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Cannabis amnesia – Indian hemp parley at the Office International d’Hygiène Publique in 1935

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Background: In 2016-2019, the WHO Expert Committee on Drug Dependence scientifically reviewed cannabis products. In that context, multiple references to a previous and similar assessment dating back to 1935 were made; but the content, outcome, and stakeholders involved in the 1935 review were unclear. Method: Transnational historiography of the international conversation on cannabis control in and around 1935, based on previously-unavailable primary material from international organisations, archives, and literature searches. Results: Two evaluations were undertaken in 1935 and 1938 by the “Comité des Experts Pharmacologistes” convened under the “Office International d’Hygiène Publique” (OIHP), predecessor of the WHO. Five specific medicines marketed by Parke-Davis were briefly reviewed, based on which the Experts recommended placing under international control all cannabis medicines –prior to that, only pure extracts were under control. The measure was confusing; few State Parties to the 1925 Convention implemented it; the second World War precipitated its oblivion. The international community resumed work on cannabis under the WHO in 1952; that same year, the OIHP was definitely closing its doors. No trace of the 1935 events appeared in any post-war proceeding. Conclusion: Political biasses and numerous methodological and ethical issues surround the 1935 episode: it cannot legitimately be called a “scientific assessment.” The role of stakeholders like Egypt and the OIHP in norm entrepreneurship and advocacy for multilateral controls over cannabis have been largely forgotten; that of the USA somewhat exaggerated. There might be other forgotten pieces of History: predecessor of WHO, the under-documented OIHP had mandates on other important fields, be it drug or epidemics control. Much knowledge on the History of humankind lays in unexplored archival records; errors made and lessons learnt from the past could inform our management of the conflict between public health and politics today.
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Cannabis amnesia – Indian hemp parley at the Oce
International d’Hygi`ene Publique in 1935
Kenzi Riboulet-Zemouli1,FaridGhehiou`eche
1, and Michael A. Krawitz1,2
1FAAAT t h i n k & d o t a n k
2Cannabis Museum
May 12, 2022
Background: In 2016-2019, the WHO Expert Committee on Drug Dependence scientifically reviewed cannabis products. In
that context, multiple references to a previous and similar assessment dating back to 1935 were made; but the content, outcome,
and stakeholders involved in the 1935 review were unclear.
Method: Transnational historiography of the international conversation on cannabis control in and around 1935, based on
previously-unavailable primary material from international organisations, archives, and literature searches.
Results: Two evaluations were undertaken in 1935 and 1938 by the “Comit´e des Experts Pharmacologistes” convened under the
“Oce International d’Hygi`ene Publique” (OIHP), predecessor of the WHO. Five specific medicines marketed by Parke-Davis
were briefly reviewed, based on which the Experts recommended placing under international control all cannabis medicines
–prior to that, only pure extracts were under control. The measure was confusing; few State Parties to the 1925 Convention
implemented it; the second World War precipitated its oblivion. The international community resumed work on cannabis under
the WHO in 1952; that same year, the OIHP was definitely closing its doors. No trace of the 1935 events appeared in any
post-war proceeding.
Conclusion: Political biasses and numerous methodological and ethical issues surround the 1935 episode: it cannot legitimately
be called a “scientific assessment.” The role of stakeholders like Egypt and the OIHP in norm entrepreneurship and advocacy
for multilateral controls over cannabis have been largely forgotten; that of the USA somewhat exaggerated. There might be
other forgotten pieces of History: predecessor of WHO, the under-documented OIHP had mandates on other important fields,
be it drug or epidemics control. Much knowledge on the History of humankind lays in unexplored archival records; errors made
and lessons learnt from the past could inform our management of the conflict between public health and politics today.
Some parts of the history of global cannabis prohibition are not enough researched
The predecessor of WHO in charge of drug control (and pandemics) is under-documented
In the 1930s, numerous medical marijuana formulations were used worldwide
Egypt pushed the League of Nations into attempting to control cannabis
The first international scientific assessment of cannabis was not in 1935 but in 2016-2019
The 2020s decade was opened by a change in the legal status of Cannabis sativa L. and some of its products,
after half a Century of stand-still: on 2 December 2020, the Commission on Narcotic Drugs (CND; the
prime policymaking body of the United Nations (UN) responsible for Cannabis -related matters) voted upon
scheduling recommendations of the Expert Committee on Drug Dependence (ECDD) of the World Health
Organization (WHO).
The ECDD is the only body with a treaty mandate to carry out scientific assessment of drugs and recommend
scheduling changes (WHO, 2018); its recommendations sketched a number of changes in the legal control
applying to “medical cannabis” under the international drug control Conventions (Mayor, 2019; Riboulet-
Zemouli and Krawitz, 2022). But that change was only the latest development in a complex and convoluted
history of multilateral controls applied to medicinal Cannabis ,plantandproducts.
Research has seen, in recent decades, a renewed interest in the historiography of the placement of Cannabis
within the framework of international drug control and its dierent legal instruments. In particular, scholar-
ship has focused either on (1) the inception (the lead to the International Opium Convention of 1925 (C25)
which incorporated some provisions related to “Indian hemp”[1] /haschish alongside coca/cocaine and pop-
py/opium; Collins, 2021; McAllister, 2000; Mills, 2016) or (2) the immediate period leading to the adoption
of the Single Convention on narcotic drugs in 1961, in the aftermaths of the second world war (WWII).
Surprisingly, however, the two decades running between 1925 and the end of WWII have received very little
This 20-year gap in the history of Cannabis control became apparent in 2014, during the early preparations of
the ECDD cannabis assessment process, when a particular episode surfaced and was labelled as an apparently
key moment of that history:
“Cannabis and cannabis resin has not been scientifically reviewed by the Expert Committee since
the review by the Health Committee of the League of Nations in 1935 [. . . ] which recommended
that preparations obtained from cannabis extract or tincture were placed under control of the
second Opium Convention” (WHO, 2014, p. 3).
This quote, extracted from the preparatory documentation of the 2014 ECDD meeting, only presents one
single reference to back the 1935 event:The Genesis of International Control of cannabis – 1912 to 1978 ,
an internal document published by the International Narcotics Control Board (INCB) on 12 May 1978, with
reference number E/INCB/W.22. Regrettably, this document is not listed (let alone conserved) in INCB or
UN archival records.[2]
That “review by the Health Committee” of the League of Nations (LoN) in 1935 was arguably an important
moment since it “recommended that preparations obtained from cannabis extract or tincture were placed
under control.” But it has disappeared from the records.
Although some direct mentions of the 1935 review are found in late compilations of the works of the LoN
(1945a, p. 187), the 1 860 bibliographical references about Cannabis compiled by UN Secretary-General in
1965 includes no mention of it (CND, 1965, p. 45). In the Bulletin on Narcotics ,publishedbytheUN,the
article “Principal League of Nations Documents Relating to Narcotic Drugs” (1952) fails to reference any
such event in 1935, similarly to important authors like Itsv´an Bayer and Hamid Ghodse (1999); only “The
cannabis problem: A note on the problem and the history of international action” (1962) details that:
“Preparations made from extract or tincture of cannabis were not mentioned in the 1925 Conven-
tion, but in 1935 were brought within the control of the Convention by a decision of the Health
Committee of the League of Nations under article 10 of the Convention.”
Note the dierence between “a review” and “a decision” of the Health Committee. . .
By contrast, documents and meetings of the “Sub-Committee onCannabis sativa (a subsidiary organ under
the “Advisory Committee on the Trac in Opium and Other Dangerous Drugs” of the LoN) are extensively
referenced. Most reviews of the early history of Cannabis control focus on this organ (Bewley-Taylor et al,
2014; Kozma, 2011b; The cannabis problem. . . , 1962). Yet, this Sub-Committee was not the organ invested
with the mandate to review substances and recommend measures of control as appropriate (as the ECDD
is nowadays): under the C25, such a task was mandated to the Oce International d’Hygi`ene Publique of
