tag:theconversation.com,2011:/uk/topics/drsa-81846/articlesDRSA – The Conversation2020-02-11T13:44:29Ztag:theconversation.com,2011:article/1304192020-02-11T13:44:29Z2020-02-11T13:44:29ZMedical waste offers insights into South Africa’s use of pharmaceuticals<figure><img src="https://images.theconversation.com/files/312842/original/file-20200130-41476-pded8t.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">The analgesic Grand-pa is among the most common pharmatrash in this study.</span> <span class="attribution"><span class="source">Rebecca Hodes</span></span></figcaption></figure><p>Much of what we know about human history comes from studying things that have been discarded. The <a href="https://www.thoughtco.com/midden-an-archaeological-garbage-dump-171806">archaeology of dumpsites and middens</a> has long informed us about societies and their pasts. This has included how people survived and sustained themselves, what they gathered, made, amassed and <a href="https://www.nytimes.com/1992/07/05/books/we-are-what-we-throw-away.html">discarded</a>. </p>
<p>Histories of rubbish have also shown that beliefs about <a href="https://iwaponline.com/washdev/article/7/2/163/30154/History-of-sanitation-and-hygiene-technologies-in">sanitation</a>, and what makes for a clean environment, change. These changes are, in turn, influenced by developments in technology, forms of governance, and consumer norms. </p>
<p>I conducted a <a href="https://www.tandfonline.com/doi/full/10.1080/02582473.2019.1668835">study</a> on an archive of medical materials, collected over three years from public waste sites around South Africa’s Eastern Cape. What I refer to as ‘pharmatrash’ serves as a proxy for which medicines were provided or purchased, consumed, and then discarded. Pharmatrash in post-Apartheid South Africa shows the vast proliferation of medical waste, the result of increased access to healthcare products in both the public and private sectors – and on the formal and informal markets. </p>
<p>I set about unpacking the meaning of the rubbish that I found. I was able to identify preferences in particular settings for certain drugs – legal and illegal. These preferences reflected global market flows, advances in science, medicine and marketing, local and domestic modes of consumption, and changing social norms and desires. </p>
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<figcaption>
<span class="caption">This waste from a TB clinic in Buffalo City is bound for disposal in the municipal dump.</span>
<span class="attribution"><span class="source">Rebecca Hodes</span></span>
</figcaption>
</figure>
<h2>Growth in medical waste</h2>
<p>In post-apartheid South Africa, there has been a massive expansion of public health care, with radical <a href="http://dx.doi.org/10.1016/S0140-6736(12)61814-5">improvements in access to drugs and diagnostics</a>.</p>
<p>In turn, these improvements have resulted in the proliferation of medical waste. According to South African laws, hospitals are required to <a href="https://iwmsa.co.za/downloads/hcwm%20in%20healthcare%20facilities.pdf">abide by protocols</a> for waste removal. Because waste is meant to be disposed of, the governance of garbage is considered to be working effectively when rubbish is removed and destroyed. But, when these systems fail, and waste ends up where it does not ostensibly belong (on beaches, in parks, and in people’s neighbourhoods), public interest is aroused. </p>
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<figcaption>
<span class="caption">A collection of discarded syringes lies on the ground behind a row of shops in the suburb of Nahoon in East London.</span>
<span class="attribution"><span class="source">Rebecca Hodes</span></span>
</figcaption>
</figure>
<p>In 2016, for example, a refuse dump <a href="https://www.iol.co.za/news/south-africa/kwazulu-natal/dumped-medical-waste-shuts-durban-beaches-2023294">gone awry</a> deposited medical and pharmaceutical waste across several kilometres of the KwaZulu-Natal coast. Syringes, condoms and pill packets were strewn across Durban beaches. The public panicked, and municipal officials closed beaches pending a clean-up. Scandals about <a href="https://www.researchgate.net/publication/325879525_A_Review_of_Medical_Waste_Management_in_South_Africa">mismanaged medical waste</a> frequently grip the popular imagination. They are understood as evidence of state incompetence, corruption, corporate greed, and disregard for public safety. </p>
<p>But these scandals obscure wider realities about rubbish in contemporary South Africa. Rather than a focus on spectacular instances of waste’s displacement, my research focused on pharmaceutical waste at its most ordinary, as it is found within the domestic waste stream, produced through everyday healthcare practices and household economies.</p>
<h2>Archiving garbage</h2>
<p>For the past four years, I have built an archive of pharmaceutical waste through collecting and classifying rubbish in the <a href="https://municipalities.co.za/overview/102/amathole-district-municipality">Amathole</a> district and <a href="https://municipalities.co.za/overview/7/buffalo-city-metropolitan-municipality">Buffalo City Municipality</a> of South Africa’s <a href="https://www.britannica.com/place/Eastern-Cape-province-South-Africa">Eastern Cape province</a>. I have gathered rubbish from poor, middle-class and affluent areas, in and around the cities of East London and King William’s Town. </p>
<p>I have picked up litter from pavements outside hospitals and clinics, and from public places where people gather, work, shop and play. I identified the days on which rubbish was collected by municipal services within different areas, and often visited those sites the day after scheduled collections to study which pharmaceutical products had escaped from split or spilt rubbish bags, remaining in domestic environs. </p>
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<figcaption>
<span class="caption">A Buffalo City Metro sign prohibits dumping but waste strewn around the site offered a midden of pharmaceutical artefacts.</span>
<span class="attribution"><span class="source">Rebecca Hodes</span></span>
</figcaption>
</figure>
<p>I mapped formal or permitted sites of domestic dumping, often on ‘islands’ of municipal land adjacent to houses or blocks of flats, as well as sites of illegal dumping. These ‘informal’ dumpsites were among the richest sources of pharmaceutical waste.</p>
<p>The pharmatrash in this archive includes both prescription and proprietary medicines. These represent the pharmaceuticals in common use, and the prevalence of medical conditions or healthcare needs at the source of their purchase, provision, consumption and disposal. </p>
<h2>The findings</h2>
<p>Analgesics such as codeine-containing tablets and syrups, and the ‘headache powder’ Grand-pa (which combines aspirin and caffeine), were the most commonplace waste artefacts in this study. </p>
