[2] Larry Campbell's election as mayor in 2002 was in part due to his willingness to champion alternative interventions for drug issues, such as supervised injection sites.

The city adopted a Four Pillars Drug Strategy, which combined harm reduction (e.g. needle exchanges, supervised injection sites) with treatment, enforcement, and prevention.

[3] The strategy was largely a response to the endemic HIV and hepatitis C among injection drug users in the city's Downtown Eastside neighbourhood.

Some community and professional groups—such as From Grief to Action and Keeping the Door Open—are fostering public dialogue in the city about further alternatives to current drug policies.

[4][5] The harm reduction strategies have been successful, with the deactivation of the St. Paul's Hospital Ward 10C, on May 27, 2014, due to the near-elimination of AIDS cases in British Columbia.

In the 2005 municipal election, the city council swung back to the right after a term dominated by the left-wing Coalition of Progressive Electors (COPE).

A proposal to change Vancouver's council elections to run on a ward basis (like most major Canadian cities) rather than its at-large system was rejected by the populace in a referendum on October 16, 2004.