subject to the same stigma as tobacco smokers but it’s important to ask why should they be as vaping, overall, is much less dangerous for both smokers and passive smokers compared to tobacco.


Dr Ingrid van Beek is a public health and addiction medicine doctor based in Sydney. She is the Director of the Kirketon Road Centre which is an integrated primary health centre for ‘at risk’ populations including young people, sex workers and people who inject drugs. The work at her centre, which includes medically supervised injecting, has been under trial status for a number of years. Despite having meticulous records and a wealth of evidence to continually demonstrate the effectiveness of the work of the centre, still does not have approval for definite long term funding. She mentioned speaking to someone who had been working at the Vancouver harm reduction facilities who ultimately deemed her work unsuccessful. Not because it wasn’t an effective, evidence-based public health initiative, but because it was politically stifled. She was told that the work of the centre was not shut down due to policy makers waiting for the right moment to find the excuse to do so. Ultimately, no matter how good your work is or how much evidence to prove its effectiveness, especially for the benefit of the most marginalised and vulnerable populations, ultimately it is the policymakers who have the say in its continuation and its always down to politics.


From attending these meetings, it is clear that despite what may seem like insurmountable odds, there are people in positions of power who are willing to listen and engage with community groups, advocates and disenfranchised populations. Professor Kevin Fenton from Public Health England had outlined a number of ways in which this institution was working to improve citizen participation in the policy making process. Individuals can make a difference if they take an interest in the decision making process. There are opportunities to become involved and speak to policy makers. More than this even, it is crucial to understand what influences the decisions of policy makers. It is easy to tar all policy makers and politicians with the same brush. During the conference a heated discussion erupted when a councillor stood up and tried to defend her position stating that she works very hard at trying to listen to her constituents. It is important to show support and collectively work to influence decision makers to ensure safer environments for ourselves and the communities we live in.

Action points!

When attending any conferences, make sure your voice is heard! Here are some ways you can make the most of your experience

  • Read up about the speakers before hand- which speakers seem most interesting? What would you like to know more about?
  • During presentations if anything strikes you, make a note. Often there is opportunity for questions after presentations and you can track down the speaker during breaks to ask them directly.
  • If you have any experiences you can share, do it! Often young people’s voices are not heard by academics, specialists, policy makers and many others. Here is a chance to show that young people are well informed, articulate and credible voices in the debates and we can speak for ourselves when we discuss exactly what challenges we face.
  • Network! Depending on what issues you feel most passionate about, speak to as many people as you can. Conferences are a great place for meeting new people who may be able to support you or at least learn from the experiences of others which may help you in your work back home.
  • Use social media and other media platforms to voice your thoughts on the discussions. If taking pictures, make sure you get the right permissions!

City Health International holds annual conferences in different cities around the world examining policy and public health in cities.

Find out more about past and upcoming conferences, including presentations and videos, here.