<p>The popularity of vitamins and dietary supplements was also evident, revealed heavy consumer demand for pharmaceutical products touted as performance-enhancers and energy-boosters.</p>
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<figcaption>
<span class="caption">Bioplus, marketed as an energy and performance enhancer, was among the most common pharmatrash items in this study.</span>
<span class="attribution"><span class="source">Rebecca Hodes</span></span>
</figcaption>
</figure>
<p>Pharmatrash from the streets around taxi ranks, markets, shopping centres, taverns and brothels showed what products people used to sustain and enjoy themselves. These included energy boosters, painkillers, vitamins, sexual performance aids and condoms. </p>
<p>Pharmatrash from public health facilities showed what medicines people were being prescribed, and what forms of pharmaceutical equipment were used to treat them. </p>
<p>It also showed the failures of state institutions to manage waste production in accordance with laws protecting public health and safety. </p>
<p>Pharmatrash sourced from residential neighbourhoods revealed the prevalence of infectious and non-communicable diseases in South Africa, and punctuated the desire of consumers and citizens to feel vital, productive and pain-free. </p>
<p>I concluded that the sale of over-the-counter drugs remains vastly unregulated and under-researched. There is little empirical evidence on how widespread is their use, and whether they are being consumed safely. The archive of pharmatrash allows us to track new forays into the world of medicines consumption. For the makers, distributors and users of these products, their shelf-life is short-lived. But their afterlife as garbage portends eons.</p>
<p><em>This is the sixth and final article in a <a href="https://theconversation.com/africa/search?utf8=%E2%9C%93&q=DRSA">series</a> on drug regimes in southern Africa. They are based on research done for a special edition for the <a href="https://www.tandfonline.com/toc/rshj20/current">South African Historical Journal</a>. Read the full paper over <a href="https://www.tandfonline.com/doi/full/10.1080/02582473.2019.1668835">here</a>.</em></p><img src="https://counter.theconversation.com/content/130419/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Rebecca Hodes has received funding from the Medicines Research Council and the Human Sciences Research Council of South Africa, the Medical Research Council of the United Kingdom, the Fogarty International Centre and the National Institute of Mental Health at the National Institutes of Health, United States, the European Research Council, and the Desmond Tutu HIV Foundation.</span></em></p>The pharmaceutical waste from Buffalo City dump sites reveals that the sale of over-the-counter drugs remains vastly unregulated and under-researched.Rebecca Hodes, Director, AIDS and Society Research Unit, University of Cape TownLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1290112020-02-09T07:41:14Z2020-02-09T07:41:14ZThe story of the pharma giant and the African yam<figure><img src="https://images.theconversation.com/files/311842/original/file-20200124-81395-1pu326k.JPG?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Traditional medicines sold at a South African market</span> <span class="attribution"><span class="source">Rebecca and William Beinart</span></span></figcaption></figure><p>It was a drug produced in Nottingham in the United Kingdom that led us on a journey to South Africa to visit <a href="https://www.researchgate.net/figure/Examples-ofmedicinal-herbs-bought-at-Faraday-muthi-market-in-Johannesburg-A-different_fig1_258217408">muthi markets</a>, archives, herbariums and nature reserves. </p>
<p>We spoke with traders, healers, scholars and conservationists to learn more about <em><a href="http://redlist.sanbi.org/species.php?species=1777-4002">Dioscorea sylvatica</a></em>. </p>
<p><em>Dioscorea</em> is a wild yam. Its name in different languages connects to its appearance – its rough skin resembles a tortoise shell. It’s known as ‘Elephant’s Foot’ in English, in isiZulu ‘ingwevu’, meaning grey/old or ‘ifudu’, meaning tortoise; in Sepedi the name is ‘Kgato’ – ‘to stamp’.</p>
<p>In the 1950s, the yam was heavily exploited by the British pharmaceutical firm Boots for the production of cortisone. But provincial conservation officials in South Africa fought back against the plundering of a wild plant that they recognised was in danger of being exploited to extinction. </p>
<h2>A factory in Johannesburg</h2>
<p>In 1949 scientists in the US announced the dramatic effects of a new drug, <a href="https://www.britannica.com/science/cortisone">cortisone</a>. It could be used to treat a variety of ailments, from arthritis to allergies to lupus and skin conditions. They found that cortisone could be made cheaply from <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5225340/">diosgenin</a>, extracted from Mexican wild yam species, and began a global search for supplementary plants. </p>
<p>By the early 1950s, South African botanists had identified <em>Dioscorea sylvatica</em> as promising. Boots, a major British pharmaceutical company, was keen to develop a source of diosgenin to manufacture corticosteroid medicines and started a factory in Johannesburg in 1955 for the initial stages of processing the plant. </p>
<p>Systematic extraction began in the eastern and north eastern part of the country, plundering a plant used by traditional healers for muthi (traditional medicine).</p>
<p>These actions weren’t a direct case of ‘biopiracy’ – in the sense of an obvious and deliberate theft of indigenous knowledge for profit. Nevertheless the exploitation of this plant took place against the backdrop of the history of plant collection and export from South Africa. Bioprospecting was facilitated by a longer process that involved drawing on a range of local knowledge in collection and scientific classification.</p>
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<figcaption>
<span class="caption">Dioscorea sylvatica, also known as elephant’s foot, could be used in making cortisone.</span>
<span class="attribution"><span class="source">Martin Heigan/Flickr</span></span>
</figcaption>
</figure>
<h2>Indigenous knowledge</h2>
<p>The conversations we had with South African traditional healers in muthi markets in Johannesburg and in Acornhoek, a rural area of Mpumalanga, brought up important questions on knowledge, ownership, plant exploitation, systems of thinking about disease and healing, and conservation. </p>
<p>The concept of medicine (muthi) is very different to the dominant pharmaceutical paradigm. Rather than a single drug to ‘cure’ a single disease, ill-health and treatment are understood in a more holistic way. </p>
<p>When we went to meet healers, we took along a piece of the yam bought from a muthi market in Johannesburg, as well as the 1950s Boots advert that had started us off on this research. </p>
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<figcaption>