Paris (OIHP),[3] which informed the decisions of the LoN’s Health Committee. Yet, few publications reflect
the role of –or indeed even mention– the OIHP.
Beyond the 1935 episode, the important drug control treaty functions discharged by the OIHP have been
generally overlooked by observers, analysts, and historians. Key publications celebrating a Century of global
drug control fail to mention the Oce even once (Pietschmann, 2009; UN Oce on Drugs and Crime, 2008).
After 2014, in the context of the assessments of Cannabis -related substances by the ECDD between 2016
and 2019 (Riboulet-Zemouli and Krawitz, 2022), additional mentions of the 1935 episode were made by
scholars (Bewley-Taylor et al., 2016; Curran et al, 2016, p. 5; Danenberg et al, 2013 p. 177) and civil society
stakeholders alike (International Drug Policy Consortium, 2018; Kazatchkine, 2016), without much clarity
as to the content or outcome of what happened in 1935, however. In 2018, the authors of the present study
found the minutes of the 1935 review meeting; they reproduced excerpts of it in a contribution to the 40th
WHO ECDD meeting, commenting:
“The myth of an assessment of Cannabis under the LoN has justified the WHO shirking its
responsibilities in the face of draconian measures of control, relying on a supposed previous
ruling to avoid making decisions on a dicult subject” (Krawitz and Riboulet-Zemouli, 2018, p.
This article seeks to document the context, stakeholders involved, content, and outcome of the 1935 review ,
and to ascertain the functions, mandates and dynamics of the world’s drug control organisation as it related
to Cannabis and its products, in and around 1935.
To do so, af ter d esc ribin g the a pproach used , the s tud y intro duc es th e legal r egi me of the t ime a nd th e
OIHP in the first subsection of the findings, before moving to a complete overview of the multifaceted
organisational structure; the third and fourth subsections respectively analyse in detail the 1935 and 1938
episodes; a fifth subsection reviews the consequences over international works related to Cannabis after
WWII, before discussing the findings in conclusion.
This study intends to present a transnational historiography based essentially on primary research in archived
materials gathered in 2016, 2018 and 2019 (LoN archives, UN and WHO libraries in Geneva, UN Archives
at Vienna, Dag Hammarskj¨old Library remotely). Additional documents and correspondence was yielded in
2017 and 2018 at the Universit´e de Paris (Sainte-Genevi`eve Library; “Biblioth`eque interuniversitaire de sant´e”
rue de l’Observatoire), the Libraries of the Acad´emie des Sciences/Institut de France, Acad´emie Nationale de
edecine, Acad´emie Nationale de Pharmacie, Mus´eum National d’Histoire Naturelle, and French Diplomatic
Archives, at former OIHP headquarters (195 boulevard Saint-Germain) and Belgian Diplomatic Archives. In
a second stage (2020–2022), literature searches were undertaken to attempt discussing the findings within the
intertextuality of the new transnational historiographies of the international drug control regime complex.
In addition to documenting the 1935 Cannabis episode, this article seeks to contribute to the study of the
history of international drug control, by expliciting its structure and organisation at that particular moment.
To aid the understanding of a complex and under-documented system, parallels are drawn with the drug
control apparatus operating in 2022 throughout the article.
1925: Cannabis in the International Convention relating to Dangerous Drugs
“Starting with the International Opium Commission (Shanghai, 1909), Governments over time
established an international consensus on the need for the regulation of psychoactive substances.
Moreover, a set of normative instruments and multilateral bodies and systems were developed to
help States implement and adjudicate such regulation” (Pietschmann, 2009, p. 1).
Cannabis was for the first time placed under international control on 19 February 1925 with the “International
Convention relating to Dangerous Drugs” (C25) adopted at the end of the Second Opium Conference, 1924–
1925 (Kendall, 2003; Kozma, 2011b; League of Nations, 1925; Mills, 2003; The cannabis problem. . . , 1962)
and entered into force in 1928 (LoN, 1928). Contrary to what is sometimes believed, this was more the result
of “a triangulation between various State interests and blocs” (Collins, 2020, p. 280) than an initiative of
the United States (Scheerer, 1997): “Indian hemp” was indeed added to the C25 “at the behest of Egypt,
and previous encouragement from South Africa, Italy, and others” (Collins, 2020 p. 281; UNODC, 2008;
Waetje n, 20 18) a nd in par tic ula r, similar ly co nse rvat ive governm ents in A fri can a nd Lati n Ame ric an countries
(Campos, 2012; Collins, 2021; Duvall, 2019; Gootenberg and Campos, 2015; Kozma, 2011a; 2011b).
During the 1924–1925 Conference, proposals to extend international controls to Cannabis were soon tabled
by the government of King Fuad I from the recently-independent Egypt, a country that “prides itself on being
the first country to ban cannabis cultivation, as early as the late 1870s” (Kozma, 2011a, p. 444). During the
Conference, the country’s Ambassador, which considered “the illicit use of hashish [being] the principal cause
of most of the cases of insanity occurring in Egypt,” (UNODC, 2008, p. 54), called on to other delegates:
“even at the risk of seeming importunate, I insist, and shall continue to insist on the importance
of this question [. . . ] I am certain that you, gentlemen, who work under the aegis of the League
of Nations, will help us in the struggle we have undertaken against this scourge, which reduces
man to the level of the brute and deprives him of health and reason, self-control and honour”
(UNODC, 2008, p. 55)
Such eorts to place hashish’s Cannabis under international control, just like with opium’s Papaver and
coca’s Erythroxylum , went knowingly “against a 2,000 year long history of drug cultivation, production, tra-
ding and use” (Buxton, 2008, p. 3). They can be seen as surprising given the fact that, at that time,Cannabis
-based medicines were well-accepted globally (Buxton, 2008, p. 3; Collins, 2020, p. 280; Duvall, 2019; Frank-
hauser, 2002; Hamilton, 1912; Krawitz, 2006; Mathre and Krawitz, 2002; Mikuriya, 1969; Pisanti and Bifulco,
2017; Zuardi, 2006). If Cannabis -based medicines enjoyed a number of standardised pharmacopeial mono-
graphs under the 1925 Brussels Agreement on the Unification of Pharmacopoeial Formulas for Potent Drugs
(Riboulet-Zemouli, 2020 pp. 13–14, 16), the plant was mainly present in traditional medicine, but also as
ciples varying importantly between pharmacies and villages.11Until the mid-20th Century, most popular
practices of day-to-day healthcare maintenance and treatment of minor ailments fundamentally relied on
self-medication, eventually under the advice of pharmacists or other traditional healers –and not necessarily
on consultations of a clinical practitioner, better documented in the medical literature.
The Egyptian Ambassador did not pretend to ignore it (UNODC, 2008, p. 55), yet, the confluence of several
moral impetus for prohibition, as far as Egyptian authorities and elites were concerned, was also solid:
“it was a public health concern, it was a religious concern, it was also Egypt’s image abroad that
was on the line here. All were backed by a strong centralizing state (since the 1870s), a nationalist
agenda and a civilizing process” (Kozma, 2011a, p. 455).
After centuries of irrelevance in the public debate, Cannabis progressively became a symbol of what certain
elites saw as “the nation’s weakness” and its moral decline, as well as a filter through which Egyptian elites
looked down at popular classes, where the use ofCannabis products was normalised. As Liat Kozma (2011,
p. 454) puts it:
“The 1924[-1925 Opium] conference was the first in which an Egyptian delegation was represen-
ted. Putting cannabis on the table, alongside opium and coca-based manufactured drugs, had
both practical and symbolic dimensions. A mere five years after the British had prevented the
participation of an Egyptian delegation in the post-First World War Versailles conference to pre-
sent its demand for independence, a purely Egyptian delegation of diplomats and medical doctors
presented an Egyptian agenda in an international forum.”
In spite of Egypt wrestling the mention of “Indian hemp” in the C25 from the international community, the
“control of cannabis was far less comprehensive than control of opium/morphine/heroin or coca/cocaine”
(UNODC, 2008, p. 55), and this was particularly explicit by the fact that
“the 1925 Geneva Convention only placed under control galenical preparations of Indian hemp,
that is the extract and the tincture, but it did not mention pharmaceutical preparations contai-
ning the extract or tincture of Indian hemp.” (OIHP, 1935, p. 161, author’s translation).
These “galenical preparations (extract and tincture) of cannabis” were
“subject to all the provisions of the 1925 Convention relating to such manufactured drugs as
morphine, except that parties need not furnish statistics on manufacture and that manufacture
need not be confined to establishments licensed for the purpose” (The cannabis problem. . ., 1962)
