Differential Policy Mobilities: Transnational Advocacy and Harm Reduction Drug Policy

Geographers have recently taken an interest in how urban policies are produced and mobilized. The effects of how policies are realized on urban landscapes have significant recourse regarding how everyday life is understood and experienced. This dissertation examines what happens to the policy, the people, and the places in which a specific drug policy model, harm reduction, is advocated for and implemented. In doing so, it addresses the tactics and techniques that are assembled in order to advocate for policy change globally. The paradoxical relationship between the increasing regulation and punitive approaches to drug use and the cheaper, purer drugs that flood illicit drug markets has resulted in increasing social and health crises for people who use drugs including social exclusion, human rights violations, and increased risk of disease. Harm reduction is an alternative policy seeking to minimize the physical, psychic and social risks associated with illicit drug use. It is a public health approach that serves as an alternative to dominant moral (criminalization) and medical (addiction-as-disease) models commonly invoked in these debates. Harm reduction is also a global social movement focused on the use of illegal drugs, issues of equality, social justice, and human rights. This dissertation addresses questions about how harm reduction drug policy is advocated for, constructed, mobilized, and implemented across cities in Europe, North America, and the Caribbean in specific relation to the geographies of transnational activism, focusing on: the role of institutional policy activists, the political nature of evidence based policy making and its attendant technologies and practices, and spatial strategies that sustain global advocacy over time. These questions correspond to broader conceptual debates over understandings of policy making and mobilization as well as the politics of urban public health. Using qualitative, multi-sited research methods, this research contributes to recent calls for a new relational comparative approach to studying cities. By examining policy advocacy networks across the Global North and South, I provide unique insight into the various social, political, institutional, and spatial mechanisms that produce successes and failures in policy mobilization. I conclude by considering new directions in understanding spaces of urban public health and what that may mean for understanding political geographies of the city.