<span class="caption">A Boots cortisone advert.</span>
<span class="attribution"><span class="source">Boots UK</span></span>
</figcaption>
</figure>
<p>Most of the healers we met were familiar with the plant. Those who knew it described it as powerful with both topical and ritualistic uses for cleansing and protection. </p>
<p>The local knowledge that led to an interest in the plant from botanists and scientists is rarely recorded in any detail in archives. We were interested in how Boots in Nottingham came across a wild South African yam as a starting point for the manufacture of cortisone.</p>
<h2>The UK connection</h2>
<p>From our limited conversations with traditional healers and looking at botanical records, it is clear that medicinal yams were known and used across many different South African communities well before the steroid industry took an interest. However, interest in <em>Dioscorea</em> in the 1950s was triggered by US research on Mexican wild yams and a global search for similar plants.</p>
<p>A South African botanist recorded in the 1910s that the plant was used by African people for its saponins with medical properties. A wider range of uses were mentioned in <a href="https://www.nature.com/articles/132336a0">The Medicinal and Poisonous Plants of Southern Africa</a>, first published in 1932. </p>
<p>In a 1950s report on their collection for Boots’ South African collaborators Biochemico, there is a brief reference to local knowledge:</p>
<blockquote>
<p>The actual digging was done by locals who need no more training than to be shown an “ingwevu” plant (which the vast majority in that area know in any case) and the size of the tuber required.</p>
</blockquote>
<p>The digging referred to here is the extraction of about 6,000 tonnes of wild yams. This was only curtailed when the plant population became endangered and South African government conservationists stopped exploitation.</p>
<p>Natal Parks Boards officers were uneasy about mass exploitation of a wild plant and attempted to enforce strict conditions. </p>
<p>By 1960, they succeeded in terminating permits and Boots ceased production of South African diosgenin. This was a significant case for a fledgling provincial conservation authority. The protection of plants such as D. sylvatica attracted little public attention and it is not a well-known story, but this episode was important in developing institutions and strategies for plant protection and state conservation more generally. </p>
<figure class="align-center ">
<img alt="" src="https://images.theconversation.com/files/312285/original/file-20200128-81352-63z35r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&fit=clip" srcset="https://images.theconversation.com/files/312285/original/file-20200128-81352-63z35r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=450&fit=crop&dpr=1 600w, https://images.theconversation.com/files/312285/original/file-20200128-81352-63z35r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=450&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/312285/original/file-20200128-81352-63z35r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=450&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/312285/original/file-20200128-81352-63z35r.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=566&fit=crop&dpr=1 754w, https://images.theconversation.com/files/312285/original/file-20200128-81352-63z35r.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=566&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/312285/original/file-20200128-81352-63z35r.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=566&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px">
<figcaption>
<span class="caption">A sangoma’s hut with a variety of traditional medicines.</span>
<span class="attribution"><span class="source">William Beinart</span></span>
</figcaption>
</figure>
<h2>Future protection</h2>
<p>Healers in South Africa seem to be well aware of their position – carriers of traditional knowledge that could be lost, but also protectors of knowledge they fear will be exploited for profit with no benefit for them or their communities. Some have worked with campaigners and legal teams to test and record the efficacy of traditional plant medicines, and to prove existing knowledge, to gain recognition that could lead to greater government protection. </p>
<p>A landmark case in 2003 saw the South African San Council sign a benefit sharing <a href="https://www.culturalsurvival.org/publications/cultural-survival-quarterly/san-reach-landmark-ipr-benefit-sharing-accord-diet-pill">agreement</a> with the Council for Scientific and Industrial Research for the use of Hoodia as an appetite suppressant and diet drug. The legal struggle led by the San Council was eventually successful and influenced subsequent legislation on indigenous knowledge and benefit sharing. </p>
<p>For the Elephant’s Foot yam it’s 70 years too late. But it has a lot of stories to tell.</p>
<p><em><a href="https://rebeccabeinart.info">Rebecca Beinart</a>, an artist and researcher, accompanied the author – her father – and contributed to the research for this article.</em></p>
<p><em>This is the fifth article in a <a href="https://theconversation.com/africa/search?utf8=%E2%9C%93&q=DRSA">series</a> on drug regimes in southern Africa. They are based on research done for a special edition for the <a href="https://www.tandfonline.com/toc/rshj20/current">South African Historical Journal</a>. Read the full paper over <a href="https://www.tandfonline.com/doi/full/10.1080/02582473.2019.1668837">here</a>.</em></p><img src="https://counter.theconversation.com/content/129011/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>William Beinart does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>In the 1950s, the African yam was exploited by drugs firm Boots to produce cortisone. But South Africans fought back against the plundering of a plant that they used for traditional healing.William Beinart, Professor, University of OxfordLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1302362020-02-06T12:44:41Z2020-02-06T12:44:41ZA history of how sedatives took hold in white South Africa<figure><img src="https://images.theconversation.com/files/312471/original/file-20200129-92992-1ka421l.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">Shutterstock</span> </figcaption></figure><p>In the early 1960s, pharmacists and government authorities were of the view that South Africa had experienced key aspects of a ‘pharmaceutical revolution’ over the course of the previous 40 years. </p>
<p>These were fulcrum decades in South African medicines’ history in which newly invented medicines became critically important. Most of the new therapeutic substances in high demand were antibiotics. But the <a href="https://www.drugs.com/drug-class/anxiolytics-sedatives-and-hypnotics.html">class of drugs</a> comprising synthetic hypnotics, sedatives and tranquillisers were also important. </p>