Only “pure” resin obtained from Cannabis was under the international controls established by the C25:
theoretically 100-percent pure “extracts” without any added substance. Since the molecular composition of
these was not known by the time (Mechoulam and Hanuˇs, 2000) it was considered that “the resin [. . . ] is
the active principle of Indian hemp” (LoN, 1939d, p. 29). Consequently, anything other than pure, uncut
raw Cannabis extract was outside of the treaty’s controls and legal realm, and this was the case
“even [for] those containing 99 parts or more of Indian hemp extract or Indian hemp tincture to
one part or less of any indierent substance, [which] are not considered as possible agents of drug
addiction” (Wesserberg, 1935).
The structure of drug control under the League of Nations
Under the C25, Article 8 (exempting preparations of drugs from international control) and Article 10 (adding
new preparations to international control) vested two international bodies with a joint mandate of selecting
the preparations that should start or cease to be internationally controlled: the Health Committee of the LoN
and the OIHP. Today, Articles 8 and 10 of the C25 find echo in Article 3 of the 1961 Single Convention on
narcotic drugs and Article 2 of the 1971 Convention on psychotropic substances, which both externalise the
appraisal of any change in the scope of control over substances to the WHO –which took over the mandates
of both LoN’s Health Committee and the OIHP (Howard-Jones, 1950; 1979; Renborg, 1957, p. 101).
A multifaceted global health leadership
The OIHP was created in Rome on 9 December 1907 in the wake of the series of International Sanitary
Conferences held in the second half of the 19th century (Howard-Jones, 1950; OIHP, 1938). The Oce
became fully operative in 1909 (incidentally also considered the year of inception of the international drug
control system with the Shanghai Commission). OIHP’s core objectives were to
“centralize all information concerning epidemic diseases, in a context of European imperialist
expansion and fear of the return on the Old Continent of large cholera epidemics” (Frioux, 2009
p. 168,translated by the author).
It rapidly ended up summing plague, tuberculosis, yellow fever and influenza to cholera, as progresses in
medicine and epidemiology boomed. Essentially focused around the “quarantine concept” for its first 10
years, the OIHP started to diversify its activities by the turn of the first world war (Howard-Jones, 1979, p.
13; OIHP, 1933). This came not only in reaction to the health-related consequences of the armed conflict,
but also to maintain the leadership of the Oce in a nascent international health landscape where glimpses
of competition had arisen with competing organisations, including from the private sector like the Red Cross
(informal, yet mentioned in humanitarian treaties; Durand, 1978; Howard-Jones, 1979) or the Rockefeller
foundation (Lin and Birn, 2021; Paillette, 2012). More threatening even for the OIHP was the adoption in
1919 of the Treaty of Versailles, founding the LoN and giving it a mandate on “the prevention and control of
disease” and task to “ [place] under the direction of the League all international bureaux already established
by general treaties” (LoN, 1935b, pp. 14–15).
The LoN quickly wished to centralise public health concerns under a single international “Health Organisa-
tion” to be based in Geneva, and “of which the [OIHP] shall be the foundation” (Howard-Jones, 1979 p. 22).
The Oce would progressively have been incorporated within the LoN system (Ghebali, 1972; Howard-Jones,
1979; LoN, 1945a, pp. 5–9; LoN, 1945b, pp. 62–64).
But the OIHP resisted, and consistently managed to maintain its independence from the League, basked in
its self-proclaimed status of first-ever international public health body,[5] arelativesuccessonthecontrol
of pandemics, “firmly rooted in 19th-century conceptions of international health work” (Howard-Jones, 1979
p. 25), and thanks to the fervent support of the governments of Italy and France which jointly handled the
Secretariat of the Oce (Howard-Jones, 1979; Paillette, 2021). Its independence is evidenced by the fact
that, after WWII, it survived six years after the dissolution of the LoN (WHO, 1947b; 1952a).
Consequently, in the 1925–1945 period, various international health organisations coexisted, in a context of
tensions and drama (Howard-Jones, 1979 pp. 27, 61; Le Monde, 1946). The situation was maintained thanks
to a status quo with the LoN that was negotiated by OIHP’s founder, French diplomat Camille Barr`ere, in
“the functions of general consultative council on health [are] entrusted to the [OIHP], which
remains autonomous and maintains its headquarters in Paris, without modification of its com-
position or its attributions” (LoN, 1945a, pp. 6–7; see also OIHP, 1925).
In the 1930 Yearbook of the LoN , this “consultative council” is described as follows:
Composition: composed by permanent representatives of about forty States, it remains autono-
mous and maintains its headquarters in Paris, without alteration of its composition or attributi-
ons. [. . . ]
Attributions: It has the power to discuss and propose international conventions. It examines the
works of the Health Committee, exposed in its resolutions, and discusses all questions submitted
to it by that Committee, so as to provide consultative advise. [. . . ]
Procedure: It meets twice a year. Its sessions follow those of the Health Committee by a few days.
It receives the text of the Committee’s resolutions in the form of a report.” (Ottlik, 1930, p. 144,
author’s translation).
Not only “the organizational structure upon which international health work was based during the twenty
inter-war years was the result of a deadlock” (WHO, 1958, p. 27), but the OIHP was a
“club of senior public health administrators, mostly European, whose main preoccupation was
to protect their countries from the importation of exotic diseases without imposing too drastic
restrictions on international commerce” (Howard-Jones, 1979, p. 17)
Far from s eco nda ry, the role of i ndi vid uals is e nli ghten ing , if not cr iti cal , in underst and ing t he shap ing o f
early international politics (Rodogno et al, 2013, pp. 96–97). This is particularly true in the field of global
drug control, where a “more personal, idiosyncratic cast” persisted until the 1950s (Fig. 1; McAllister, 2000,
p. 210).
Camille Barr`ere illustrates this. French Ambassador in Rome (1897–1924) and “great protector” of the OIHP
(Howard-Jones, 1979, pp. 31–33; Paillette, 2021), he had chaired the 1907 funding conference of the Oce.
Barr`ere, who had an opinion on all issues, assiduously attended OIHP meetings until his death, in 1940.
In addition to unconditional support from France, his views of “the nascent fascist movement [in Italy]
with almost unalloyed favour and enthusiasm” (Shorrock, 1975, p. 595),33Renzi (1971, pp. 193-194) even
presents evidence that Barr`ere provided personal financial support to Benito Mussolini. and his inclination
to balancing public health concerns with trade requirements –and particularly, commerce in and between
European countries and their foreign colonies (Howard-Jones, 1979)–, Camille Barr`ere knew how to play “the
hostility of the United States and USSR, membersof the Oce, but from which [the LoN] had not obtained
adherence” (Le Monde, 1946) in order to sustain the OIHP and its independence. Howard-Jones (1979, p.
32) explains:
“In fact, that Barrere should have had any influence at all in planning international health work
was grossly anomalous. He was neither a health expert nor a health administrator, but a fulltime
professional diplomat.”
Figure 1: Picture from the meeting of OIHP’s Comit´e Permanent, Paris, May 1933 (Camille Barr`ere is
visible at the centre on the front row, with a white hat in hand. Photo from the public domain).
Beyond the role of individuals, the democratic, representativity, and health-focused characteristics of the Of-
fice were dubious. The OIHP was not composed of members acting in their personal capacity as independent
experts, but by Government representatives. Worse, the weight of each member’s vote was indexed on the
financial contribution of his country to the Oce (OIHP, 1938). Within the Oce, the broadly-shared vision
of an international sanitary action limited to the “minimum hindrances to commerce compatible with the
protection of public health” (Howard-Jones, 1979, p. 32) probably contributed to gather sympathy, among
governments, for maintaining the politically-docile OIHP independent from a Health Committee of the LoN
which may have been inclined to put health first.
Heir of an international trade order recently established on the basis of colonial trade wars, and direct
continuation of the eurocentric, coercitive, trade-oriented, and morally-tainted “civilising” mission that cha-
racterised international public health in the second half of the nineteenth and early twentieth centuries
(Howard-Jones, 1979; Huber, 2006; Lin and Birn, 2021; Paillette, 2012; Sinha, 2001; Tworek, 2019) the
OIHP represented a continuation, in the early twentieth century, of an
“international health diplomacy [which] proved how vulnerable global health governance was to
the machinations of states and the volatile dynamics of international politics” (Fidler, 2001 p.
This was far from unfamiliar to the development of drug control treaties. Politics, trade, and (opium) trade
