ABSTRACT
1925–2025: a century of international pharmaceutical law
The 1925 Brussels Pharmacopoeia Agreement and Geneva Opium Convention were foundational in shaping international pharmaceutical regulation. The former sought to standardise potent medicines, while the latter established controls over psychoactive substances. Despite differing objectives, both treaties influenced global pharmaceutical governance, contributing to modern regulatory frameworks and standards such as those of WHO or the European Pharmacopoeia. A century later, the year 2025 is witness to turbulent shifts in geopolitics and global health governance, but also revived contemporary debates on drug policy and traditional medicines. This letter revisits the seldom-documented history and impact of international pharmacy law, highlighting the relevance of these two pioneering treaties to evolving pharmaceutical governance and international health law.
Some of the first executive actions taken by the incoming US administration of President Donald J. Trump in January 2025 included initiating the withdrawal of the US from WHO, and leveraging a rhetoric of pharmacological dependence-producing substances in trade-related political endeavours. From a pharmaceutical policy perspective, the timing of these actions is particularly striking. Indeed, 2025 marks the centenary of a series of milestone events in the global governance of the pharmaceutical and broader health sector.
In 1925, two pivotal treaties were adopted that regulated the same goods – potent medicinal products, at that time, essentially derived from animal, botanical, or mineral sources (Seddon, Citation2016) – although coming from different origins and perspectives. On 19 February 1925, the Geneva Opium Convention was signed, as a ‘top-down’ treaty reflecting efforts to control the global trade in pharmaceuticals associated with a potential for dependence as well as preventing their use in covert destabilisation efforts. It was rooted in the geopolitical aftermath of the ‘Opium Wars,’ a series of trade and military wars geared around rhetorics of opium. Conversely, the Brussels Pharmacopoeia Agreement, adopted on 29 September 1925, was driven by ‘bottom-up’ efforts from scientific societies and professional associations of pharmacists, who had long sought to standardise pharmaceutical formulations across borders. Although these treaties originated from distinct contexts with different purposes and narratives, they eventually became foundational elements of global health governance during the interwar period (Howard-Jones, Citation1979), and laid the ground for the WHO to embrace, at its creation, its core functions of international standardisation and regulation of the safety, purity, potency, and labelling of pharmaceutical products moving in international commerce.Footnote1
The legacy of these two pioneering pharmaceutical treaties and their significance – not merely as historical artefacts, but as living documents that established the foundation for international pharmaceutical law – continues to influence global health, a century after. However, the lessons learnt for and from these treaties may have been forgotten, perhaps because of their relegation to historical obscurity. The year 2025 may signify the return of geopolitical practices which were thought to have been relegated to a distant past. But 2025 is also a year of achievements for a number of workstreams started in previous years (at the regional and international level) that reflect a growing interest for revisiting trans-national pharmaceutical standards, in particular with regards to herbal and traditional pharmaceutical products, but also on some of these products associated with a potential for dependence – which sometimes overlap. In 2025, it is more than ever critical to look back at these treaties, on their centenary, to enlighten contemporary global pharmaceutical policy discussions.
Standardising potent pharmaceuticals globally: the 1925 Brussels pharmacopoeia treaty
Early efforts towards the harmonisation of medicines through pharmacopoeial monographs began in the mid-nineteenth century, driven by pharmacists concerned about the variability of medicines. In an increasingly-interconnected Europe, despite the adoption of national pharmacopoeias in most countries, significant differences in formulations persisted across borders.
In 1864, in Strasbourg (a border city that would swing back and forth between France and Germany in the following decades), the participants at a pharmaceutical society meeting, decided to start working on standardising terminology, dosages, and composition into an ‘international pharmacopoeial compendium’ (WHO, Citation2008, p. 4). Pharmacists meetings continued, and, at the ninth such international pharmaceutical congress in 1900, the decision was taken to focus the work of harmonisation on a subset of the materia medica: ‘potent medicaments’ (officially, in French ‘médicaments héroïques’). Although never precisely defined, these ‘heroic’ medicines referred to pharmaceutical ingredients for whom relatively-minor variations in potency could lead to significant differences in patients’ clinical outcomes (Volckringer, Citation1953, pp. 36–74, 278–288). This choice of a smaller subset of galenical preparations served as a pretext to engage in the much needed preliminary work of harmonising weights, measures, naming conventions, and a series of connex elements not directly related to the properties of individual medicines.
The following – tenth – pharmaceutical congress was held in December 1902 in Brussels. Titled ‘Conference for the Unification of the Formulae of Potent Medicaments,’ pharmacists had this time been vested with diplomatic powers from their governments, allowing them to agree on a final text (Power, Citation1903), the ‘Agreement for the Unification of the Formulae of Potent Medicaments’Footnote2
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