When the League of Nations was founded, one question of necessity arose in the fighters against alcoholism: could not and would not the new international organization, which does not confine itself to political aims but displays a beneficent activity in the fields of public hygiene and philanthropy, interest itself in the alcohol question? ... Are not alcohol and opium both narcotic drugs and cannot their effects be compared? If the League of Nations does such splendid work against opium why would it not do the same against alcohol?
R. Hercod, Proceedings of the International Conference against Alcoholism, Geneva, 1925

Prohibition in Africa

Alcohol became an object of international control endeavors less through a general acceptance of its dangerousness than through its connection with the problem of slavery. Provisions for the control of arms and liquor were included in the Brussels General Act of 1889-90, under which colonial powers in Africa agreed to take measures against the slave trade. This almost forgotten act has a chapter (6) on "Restrictive Measures Concerning the Traffic in Spirituous Liquor"; the regulations, which were valid for all Africa, except for north of latitude 20°N and south of 22°S latitude, prohibit the importation and manufacture of distilled liquors ("des boissons distillés"). There were two important exceptions to these strict rules. First, not all areas were subject to total prohibition, but in the areas outside prohibition economic control was to be exerted through the imposition of import and excise duties; second, exceptions were made for the nonnative population based on the belief that it was not the liquor as such but the characteristics of the African people which accounted for the dangerous results of drinking.

Not only were the signatory powers obliged to take necessary steps to bar the introduction of liquor to the areas indicated, they were also called upon by the act to report the measures taken to an office established in Brussels. Revisions of the agreement in terms of progressive increases in the stipulated rate of duty were adopted at conferences held in 1899, 1906, and 1912. New minimum duties were fixed, but more important than these was the introduction of the principle that the duty should vary according to the strength of the spirit.

After the First World War the question of the administration of the German colonies had to be resolved. Under a system of mandates set up by the covenant of the League of Nations, former German territories in Africa were assigned to other colonial powers (called "advanced nations" in the covenant), and these powers were held responsible for their administration "under conditions which will guarantee freedom of conscience or religion, subject only to the maintenance of public order and morals, the prohibition of abuses such as the slave trade, the arms traffic and the liquor traffic" (article 22).

The responsibility placed upon these states for the control of the liquor traffic was further confirmed by a Convention on the Liquor Traffic in Africa which was adopted at St. Germain-enLaye on 10 September 1919 and which replaced the Brussels General Act referred to earlier. This convention was signed by the U.S., Belgium, the British Empire, France, Italy, Japan, and Portugal. The text of the convention reiterated, in somewhat different wording, the stipulations of the Brussels act. However, the control measures relating to alcohol went somewhat further, as is exemplified by article 2, which reads: "The importation, distribution, sale and possession of trade spirits of every kind and of beverages mixed with these spirits are prohibited." Prohibition of manufacture was covered by another article (5) as were controls over access to distillation apparatus. The tightening of control these provisions represented may have been a reaction to an increased illicit traffic to which earlier control measures had given rise.

The League of Nations supervised the administration of the mandates by the various powers through a Permanent Mandates Commission composed of experts—these were not perceived as government representatives—from the countries concerned. The commission inspected the annual reports of the madatory powers, made observations on the conditions in these territories, and reported them to the Council of the League. During the first decade, the illicit liquor traffic was dealt with at length both in the commission's discussions and in the reports of the mandatory powers. From 1932 onwards however, very little interest was shown in either the liquor traffic or in any other aspect of the alcohol problem, and this may reflect the resignation felt towards the lack of support for alcohol prohibition in general (it had, for instance, been repealed in the U.S.). The work of the mandates commission had been made easier as far as alcohol was concerned by the fact that the bureau in Brussels had continued its data-collecting service.

The activities of the Permanent Mandates Commission were followed with interest by the antialcohol movement, and on several occasions its members communicated their views to the commission. The interest in the liquor question in the commission was probably partially due to the pressures applied by the antialcohol movement.