wars are also the genesis which led to legal drug control instruments that, although claiming to protect
health, ended up regulating commercial activities.
Organisational structure of international drug control in 1935
This rugged landscape of international health organisations resulted in the administration of drug control by
2017; Howard-Jones, 1979, pp. 30–31; Paillette, 2012). Dozens of interlinked, overlapping, sometimes “do-
nothing” sub-, joint-, or interim- committees, commissions, boards, and bureaux, shared a piece of the cake
of drug-related treaty mandates, rarely reaching eciency (Ghebali, 1972).
Nonetheless, the basic structure Secretariat-Executive Council-Assembly was generally retained (as is still
often the case today with international organisations). Within the LoN, the “Health Committee” represented
an organ that could nowadays be assimilated to something in-between the WHO’s Executive Board and
World Health Assembly (Fig. 3). Under the C25, the Health Committee was mandated by Articles 8 and 10
to decide on the addition of new preparations to, or withdrawal from international control (Lande, 1945).
The Secretariat of the LoN (equivalent to today’s UN Secretary-General’s oce) had a dedicated Health
Section (the main roles of which are nowadays assumed by WHO Director-General, and for some drug control
functions, by the UN Oce on Drugs and Crime).
Together, Health Committee and Health Section of the Secretariat formed the upper part of the hierarchy
of a very-theoretical “Health Organisation” of the LoN (Fig. 2).
Below the Health Committee, within the LoN (1945b, p. 61) was the Advisory Committee on Trac in
Opium and other Dangerous Drugs: the central policy making body where State Parties to the drug control
treaties convened –an ancestor of today’s CND (Bayer and Ghodse, 1999; Boister, 1997, p. 16). Within the
Advisory Committee was eventually created a Sub-Committee on Cannabis (ocially “Sub-Committee to
study Questions in regard to Indian Hemp and Indian Hemp Drugs” where tumultuous political discussions
recurred; Kozma, 2011b) and a Sub-Committee on the List of Drugs to keep track of inclusions and exempti-
ons of preparations from control (“Sub-Committee of Experts to draw up the List of Drugs and Preparations
coming under the Hague (1912) and Geneva (1925) Opium Conventions and the Limitation Convention (Ge-
neva, 1931)” (LoN, 1945c, p. 61), a task nowadays assumed by the INCB with its regularly-updated “Yellow
List” and “Green List;” INCB, 2021a; 2021b), among others.
Within the Health Organisation (but outside of the LoN!) and in Paris, was the OIHP –or, as they preferred to
call it in Geneva, the “general advisory health council” (LoN, 1945c, p. 64). Under Articles 8 and 10, C25, the
Oce was tasked with providing scientific advice ahead of the decisions of the Health Committee. Diering
from the classical Secretariat-Board-Assembly structure of the LoN, the OIHP had a single plenipotentiary
decision-making body called “Comit´e Permanent,” whose president was ex ocio vice-president of the Health
Committee (LoN, 1945c, p. 63). Within the Comit´e Permanent was a “Commission de l’Opium” which
eventually discussed drug control matters.[7] Because Governments tabled every week new demands for the
exemption of preparations under Article 8, the OIHP had developed an internal process and “constituted, to
enlighten its decisions, a Committee of Expert Pharmacologists, currently composed of six members” (OIHP,
1933, p. 61, author’s translation ). This “Comit´e des Experts Pharmacologistes” (CEP) is the ancestor of
today’s ECDD. To assist the OIHP’s advising role to the Health Committee, the same six individuals met
within the CEP from its start to 1935:
Pr. Emil B¨urgi (Switzerland),
Pr. James Andrew Gunn (UK),
Pr. Erich von Kna-Lenz (Austria),
Lieutenant-colonel Dr. Jerzy “George” Leopold Modrakowski (Poland),
Dr. ´
Emile Perrot (France), and
Pr. Walther Straub (Germany).
The CEP was not always the body tasked with drug assessment: that role was sometimes held by the
Commission de l’Opium (OIHP, 1933b, p. 26).
Finally, separately from the Health Organisation, two organs were monitoring and controlling the application
of the drug treaties:
the Permanent Central Opium Board, established under the C25, partially operated within the LoN
system as of 1935;
the Drug Supervisory Body (Organe de Contrˆole), established under the “Limitation Convention” of
1931, remained independent from the LoN system (McAllister, 2000, pp. 73, 96).
With the adoption of the Single Convention of 1961, both Permanent Central Opium Board and Drug
Supervisory Body were merged into a single body: the INCB (Fig. 3). Notably, one of the four members of
the Drug Supervisory Body was appointed by the OIHP (Lande, 1945, p. 410; LoN, 1945c, p. 22) which is
reflected nowadays by the fact that WHO appoints 3 of the 13 Members of the INCB.
Figure 2: Organisational chart of intergovernmental organisations with a mandate related to Cannabis
control in 1935 (LoN emblem: CC BY-SA 4.0 Martin Grandjean 2018/League of Nations 1939. OIHP
emblem: public domain).
Figure 3: Layer of the organs in charge of international drug control in 2022, superposed over the organisa-
tional chart presented in Fig. 2.
1935: The non-review of Cannabis by the Oce International d’Hygi`ene Publi-
In 1933, although seizures of raw Cannabis ,mostlyimportedfromSyria,hadbeencutbyhalfinthe3
previous years (LoN, 1933, p. 12), the Egyptian government sent a notification to LoN’s Health Section
(OIHP, 1935, p. 161; Supplemental materials Table S1) alerting of the alleged widespread harms caused
by five particular medicines sold by the firm Parke, Davis & Co. (nowadays part of Pfizer, the Detroit-
based “Parke-Davis” was then already a global pharmaceutical company; Hoefle, 2000, p. 33; Pfizer, s.d.).
Alongside Merck in Germany, Holtmann-La Roche & Co. in Switzerland, Eli Lilly in the USA, and many
other important or smaller pharmaceutical manufacturers (Frankhauser, 2002; Hamilton, 1912; Krawitz,
2006; OIHP, 1934b, pp. 104–110), Parke-Davis was proactively marketing two classes of Cannabismedicines
(Museum of Healthcare. . . , 2022b; Parke, Davis & Co., 1911, p. 12):
A wide array of specific (often proprietary) preparations, some containing Cannabis herb or extract as
main ingredient (pills, tablet triturates), others compounded preparations containing it as an additional,
residual ingredient (elixirs, tablets, and “a number of combinations”);
Raw extracts (fluid and solid extracts of North American-grownCannabis), herbal parts (powdered
Cannabis,driedtops),andUnitedStatesPharmacopœia standardised products (fluid extract, solid
extract, and tincture of Indian-grown Cannabis), used for compounding by local pharmacist –a main-
stream practice at the time.
In a specific booklet dedicated to these medicines, Parke, Davis & Co. (1908, p. 2) claimed that Cannabis
“has been used as an intoxicant in Asiatic countries from time immemorial, and under the name of
‘hashish,’ ‘bhang,’ ‘ganja’ or ‘charas,’ is habitually consumed by upwards of two hundred millions
of human beings.”
The five preparations that Egypt notified did contain extracts ofCannabis ,but,comparedtosomanyother
popular medicines at the time, contained relatively minor amounts of Cannabis extract but instead copious
amounts of other particularly notable sedatives or harmful substances[8] (Table 1; Fig. 4). As noted by
the OIHP (1934b, pp. 106–110), if someone wanted to get high with these preparations, the lethal dose of
strychnine would most likely be reached much before any narcotic eect could be felt.
Because they were not “pure” extracts of Cannabis ,however,thesepreparationsdidnotfallundertheterms
of C25. Pursuing its agenda started in 1925, Egypt saw this as something convenient to object to. The reasons
for the particular attention given to Parke-Davis medicines, however, remain unclear, particularly since “the
only among these [preparations] that [was] being exported in appreciable quantities to Egypt [was] the one
called Compounded Damiana Tablets,” which was only supplied on medical prescription (OIHP, 1934b, p.
As a matter of fact, the intention of Egypt was to extend international controls “not only to the five pre-
parations mentioned earlier, but all preparations containing an extract or tincture of indian hemp” (OIHP,
1935, p. 162, author’s translation )oratleasttopreparationscontainingaboveacertainpercentofCan-
nabis extract (OIHP, 1934, p. 23). On 12 June 1934 (OIHP, 1934, pp. 23–24) the Health Committee of the
LoN triggered the mechanism of Article 10, C25, allowing the OIHP to convene its CEP, towards eventually
“recommend[ing] that the provisions of [C25] be applied to such drug” in case it “is liable to similar abuse
and productive of similar ill-eects as the substances to which this Chapter of the Convention applies” (LoN,
Table 1. Translation of the “List of preparations made of Indian hemp indicated by the Egyptian
Government as being used by drug addicts” reviewed by the Oce International d’Hygi`ene
Publique in 1935.
Source: “Liste des pr´eparations `a base de chanvre indien indiqu´ees par le Gouvernement ´egyptien comme
employ´ees par des toxicomanes,” in: OIHP (1935, pp. 163–164). Author’s translation. A full list and the
reproduction or the original can be consulted in the Supplemental Materials.
  
