Methods of Work
Conclusions and Recommendations
Pages: 41 to 47
Creation Date: 1950/01/01
At the request of the Government of Peru, then of the Government of Bolivia, the United Nations sent, during the autumn of 1949, to these countries, a Commission of Inquiry to investigate the effects of chewing the coca leaf and the possibilities of limiting its production and controlling its distribution (see Bulletin on Narcotics, vol. I, no. 1, October 1949).
The Commission and its secretariat left New York on 10 September 1949 and returned on 4 December 1949. Its report was completed in May 1950: two parts of this report are hereby reproduced, namely, the methods of work of the Commission, and its conclusions and recommendations.
Mindful of the instructions of the Economic and Social Council, and with a view to concluding its local inquiries as efficiently and speedily as possible, the Commission adopted the methods of work described below, both in Peru and in Bolivia.
Immediately on its arrival at Lima the Commission entered into official contact through the Ministry of Foreign Affairs with the central Peruvian authorities. After visiting the Minister of Foreign Affairs, the Minister of Public Health, the Minister of Justice and the Minister of the Interior, the Commission and its secretariat consulted on particular points of interest for its inquiries with the higher officials of the above mentioned Ministries and of the Ministry of Finance and Agriculture. In addition to these consultations, the Commission applied to the competent authorities for statistical and other data more readily obtainable in the country's administrative centre.
In Bolivia the Commission, after establishing official contacts through the Ministry of Foreign Affairs with the Bolivian authorities, held consultations with the Minister, of Foreign Affairs, the Under-Secretary of State for Foreign Affairs, the Minister of Finance, the Minister of Economic Affairs, the Minister of Public Education, the Minister of Agriculture and the Minister of Public Health. As in Peru, these consultations were followed by conferences with the higher officials of the above-mentioned Ministries, who were asked to furnish information material similar to that requested of the Peruvian authorities at Lima.
In order to facilitate its negotiations with both the central and the local authorities, the Commission requested the Governments of Peru and Bolivia each to appoint a government official as liaison officer for that purpose. The Government of Peru appointed Dr. Carlos Avalos, Chief of the Narcotics Department of the Ministry of Public Health and Social Welfare, representative of Peru to the United Nations Commission on Narcotic Drugs, member, of the National Executive, Council against Illicit Traffic in Narcotic Drugs and representative of the Ministry of Public Health on the State Coca Monopoly. The Government of Bolivia appointed Dr. Alfredo Quiroga, Director of the Nutrition Department of the Ministry of Public Health.
The appointment of liaison officers proved to be highly useful, and the Commission cannot too greatly emphasize how efficiently these officers co-operated with it.
The Commission had requested the central authorities of Peru and Bolivia to take the necessary steps so that it might enter into relations with the authorities of the areas to be visited.
These measures having accordingly been taken, the Commission was able in the course of its movements to obtain the full co-operation of the prefects, deputy prefects, mayors, and municipal and police authorities. Similar facilities were extended to enable the Commission to approach the local authorities representing the Ministries chiefly concerned; in Peru, these included the representatives of the Ministry of Public Health and Social Welfare, the Ministry of Finance (and more particularly this Ministry's Deposit and Trust Fund), the Ministry of Agriculture and the Ministry of Education; and, in Bolivia, officials of the Ministry of Public Health, the Ministry of Labour and Social Welfare, the Ministry of Agriculture, the Ministry of Finance and the Coca Excises, and the Ministry of Economic Affairs. In addition, the Commission made contact whenever necessary with officials not included in the above categories.
Both in Peru and in Bolivia the military authorities lent their assistance to the Commission in its inquiries. The regional commandants and their staffs placed themselves at the Commission's disposal for any information required; the military medical officers in both countries deserve special mention.
In all the localities visited by the Commission the members of its medical section, sometimes joined by one or two members of its economic and social section, held conversations with local medical practitioners. In university towns the Commission did not fail to use the good offices of faculty members. The talks with representatives of local pharmacists were frequently found useful.