To illustrate the kind of ideas expressed at the time, we may take as an example the following resolution adopted by the League Council on 18 July 1922:

The Council of the League of Nations conscious of the gravity of the danger for the native populations of Central Africa arising from the scourge of alcoholism, recommends that the Mandatory Powers should do everything in their power that their administrations should protect the populations from the above-mentioned danger.

But before the Council adopted this resolution, the mandates commission had, of course, discussed the liquor problem at some length. During the second session in 1921, the Portuguese member, d'Andrade, had pressed for the strictest possible control, using among others the following arguments:

Everyone knew that a native who was addicted to alcohol, when deprived of spirit, did not hesitate to drink alcohol in any other form.

The native must be defended against his natural vice, alco-
hol. . . . The abuse of alcohol could only be avoided by prohibition of import and manufacture of alcoholic liquors both for whites and for blacks (PMC: 5 October 1921).

The minutes of the commission sessions show that there was constant disagreement among its members on the degree of control which was to be exerted. Some of the arguments revolved around interpretations of the relationship between the covenant of the League, the St. Germain Convention, and the various rules governing mandates, and of the intentions behind these documents. One of the difficulties was the definition of such terms as "trade spirits." Finally, problems arose because of the inequality of the duties levied by primarily the British and the French mandate administrations, and these had to be resolved through negotiations between the two countries.

There were further signs of pressure from the antialcohol Bureau in Lausanne.* These were discernible in the resolutions adopted at its international conference in Geneva in early September 1925, at which the mandates commission as well as a number of governments were represented. Much attention was given to the colonial question, and on the basis of lengthy reports from all parts of Africa the conference adopted six resolutions ranging from expressions of appreciation for the work of the mandates commission to injunctions to interpret the St. Germain Convention in the strictest terms. The conference also demanded that prohibition be applied without distinction as to race (Proceedings, Alcoholism Conference, 1925).

The total effect of these pressures is difficult to gauge. It is true that they influenced the debates in the mandates commission, which led the League Council to request further steps to be taken, with the result that a document on the liquor situation in Africa was published (L608.M.235.1930.VI). But interest in the liquor question petered out by the early 1930s, and so far as we are aware there has been no assessment of this experiment in internationally supported regional prohibition.

Passivity in the League

The liquor question was, however, brought to the League's attention through other channels. One of the main problems for which international cooperation was sought was that of the illicit traffic. The prohibition-ridden U.S. worked out a series of bilateral treaties with, among other countries, Great Britain, Norway, Germany, Denmark, Sweden, Panama, the Netherlands, and France, making it possible for the U.S. to search vessels outside the three-mile limit that were suspected of smuggling. With Canada and Mexico special problems arose from the fact that each had a land border with the U.S., but arrangements were arrived at nonetheless. Because the U.S. was not a member of the League, it had to negotiate on a bilateral basis.

With regard to Finland, which was also attempting total prohibition, the Baltic powers, consisting of eleven governments, adopted a convention in Helsinki in 1925 which dealt with alcohol above a strength of 18 percent by volume. The convention specified the kind of vessels which were authorized to transport liquor, but the effect of this was that the ships of contracting parties registered themselves in nonparty countries and began to sail under Greek or other national flags (Immonen, 1965). This led the Finnish government, particularly, to seek more effective international support. At the alcoholism conference in Geneva referred to earlier, smuggling, like the colonial problems, had been an issue. Inevitably, conflict had arisen between the prohibitionist and the alcohol-producing countries, but in the resolutions adopted the conference enjoined countries to respect each other's control systems and asked for action from the League of Nations (Proceedings, Alcoholism Conference, 1925).

In 1926 the governments of Finland, Poland, and Sweden addressed a proposal to the League that steps be taken to arrive at an international convention on the illicit traffic in liquor and at a thorough international investigation into the alcohol question. This item actually appeared on the agenda of the League Assembly but consideration of it was postponed to the next session. Meanwhile, the foreign ministers of the countries mentioned above and of Belgium, Denmark, and Czechoslovakia submitted a note to the League and its member states supporting the proposal to convene an international conference for the purpose of drawing up an international convention on the liquor traffic. Furthermore they proposed that an Advisory Committee on Alcoholism, analogous to the narcotics control body, be set up.