<p>As early as the 1930s these substances – especially <a href="https://www.drugs.com/drug-class/barbiturates.html">barbiturates</a> – posed challenges to those who sought their control. Enmeshed in multiple issues of chemical, commercial, professional, and regulatory definition, timid controls were proposed in 1937. But even these failed to gain support, facilitating a permissive market for those who could afford the new drugs. These were, by and large, white South Africans. </p>
<p>In <a href="https://www.tandfonline.com/doi/full/10.1080/02582473.2019.1648539">my research</a> I identified a number of moments when these sedatives became of pharmacological, professional or public interest. I sketch a chronology of their regulatory politics in South Africa in the mid-twentieth century. </p>
<p>South African markets remained limited. Nevertheless, many local pharmacists, manufacturers, importers, and consumers were quick to embrace the therapeutic aspirations and chemical technologies of the time. In turn, they helped to accelerate multiple changes in the uneven emergence of ‘pharmaceutical modernity’ in South Africa.</p>
<h2>Modernising white identity</h2>
<p>The 1950s was a decade of an even greater variety and popularity of pharmaceutical preparations. Most were imported, particularly from the US. Another bid was made to restrict the use of tranquillising and other drugs. </p>
<p>In 1954 a new classification, that of ‘Potentially Harmful Drugs’, was established. Professional pharmacies’ discretion over the sale of these substances was limited. Even so, dozens of products were available via medical prescription. This was often on the back of unsubstantiated claims that their chemical properties would relax, soothe, calm, pacify, and take away anxiety, fear and fretfulness. Others were still readily attainable from pharmacists as over-the-counter products. </p>
<p>One such was ‘OblivonC’, which has not lingered in South Africans’ medical memory. Others have proven more durable, continuing as mainstays of frequently prescribed medicines into the present.</p>
<figure class="align-left zoomable">
<a href="https://images.theconversation.com/files/312518/original/file-20200129-92969-1y0r527.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/312518/original/file-20200129-92969-1y0r527.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/312518/original/file-20200129-92969-1y0r527.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=439&fit=crop&dpr=1 600w, https://images.theconversation.com/files/312518/original/file-20200129-92969-1y0r527.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=439&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/312518/original/file-20200129-92969-1y0r527.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=439&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/312518/original/file-20200129-92969-1y0r527.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=552&fit=crop&dpr=1 754w, https://images.theconversation.com/files/312518/original/file-20200129-92969-1y0r527.jpg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=552&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/312518/original/file-20200129-92969-1y0r527.jpg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=552&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">Three tubes of Oblivon capsules from 1953.</span>
<span class="attribution"><span class="source">Wellcome Images/ Wellcome Collection</span></span>
</figcaption>
</figure>
<p>One example is Meprobamate. Popular in the 1960s, it’s still widely prescribed today, albeit in different medical preparations. </p>
<p>From many descriptions, official as well as popular, it is evident that white South Africans readily and legitimately consumed pharmaceuticals (especially in pill form) for a wide variety of ailments. </p>
<p>In part, the popularity of the new drugs may be explained in terms of the quest for a white, ‘modern’ identity. As <a href="https://www.jstor.org/stable/pdf/24915880.pdf">one historian</a> puts it, in the prosperous decades of post-war South Africa, and especially in the 1960s, whites </p>
<blockquote>
<p>self-consciously fashioned their personal appearance, public architecture, and consumer and lifestyle choices to demonstrate (to other South Africans and international observers) their distinctness from the non-white [sic] majority and to advertise their modernity. </p>
</blockquote>
<p>If this was indeed a factor of a modernising white identity, it was white women and (generally) male medical practitioners who by the 1970s had become unwitting agents in a reciprocal relationship of need and aspiration. If relative affluence and attitude facilitated access to the new sedative drugs for some, the consequences of their consumption were often ambivalent.</p>
<p>Some of these substances were ineffectual. Others gave profound relief to those who suffered from sleep deprivation, extreme anxiety, and other forms of socially or psychologically induced torment. Some proved dangerous and destructive. Many also possessed damaging powers when taken in combination with other substances (such as alcohol) or if imbibed, ingested or injected in excess or over extended periods of time. </p>
<p>At the same time, the limited ‘legitimate’ usage of synthetic sedatives and tranquillising preparations by black South Africans can be largely explained by reasons of political economies of health. In the 1960s, there were few black doctors outside of the cash-strapped mission hospitals prescribing to middle class private patients. In addition, chemist shops were concentrated in the urban areas. And the unregulated ‘traditional’ medicines sector remained significant, both economically and ideologically. </p>
<p>But apartheid capitalism required the growth of black consumer markets at the same time as enforcing racial segregation. A commissioned survey reported in 1969 reported that</p>
<blockquote>
<p>the natural potential of the Bantu [sic] market […] holds tremendous promise for the future’.</p>
</blockquote>
<p>Pressure to extend formal education and training of black technicians, assistants and pharmacists also finally gathered momentum by the mid-1960s. </p>
<figure class="align-right zoomable">
<a href="https://images.theconversation.com/files/312530/original/file-20200129-92949-hv7nak.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=1000&fit=clip"><img alt="" src="https://images.theconversation.com/files/312530/original/file-20200129-92949-hv7nak.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=237&fit=clip" srcset="https://images.theconversation.com/files/312530/original/file-20200129-92949-hv7nak.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=600&h=746&fit=crop&dpr=1 600w, https://images.theconversation.com/files/312530/original/file-20200129-92949-hv7nak.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=600&h=746&fit=crop&dpr=2 1200w, https://images.theconversation.com/files/312530/original/file-20200129-92949-hv7nak.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=600&h=746&fit=crop&dpr=3 1800w, https://images.theconversation.com/files/312530/original/file-20200129-92949-hv7nak.jpeg?ixlib=rb-1.1.0&q=45&auto=format&w=754&h=938&fit=crop&dpr=1 754w, https://images.theconversation.com/files/312530/original/file-20200129-92949-hv7nak.jpeg?ixlib=rb-1.1.0&q=30&auto=format&w=754&h=938&fit=crop&dpr=2 1508w, https://images.theconversation.com/files/312530/original/file-20200129-92949-hv7nak.jpeg?ixlib=rb-1.1.0&q=15&auto=format&w=754&h=938&fit=crop&dpr=3 2262w" sizes="(min-width: 1466px) 754px, (max-width: 599px) 100vw, (min-width: 600px) 600px, 237px"></a>