Whenever possible the Commission endeavoured to make contact with existing agricultural, industrial and other employers' or workers' organizations. Particular reference should be made to the contacts established with coca-leaf producers and, in Bolivia, the Society of Landowners of the Yungas area, and with representatives of the mining companies and of workers' trade unions both in Peru and Bolivia.
In a number of localities the Commission interviewed representatives of the religious authorities and members of Catholic and Protestant missions.
Anxious to obtain as comprehensive a picture as possible of the currents of public opinion on the coca-leaf problem, the Commission was eager to establish contact not only with the medical and scientific circles mentioned above, but also with the Press and all organizations or persons interested in this problem. A number of Press releases on the Commission's work were issued. Interviews were given to journalists. Conferences were held with engineers, agronomists, jurists, politicians and other persons interested in the problem.
The Governments of Peru and of Bolivia have each set up a National Coca Leaf Commission. It was part of the duty of these Commissions, which are responsible for studying the coca-leaf problem on a national scale, to co-operate with the United Nations Commission of Inquiry.
Both in Peru and Bolivia the United Nations Commission held a number of joint meetings with these National Commissions, which are composed of prominent persons, and furnished information highly valuable for the Commission's work. The membership of the two National Commissions is shown in annex IV of the present report.
In each of the principal localities visited in the interior of Peru and of Bolivia, the Commission, in order to obtain most promptly the greatest possible variety of views on the coca-leaf problem, held conferences at which the local prefect, deputy prefect or mayor usually presided. These conferences were usually attended by the members of the Commission and its secretariat, the principal civil and military officials, representatives of the medical profession, of the civil, military and police authorities, the Civil Guard, producers, merchants, manufacturers, engineers, agronomists, journalists, workers and others. Conferences of this kind were held in Peru at Arequipa, Puno, three at Cuzco Quillabamba, Tingo Maria, Huanuco, Cerro de Pasco, Trujillo and Cajamarca; and in Bolivia, Acha-Cachi, Huarizata Coroico, Chulumani Cochabamba and Catavi.
At Huanuco, for example, the meeting was convened by the local prefect and mayor, who published a notice in the local Official Gazette inviting all persons interested in the problem to attend the conference. These conferences, the Commission believes, did a great deal to provide valuable information and enable the Commission to hear expressions of public opinion on the coca-leaf problem.
The Commission endeavoured to assemble as much written information as possible on the coca-leaf problem, both by applying to central or local authorities, as mentioned above, for statistics and documents, and by asking the National Commissions, or organizations or private persons, to submit written reports on the question.
In addition to these written data, the Commission also made observations on the spot. It visited laboratories, hospitals, schools, missions, prisons, agricultural stations and farms, factories, mines, mining camps and co-operatives. In the course of its travels the Commission was able to observe living and housing conditions in widely separated regions. The Commission ascribes great importance to this part of its work, since it was able in this way to compare its field observations with the written data and the literature on the coca leaf.
This congress was held under the auspices of the United Nations Educational, Scientific and Cultural Organization at Lima from 23 to 30 November 1949, and was attended by representatives of a number of countries who are specialists in the study of the biological problems connected with altitude. The experts of the Commission's medical section were invited to attend the meetings, and were thus enabled to obtain information, connected with its own terms of reference.
Under the resolution of the Economic and Social Council (159 (VII) IV, 10 August 1948, document E/968) the terms of reference of the Commission of Enquiry into the effects of chewing the coca leaf include the following two points:
A. Investigation of the effects of chewing the coca leaf in Peru and Bolivia, and;
B. Investigation of the possibilities of limiting the production and controlling the distribution of the coca leaf in the said countries.
Both questions have been dealt with in this report. On the basis of the investigation conducted in Peru and Bolivia, the Commission unanimously decided to submit the following conclusions and recommendations. Mr. Fonda dissenting only on the recommendation concerning "Gradual Limitation".