When the main debate took place in the Second Committee of the Assembly in 1927, it was attended by a person referred to in the minutes as a representative of the French wine growers. The position which he represented lent intensity to the conflict of interests expressed in the debate. The Finnish delegate, VNinii Voionmaa, pointed to the international character of alcoholism, referred to its having been a concern of the Permanent Mandates Commission and the League Committee on Traffic in Women and Children, and proposed that an Advisory Committee on Alcoholism be established. The opposition came predominantly from the French representative, Loucheur, who argued that such a new question could not be discussed without preliminary investigation into whether it was part of the League's activities. He was opposed moreover to the labeling of alcohol as a "dangerous drug." He held that:

It was essential not to risk causing internal political disturbances in any country by extending the League's activities indefinitely. Certain congresses had even gone so far as to warn people against the use of grape juice. As a defender of France and its wine [he] opposed the abolition of good wine, which brought joy into the lives of the people and from which the French derived many of their sturdy qualities.

Furthermore, he opposed the idea of the League associatig with the Bureau in Lausanne.

The French position was supported by Austria, Denmark, Italy, Portugal, Uruguay, and Australia, while Sweden, Hungary, and Belgium aligned themselves with the Finnish view. It was said by the Belgian delegate that, while efforts were being made by the League "to mitigate the evils caused by dangerous drugs used in certain distant countries," "some of its Members seemed hardly inclined to fight with the same energy against the abuses and dangers resulting from the use of dangerous drugs in Europe," which nicely reflected the double standards that were being applied. Great Britain, India, and Switzerland took intermediate positions and recommended the withdrawal of the motion in its present form. The solution which was finally accepted was based on a Finnish proposal and was recorded in the following terms:

. . . considering the difficulties of principle and procedure which have been raised, the signatory delegations, while maintaining the principle of their motion, have decided to withdraw it provisionally, while reserving the right to submit it in another form.

A week later, a new proposal was submitted by Finland, Poland, and Sweden, supported by Belgium, Denmark, and Czechoslovakia, suggesting that an expert committee be convened to study those alcohol-related questions that were under the domain of the League. In September 1928 the Assembly passed this motion on to the Health Committee and the Economic Committee. The latter discussed the question of illicit traffic but considered it to be part of a larger problem. Although the intention behind the motion was thereby diluted, the committee did pass a resolution on 6 June 1930 which held that the flags of member states should not be used on vessels engaging in illicit traffic (Immonen, 1965).

However, the more crucial discussion was the one held in the Health Committee in October 1928. Here, much of the discussion was centered on the wording of the Assembly request, which read as follows:

. .collect full statistical information regarding alcoholism, considered as a consequence of the abuse of alcohol, giving prominence, inter alia, according to the data available, to the deleterious effects of the bad quality of the alcohols
consumed . . . .

It is understood that this resolution does not refer to wine, beer or cider (A.72.1928).

The British representative expressed dissatisfaction with the exclusion of wine, beer, and cider, observing that a combination of whiskey and soda was no more powerful than these. The Polish delegate thought it impossible to deal only with some varieties of alcohol. However, the wine-producing countries were not interested in taking the matter further than was delimited by the resolution, and the ultimate decision was that the medical director should consult the three countries whose initiative this was, to ascertain their intentions. A further discussion was to take place after this piece of information had been secured (CH Minutes: 13th, 1928). No account was taken of communications sent by various organizations to the League secretary-general supporting the Finnish proposals, presumably because the document containing these (CH 762, 1928) was not made available before the decision was taken. These organizations were: The Latvian "Help the Children" Union at Riga; the National Union of Teachers, London; the National Council of Hungarian Women, Budapest; the Romanian Temperance Society, Bucharest; and the Scottish Temperance Alliance. There were also associations expressing disapproval, namely: the League for the Defence of Individual Liberty, Copenhagen; the Swedish "Abstinence without Prohibition" Association, Stockholm; and the "Arbeitsgemeinschaft der Gaerungsgewerbe," Berlin. The most thorough of the latter category of counterarguments was that of the Danish association, which rejected the formation of a committee of investigation, on grounds of fear that such a committee would be dominated by prohibitionist viewpoints.