<figcaption>
<span class="caption">An advert for Medigesic painkiller.</span>
<span class="attribution"><span class="source">Nattermann South Africa / South African Pharmaceutical Journal</span></span>
</figcaption>
</figure>
<h2>Pharmaceutical politics</h2>
<p>By the late 1960s, South Africa had been unevenly propelled towards a new phase of ‘pharmaceutical modernity’. This too would be marked by intense local pharmaceutical politics. </p>
<p>By the 1970s, locally-based manufacturing of pharmaceuticals had grown. On the recommendation of the Steenkamp Commission of Inquiry into the Pharmaceutical Industry of 1978, reporting after the Soweto uprising, the apartheid regime’s support for the domestic manufacture of chemicals and medications was to grow “in case of boycott or war”. </p>
<p>This ominous atmosphere was reflected in the pharmaceuticals sector of the late apartheid era. An advertisement for ‘Medigesic’ reproduced from the South African Pharmaceutical Journal in 1980 portrays an atmosphere of intense stress for many white South Africans. To many whites the ad projected their physical and mental state of being under siege, both from ‘within’ the country and from apartheid’s opponents ‘without’. </p>
<p>“Especially formulated for the professional in medicine,” Medigesic invoked the state’s “traditional” staunch commitment to their “safety” and “defence”.</p>
<p>Portraying the fortress of the Castle of Good Hope, the military emblem of the South African Defence Force, patients who consumed the analgesic were promised relief from pain, reduction of inflammation and fever, and “general sedation”.</p>
<p><em>This is the fourth article in a <a href="https://theconversation.com/africa/search?utf8=%E2%9C%93&q=DRSA">series</a> on drug regimes in southern Africa. They are based on research done for a special edition for the <a href="https://www.tandfonline.com/toc/rshj20/current">South African Historical Journal</a>. Read the full paper over <a href="https://www.tandfonline.com/doi/full/10.1080/02582473.2019.1648539">here</a>.</em></p><img src="https://counter.theconversation.com/content/130236/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Julie Parle receives funding from the National Research Foundation (NRF)</span></em></p>Sedatives contributed to a pharmaceutical revolution in South Africa in the divided 1950s, especially among white users.Julie Parle, Honorary Professor in History, University of KwaZulu-NatalLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1299152020-02-04T13:02:22Z2020-02-04T13:02:22ZCannabis in South Africa: the duplicity of colonial authorities<figure><img src="https://images.theconversation.com/files/311610/original/file-20200123-162240-1eabgxz.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>The history of <a href="https://www.tandfonline.com/doi/full/10.1080/02582473.2019.1641738">cannabis in South Africa</a> contains two particular trajectories that were sometimes in direct contradiction with one another. </p>
<p>The one, the 100-year-old effort to prohibit its use. The other, a history of colonial governments and administrators trying to develop cannabis in order to make money out of it.</p>
<p>These two paths began to develop in earnest after 1916.</p>
<p>The government of the day was preoccupied with domestic political tensions and an international imperial war. As part of the British Empire, the <a href="https://www.sahistory.org.za/article/union-south-africa-1910">Union of South Africa</a> had to pass domestic legislation to comply with international treaties it was signatory to, either directly or indirectly. </p>
<p>So the Union government introduced the Opium and Other Habit-forming Drugs Bill to fall in line with international agreements signed at <a href="https://www.unodc.org/unodc/en/frontpage/the-1912-hague-international-opium-convention.html">The Hague in 1912</a>. The bill also included <a href="https://www.who.int/substance_abuse/facts/cannabis/en/">cannabis</a> and <a href="https://www.britannica.com/plant/Indian-hemp">Indian hemp</a>. This was despite little justification that these were habit-forming drugs on par with <a href="https://www.britannica.com/science/opium">opium</a>. The bill built on smaller-scale laws previously enacted in colonial Natal and the Cape Colony. </p>
<p>The second narrative was happening simultaneously. In July that year the S.S. Balmoral Castle set sail for London from the eastern Cape with 11 bags of dagga, as it is called in South Africa, in its hold for Dreyfus and Co Ltd. The Union government’s Department of Mines and Industries was keen on having the sample tested with a view to its potential development as a profitable economic plant for the international pharmaceutical market.</p>
<p>Such cleavages within the state show how the political impulses behind dagga criminalisation contradicted – but also cohabited with – the commercial pursuit of dagga as a lucrative global commodity. </p>
<h2>South Africa’s dagga promoters</h2>
<p>In 1917, London’s <a href="http://www.open.ac.uk/researchprojects/makingbritain/content/imperial-institute">Imperial Institute</a> declared the Dreyfus samples chemically not on par with Indian-grown cannabis in the empire’s connected market. </p>
<p>But this did not deter the Department of Mines and Industries and the Union government’s Division of Botany in Pretoria. Both realised the need for more accurate and careful testing and standardisation of dagga in South Africa. They actively worked with settler farmers and trading companies to experiment on cannabis with the aim of developing an international commercial market. </p>
<p>The empire already connected South Africa to cities in Britain, India, Mauritius, and the wider Caribbean colonies. Since the Imperial Conference of 1907, British dominions and colonies had actively participated in creating markets for commodities produced within the empire. They did this by promoting them through Trades Commissioner’s Offices. By late 1917, the Trades Commissioner for South Africa was helping test samples and finding influential buyers in places like London. </p>
<p>But market instabilities and competition with standardised cannabis products marketed from India challenged these ambitions.</p>