 
  
 
 
  
 
  
 
 
  
 
 
 
 
  
 
 
  
  
  
 
 
  
 
   
                
                
                   
                
                
  
 
The Expert Committee meets in Bern
On 4 and 5 March 1935, in Bern, Switzerland, the same six European men that had been attending every
previous CEP meeting reconvened to address the issue raised by Egypt (OIHP, 1935, pp. 161–165, 207–209).
Three observers joined:
Dr. Henri Carri`ere (Switzerland), director of the Federal Oce of Public Health, who attended in his
capacity of Chair of theCommission de l’Opium at the OIHP (1935, p. 207; Steen Gerber, 2003).
Surprisingly, he also chaired the CEP meeting,
Dr. Ignatius Wasserberg (Poland) from the Health Section (LoN Secretariat; LONSEA, s.d.), in repre-
sentation of the Health Committee, and
Dr. Georges Abt (France), OIHP director.
Three questions were asked to CEP Experts:
“a. Are all preparations based on an extract or tincture of Indian hemp liable to lead to similar
abuse and produce similar ill-eects as [a pure extract or tincture]; or b. At the least, those of
which the content in the above-mentioned substance exceeds a particular upper threshold, and
c. What is, in this case, such an upper threshold?” (OIHP, 1935, p. 208, own translation)
It is notable that the CEP remarked the manoeuvres of the Egyptian government: their concerns about
increased, massive imports of these preparations, and widespread use in Egypt, was not reflected in the
statistics (OIHP, 1935, p. 162) and, pharmacologically, the potential for harm was clearly not primarily
related to Cannabis extracts “because of the little quantities of hashish they contain, and the associated
presence of toxic substances” (OIHP, 1935, p. 163). Henri Carri`ere reported that the five preparations
were “so to speak, unknown” by the delegates from Australia, Belgium, British India, Canada, Germany,
Italy, the Netherlands, Turkey, Tunisia and the United States.[9] Germany and the Netherlands had opposed
straightforward Egypt’s proposal, but Canada had expressed support (OIHP, 1934b, p. 105) out of concern
for the “mariuana cigarettes” sold on its territory (LoN, 1933, pp. 11–13; 1935a, p. 20; OIHP, 1934b, p.
Among the Experts, only the rapporteur, Kna-Lenz, clearly favoured placing all Cannabis -containing
preparations under control. He found it illogical that “hashish preparations be treated dierently than
opium or cocaine preparations” (OIHP, 1935, p. 208, author’s translation ). LoN’s representative Wasserberg
eventually joined him, asking however for the establishment of a maximum threshold of extract above which
the preparations would fall under control. The proposal was quickly dismissed by the Experts, which
recognized that
“no method currently exists allowing to ascertain the content in extract or in tincture of a prepa-
ration, and also that it is not possible to measure the activity of an Indian hemp extract which,
besides, is rather uneven” (OIHP, 1935, pp. 208–209, author’s translation).
The minutes of, and correspondence surrounding the meeting suggest that no additional documentation
or bibliographical support was relied upon –unlike the LoN’s Sub-Committee on Cannabis ,createdthree
months later, which would consult many knowledgeable experts, compile much information, and even commis-
sion research on various aspects of the plant (CND, 1965; Kozma, 2011b; LoN, 1935a). The Sub-Committee
did not provide input to the CEP meetings since it first met in May 1935 (LoN, 1935a, p. 32).
Uncomfortable with the whole process, but willing to move forwards, the Experts agreed on a consensual
option proposed by Wasserberg of the LoN Health Section, as middleground: the CEP would recommend
placingCannabis preparations under control generally, while keeping “the benefit of Article 8” allowing to
later exempt specific ones from international control on a case-by-case basis. It was argued, among others,
that control over Cannabis -containing preparations would reduce the likelihood of them being used as
carriers for more harmful compounds.
After the review: confusion and reservations
The CEP’s recommendation still had to go through OIHP’s Comit´e Permanent in May 1935 –first, Com-
mission de l’Opium, then plenary– before being considered at the LoN’s Health Committee in October 1936
(LoN, 1935c, pp. 5–6). Because “it is a matter of course that the opinions of the [OIHP] are confirmed by
the Health Committee” (OIHP, 1933, p. 62,author’s translation ), the recommendation was agreed on (LoN,
1937), and then again at the Council of the LoN (90th meeting, 5th seance, 23 January 1936).
Surprisingly, the LoN’s Sub-Committee on Cannabis, which started its works on 29 May 1935, seemed to be
totally unaware of the entire process going on under the C25 (LoN, 1935a, p. 34).
After the multi-approval procedure of the CEP recommendations, the C25 mandated the Secretariat of the
LoN to “communicate the said recommendation to the Contracting Parties” but, contrary to today’s drug
control treaties –where the scheduling changes agreed on take eect upon notification, worldwide– the C25
leaved the option for each country to accept or not the placement of a new drug or preparation under control.
The recommendations of the CEP, consequently, had legal eect only “between the Contracting Parties who
have accepted [them]” (LoN, 1925).
On 10 September 1936 (LoN, 1936) a Circular Letter was sent to the 52 countries party to the C25 at the
time (LoN, 1935a, pp. 7–8, 38–39), among which Argentina, Canada, Mexico, the USSR, Peru, and others.
Nonetheless, notable countries had not, and never ratified the C25, like the USA (Leinwand, 1971, p. 415;
LoN, 1935a, p. 38; McAllister, 2000) or China (LoN, 1935a, p. 39; UNODC, 2008, p. 53).
But even among the 52 Parties, the “formal acceptance” of the CEP’s recommendation“necessary in order to
establish as between the High Contracting Parties the international obligations to which allusion is made”
(LoN, 1936) remained scarce. One year after the notification, 25 countries had accepted the placement under
control,[10] 20 were silent, and seven governments had expressed direct reservations: Austria, Denmark,
Netherlands, and Norway wished to exempt a number of specific proprietary formulations manufactured in
their country, and Germany, Portugal, and Sweden wished for all topicals to be exempted (LoN, 1937, p. 2).
This was leaving the change without eect in two dozens of ratifying countries, such as Brazil, Colombia,
Cuba, Finland, Luxemburg, Spain, Switzerland, Uruguay, Yugoslavia, and colonial empires like France and
the UK. In addition to all the non-Parties, this was de facto making the change null even for the Parties
that had accepted it. Dr Carr`ere had anticipated that as soon as he had heard of Egypt’s request, in 1934
(OIHP, 1934, p. 23)
At its 26th Session, in November 1937, the Health Committee noted that these feedback “must be taken into
consideration, with a view to the possibility of so modifying the Health Committee’s decision of October
1935,” with the goal of securing “unanimous and unconditional acceptance” (LoN, 1937, p. 2). Noting that
“it would be impossible to exempt from the Convention a group of preparations described in such a vague
manner” (LoN, 1937, p. 3), the Health Committee seconded the question to the OIHP, again, for further
1938: A second review at the verge of War
Less archives of the second CEP meeting are available. It was convened on 22 September 1938 in Bern,
again, under the chairmanship of the “observer” Dr Carri`ere. For once, the cast had changed: Carri`ere’s
fellow countryman Emil B¨urgi was absent for health reasons (Ledermann, 2005; OIHP, 1939, p. 2), and Marc
Tieneau, another Frenchman, replaced Pr. Perrot (LoN, 1938b, p. 2; Table 2). Carri`ere relates about this
second review of preparations containing extract or tincture ofCannabis :
“...the Experts maintained their previous decision, that is, these preparations should be placed
under control, except corn-removers, even if these preparations are obtained directly from Indian
hemp in natural form or its resin, without having gone through an extract or tincture.
The Experts motivated this decision, as the previous, by the fact that, to date, no certain method
exists to determine the content in extract or tincture of Indian hemp –or, to say it better, in the
active principle of Indian hemp, which is cannabinol– of a preparation.” (LoN, 1938b, pp. 2–3)
This time, the works of the LoN’s Sub-Committee on Cannabis had been shared and received by the OIHP,
and in particular, the studies of Dr. Bouquet (Tunis) Dr. de Myttenaere (Brussels) related to “the value of
Beam’s reaction for the detection of cannabinol and [. . . ] a method for the assay of this substance” (LoN,
1935a, p. 7) which were a focus of the CEP’s interest. But because the method had only been published in
LoN document, not in the literature, the Experts refused to refer to it: instead, they expressed the conviction
that the assay would certainly be considered in a future CEP meeting (OIHP, 1939).
The CEP never reconvened. Anyways, while cannabinol is indeed an active compound present in Cannabis
,itisnottheonethatEgyptandmostpartiesinvolvedprobablyhadinmind: cannabinoldoesnotcause
the eects that characterise the use of Cannabis products, but dronabinol ([?]9-tetrahydrocannabinol), a
substance that was only identified three decades after later (Mechoulam and Hanuˇs, 2000).
Table 2. Dramatis personæof the 1935 and 1938 CEP meetings.
Role(s) at the
time Nationality Role in 1935 Role in 1938
Abt, Georges
Director, OIHP.
Medical doctor.
Scientist, Pasteur
Institute, Paris.
France Obser ver Obs erver
urgi, Emil
Professor of
pharmacology and
medicinal chemistry,
University of Bern.
Swiss CEP member CEP member
Role(s) at the
time Nationality Role in 1935 Role in 1938
Carri`ere, Henri
Director, Federal
Oce of Public
Health (1916–1937).
Member, OIHP’s
Comit´e Permanent.
President, OIHP’s
Commission de
LoN Advisory
Committee on
Trac in O piu m
and other dangerous
drugs (1934–?*).
Member, Drug
Supervisory Body
Swiss Observer; Chairman Observer; Chairman
Gunn, James
Professor of
pharmacology (until
1937) and
Oxford. Specialist
in psychedelic
alkaloids. Member,
Founde r, Br iti sh
British CEP member CEP member
Erich von
Professor of
pharmacology and
toxicology, Medical
University, Vienna.
Member, LoN
Health Committee.
Austrian CEP member;
CEP Member
Jerzy Leopold
Professor, Faculty
of Medicine,
University of
Warsaw. Delegate
of Poland at several
LoN meetings on
opium. Died at the
Wroc law
concentration camp.
Polish CEP member CEP member
Role(s) at the
time Nationality Role in 1935 Role in 1938
Perrot, ´
Professeur of
medicine, Faculty of
Pharmacy, Paris.
Member of various
committees related
to plants and
natural resources in
numerous French
French CEP member n/a
Straub, Walther
Professor of
Ludwig Maximilian
University of
Munich. Known for
the Straub
Spasticity Test
(“Straub tail”)
German CEP member CEP member
Tieneau, Marc
Chemist, known for
the “Tieneau–
Member, Drug
Supervisory Body
Member, LoN
Member, LoN
Committee on
Trac in O piu m
and other dangerous
drugs (1935–?*)
French n/a CEP member
Ignatius (Ignacy
Izak) (1879–1942)
Techni cal oc er,
LoN Health Section
Medical doctor;
philosopher. Died
at the Auschwitz
concentration camp.
Polish Observer Observer
* At least until the end of 1935.
Corn-removers and Pact of Steel
In May 1939, at its 30th session, the Health Committee agreed on maintaining the conclusions from the
first CEP review, this time clearly “declaring however that these conclusions do not target those of these
preparations that can only be used externally” (LoN, 1939a, p. 5; Preparations exempted. . . , 1951). The
Council of the LoN ratified the move at its 105th session, on 23 May 1939 –one day after Hitler and Mussolini