It was not until October 1930 that the question was discussed by the Health Committee again. By that time the three countries which had recommended the inclusion of the alcohol question in the program of the League had clarified their position in writing to the medical director (CH 877, 1930). As may be expected) their responses were largely similar. In both the Finnish and Swedish replies proposals were made as to the kind of studies which might profitably be pursued and which would be of value to the health authorities of their respective countries; the Finnish response referred specifically to the relationship between alcohol and cirrhosis of the liver, alcoholism and tuberculosis, use of alcohol and pneumonia, alcoholism and mental diseases, alcoholism and venereal diseases, alcoholism and accidents, and alcoholism and crime.

The discussions in the Health Committee resulted in a limited program which entailed no extensive studies but provided for some services to the three countries concerned. Meager as this concession was, to the French it was still too much. Reservations were also expressed by the Belgian representative, Professor Bordet, who, while not opposing "the suggested procedure . . . would urge that any enquiries into alcoholism should be conducted in great secrecy, for, if public opinion felt any doubt that an International Committee of Health Specialists thought that alcohol played no part in the various diseases mentioned, a certain degree of consternation might be caused." Nevertheless, the program was approved after assurances were made that it would not involve too much work. And, with the close of this meeting came the end of the concern of the Health Committee with alcoholism. No plan was actually submitted to the League Council for consideration.

Problems of Definition in WHO

In contrast to the League's disinclination to institute alcohol programs, WHO, when it came into being, was quick to assume responsibility for alcoholism. In WHO's first assembly in 1948, alcoholism was recognized as being part of its mental health work, and, in 1949, when the first Expert Committee on Mental Health was convened, it dealt with, among a variety of problems, that of alcoholism and drug addiction. The chairman of this committee was Menninger of the U.S.; the secretary was G. R. Hargreaves, chief of the Mental Health Unit, who was British (as was the rapporteur). The committee held that studies on the incidence and prevalence of the various types of addiction in different countries were of high priority and stressed the complex social, economic, and cultural factors involved. The committee furthermore believed that:

although there are many aspects common to the problem of both alcoholism and other forms of drug addiction, there are also significant differences, and they therefore strongly recommend the setting up of two separate specialist sub-committees--one on alcoholism and one on drug addiction.

As to the composition of these committees, it was thought that not only psychiatrists "but also individuals capable of contributing to the understanding of the social and cultural factors which play a large role in the epidemiology of these phenomena" were necessary. Finally, the committee expressed some doubt in regard to Papaver somniferum (opium) and cannabis as to "whether control measures alone can ultimately hold the problem in check" and recommended that a program in preventive medicine be undertaken.

These views coincided with those of Hargreaves, who was deeply interested in the alcohol problem and who was to invite E. M. Jellinek to come to WHO to work as a consultant. Jellinek came to WHO as the erstwhile head of the world's leading research institute on alcohol (the Yale Center for Alcohol Studies), and what he brought to WHO was essentially the benefit of the knowledge which had been accumulated by the institute. His years in WHO-1950 to 1955—marked a period of intense activity in the field of alcoholism; four expert committees were convened (WHO/EC MH, 1951; 1952; 1954; 1955) and a study group concentrating on statistics was held; international seminars were organized; recommendations on public health measures and treatment were formulated; methods for measuring the extent of the alcoholism problem were developed, and much work was done to clarify key terms and concepts. One may also include among the contributions the sponsoring of a film—To Your Health—which was awarded an international prize and which was mentioned with pride in a history of WHO—The First Ten Years of the WHO (1958)—with a note of regret that WHO's name was not mentioned in the film. (On the other hand, Jellinek's name was not mentioned in the history!)