The chewing of coca leaf must be considered not as an isolated phenomenon but as a consequence of the social and economic conditions under which large sections of the population of Peru and Bolivia are living. These conditions affect principally but not exclusively the indigenous agricultural and mining populations of the two countries. The great majority of chewers is to be found in those two population groups. Although the chewer is predominantly Indian, there are also chewers amongst the "mestizos". It is not always easy to draw a sharp distinction between the two; the living conditions of certain sectors of the mestizo population being very similar to those of the population regarded as Indian.
The leaves of the coca plant contain cocaine. In the present state of knowledge the indications are that the effects produced by chewing coca leaf are to be explained by the action of cocaine.
It does not at present appear that the chewing of the coca leaf can be regarded as a drug addiction in the medical sense.
The Expert Committee on Drugs liable to Produce Addiction gave the following definition of addiction at its meeting of 9 to 14 January 1950 (WHO Technical Report Serial No. 21, 1950):
"6. 1 Definition of drug addiction:
"Having considered the request of the Commission on Narcotic Drugs, the committee drafted the following definition of 'drug addiction':
"Drug addiction is a state of periodic or chronic intoxication detrimental to the individual and to society, produced by the repeated consumption of a drug (natural or synthetic). Its characteristics include:
"(1) An overpowering desire or need (compulsion) to continue taking the drug and to obtain it by any means;
"(2) A tendency to increase the dose;
"(3) A psychic (psychological) and sometimes a physical dependence on the effects of the drag."
Compared with this, the observations of the Commission show that coca chewing is not an addiction (toxicomania) but a habit. It may, however, in some individuals, become an addiction, but generally it can be given up like other habits.
Briefly the harmful effects of chewing coca leaf, from the point of view of the individual and of the nation, are the following:
It inhibits the sensation of hunger and thus maintains, by a vicious circle, a constant state of malnutrition;
It induces in the individual undesirable changes of an intellectual and moral character. This is especially clear in exceptional cases, and it is much discussed how far this is general. It certainly hinders the chewer's chances of obtaining a higher social standard;
It reduces the economic yield of productive work, and therefore maintains a low economic standard of life.
Coca leaves contain, as do other green leaves, vegetables and fruits, most of the known vitamins, especially B 1, B 2 and C in significant quantities. In spite of this fact it would by no means be advisable to supply these vitamins in the form of coca leaf chewing i.e., together with the toxic substance cocaine. In no way can the chewing of coca leaves therefore be regarded as a substitute for an adequate diet.
The Andean man is highly acclimatized to the life at great altitudes. All our knowledge up to the present time supports the conviction that it is unnecessary to regard the Andean Indian as a race for which special physiological laws must be assumed. We have no right to suppose that cocaine acts differently on him. No advantage of coca chewing for acclimatization and for continuous life at high altitudes has been shown scientifically, and persons of non-Andean origin have become acclimatized in large numbers to life in the high altitudes of the Andes without chewing coca leaf.
Since chewing coca is not an isolated fact, but the consequence of a number of unfavourable social and economic factors, the solution of the problem involves two fundamental and parallel aspects: firstly, the need for improving the living conditions of the population amongst which chewing is a general habit, and secondly, the need for initiating simultaneously a governmental policy to limit the production of coca leaf, to control its distribution and eradicate the practice of chewing it.
The chewing of coca leaf is a habit which can be eradicated if the conditions under which it originated are suitably modified.
In view of the social and economic nature of the factors determining coca chewing, an immediate and radical suppression of the habit is not possible. Instead of solving the problem, such a suppression would only aggravate the existing situation. Consequently the Commission envisages only a gradual suppression of the habit, that is, a process which, while taking into account the complexity of the problem, should not be so long as to permit the harmful continuation of the habit nor so short as to damage the economic interests involved.
On the basis of the above conclusions, two groups of recommendations are formulated. The first comprises recommendations relating generally to the existing social and economic factors which give rise to coca leaf chewing. By their very nature these recommendations are here formulated in a general way.
The second group of recommendations is related to the possibility of limiting the production of coca leaf, of controlling its distribution and finally of gradually eradicating the practice of chewing. In accordance with the terms of reference as defined by the Economic and Social Council, these recommendations are given in detail.
