This paper explores the connections between activism for drug policy reform and the post-political conditioning of urban politics. The emergent literature on policy mobilities is brought into conversation with post-political analyses on the constitution of the properly political, arguing that there has been much focus on moments of rupture in the seemingly post-political condition while ignoring ongoing political resistances, what I call ‘everyday proper politics’. Resultant analyses of urban politics are therefore often incomplete. This paper moves to address the gap between rupture and resistance through a global examination of harm reduction; a policy, practice and philosophy that embodies contemporary (post-) political contradictions. It is an evidence-based public health policy often enacted through medicalised practices across state, public and private space, yet its history and philosophy are rooted in radical understandings of participatory democracy. Exploring activism for harm-reduction policies and the ways they are made manifest in cities globally begins to unravel the paradox of radical care practice and liberalised notions of self-care that harm reduction embodies. Harm reduction, as it is mobilised across cities with divergent histories, localities and political contexts, demonstrates that its post-political framing does not foreclose a radical politics of public health but rather can enable it. This paper demonstrates that public health and post-politics intersect at the important points of health, wellbeing and urban development. In a post-political condition, public health agencies assume the role of technical experts under the auspices of advanced neoliberalisation. Yet when questions arise regarding the management of drug use, drug users’ right to health and resources that engage and facilitate these activities, it becomes apparent that there indeed remain properly political battles to fight, battles that attract extra-local audiences and coalitions from both sides of the debate that to attempt to influence policy outcomes in places far away.