We turn now to the work of the expert committees, much of which was concerned with the definition of concepts. The first committee on alcoholism which met in 1950 termed alcoholism a disease and a social problem and was of the opinion that public health authorities had been slow in recognizing the extent and the seriousness of the problem. The committee pointed to the drawbacks of the vague term "chronic alcoholism" and tentatively defined the term "alcohol addiction" as a special and extreme form of alcoholism. During its discussion of these terms the committee referred to another expert committee's report (WHO/ EC DD, 1959) which had defined "addiction" at the request of the Commission on Narcotic Drugs.* A new subcommittee to deal with these definitions was recommended, and it is evident that this implied a wish to have a common basis for a joint discussion of addiction to alcohol and other drugs. At its eighth session the executive board of WHO acknowledged the report of the committee as a basis for future action and supported its recommendations.

The question of definitions recurred in the next meeting (1951) on alcoholism which attempted to define alcoholism and "excessive drinking." The following year, the Expert Committee on Drugs Liable to Produce Addiction concluded that:

there are some drugs whose pharmacological action is intermediate in kind and degree between the two groups already delineated so that compulsive craving, dependence and addiction can develop in those individuals whose psychological make-up is the determining factor but pharmacological action plays a significant role. In some instances individual and sociological damage may develop, but since the incidence of the damage is not general, the type and degree of control of drugs of this group are better left at present to national consideration (WHO/EC DD, 1952).

The committee had evidently been thinking of alcohol and barbiturates, although this was not explicitly stated; the expert committees on alcoholism had come very close to regarding alcohol as an addiction-producing drug, and, as this did not at all fit in with the view of the Drug Dependence Unit of WHO or of the UN narcotics control bodies, some distinguishing marks had to be found to justify its exclusion from international control. The committee acknowledged that barbiturates had addiction potential yet did not see them as deserving control, whereas coca-chewing, which was an object of international control, was seen as coming "so closely to the characteristics of addiction . . . that it must be defined and treated as addiction, in spite of the occasional absence of some of its characteristics."
This position acquires more meaning when viewed against the conclusions of the Commission of Inquiry on the Coca Leaf, which had returned from Peru and Bolivia and reported their findings to the Commission on Narcotic Drugs (1950). Some of these findings had implicitly struck at the premises upon which international coca leaf control was based. In the Narcotics Commission the query was raised as to whether coca-leafchewing was an addiction, as opposed to an economic and social problem (CND: 6th, 1951). Wolff himself was both "surprised" by and disappointed with these conclusions, being in favor of stricter controls in this area (Wolff, 1952). In contriving to fit coca-leaf-chewing into their addiction model so as to vindicate its position in the international treaty system, the expert committee members were allowing considerations of control policy, as opposed to purely pharmacological ones, to enter into their scientific judgments. Moreover, the Commission of Inquiry had observed that coca-leaf-chewing in the Andes was intertwined with heavy alcohol use, which was as much of a "social, economic and criminological problem" as the chewing (Report of Inquiry, 195031), but this observation was entirely ignored.

The following two expert committees on alcoholism continued with the discussion of definitions, accepting the view that alcohol was somewhere between the addiction-producing and habit-forming drugs, but dwelling upon differences in addiction characteristics and how these related to the case of alcohol. The published report of the expert committee which met in 1954 did not cover some crucial points made in the material used at the meetings: in a background paper (WHO/Ment/58) Jellinek had touched upon the vested interests in alcohol and the need for research to incorporate consideration of this factor, but this was omitted in the final version; also left out were arguments for taking on problems of alcohol rather than the problem of alcoholism. There were references to some points contained in a working paper by Harris Isbell in which he challenged prevailing tendencies to exaggerate the differences between alcohol and morphine addiction (WHO/Ment/83); it was acknowledged that physical dependence on alcohol existed and that withdrawal symptoms were far more severe for alcohol than for opiates. Nevertheless, in the printed report, alcohol was still seen as occupying an intermediate position between habit-forming and addiction-producing drugs.