A. Recommendations concerning the factors chiefly responsible for the chewing of coca leaf
Before formulating these recommendations, the Commission desires to point out that the Governments of Peru and Bolivia have made, and are at present making, certain efforts to improve the living conditions of the respective populations amongst which the bulk of the chewers are to be found. But the vastness of the problem and the great complexity and cost of the measures necessary to solve it have not permitted these Governments to obtain the results which they would doubtless desire to achieve.[1] Consequently the Commission formulates the following recommendations:
The primary need is to improve the nutritional status of that part of the population which is affected by the chewing of coca leaf. One of the basic observations of this Commission was that where the food is good and sufficient, chewing stops. This observation is in agreement with many medical and military opinions in these countries. Of all the factors concerned, better nutrition abolishes most quickly the habit of chewing. Specific and detailed reference has been made in this respect to the malnutrition existing in the coca leaf producing and chewing areas. Reference has also been made to the studies carried out both by national and international commissions and organizations.
The bettering of nutrition as recommended above implies the application of a co-ordinated plan which would take a certain amount of time and effort on the part of the Governments of Peru and Bolivia. The technical assistance of the United Nations seems possible, especially of its specialized agencies whose own objectives bring them into contact with these problems. Among these agencies special mention should be made of the United Nations Food and Agriculture Organization which had already made a report in 1949 on the "Agriculture of the Altiplano", and which has referred to the food situation of these countries at its Montevideo Conference of July 1948. The World Health Organization is equally interested in nutrition as a basis of good health which results in greater productivity and higher social standard. The International Labour Office called attention, in 1943 and 1946, to under-nutrition. From an educational point of view, the United Nations Educational, Scientific and Cultural Organization is interested also. All these organizations have dealt in some measure in their own sphere with the problem of under-nutrition in these populations.
In any case the studies already made provide a more than sufficient basis for the adoption of a policy designed to produce an immediate improvement in the nutrition of the population affected by the habit of coca chewing. This population comprises not only the chewers but their families and all those who live in the coca leaf producing and chewing areas.
Reference has repeatedly been made in the present report to the efforts which the above-mentioned Governments, acting either on their own account or in collaboration with some other Government, have made to improve certain aspects of the living conditions of the population in general by the establishment of special bodies.
( a) Hygiene
Sanitary and hygienic conditions should be improved in the regions affected.
( b) Housing
The improvement of housing conditions both in rural areas and in the mining districts is also essential. Here education in what housing is and means should form an integral part of the policy to be adopted.
( c) Education
This should be understood in a general sense and also in a special sense. The first involves an improvement in general education and the speedier possible elimination of illiteracy. Between the latter and coca leaf chewing, there is a clear connexion. The Commission has been able to observe that where education increases, there is a parallel decrease in chewing.
The second aspect relates to education in agricultural, hygiene and health matters already mentioned in the preceding recommendations. An improved agricultural education is essential in order to secure:
A general improvement in the peasant's living conditions;
An improvement in production and thus in the diet of the people.
( d) Labour
The existing labour conditions, particularly in the rural districts, should be improved. An essential condition of such an improvement is the institution of a legal system of land tenure ( arrendamiento) which would gradually replace the existing system, since the latter cannot be regarded as suited to present agricultural requirements.
The new system should also institute more equitable relations between landlord and tenant. The latter should be given greater legal security than he now has.
The form of sub-tenancy, particularly those of the so-called allegados in Peru, should be carefully studied with a view to finding, if possible, a contractual formmore in harmony with modern legal, social and economic requirements.
As has been said, Act No. 10.885, in Peru, is now being revised, and there is a plan of agrarian reform in Bolivia. It is to be hoped that both plans will result in an improvement in the legal conditions of labour considered in this report.
( e) Extension of agricultural credit
This is to some extent now being practised in both Peru and Bolivia, mainly through the activities of the respective Agricultural Banks.