signed the Pact of Steel– and communicated to State Parties on 12 July a Circular Letter titled “Application
of Article 10 of the Geneva Convention of 1925 to preparations based on Indian hemp Extract or Tincture
under reserve of certain exemptions” (LoN, 1939a) –the one from 1936 did not made that precision (LoN,
1936). Shortly after,
“with the outbreak of the Second World War and the occupation of Paris, the OIHP was not able
to function as intended and could not fulfil its international health functions” (UN, s.d.).
Although its headquarters were occupied in 1940 (Tworek, 2019), part of the OIHP stahad managed to
escape to Southern France, with documents and archives.
In Geneva, the LoN had already started reducing activities in 1938 (Magliveras, 1999, p. 31; LoN, 1938a),
and drastically after the expulsion of the USSR in December 1939 (LoN, 1939c). “By June 1940, the staof
the Health Section had been so depleted by resignations and departures for national service that it included
only two medically qualified members” (Howard-Jones, 1950) and almost all activities of the LoN had been
phased out (Le Monde, 1946) except a few programmes that passed on to be carried on by the Secretariat,
among which was the “protection of public health and control of the manufacture of and illicit trac in
narcotic drugs” (Magliveras, 1999, p. 31), carried on throughout WWII and the immediate post-war period
(LoN, 1945c; Tworek, 2019); the Permanent Central Opium Board and Drug Supervisory Body also reduced,
but maintained activities (Dangerous drugs.. . , 1946, p. 175; May, 1948, pp. 342–345; McAllister, 2000, pp.
The last action of the LoN related to Cannabis and its 1935/1938 CEP assessments had taken place on 31
December 1939 (Table 3) when, in an attempt of normality, the Secretariat issued a revised list of drugs,
preparations, and medicines under international control (drawn-up by the Sub-Committee to the List), which
confusingly acknowledged the placement of “preparations made of extract and tincture of Indian hemp” under
international control, with a footnote reading:
“This clause applies to countries which have adopted the recommendation of the Health Commit-
tee of the League of Nations to place these products under control [. . . ]. The Health Committee
[. . . ] stated that their conclusions, however, do not apply to those of the said preparations which
are capable only of external use” (LoN, 1939d, p. 28)
After the War
The LoN was dissolved in 1946, its mandates transferred to the UN (Myers, 1948; WHO, 1947b). That same
year, the penultimate meeting of OIHP’s Comit´e Permanent meeting was held: it discharged its mandates
to an interim commission tasked with establishing the WHO (1950a), and suspended the publication of its
landmark Monthly Bulletin (WHO, 1958, p. 430). By February 1948, the WHO “had absorbed all the OIHP’s
obligations towards the States parties” (WHO, 1958, p. 56; Fig. 3) including drug assessment under the C25.
Governments had agreed, in 1946, on a plan for the denunciation of the 1907 Rome Agreement (OIHP’s
constitution) and termination of the Oce by 15 November 1949 (UN Relief and Rehabilitation Administra-
tion, 1943; WHO, 1948a, add.1; 1950a, p. 2). The decision was unpleasant to France, which feared losing its
influence on international health matters (Paillette, 2021); others also continued defending the active role of
the Oce amidst its liquidation: in September 1947 Dr Morgan, chairman of the Comit´e Permanent, argued
that as long as the Oce was not eectively terminated,
“the consultative opinion of the latter, in pursuance of Articles 8 and 10 of the 1925 Geneva
Convention, would be required to give legal authority to the recommendations of the [WHO]
experts” (WHO, 1947b).
The LoN was liquidated in eect in July 1947, 15 months after the decision to terminate it (Myers, 1948).
But the OIHP was a dierent story. It continued functioning even after its programmed death: an obscure-
motivated refusal of Spain to denounce OIHP’s funding Agreement, added to legal uncertainties surrounding
its termination by the non-self-governed occupied territories of Germany, Japan, and Libya, and by newly-
independent countries (WHO, 1949, pp. 2–3) had made “apparent that the Oce must continue” (WHO,
1949, p. 4). On 15 November 1950, the last few remaining activities of epidemiological monitoring carried
out by the OIHP ceased –one year after the deadline set, and mostly because of a cruel lack of resources
(WHO, 1950a; 1950b). Nevertheless, an empty OIHP continued existing de jure until 1952 when, finally, the
denunciation of the Federal Republic of Germany, Japan, and Spain ended its long agony (WHO, 1950a;
1952a, p. 30).
Early work of the WHO on Cannabis
The inception of WHO did not look particularly promising forCannabis medicines: as early as 1947, the
three monographs ofCannabis were withdrawn from the International Pharmacopoeia, the management of
which WHO had just taken over –although countless other medicines were deleted, particularly herbal ones
(WHO, 1947a).
The WHO however really engaged with the drug control aspect ofCannabis products in 1952, at the third
ECDD meeting –initially named the Expert Committee on Narcotic Drugs (WHO, 1948b), this body created
to carry on the scientific tasks previously assumed by OIHP’s CEP changed titles several times, until being
named ECDD in 1968 (Danenberg et al, 2013). At its 1952 meeting, “the question of justification of the use
of cannabis preparations for medical purposes” was discussed, and the committee declared that
“cannabis preparations are practically obsolete. So far as [the Committee] can see, there is no
justification for the medical use of cannabis preparations.” (WHO, 1952b)
An opinion reiterated at subsequent meetings (Krawitz and Riboulet-Zemouli, 2018; Riboulet-Zemouli, 2018).
There is no trace of any inputs from any pre-WWII meetings, decisions, or documentation in 1950s ECDD
meetings, let alone of the 1935/1938 episode. The never-ending termination of the OIHP, in conflict with
WHO, might not have facilitated knowledge-sharing.
In 1962, an article reported that all Cannabis preparations were under control, with the exception of topical
preparations and “a medicinal cigarette called ‘Indian Cigarettes of Grimault’ [. . . ] exempted from control”
(The cannabis problem. . . , 1962),[11] but Parke-Davis medicines of the 1935 list were still produced in the
late 1940s (Museum of Healthcare at Kingston, 2022a) and in the 1950s “some Governments had reported
that there still existed an appreciable use of cannabis drugs in medical practice” (CND, 1955). In an analysis
of “The position of preparations of narcotic drugs under the narcotics treaties. . . (1959), the scope of the
1935/1938 decisions was considered “to be a matter of doubt.”
Secretary-General’s note on “The Question of Cannabis” (CND, 1960) ignores the issue, and its compilation
of 1,860 references onCannabis incidentally mentions OIHP, only once, and unrelated to the 1935 assess-
ment (CND, 1965, p. 45). The list of drugs under international control edited by the CND (1961) during
the negotiation of the Single Convention only mentions: “Relevant articles of the 1925 Convention which
are applicable to Cannabis and its resin, and to galenical preparations of Cannabis” –without mentioning
anything about preparations, ignoring the last list of drugs under control of the LoN in December 1939,
omitting the entire 1935/1938 episode.
Table 3. Timeline of discussions on Cannabis control, 1933-1939.
* indicates an action taken by the League of Nations; + indicates an action taken by the Oce International
d’Hygiene Publique; other rows are actions taken by Governments. C25: International Opium Convention
of 1925; CEP: Comite des Experts Pharmacologistes; OIHP: Oce International d’Hygiene Publique; LoN:
League of Nations.
When Who What Source
May 1933 Egypt Notifies the Health
Section about 5
preparations containing
trace-amounts of
Cannabis extracts
marketed by Parke, Davis
& Co. should be
subjected to Article 10,
OIHP (1935, p. 161)
October 1933 * Health Committee First meeting where
the issue raised by
Egypt is addressed.
More precisions are
asked to Egypt.
OIHP (1935, p. 208)
28 May 1934 Egypt Answers to the LoN’s
Health Committee,
providing details.
Clarifies that the
proposal is to extend
controls to all
preparations, not only
the 5 notified in 1933.
OIHP (1935, p. 162)
12 June 1934 * Health Committee Asks Egypt further
information. Refers the
case to OIHP’s Comit´e
Permanent, attaching a
detailed descriptive note
–triggers mechanism for
review under Article 10,
OIHP (1934a, p. 23)
Summer 1934 +Comit´ePermanent Refers back to the LoN,
to undertake preliminary
consultations among
Governments asking
whether the 5
preparations notified by
Egypt were reported as
liable to produce
addiction in their
OIHP (1934a, p. 23)
Germany, the
Express refusal of
Egypt’s proposal.
OIHP (1934b, p. 105)
When Who What Source
* Secretariat’s Legal
Clarifies that the
inclusion of
preparations of Indian
hemp under the
controls of C25 is
“perfectly legitimate”
and depends only on
the responsibility of
the Health
Committee’s decision,
upon OIHP’s advice.
OIHP (1935, pp. 162,
8Oct.1934 * Health Section Dr. Ludwik W.
Rajchman (director,
Health Section) mentions
at OIHP’s Comit´e
Permanent that the
proposal of Egypt entails
problems, some “issues of
OIHP (1934a, p. 30)
When Who What Source
12 Oct. 1934 +Comit´ePermanent Considers a research
made by British
representative Dr.
Morgan about Parke,
Davis & Co.’s
preparations, finding that
“the only among these
that is being exported in
appreciable quantities to
Egypt is the one called
Composed Damiana
Tablets” while the other
preparations were not
exported to Egypt by
Parke-Davis, except the
elixir, of which less than
half a kilogram per year
was exported. Regarding
Demiana Tablets, the
exports were of 3,358
bottles in 1932, 4,576
bottles in 1933, and 2,080
bottles from January to
Septembre 1934 (100
tablets per bottle). It was
noted that the interest in
the tablets may instead
have been due to their
use as an aphrodisiac
(unrelated to cannabis
intoxication). The
Comit´e decides that no
further action is needed,
except a possible future
examination, should it be
recognised as necessary.
OIHP (1934b, pp.
Canada Express support for
Egypt’s proposal;
mentions “Mariuana
cigarettes” as desirable
to be placed under
OIHP (1934b, pp.
When Who What Source
A dozen of
The preparations are
unknown, and the
elements put forward
by Egypt seem
doubtful due to the
composition of the
preparations and the
presence of other
harmful substances.
OIHP (1934b, pp.
27 Nov. 1934 * Health Committee Requests more data to
Governments. Decides
the creation of a
Sub-Committee on
OIHP (1934b, pp.
14 Jan. 1935 * Council Acknowledges the need
for more research, takes
note of the creation of
the Sub-Committee.
84th session
4–5 March 1935 +CEP Meets in Bern, issues the
recommendation: “The
Committee of Experts is
of the opinion that all
preparations based on
extracts and tinctures of
Indian hemp are liable to
give rise to similar abuse
and to produce similar ill
eects as the extract and
tincture themselves; it
recommends that they be
subject to the provisions
of the 1925 Convention,
granting them, where
appropriate, the benefit
of Article 8 of the said
Convention” (translation
is of the author).
OIHP (1935, pp.
207–211, 163–164)
6May1935 + Commission de
Approves the
recommendation, as
adopted by the CEP on 5
OIHP (1935, pp.
8May1935 +Comit´ePermanent Approves the
recommendation, as
adopted by the
Commission de l’Opium
on 6 May.
OIHP (1935, pp.
When Who What Source
29 May 1935 * Sub-Committee on
First meeting. Visibly
unaware of the CEP
recommendation, the
Sub-Committee wonders
about “the possible
expediency of
recommending a
modification of, or an