If conflict arose, as seems likely, out of the incompatible positions maintained by the various people involved, it probably lost its edge with the departure from WHO of Hargreaves and Jellinek in 1955 and of Wolff at around the same time. These changes in personnel meant a virtual cessation of interest in the alcohol question, and nearly ten years elapsed before it was renewed. Under Hargreaves's successor, E. E. Krapf, a study group on the treatment and care of drug addicts was convened (WHO/MH, 1957). But hardly any additional activity was undertaken. At about the same time, Hans Halbach was appointed as chief of the Drug Dependence Unit. Halbach and Krapf informally agreed that alcoholism was a matter of mental health (Halbach, interview). As alcoholism had low priority, there was little risk of its featuring in discussions of drug addiction and control and of confronting the international control system with the inconsistencies of the classification scheme on which it rests.

It was not until 1966, after Krapf had been replaced by P. A. H. Baan as chief of the Mental Health unit that another alcoholism expert committee was convened. This one was particularly concerned with the combined approach towards alcohol and other drugs, a subject discussed in a paper prepared by Joel Fort in 1965 (PA/100/65). Fort was a consultant first to the Division of Narcotic Drugs and later to WHO, but he was too critical of the international drug policy, especially as regards cannabis, to remain for long in the organization, and on at least one occasion after he left (at the International Alcohol Congress in Melbourne, 1970), he leveled direct criticisms at the work of the international bureaucracy (Fort, 1970). However, general acceptance of the combined approach was slow in gaining ground, and five years passed before the responsibility for alcohol problems and "drug dependence" was given to the same unit. This move does not, however, guarantee increased activity in the field of alcoholism, and the outlook is that the other drugs will continue to receive much more attention and attract more programs and resources.

To illustrate further the attitude of WHO towards alcohol control, we will digress a little and recount the events leading up to the International Council on Alcohol and Addictions (ICAA) being accorded the status of a "nongovernmental organization" (NGO) in official relationship to WHO. In early 1947, R. Hercod, the director of this organization, suggested to WHO that alcohol should be included in its program, considering the size of the problem, its international character, and the need for education and research in the field. An application was lodged for his organization to be accredited to WHO as an NGO. WHO had difficulties in deciding on the application and negotiations took place between its staff members and Hercod. In November 1948, WHO postponed a decision until, it informed Hercod, "it disposes of further information on the present tendency of your Bureau's activity." It added that "only questions of a medical order should justify an official collaboration" and considered it "desirable that the moral and emotional aspects of the problem of alcoholism should therefore no longer play the preponderant part in your programme" (letter from Gautier, 1948). Additional correspondence followed, and when the Bureau's own executive committee came to review the situation in September 1949, it decided to appoint a medical committee and publish the medical papers presented at a recent meeting in Locarno as separate proceedings (Minutes of the Executive Committee, 13-14.9.1949). This excursion into medical territory attests to an intense desire to qualify for WHO acceptance. In October 1949 Hercod completed a lengthy questionnaire required by WHO, but in March 1950 he was informed that WHO had postponed its decision. In May Hercod provided yet more documentation and had a meeting with WHO's assistant director-general, Bertrand, from which he emerged declaring that "while recognizing the social aspects of the alcohol problem, this appears to us to be above all a medical problem" in an attempt evidently to accommodate to the WHO view. In June 1950 the WHO executive board recognized that "the evolution . . . into a more scientific body was taking place" but postponed its decision once again. This led to a spate of correspondence between Hercod and Wolff, who had become head of the drug addiction section. In the exchange of letters Wolff pointed to some members of the Bureau's medical committee as being not entirely to WHO's satisfaction. Although new information was transmitted yet again and adjustments were made to the composition of the medical committee (for instance, in a letter from Hercod to Wolff on 7 November 1950), no commitment on the part of WHO was forthcoming. The question was raised again in 1960 and this time the rejection was on the grounds that the organization was not sufficiently scientific. It was not until 1968, after a new application had been lodged, that a wish entertained from twenty years back was fulfilled, and the ICAA became a nongovernmental organization under WHO.

