Beyond the role of individuals, the democratic, representativity, and
health-focused characteristics of the Office 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 Office (OIHP, 1938). Within the Office, 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 characterised 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. 847).
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 a large number of organs
interacting in a complex fashion, not uncommonly at the time (Fig. 2;
Grandjean, 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
efficiency (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
office) 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 Office 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 Traffic 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 (officially “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
exemptions 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
(Geneva, 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 Office was tasked with providing scientific advice ahead of the
decisions of the Health Committee. Differing from the classical
Secretariat-Board-Assembly structure of the LoN, the OIHP had a single
plenipotentiary decision-making body called “Comité Permanent,” whose
president was ex officio vice-president of the Health Committee
(LoN, 1945c, p. 63). Within the Comité Permanent was a “Commission de
l’Opium” which eventually discussed drug control matters.11At
the time, the Commission de l’Opium was chaired by Swiss
representative Henri Carrière and integrated by the ambassadors of
Egypt (Dr. Shahin Pacha), British India, and United States. 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 “Comité 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 Bürgi (Switzerland),
- Pr. James Andrew Gunn (UK),
- Pr. Erich von Knaffl-Lenz (Austria),
- Lieutenant-colonel Dr. Jerzy “George” Leopold Modrakowski (Poland),
- Dr. Émile 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 Contrôle), 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.