<p>Soon after, the Mines and Industries Department started helping businessmen seek out international paper manufacturers interested in the fibrous stalk of the cannabis plant. One was a farmer called E.D. Punter. Punter also wanted to grow the hemp plant for oil pressing and bird seed. His close work with the Industries Department earned the ire of the Department of Public Health, which in 1923 strongly reprimanded them for their efforts. </p>
<h2>The law route</h2>
<p>By 1923, debates around dagga had become highly racialised. Cannabis consumption had historically been described by white colonists as an immoral habit of African and Indian communities. In the years after Union, calls for prohibition of cannabis combined racist fears popular in the print media with policies meant to control cannabis-based livelihoods, medicine, and leisure. </p>
<p>This emboldened domestic criminal legislation as well as a push for global prohibition. On the international stage, the government of <a href="https://www.sahistory.org.za/people/general-jan-christiaan-smuts">Jan Smuts</a> urged international diplomats at the <a href="https://www.britannica.com/topic/League-of-Nations">League of Nations</a> in Geneva to consider including cannabis alongside opium in an updated international drugs convention. </p>
<p>In 1925, the original template for policing and suppressing cannabis production, consumption, and trade worldwide was agreed upon. Known as the <a href="https://www.jstor.org/stable/2213324?seq=1#metadata_info_tab_contents">Geneva Convention on dangerous drugs</a>, it effectively fixed the entire cannabis plant as a subject of criminal law in domestic and international contexts. In one dramatic action, the deeply diverse forms and commodities of cannabis in Africa and Asia were effectively swept aside. </p>
<p>Even as Smuts’ government pursued international criminalisation, the Industries Department elicited private efforts to test the commodity’s prospects. Mr W. Perfect from Ladysmith in Natal urged the department to experiment with “insangu-based rope”. He hoped that hemp rope would be a great representation of the dominion at the 1924 British Empire Exhibition in London. </p>
<p>But the Smuts government had other plans. It continued to apply diplomatic pressure to ensure that cannabis was criminalised alongside opium.</p>
<h2>Ripples</h2>
<p>The ripples of this historical contradiction are worth revisiting as South Africa enters a new phase of regulation. In 2018 the country’s Constitutional Court passed a <a href="https://theconversation.com/south-african-court-frees-cannabis-from-colonial-and-apartheid-past-103644">landmark judgment</a> decriminalising cannabis consumption inside private dwellings. This paved the way for an estimated 900,000 farmers to cultivate cannabis licitly.</p>
<p>Pro-legalisation voices have hailed the judgment as an important step. It challenged the racial history of dagga legislation that was rooted in colonial systems of prejudice. But 100 years later, small-scale farmers and consumers remain <a href="https://www.sowetanlive.co.za/news/south-africa/2019-10-04-legalisation-is-killing-our-market-say-small-scale-dagga-growers/">vulnerable</a> to the international cannabis market unless they’re adequately protected. Specific cultural knowledge of cannabis must also be factored into <a href="https://www.timeslive.co.za/news/south-africa/2019-11-27-dagga-grannies-must-not-be-left-behind-in-rush-to-cultivate-cannabis/">policy</a> because cannabis has diverse symbolic meanings and styles of cultivation and use.</p>
<p>With billions in potential revenue at stake, the ordinary South African consumer for whom dagga has historically been a normal everyday object of leisure or healing must not be written out of history.</p>
<p>_ <em>This is the third article in a <a href="https://theconversation.com/africa/search?utf8=%E2%9C%93&q=DRSA">series</a> on drug regimes in southern Africa. They are based on research done for a special edition for the <a href="https://www.tandfonline.com/toc/rshj20/current">South African Historical Journal</a>. Read the full paper over <a href="https://www.tandfonline.com/doi/full/10.1080/02582473.2019.1641738">here</a>.</em></p><img src="https://counter.theconversation.com/content/129915/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Utathya Chattopadhyaya does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.</span></em></p>There are two histories of dagga in South Africa - the one of criminalising it and the other of the state trying to make money off it.Utathya Chattopadhyaya, Assistant Professor, University of California, Santa BarbaraLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1293922020-01-30T12:44:41Z2020-01-30T12:44:41ZThe highs and lows of the opium trade in southern Africa<figure><img src="https://images.theconversation.com/files/311814/original/file-20200124-81336-1d1c10h.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>The reach of European empires and of Indian Ocean trade networks drew southern Africa into the global politics of opium around the turn of the twentieth century. Between the late 1880s and early 1920s and there was a shift from economies of supply to regimes of control. </p>
<p>The colonies of Mozambique and South Africa were caught up in these big changes. </p>
<p>In a <a href="https://www.tandfonline.com/doi/full/10.1080/02582473.2019.1627402">recent paper</a> I highlight how official and unofficial actors shaped and responded to the global politics of opium and, in different ways, worked to benefit from these developments. </p>
<p>With a focus on Mozambique and, especially, South Africa, I demonstrate how the changing global politics of drug supply and suppression influenced local colonial social and political processes. </p>
<p>I also show how these histories influenced events worldwide, including the first efforts to use the League of Nations to control the international cannabis trade.</p>
<h2>Opium cultivation in Mozambique</h2>
<p>In July 1877 an unpleasant surprise greeted British Imperial consul, Captain James Frederick Elton, as he led an expedition through the Zambezi valley in <a href="https://www.britannica.com/place/Mozambique">Mozambique</a>. An agricultural experiment was underway, and it seemed to be thriving. The enterprise was Portuguese; the crop was <a href="https://www.history.com/topics/crime/history-of-heroin-morphine-and-opiates">opium</a>. </p>
<p>This was a problem for him because there was open contestation between European countries hungry to <a href="https://www.newworldencyclopedia.org/entry/Scramble_for_Africa">colonise the continent</a>. Elton recognised that active farming in this region was bad news for British interests and claim-making. </p>
<p>Worse, the healthy crop of <em>Papaver somniferum</em> heralded a new source of competition with <a href="https://www.britannica.com/topic/Opium-Wars">British Indian opium</a> that monopolised the lucrative Chinese market.</p>
<p>In 1874, the Mozambique Opium Cultivation and Trading Company launched its experiment with £180,000, a concession of 50,000 acres of Portuguese crown land and exclusive rights to duty-free export for 12 years. </p>