addition to, the existing
conventions” because
“The Sub-Committee did
not go into the question
of galenical preparations
of Cannabis sativa but
its attention was drawn
to the fact that the
present international
conventions, in so far as
internal control is
concerned, establish a
control for preparations
of the resin of this drug,
which is less strict than
that prescribed for other
LoN (1935a, p. 34)
7–14 Oct. 1935 * Health Committee At its 22nd session,
approves the
recommendation adopted
by the OIHP on 8 May,
rephrasing it as follows:
“preparations made from
tincture or extract of
Indian hemp may lead to
the similar abuses and
may produce similar
ill-eects to those
resulting from use of the
tincture or extract of
Indian hemp themselves,
and consequently decides
that these preparations
shall be brought within
the control of the 1925
Convention” (note that
the rephrasing happened
both in French and
English languages).
LoN (1935c, pp. 5–6;
When Who What Source
23 Jan. 1936 * Council At its 90th session (5th
meeting), approves the
recommendation, and
decides to
communicate it to
States Parties to the
C25, and for
information to States
Parties to the 1931
LoN, Journal Ociel,
Feb. 193 6
10 Sept. 1936 * Secretary General Shares Circular Letter
C.L.161.1936.XI titled
“Application of Article
10 of the Geneva
Convention of 1925 to
preparations based on
Indian hemp Extract
or Tincture” which
included the wording
from the Health
Committee’s 22nd
session, asking each
Government “whether
it would agree, so far it
is concerned, to the
inclusion of
preparations made
from Indian
hempextract or
tincture within the
scope of the
Convention. [. . . ] a
formal acceptance is
necessary in order to
establish as between
the High Contracting
Parties the
obligations to which
allusion is made in
[Article 10, C25].”
LoN (1936)
When Who What Source
Fall 193 7 32 Governments Answer the Circular
Letter agreeing on, or
objecting to, the change.
25 countries accepted
without reservation
(some that accepted were
not even Parties to the
C25), 7 countries
accepted only under
specific conditions. All
other non-respondent
countries de facto did not
accept the change.
LoN (1937)
16 Oct. 1937 * Health Section Refers the objections and
reservations received by
countries to OIHP’s
Comit´e Permanent for a
new examination.
LoN (1937, p. 3)
27 Oct. 1937 * Health Committee At its 26th session, notes
the diverging opinions
among Governments, and
various reservations sent .
LoN (1937)
22 Sept. 1938 +CEP Blames the Health
Committee for altering
the content of the
recommendation, and
reiterates the same
recommendation as in
OIHP (1939)
Sept. 1938 * General Assembly The LoN reduces its
activities due to the tense
geopolitical situation.
LoN (1938a)
17 Oct. 1938 + Commission de
Approves the
recommendation, as
adopted by the CEP on
22 Septembre.
OIHP (1939)
22 Oct. 1938 +Comit´ePermanent Approves the
recommendation, as
adopted by the
Commission de l’Opium
on 17 Octobre.
OIHP (1939)
10 Nov. 1938 +Comit´ePermanent Shares the
recommendation with the
Health Committee.
LoN (1939a, p. 5)
When Who What Source
9May1939 * Health Committee At its 30th session, notes
the recommendation
transmitted by the OIHP
in Novembre 1938,
expresses the will to
reach “unanimous assent”
for any decision related
to Indian hemp, and
decides: “WHile
maintaining the
conclusions of the 22nd
session [. . . ] declares
however that such
conclusions do not
concern those
preparations which can
only be used externally”
LoN (1939a, p. 5)
23 May 1939 * Council At its 105th session,
approves the
recommendation, and
decides to communicate
it to States Parties.
LoN (1939a)
12 July 1939 * Secretary General Shares Circular Letter
C.L.99.1939.XI titled
“Application of Article 10
of the Geneva
Convention of 1925 to
preparations based on
Indian hemp Extract or
Tincture under reserve of
certain exemptions”
LoN (1939a)
31 August 1939 Invasion of Poland and
outbreak of the second
world war.
Invasion of Poland and
outbreak of the second
world war.
When Who What Source
31 Dec. 1939 *Advisory
Committee on trac
in opium and other
dangerous drugs
Circulates a “Revised list
of drugs, preparations,
and medicines coming
under the international
drug conventions” which
lists: “Preparations made
of extract or tincture of
Indian hemp[1] [1] This
clause applies to
countries which have
adopted the
recommendation of the
Health Committee of the
LoN to place these
products under control as
well as extracts and
tinctures [. . . ]. The
Health Committee, in
further recommendation
[. . . ] stated that their
conclusions, however, do
not apply to those of the
said preparations which
are capable only of
external use” and a list of
29 proprietary medicines
of “extracts or tincture of
Indian hemp base”
(where, from the 5
preparations notified by
Egypt, only the “Elixir
Bromide and Chloral
Compound” from Parke,
Davis & Co. is listed)
stating again in a
footnote that “this clause
applies to countries
which have adopted the
recommendation of the
Health Committee of the
League of Nations” and
mentioning that “other
preparations, however,
are to be found in the
market which fall under
the Conventions but
which are not included in
the list,” and precisind
that “all drugs,
preparations or
proprietary medicines
mentioned in the list are
not subject to an
identical form of control
[. . . ]; for instance, Indian
hemp, its resin and its
preparations are not
covered by Chapter III,
Article 4, [C25], but fall
under chapters IV and V”
LoN (1939d, pp. 9,
28–29, 102–106)
, Article 4, [C25], but fall under chapters IV and V”
When Who What Source
For reas ons yet t o b e deter min ed, t he proce ss of e valu ati on and sc hedul ing i nit iated b y Egypt i n 193 3,
which occupied the international community until the last day of December 1939, was forgotten. Already
hardly-accepted by, and poorly-implemented among the Parties to the C25 at the time, it was lost to history
during WWII. In 2014, the date “1935” resurfaced in a document of the WHO (2014); stakeholders, content,
outcome, or consequences of the event did not. A partially-mistaken idea then followed: Cannabis had been
scientifically assessed in 1935. The present study suggests that no such thing happened.
While in 1935, a review meeting of the Comit´e des Experts Pharmacologistes of the Oce International
d’Hygi`ene Publiquedid take place under the auspices of the LoN, it did not assessCannabis or even Cannabis
extracts. Instead, it briefly considered five specific proprietary medicines containing a variety of highly potent
compounds alongside residual amounts of Cannabisextracts, and drew conclusions for a myriad of products
based on the rapid overview of that random sample of five.
No methodology or supplemental documentation appear to have guided the work of the Experts and, even
after (1) acknowledging the political motivations of Egypt’s request and (2) noting the likelihood that
any harm derived from the use of these preparations was most likely due to any other active principle
than Cannabis extracts, the Experts still decided to maintained the focus on Cannabis as the ingredient
deserving their scrutiny, and an increase of controls. A recommendation already weakly-justified for five
precise preparations was arbitrarily extrapolated to dozens, if not hundreds of others. But it should be
recognized that the way in which were termed the three questions that the Experts were asked already
conducted them into such an outcome.
Although it was common at the time, the cruel lack of gender balance (not a single woman was involved in
the entire process), the fully-European composition of the bodies involved in the process, and the weight of
the personal moralist and conservative beliefs of norm entrepreneurs and drug control advocates arguably
participated in hampering any objective and inclusive consideration of the variety ofCannabis medicines –at a
time where the plant was still broadly used both in popular Western medicine and within traditional healing
contexts, worldwide. The influence of two observers in the meetings’ decisions should be highlighted (Henri
Carri`ere chaired both meetings; Ignatius Wasserberg came up with the idea of the final recommendation
in 1935), and balanced with the absence of any person knowledgeable aboutCannabis . In addition, the
endogamy of stakeholders is extreme: a figure like Dr Carri`ere was simultaneously holding positions at every
stage of the decision-making process: review (CEP observer), decision-making (OIHP Comit´e Permanent),
monitoring (Drug Supervisory Board), as well as diplomatic representative of a particular country.
For these reasons, while many considered the WHO ECDD scientific assessment of Cannabis of 2016–2019
as the first of its kind since 1935, it is fair to consider that it was actually the first-ever and only.
Finally, the oft-perceived leadership of the USA (Party to no international treaty controlling Cannabis until
1968) in the inception of multilateral Cannabis control is questioned, and the role of Egypt as prime advocate
of ever-stricter multilateralCannabis controls, already highlighted by Kozma (2011) and Jelsma et al. (2014),
calls for a reconsideration. At the same time the international community was discussing Egypt’s request
to increase controls over cannabis, USA Surgeon-General Hugh Cumming had written to the OIHP (1934b,
p. 107): “It does not seem that the abuse of galenical preparations of indian hemp raise any considerable
diculty in the United States.”
This study, presenting previously-undocumented historical records, can be of interest both to an improved
understanding of the legal history ofCannabis globally, and to analyses of possible future developments. Inde-
ed, many aspects of pre-WWII institutions and organisations are echoed in today’s multilateral drug control
complex (if not directly inherited from them), making their study to the least enlightening. Furthermore,
while the CND approved the withdrawal of “cannabis and cannabis resin” from Schedule IV of the Single
Convention on narcotic drugs on 2 December 2020, other ECDD recommendations were rejected (CND,
2020; Riboulet-Zemouli and Krawitz, 2022). Prospects for future works of the ECDD or other treaty-related
considerations would benefit from a fresh look at the past –not only the lost history of international coope-
ration on Cannabiscontrol, but also the forgotten tale of the galaxy of formulas withCannabis ingredients,
the reported hundreds of millions of people who prepared, prescribed, and used them, or the fact that large
pharmaceutical firms had, at the time, such a vivid interest in the plant and an apparently substantial global
distribution of its derivatives. As Cannabis reemerges in medicine, and as laws and policies surrounding it
continue to evolve in every corner of the globe, these findings seem timely.
Beyond Cannabis ,thisstudyshedslightonanunderexploredareaofthehistoryoftheinternationaldrug
control system, untapping the fundamental, surprisingly forgotten role of the OIHP in early drug scheduling.
Generally, the OIHP is a figure of international public health which has surprisingly been forgotten, at a
time where a look at the history of global health can, for instance, enlighten contemporary concerns on the
links between trade and health policies, or inform the debates of our days on the course of international
actions to take, be it on infectious diseases or on access to controlled medicines.
The authors are grateful to Renaud Colson for comprehensive review and constructive criticism, to Laury
Renard, Willem Scholten, Gilles Forte, and Christopher Hallam for helpful references, and to Shomi Malik for
proofreading. This study would never have been possible without the assistance and guidance from Jacques
Oberson, Lee Robertson (LoN archives), Reynald Erardt, and Thomas Allen (WHO Library). The authors
