Discussion

For reasons yet to be determined, the process of evaluation and scheduling initiated by Egypt in 1933, 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 Comité des Experts Pharmacologistes of the Office International d’Hygiène 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 Carrière 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 Carrière was simultaneously holding positions at every stage of the decision-making process: review (CEP observer), decision-making (OIHP Comité 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 difficulty in the United States.”

Conclusion

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. Indeed, 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 cooperation 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 , this study sheds light on an underexplored area of the history of the international drug 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.