<p>In fact, growing opium in the Zambezi valley proved a short-lived venture. </p>
<p>In 1884, poppy cultivation was ended by an anti-colonial uprising. Although the violence had broader aims and targets, African workers were motivated to destroy the opium plantation because of the company’s extortion of workers through taxes and forced recruitment. </p>
<p>Quests to profit from opium were taken up in a different way further south. </p>
<h2>The South African leg</h2>
<p>By the early 1900s the consumption of opium and its alkaloids, like morphine, were well established in southern Africa. A common ingredient in over-the-counter <a href="https://americanhistory.si.edu/collections/object-groups/balm-of-america-patent-medicine-collection/history">patent medicines</a>, opiates were distributed by shopkeepers, pharmacists and missionaries. </p>
<p>Because of disproportionate access, white citizens were most at risk of forming a ‘habit’. Afrikaans poet <a href="https://www.uj.ac.za/library/informationsources/special-collections/Online-Exhibitions/Eugene-Marais/Pages/Eugene-Marais-Early-Life.aspx">Eugene Marais</a> was famously a life-long morphine injector. At least one historian has argued that the writing career of <a href="https://digitalcollections.lib.uct.ac.za/humanitec/schreiner">Olive Schreiner</a> was, for a time, hampered by over-consumption of opiated Chlorodyne. </p>
<p>Opium also figured in labour control. Early in the century, until 1910, the Transvaal legally imported tons of opium for the use of migrant Chinese workers recruited to the gold mines. It legislated a <a href="https://www.cambridge.org/core/journals/journal-of-african-history/article/poppies-and-gold-opium-and-law-making-on-the-witwatersrand-190410/7F346245184D53E8B084CE30C1F772B7">formal system of opium provision</a> for these workers and farmed the revenue through a customs act.</p>
<p>Opium consumption was entirely legal. Nevertheless, especially from 1910, the South African government sought to <a href="https://mh.bmj.com/content/44/4/253.full">regulate all forms of opium sales</a>. Police showed most interest in opium used for smoking and occasionally raided ‘opium dens’. In 1910, police reported six such venues in Cape Town. All were in fact just rooms in private homes. Salon owners supplied opium, along with the pipes and lamps used to smoke it. </p>
<p>Their patrons were a small and eclectic community. There was, for example, William Birch, a ‘Coloured’ Pierrot troupe player, small time drug dealer and police informant; Daisy Harris, a ‘European’ hotel barmaid; Mr Kong Lee, who ran a laundry with his wife, a ‘St Helena woman’; Hamat Rajap, a Muslim tailor; and Richardson (alias ‘Country’), a black American traveller.</p>
<p>In Cape ports, sailors brought opium. Train stewards were known to move it inland. Some medical professionals also profited from a sideline supplying opium. In Johannesburg, risk-takers could try their luck smuggling Indian opium from up the coast and the port at Lourenço Marques (now Maputo).</p>
<h2>Colonial rule</h2>
<p>After 1910, quantities of opium in circulation remained relatively small. Yet, international opium conferences held in the <a href="https://www.unodc.org/unodc/en/frontpage/the-1912-hague-international-opium-convention.html">Hague in 1912</a> and in 1914 identified the Union of South Africa as a critical region for controlling ‘dangerous drugs’. Bordered by two oceans, with multiple ports and a growing pharmaceutical manufacturing sector, the Union was instructed to embrace the protocols being drafted. </p>
<p>But South Africa dragged its feet. That is until the 1920s when government officials such as <a href="https://www.sahistory.org.za/people/general-jan-christiaan-smuts">Jan Smuts</a>, who served as prime minister of the Union, promoted restrictive legislation. </p>
<p>Smuts was also one of the architects of the <a href="https://www.unog.ch/80256EDD006B8954/(httpAssets)/36BC4F83BD9E4443C1257AF3004FC0AE/%24file/Historical_overview_of_the_League_of_Nations.pdf">League of Nations</a>. He soon recognised that the international campaigns against ‘dangerous drugs’ could suit local political aims. </p>
<p>The government led by Smuts sought to control the consumption and production of cannabis (known as ‘dagga’ locally) within its borders. Cannabis had been used as medicine and recreational intoxicant by indigenous communities for at least 500 years. But the British <a href="https://theconversation.com/south-african-court-frees-cannabis-from-colonial-and-apartheid-past-103644">colonial view</a> of the plant became woven into narratives that fed white panic about crime and racial control. </p>
<p>South Africa requested that international bodies add cannabis to the ‘dangerous drugs’ list. With support from Egypt and other nations, cannabis was – along with opium, heroin, and cocaine – criminalised internationally in 1925.</p>
<p>The South African government also set about putting rigorous controls in place on the Mozambican border. The drive to control ‘dangerous drugs’ therefore also bolstered its capacity for territorial sovereignty.</p>
<p><em>This is the second article in a <a href="https://theconversation.com/africa/search?utf8=%E2%9C%93&q=DRSA">series</a> on drug regimes in southern Africa. They are based on research done for a special edition for the <a href="https://www.tandfonline.com/toc/rshj20/current">South African Historical Journal</a>. Read the full paper over <a href="https://www.tandfonline.com/doi/full/10.1080/02582473.2019.1627402">here</a>.</em></p><img src="https://counter.theconversation.com/content/129392/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Thembisa Waetjen receives funding from the National Research Foundation (NRF).</span></em></p>Opium played a fascinating role in southern African colonial politics, conflict and social change - from the poppy fields of Mozambique to the early days of Johannesburg city.Thembisa Waetjen, Associate Professor of History, University of JohannesburgLicensed as Creative Commons – attribution, no derivatives.tag:theconversation.com,2011:article/1282462020-01-29T12:41:41Z2020-01-29T12:41:41ZSecret histories of drugs – legal and illegal – in southern Africa<figure><img src="https://images.theconversation.com/files/311110/original/file-20200121-117907-1k57lih.jpg?ixlib=rb-1.1.0&q=45&auto=format&w=496&fit=clip" /><figcaption><span class="caption">
</span> <span class="attribution"><span class="source">Shutterstock</span></span></figcaption></figure><p>If you want to score heroin in some of the historically black suburbs, or townships, of Johannesburg, South Africa, you need to find yourself a ‘Snyman’. A ‘Snyman’ is a drug dealer. The word is used in <a href="https://link.springer.com/chapter/10.1057/978-1-137-01593-8_18">tsotsitaal</a>, the creole, urban dialect that emerged during the colonial and apartheid eras of segregation. </p>