The present system is generally based on individual loans secured by a specific guarantee. Though recognizing the importance of the work done by the above mentioned banks, the Commission is of the opinion that greater attention should be paid to the problem of establishing and maintaining producers' and consumers' co-operatives. The individual loan, though useful, is always of limited economic and social effect, particularly in view of the conditions in which the small farmer now lives. In such conditions, he cannot always offer the guarantees necessary to obtain a loan.
The problem of establishment and maintenance of co-operatives presents evident difficulties, but they are not insuperable. An adequate policy would enable a start to be made with them in the immediate future. The spirit of co-operation existing in the present Indian communities could be enlisted to assist in the organization of these co-operatives.
( f) Transport
The carrying out of the preceding recommendations would be greatly facilitated by a general improvement and further development of transport, mainly roads and railroads.
The implementation of the above recommendations implies the application of a vast and co-ordinated plan which would take a certain amount of time and effort on the part of the Governments of Peru and Bolivia with the technical assistance of the United Nations and of its specialized agencies whose own objectives bring them into contact with the problems here described.
B. Recommendations relating to the possibility of limiting the production of the coca leaf and controlling its distribution and the gradual suppression of chewing
In formulating these recommendations, the principles previously laid down have been borne in mind.
Although the limitation of the production of coca leaf and the control of its distribution necessarily entail limitation of consumption, it has been considered advisable to arrange the following recommendations in two groups. Such a distinction should be understood not as a division but as an arrangement of two closely complementary groups of recommendations.
1. Recommendations Relating to the Limitation of Production and the Control of Distribution
A policy for the limitation of the production of coca leaf and the control of its distribution should be adopted simultaneously by Peru and Bolivia. The respective legislative provisions should be based on the same principles and pursue identical purposes. In implementing a policy of limitation, these legislative measures should take into account the national characteristics which the coca leaf problem presents in each of the two countries concerned.
In applying measures for limiting the production of the coca leaf, account should be taken of the purposes for which the leaf is used namely:
The satisfaction of world medical and scientific requirements and of other requirements in accordance with the existing International Conventions on Narcotics;
Chewing.
The purposes mentioned necessitate a limitation of production governed by both national and international provisions. The production of the quantities necessary to satisfy ( a) and ( b), should be subject to the estimates established internationally by the competent organ.[2]
Limitation of the production of coca leaf for the purpose mentioned in ( b) above should be effected gradually until complete suppression is achieved within a period of fifteen years or any shorter period which the Governments concerned may consider practicable.
For that purpose the Governments concerned should take the necessary steps to secure an annual reduction by one-fifteenth of the production of coca leaf at present used for chewing or by such larger proportion of the said production as the Governments concerned may consider practicable.
The Governments concerned shall forward to the Secretary-General of the United Nations an annual report on the progress of the gradual suppression of the production of coca leaf and its chewing.
As a minority opinion, Mr. H. B. Fonda considers that the gradual suppression should take place within a period of five years. The reasons are that with the implementation by the Governments concerned of the other conclusions and recommendations on which he concurs the above period of five years is a practicable one. Therefore, a complete suppression of the habit of chewing can be achieved in the maximum of five years.
To ensure the success of the limitation of production in accordance with purposes ( a) and ( b) (see recommendation II), it is necessary:
That a cadastral survey of the cultivation of the coca leaf should be carried out as soon as possible in Peru and Bolivia;[3]
That taking into account the above-mentioned economic and regional characteristics and the quality of the coca leaf, etc., the respective Governments should decide which coca leaf producing areas will satisfy within the period during which gradual suppression is to be effected, the requirements indicated in recommendation II;
Any other cultivation of the coca leaf, outside the scope of the purposes and limitations referred to, should be considered illicit and subject to the appropriate legal penalties;
That the respective Governments should establish a system for the registration of
(i) Existing producers, and
(ii) Existing dealers (wholesale and retail) in coca leaf;[3 ]
Once the registration of the above is complete, no other person should be authorized to produce coca leaf or trade in it in any way;
Authorizations to trade in coca leaf should be understood as granted on a personal basis and should lapse as soon as the person authorized ceases for any reason to deal in coca leaf;
That a system to control the actual production and distribution of coca leaf should be established;[3]
That an official organ or an organ under official supervision should be set up and entrusted with the task of applying the control measures to all operations affecting the coca leaf. Such an organ should also be the only one authorized to export coca leaf, for whatever purpose it is intended.[3]
No authorization should be granted for any other coca plantation beyond those already in existence.
