Now that a few journal articles (leftover work from Edinburgh) have been sent off, I can finally dedicate time to my book on the history of WHO in international drug control with McGill-Queen’s! I was referred to MQUP’s intoxicating histories series by its commissioning editor, Virginia Berridge, an AIDS and drugs historian at the London School of Hygiene and Tropical Medicine. I first met Virginia at a workshop mini-series I’d organized in April 2021 called “Scotland in the Global: HIV thru Injecting Drugs and Beyond”.[1] Throughout this fall 2021 term, in and around article revisions, I was dialling into sessions on academic publishing for popular audiences while slowly but surely chipping away at my book.[2] I’ll write a later post reflecting on what I’ve learned about book-length argument-driven writing in a way that captures the reader’s attention.
For today, I’d like to consider a key argument in international drug policy studies: are entities like UN and WHO effective in controlling the global drug problem? Direct causation in explaining addiction problems is difficult: are substances problematic at their source (supply control) or after their consumption (demand reduction)? And bearing that point of intervention, is action most appropriately undertaken by a multilateral agency or a national government?[3] The contrast between two classic works in international drug policy studies perfectly encapsulates these different perspectives: Kettil Bruun, Lynn Pan and Ingmar Rexed’s The Gentlemen’s Club (University of Chicago Press, 1975) and Alfred McCoy’s The Politics of Heroin (Lawrence Hill Books, 1972).
The Gentlemen’s Club, as you might guess from the title, approaches the international drug control regime as a close-knit group of civil servants (and their extended networks of like-minded individuals representing member states), who gather each year in Vienna to direct policy. Bruun, Pan and Rexed represent the International Research Group on Drug Legislation and Programs, a kind of advocacy/think tank based in Geneva that I believe no longer exists, and their methodology is a mix of observation and participant interviews. Each chapter goes over the key organs and their functions, as well as the practical difficulties in the execution of their goals.[4] A few shortcomings: the book is weak on the UN’s field activities, likely due to it being published in 1975, just a few years after the creation of the UN Fund for Drug Abuse Control. Moreover, while The Gentlemen’s Club identifies the key dilemma for WHO being the boundary of an addictive substance vs. licit medicine, the agency is still treated as a fundamentally neutral and technical expert.
Ultimately, the point driven home by The Gentlemen’s Club is that the regime thinks too highly of its own abilities: “like many organizations, affirms its own value as if this was an assessment of objective reality.” (p. 33) In doing so, the objectives and the methods of international drug control have become inseparable:
"A clear-cut separation of goals and means is not possible. Ultimate goals – such as “the health and welfare of mankind” – are sought through processes which often come to acquire the values of ends; thus prevention of “drug abuse” as a step towards universal health and welfare has come to be an end itself. Farther down on the scale between immediate and ultimate perspectives, such means for achieving drug control as regulation of international trade, law enforcement, international cooperation, and the like acquire more than instrumental value and come to assume the importance of goals in themselves. Excluded from the treaties is a statement of their levels of aspiration in what they seek to do." (p. 40)
However, it would be unfair to caricature the book as generic “UN bashing” and there is plenty of room for nuance. The Gentlemen’s Club is insightful as to why and how the international regime has its internal inconsistencies. As in any institutional constellation, the various bodies are primarily concerned with increasing their budgetary allocations and influence within the UN family. International action, particularly through the reporting of narcotic import/export statistics to the International Narcotics Control Board, is dependent on the goodwill and mutual observation of laws by country governments, as well as the quality of the data submitted (which in the mid-1970s when the book was published was still haphazard; see the photo below).[5] Finally, the authors recognize that the UN’s actions are fundamentally limited by resource constraints and logistical barriers. And yet, despite such difficulties, the interests of all participating parties is that the consensus and the status quo is to be maintained: “the unspoken rules of the game upon which the entire international system rests should not be broken” (p. 61). The authors conclude that, while the system needs an overhaul and a healthy dose of outside criticism, it is still functioning largely according to the aims set by the 1909 Shanghai Opium Commission, which is more than can be said for most UN initiatives.
Genuinely had a chuckle: “an 85-year-old woman who takes drugs in her whisky”
On the other hand, Alfred McCoy’s The Politics of Heroin focuses on the illicit trade created by American foreign policy. It is a classic piece of Southeast Asian area studies scholarship, drawing from oral historical and anthropological fieldwork. Its key achievement and the work’s distinguishing feature is McCoy’s bold ability to richly detail complicated and clandestine activities such as the Nugan Hand Bank incident, an Australian bank widely rumoured to be a front for laundering CIA-connected drug money, issues most scholars (even in drug policy studies) would keep at arm’s length.[6] Its status as a widely discussed piece of non-fiction in the early 1970s does not detract from its scholarly value, and in fact, McCoy’s skill in piecing together the trails and patterns of illicit trafficking all over the world (in this 1991 edition, not just Southeast Asia, but the Middle East and a little on cocaine in Latin America) using over 200 oral history interviews with US, Thai, Vietnamese, etc. military leaders, reports from various American drug agencies (FBN, DEA, etc.), UN or League policy pieces, newspapers, and archival grey literature is truly breathtaking.[7] I aspire to achieve such a level of depth and mastery in historical documentation.
