Findings
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; Waetjen, 2018)
and in particular, similarly conservative governments in African and
Latin American 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 efforts 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, trading 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; Frankhauser, 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 monographs
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 a commonly
used ingredient in locally-compounded medicines, often containing a
variety of actives principles 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 represented. 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 present 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 containing 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 Hanuš,
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 indifferent
substance, [which] are not considered as possible agents of drug
addiction” (Wesserberg, 1935).
A situation evidently unsatisfactory for Egyptian diplomacy at the
time.
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 Office 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 Office 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 Organisation” to be based in Geneva, and
“of which the [OIHP] shall be the foundation” (Howard-Jones, 1979
p. 22). The Office 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] a relative success on the control 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 Office (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 Barrère, in which:
“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 composition 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 autonomous and maintains its headquarters in
Paris, without alteration of its composition or attributions. […]
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 secondary, the role of individuals is enlightening, if not
critical, in understanding the shaping of 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 Barrère 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
Office. Barrère, 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
Barrère 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
Barrère knew how to play “the hostility of the United States and USSR,
membersof the Office, 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.”