The substitution of other crops for the cultivation of the coca leaf should be encouraged as far as possible by the Governments concerned. Among other measures, a preferential system might be established for providing agricultural, economic and technical aid to any grower of coca leaf who wishes to replace it by some other crop.
As a complement of such a policy, it would be advisable to establish that in principle no agricultural loan will be granted for the production of coca leaf. As a consequence of a practice established by the respective Agricultural Banks, no loans for the cultivation of coca leaf are at present granted by those banks either in Peru or in Bolivia. The object of the present recommendation is to convert this practice, which is still not altogether universal, into a legal provision.
It would be desirable that in making agricultural loans preference should be given to those growers who do not produce coca leaf and who undertake not to grow it.[3]
Consideration might also profitably be given to the possibility of providing that the rate of interest on any loan granted to a farmer who also grows coca leaf, be higher than that on loans granted to farmers who do not grow coca leaf.
Promulgation and application of legal provisions establishing adequate administrative and penal sanctions against those who violate the provisions relating to the limitation of production and the control of distribution of the coca leaf.
2. Recommendations Relating to the Gradual Suppression of the Practice of Chewing Coca Leaf
The practice now adopted by the armies of Peru and Bolivia of not permitting the chewing of the coca leaf during military service should be elevated to the status of a legal prohibition.
Appropriate legislation should render compulsory the provision in every centre of education or place of work of adequate information regarding the harmful effects of chewing coca leaf.
Such legislation should be supplemented by such other propaganda measures as the Governments of Peru and Bolivia may consider it advisable to introduce, particularly amongst the Indian agricultural and mining population.
It should be legally prohibited on pain of appropriate penalties:
To pay for work or any kind of loan or service directly or indirectly, wholly or partly, with coca leaf;
To infringe the provisions regarding the gradual reduction in the daily supply of coca leaf to the workers;
To infringe any of the legal provisions intended to secure the gradual suppression of the practice of chewing coca leaf.
Official regulation of the price of coca leaf intended for chewing during the period of gradual suppression, in order to avoid excessive prices which might endanger the adequate satisfaction of requirements relating to food, housing, clothing, hygiene and health.
In view of the existence, in the north of the Argentine Republic, of a large group of chewers who, though largely not of Argentine nationality, consume annually a considerable quantity of coca leaf, it would be desirable that the Government of that country should be invited to collaborate to the extent it may deem necessary in the gradual suppression of the coca leaf in that area.
The complete success in one country of a policy of the gradual suppression of the habit of chewing coca leaves, of the corresponding limitation of the production of these leaves, and the control of their distribution will depend in a very large measure on identical policies being pursued and carried out in other countries where this habit exists.
To further the adoption of such policies by all countries concerned and facilitate the co-ordination of the measures resulting therefrom, it might be advisable to convene, under the auspices of the United Nations, a meeting of these countries with a view to reaching an agreement on the questions referred to above, pending the adoption of the new single convention on narcotic drugs.
In submitting these recommendations and thus concluding the present report, the Commission is aware that they represent no more than the basic steps to be taken to secure limitation of the production of the coca leaf, control of its distribution and the gradual reduction of chewing.
The implementation of the recommendations with all the complementary aspects which that implies is a task which falls exclusively within the competence of the Governments concerned.
1The Commission is of the opinion that the keynote of the whole action against chewing coca leaf can and must be the bettering of nutrition.
2See document F.N.7/AC.3/3.
3The Government of Peru has already begun to implement this recommendation
3See note 3 on preceding page.