declare no conflict of interest; research was conducted in total independence thanks to support received on and from the non-profits FAAAT think & do tank and DRCNet Foundations.
Supplemental materials
Supplemental materials have been posted on Researchgate at this link: htt-
[1] The term “Indian hemp” is used throughout the text in reference to Cannabis sativa L.. It should not be
mistaken with Apocynum cannabinum L., an unrelated plant native to North America and also sometimes
called “Indian hemp” or “black Indian hemp.” The word “hashish” is used indistinctively to refer to the Can-
nabis plant, its tops, or its resin. Generally, the terminology related to plants “is somewhat awkward” in
these old treaties (Unification of Conventions. . . , 1950; see also LoN, 1935a, p. 33).
[2] Communications with INCB, UN libraries in Geneva and Vienna, and Dag Hammarskj¨old library. This
is not particularly surprising, given INCB’s track-record of great secrecy (Csete, 2012; Fields of Green for
All NPC, 2021) in a context where access to the documentation of intergovernmental organisations is often
a complicated endeavour (Church and McCarey, 2013).
[3] This is sometimes translated as “International Oce of Public Hygiene” or “International Public Health
Bureau.” However, French was the only ocial language for all names and documents of the OIHP, since that
language was at the times the hegemonic diplomatic language. The fact that only French-language versions
of the work of OIHP are available may have contributed to their scare presence in the literature. In addition,
the archives of the OIHP have had a convoluted history: evacuated from Paris and disseminated during
WWI, partially lost, partly transferred at the WHO library in 1950 by decision of the third World Health
Assembly (Resolution WHA3.98; WHO, 1950b, p. 59), subsequently de-catalogued by parts, split between
various collections of archives, parts of which have been decatalogued: the few archives that survived is
nowadays kept at the WHO library and LoN Archives, in Geneva.
[4] Until the mid-20th Century, most popular practices of day-to-day healthcare maintenance and treatment
of minor ailments fundamentally relied on self-medication, eventually under the advice of pharmacists or
other traditional healers –and not necessarily on consultations of a clinical practitioner, better documented
in the medical literature.
[5] This claim reflects the Eurocentric views of the OIHP, and could be disputed: indeed, the International
Sanitary Bureau (nowadays the Pan-American Health Organisation, regional oce of WHO for the American
continent) was established in 1902 under the International Bureau of the American Republics (nowadays
Organisation of American States) –that is five years prior to the OIHP (Pan-American Health Organisation,
[6] Renzi (1971, pp. 193-194) even presents evidence that Barr`ere provided personal financial support to
Benito Mussolini.
[7] At the time, the Commission de l’Opium was chaired by Swiss representative Henri Carri`ere and integrated
by the ambassadors of Egypt (Dr. Shahin Pacha), British India, and United States.
[8] Strychnine (also known as “rat poison”), arsenous acid (closely-related to arsenic), and products like
sodium arsenate, potassium bromide, chloral hydrate, or zinc phosphide, are highly toxic substances, today
only used as insecticides, pesticides, or products such as semiconductors.
[9] Parke-Davis had three well-established manufacturing laboratories in the USA, Canada, and the UK.
This could suggest that the five preparations found in Egypt were marketed from (or via; and possibly also
manufactured at) the facilities and laboratory of the company in Hounslow, UK (Hoefle, 2000 p. 31; Parke,
Davis & Co., 1908, 4th cover page; Wellcome Collection, 1927). That all correspondence between the OIHP
and Parke-Davis in preparation of the CEP meeting of March 1935 was undertaken either by Pr. James
Gunn from London (“Obituary,” 1958) or by the representative of the UK at the OIHP (1934b; 1935, p. 162)
seem to support that suggestion.
[10] Belgium, Bolivia, British India, Bulgaria, Canada, Chile, Czechoslovakia, Egypt, Ecuador, Greece, Haiti,
Hungary, Irish Free State, Italy, Japan, Lettonia, Monaco, Peru, Poland, Rumania, Siam, Sudan, Turkey,
Union of South Africa, Venezuela (LoN, 1937, p. 1)
[11] These cigarettes contained Belladonna leaves (0.962 g), nitrate of potash (0.033 g) and very small amounts
of Cannabis extract (0.0005 g); they were produced in Paris, France (Fig. 4.D; Agence Bibliographique de
l’Enseignement Sup´erieur, 2021; Preparations exempted. . . , 1951) and commercialised not only in Europe
(France, Germany, Italy, Spain, UK) but as far as Siam (Preparations exempted. . . , 1951), New Zealand
(Phillips, 2013), India (Franco-Indian Pharmaceuticals Pvt. Ltd., 2017), and the United States (Daven-
port, 1880); they were reportedly marketed from the 1860s (shortly after the landmark publications of
O’Shaughnessy and Moreau de Tours, see Frankhauser, 2002) until the mid-20th Century.
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“Drugs” have been regulated at the international level since 1912, while cannabis has been specifically regulated since 1925. Contemporary local, national, and international cannabis regulations are now diverging, with some jurisdictions legalising its recreational production, sale and consumption. This essay explores the legal and historical complexity and contingencies around the development of international cannabis regulations and prohibitions. It highlights that the global drug control system was not solely focused on prohibition and instead was a complex mix of regulations underpinned by frequently ill-defined and unclear prohibitions. It argues that the international drug control system should not serve as a bar to national-level reforms and that the two can continue to coexist. The essay favors a flexible, functional and pragmatic interpretation and implementation of the system as the most likely and indeed preferred outcome of international cannabis policy reforms.
Full-text available
Objective: Identify a coherent nomenclature of products containing cannabinoids (whether derived from Cannabis sativa L. or not). Design: Research undertaken in parallel to the three-year assessment of Cannabis derivatives by the World Health Organisation. The scope is limited to Cannabis products intended for human incorporation (internal and topical con- sumption). Primarily embedded in pharmacognosy, the study incorporates a wide range of scholarly and grey literature, folk knowledge, archives, pharmacopœias, international law, field pharmacy, clinical and herbal medicine data, under a philosophical scrutiny. Generic and Cannabis-specific nomenclatural frames are compared to determine the extent to which they coincide or conflict. Results: All lexica reviewed use weak, ambiguous, or inconsistent terms. There is insufficient scientific basis for terms and concepts related to Cannabis at all levels. No sound classification exists: current models conflict by adopting idiosyncratic, partial, outdated, or utilitarian schemes to arrange the extraordinarily numerous and diverse derivatives of the C. sativa plant. In law and policy, no clear or unequivocal boundary between herbal and non-herbal drugs, nor natural and synthetic cannabinoids was found; current nomenclatures used need updates. In science, the botanical Cannabis lexicon overlooks parthenocarpy, and wide disagreement remains as to the taxonomy and systematics of the plant; chemical research should address differences in kinds between synthetic cannabinoids; pharmacopœias include little information related to Cannabis, and disagree on broader classes of herbal medicines, virtually failing to embrace many known Cannabis medicines. Since existing products and compounds fail to be categorised in an evidence-based manner, confusions will likely increase as novel cannabinoid compounds, genetic and biotechnological modifications surge. Conclusions: The lack of clarity is comprehensive: for patients, physicians, and regulators. The study proposes an update of terms at several levels. It points at gaps in morphological descriptions in botany and pharmacognosy and a need for a metaphysical address of cannabinoids. Methods of obtention are identified as a common criterion to distinguish products; the way forward suggests a mutually exclusive nomenclatural pattern based on the smallest common denominator of obtention methods. In the context of a swelling number of Cannabis products being consumed (be it via medical prescription, adult-use, ‘hemp’ foodstuff and cosmetics, or other purposes), this study can assist research, contribute to transparent labelling of products, consumer safety and awareness, pharmacovigilance, medical standards of care, and an update of prevention and harm reduction approaches. It can also better inform regulatory policies surrounding C. sativa, its derivatives, and other cannabinoid-containing products. Original article available at:
This article examines the recent trends in international, in particular multilateral, drug policy and the implications of these changes for shifting alignments and coalitions of actors and stakeholders. It places these changes in the context of the system's historical developments and applies previously unutilised analyses of other international governance structures. It suggests that the the international drug control system is undergoing a long-term process of fragmentation and evolution towards a ‘regime complex’. In the short to medium term it suggests that exogenous challenges to the system remain somewhat limited. This is due to institutional battles over issue suzerainty and a limited funding incentive for other agencies to become involved. Instead, endogenous challenges and changes within the system represent the main avenues of adaptation. It continues on to suggest that in the longer term these endogenous changes will encourage and accelerate exogenous interactions with the system from other regimes and issue areas and thereby expand the terrain for cross-issue and cross-sectoral engagements. Thus, the short to medium term trends within drug control, while in some cases appearing to be in stasis or moving backwards, continue the overarching trend of regime fragmentation and shifting into an archetypal regime complex.
Globalization is classically defined as the increased movement of people, goods, and information around the world. Yet not all aspects of globalization and deglobalization happened simultaneously. This article uses the development of an international health information network to explore why information did not globalize concurrently with migration and trade. Nearly seven decades after states had understood disease as a cross-border problem, the League of Nations Health Organization (LNHO) brought together states, empires, and foundations in a voluntary exchange of health information that reached two-thirds of the world’s population and outlasted the League itself. The LNHO organized an infrastructure based on new wireless technology around colonial networks, port cities, the sea, and the air. Singapore and Saigon were more central than Geneva. Health information was meant to prevent epidemics; it enabled the LNHO to justify its own existence as a neutral broker for standardized, technical information; it helped colonial powers like Britain and France to share the financial burden of empire; it provided others like Japan with military advantages; and it enabled Germany to participate in international endeavors to regain national prestige. Tracing such infrastructures enables historians to overcome artificial divides between the national, international, imperial, and global.