The foregoing history of frustration is to be compared with that of the International Federation of Pharmaceutical Manufacturers Associations (IFPMA), founded in 1968 and accorded NGO status in January 1971. There had been no change in WHO qualifications for admission; yet it is ironic that IFPMA, which is essentially a lobby for drug industry interests, should be so readily accepted into the system, while a procontrol candidate was barred. The standing committee on NGOs, at its meeting on 26 January 1971, had originally recommended that a decision on the IFPMA application be postponed because the organization was "still in a formative stage and should increase its international character" (WHO Off. Rec. 189 Annex 14). However, at a meeting of the WHO executive board the argument was advanced by some members that, in view of the executive board's recent decision to stimulate pharmaceutical industry in developing countries, relations with international pharmaceutical associations should be encouraged. Halter, the Belgian chairman of the committee referred to it as a "special case, for which the Standing Committee had assessed all possible factors and merely suggested postponing its admission." Afterwards, the board decided in favor of admitting IFPMA as an NGO (EB 47 SR 17: 275).

All that we have discussed so far does not, however, constitute the entire involvement of the UN system in alcohol control. An interesting form of drug control is embodied in the ILO Convention No. 95 on the Protection of Wages.* Article 4 of this convention stipulates that "the payment of wages in the form of liquor of high alcoholic content or of noxious drugs shall not be permitted in any circumstances"; article 13 states that "payment of wades in taverns or other similar establishments . . . shall be prohibited except in the case of persons employed therein". The text of the convention as drafted by the ILO did not initially contain the provision relating to alcohol and noxious drugs, and the addition in the final text stemmed from an initiative of the workers' members who, despite opposition from the employers' members, secured this amendment to the original text (ILO Conference: 32nd, 1949, Report and Proceedings). Earlier ILO conferences had also dealt with this question: the Convention concerning Social Policy in Non-Metropolitan Territories (1947), for instance, contains a number of provisions for the protection of wages including one which reads as follows:

The substitution of alcohol or other spirituous beverages for all or any part of wages for services performed by the worker shall be prohibited;

Payment of wages shall not be made in taverns or stores, except in the case of workers employed therein (article 15, pars. 486).

SUMMARY

1. During the first four decades of the twentieth century, an international agreement for alcohol control existed for the African region. The effects of this control have not been systematically evaluated.

2. Trials to interest the League of Nations in international control of alcohol did not attract significant support. They were largely blocked by the resistance of wine-growing countries and the ideological conflict between the prohibitionists and the anti-prohibitionists. International cooperation was even lacking in controlling the illegal trafficking in alcohol: the United States worked on a bilateral basis and while an agreement was reached in the Baltic Sea area this was not extended with League support.

3. While action on alcohol problems was part of WHO's program from its inception, activity in this area, except for Jellinek's period, has been modest indeed.

4. The exclusion of alcohol from international control highlights the inconsistencies of drug classification by the WHO expert committee.

5. An example of drug control measures being combined with other instruments of social policy on an international level is afforded by the ILO Convention on the Protection of Wages.

* The office of an organization which has undergone several changes of name: it has been known as the International Temperance Union Against Alcoholism; International Council on Alcohol and Alcoholism; and, today, International Council on Alcohol and Addictions (ICAA).

* This definition was based on a paper by P. O. Wolff, head of the Drug Dependence Unit (WHO/HFD/19, 5 January 1950), in which he looked back to the 1925 and 1931 conventions which contained references to the "drug habit" and to products "capable of producing addiction" respectively. At the conference which adopted the latter treaty a technical subcommittee had found it impossible to arrive at a satisfactory definition of the term "habit-forming narcotic drug" and had therefore dropped it. Wolff, who participated in this conference, had argued against the use of the expression "habit-forming drugs" on the grounds that the concept of "habit" is widely used to describe behavior which has nothing to do with pharmacological effect. Accordingly the Expert Committee on Habit-forming Drugs was renamed the Expert Committee on Drugs Liable to Produce Addiction. It might also bear noting that in his paper Wolff very clearly underlined the difference between opiate, cocaine, and cannabis addiction.

* Date of coming into force: 24 September 1952. According to Landy (1966), it had fifty-seven ratifications and twenty-nine declarations.