In the endnotes are letters to McCoy from his interviewees, clarifying certain details after the first edition’s publication
McCoy’s key message is first, to highlight the hypocrisy of US bilateral actions (pressure a government to ban opium) while the CIA also fights the Cold War with drug money (prop up an anti-Communist warlord with opium connections), and second, how this misalignment inevitably complicates and diverts routes of illicit traffic to new destinations (such as Europe), not to mention backlash in the country concerned (such as Turkey). This work is very much about the failures of US foreign policy and the effectiveness of the UN is seen in this light. As McCoy argues, the League’s drug diplomacy in the early 20th century was “remarkably successful” in reducing the global supply of opium and heroin, but the US in its post-war dominance placed its Federal Bureau of Narcotics agents in key countries to “change the character of international drug control” from one of international community to one of bilateral diplomacy.
"Although slow and seemingly inefficient in reducing America’s drug supply over a short-term, the UN’s multilateral drug diplomacy has a proven record of long-term effectiveness. Narcotics are global commodities and only a world-wide approach of universal suppression can reduce supply and, ultimately, addiction. By contrast, America’s bilateral efforts simply deflect production and consumption to other markets, creating a short term illusion of success for a few years until redoubled supplies from an expanded global market sweep America, producing yet another drug epidemic of unprecedented proportions. Using the medical analogy for heroin addiction, the US policy of bilateral, local drug suppression is rather like dealing with a global epidemic of smallpox or yellow fever by trying to seal the country’s borders against the microbes." (p. 489)
So how does my book engage with this debate by focusing on WHO’s little corner as a health agency in these complex overarching politics? I’m not 100% sure yet until I’ve written all six chapters, but for now, I can say that WHO contributed key insights into addiction approached from a health systems and social medicine perspective, drawing from its mental health programme (Harry Wu’s recent Mad by the Millions has shown how important mental health and the psychosocial approach to health was for WHO in the post-war period) and its focus on health infrastructure building (establishing food and drug control systems includes techniques to identify narcotics and pharmaceuticals). The WHO I’ve explored in other works (India’s AIDS programme or interactions with World Bank on health financing) is still recognizable in international drug control.
I’ll leave the debate there and get back to chapter drafting. In other news: it’s the new year and I’m buzzing with excitement and anticipation for 2022! I feel so blessed: journal articles tidied up, book chapter drafting coming along well, hopefully an overseas research trip soon (fingers crossed!), some exciting student projects, extra responsibilities as a faculty member, new projects to put into research grant format, and experimenting with “coming out” as an academic on social media. I can’t wait to take on this coming year (yes, I know rest is also important)! Wishing everyone the most amazing start to the year, whether you are with family, friends or on your own. Wherever you are on your journey, don’t forget to treasure yourself and every experience that comes into your life!! Let’s make 2022 amazing :)
Happy new year all!!
[1] Links to sessions: https://www.ed.ac.uk/usher/biomedicine-self-society/centre-news/scotland-in-the-global-hiv-through-injecting-drugs [2] I’ll discuss in a future post the issues with open access and the futures of academic publishing, particularly in Japan. I’ve been following the “Publication Success” series organized by Academic Language Experts (ALE), which has been really helpful on how academics can write “brainy non-fiction” for popular audiences; recordings here: https://www.aclang.com/past-recordings/ [3] I’m not going to be discussing adverse reactions to licit pharmaceuticals until Ch. 4; we’ll leave that for another blog post. [4] In recent years, the scholarship has moved much more towards this tradition of being critical of international agencies: William B. McAllister’s more IR-focused Drug Diplomacy in the Twentieth Century (2000) and David Bewley-Taylor’s advocacy-infused International Drug Control: Consensus Fractured (2012) are two works that come to mind. [5] This is changing in recent years and the UNODC (replacement of UNFDAC, complicated, explained in Ch. 6 of my PhD disst) has become much more transparent about the drug statistics it receives, how it deals with variations in data quality, and, critically, how it is employing new techniques to meaningfully interpret the data. I dialled into the “UNODC: Data Explained” seminar on 15 December 2021, recording and presentation slides here: https://vngoc.org/2021/12/unodc-data-explained/ [6] Available here: https://renincorp.org/bookshelf/politics-of-heroin-in-south.pdf [7] The CIA reacted strongly to McCoy’s accusations but the original publisher Harper & Row defended the work’s scholarly value. The American sociocultural milieu in the early 1970s was becoming skeptical of the Cold War in Asia, with the growing consciousness of heroin-addicted Vietnam vets.
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