<p>‘Snyman’ entered this lexicon in the late 1960s and early 1970s. It was around this time that cannabis smugglers supplying the gold mining compounds and nearby settlements began to diversify into pharmaceuticals. One drug of choice was methaqualone, also known as Mandrax. </p>
<p>Today, most young people who rely on a Snyman to supply them with a
bit of a heroin admixture locally known as <a href="https://www.sciencedirect.com/science/article/pii/S037907381830481X">nyaope</a> aren’t aware that they are invoking the name of a mid-century professor of medicine at the University of Pretoria, Dr HW Snyman. In 1961 Snyman headed a governmental commission that bore his name. Its recommendations led to the Medicines and Related Substances <a href="https://www.nda.agric.za/vetweb/Legislation/Other%20acts/R_Medicines_and_related_substances.htm">Control Act</a> of 1965.</p>
<p>This means that, at the height of the apartheid era, black entrepreneurs trading in illicit pharmaceuticals adopted and repurposed the name of a white medical expert who enacted the state’s vision of drug regulation. In calling themselves ‘Snyman’, they showed a hefty dose of defiance as well as ironic humour.</p>
<p>The anecdote may be read as a metaphor of grassroots challenges to apartheid statecraft. But it also confirms growing, global evidence that drug prohibitions have never been far from the workings of ‘shadow’ economies. Indeed, chemically and socially, the <a href="https://www.strath.ac.uk/humanities/schoolofhumanities/history/centreforthesocialhistoryofhealthhealthcare/beyondthemedicinesdrugsdichotomyhistoricalperspectivesongoodandevilinpharmacy/">dichotomies</a> historically crafted between (legitimated) medicines and (illicit) drugs just don’t hold in practice. </p>
<p>We see this currently, for example, in the rapidly <a href="https://www.economist.com/international/2019/08/29/a-global-revolution-in-attitudes-towards-cannabis-is-under-way">shifting legal status</a> of cannabis (including in <a href="http://theconversation.com/south-african-court-frees-cannabis-from-colonial-and-apartheid-past-103644">South African law</a>) and its speedy absorption into <a href="https://www.marketwatch.com/story/10-largest-marijuana-companies-2019-01-02">corporate commerce</a>; in <a href="https://www.theguardian.com/us-news/2019/oct/04/purdue-pharma-oxycontin-sacklers-opioid-lawsuits">painkiller</a> ‘opioid crises’ and <a href="https://www.cdc.gov/nchs/pressroom/podcasts/20190911/20190911.htm">fentanyl overdose deaths</a> in the US; in the <a href="https://www.unodc.org/nigeria/en/key-findings-of-unodc-study-on-tramadol-trafficking-in-west-africa-discussed-at-regional-meeting.html">illicit trade</a> in the painkiller Tramadol in West Africa; and in clandestine exports of Chinese Xanax into the hands of South African <a href="https://www.newframe.com/prescription-drug-poses-new-threat-to-youths/">school kids</a>.</p>
<p>A special issue of the <a href="https://www.tandfonline.com/toc/rshj20/current">South African Historical Journal</a>, Drug Regimes in Southern Africa, showcases research about some of the ‘secret’ histories of drugs from the southern region of the African continent. These range from Cape Town’s opium dens to cannabis experiments on cats; from big pharma bio-prospecting to the politics of synthetic sedatives and controversial cow vaccines.</p>
<p>But why spend time reading about the past when today’s drug dilemmas seem so urgent?</p>
<h2>Why history matters</h2>
<p>Historical research can offer critical perspectives that help make sense of current dilemmas. Historians don’t generally set out to inform policy. Nevertheless complex understandings of the past are key to sound decision-making in both legislative and medical practices. Historians know that debates about substances commonly called ‘drugs’ are far from new. As was pointed out by organisers of a recent <a href="https://www.strath.ac.uk/humanities/schoolofhumanities/history/changingmindssocietiesstatesthesciencesandpsychoactivesubstancesinhistory/">history conference</a> held in Shanghai:</p>
<blockquote>
<p>After all, experts offering definitive accounts of psychoactive substances, vacillating bureaucrats and politicians, unyielding moralists and fickle consumers are all among the figures familiar to historians from other periods and a range of places.</p>
</blockquote>
<p>Historical research on ‘drugs’, whether defined as <a href="https://www.intoxicatingspaces.org/">intoxicants</a> or medicines, is an established field among scholars in the global North. This is shown in the work of the <a href="https://alcoholanddrugshistorysociety.org/about/">Alcohol and Drugs History Society</a> and its excellent journal, <a href="https://www.journals.uchicago.edu/toc/shad/current">Social History of Alcohol and Drugs</a>. </p>
<p>But drugs history scholarship from and about the global South grows ever more vibrant. Histories of <a href="https://uncpress.org/book/9780807859056/andean-cocaine/">cocaine </a> in South America and <a href="https://www.strath.ac.uk/humanities/schoolofhumanities/history/centreforthesocialhistoryofhealthhealthcare/ourresearch/theasiancocainecrisis/">Asia</a>, <a href="https://uncpress.org/book/9781469613727/home-grown/">cannabis in Mexico </a> and <a href="https://www.cambridge.org/core/journals/journal-of-modern-african-studies/article/politics-of-law-enforcement-in-nigeria-lessons-from-the-war-on-drugs/8B56707532B2902B3C2A26354C97966B">Nigeria</a>, <a href="https://brill.com/view/title/13754">khat in Kenya</a> and the politics of <a href="https://www.cambridge.org/core/books/drugs-politics/E2EFB2A2A59AC5C2D6854BC4C4501558">drug use in Iran</a> are a few examples. </p>
<p><a href="https://www.palgrave.com/gp/book/9781137321893">Histories of drugs in Africa</a> are of growing interest worldwide.</p>
<p>Since the late 19th century especially, global flows of neurochemical substances and products have deepened the entanglements of consumers in Africa in networks of legal and illicit drugs production, flow, profit and risk. Historical perspectives bring to light the social processes through which bioactive plants, manufactured pharmaceuticals and techniques of treatment come to figure in diverse and changing human experiences. </p>
<p>In the 20th century, the contexts of colonialism, apartheid and democracy shaped <a href="https://mh.bmj.com/content/44/4/253">drug control, provision and regulation</a> in South Africa.</p>
<p>Today media reports on drug issues in this country often invite panicked responses. Journalism frequently reproduces the hyperbole and moralism that have – for over a century – shaped public opinion here. Narratives that sometimes exaggerate or even mislead the public about new forms of substances, coming across borders, or the behaviours they allegedly cause, have had very negative consequences. These have included fuelling <a href="https://www.theguardian.com/world/2019/sep/10/we-are-a-target-wave-of-xenophobic-attacks-sweeps-johannesburg">xenophobic sentiments</a> as well as <a href="https://www.hsrcpress.ac.za/books/opioids-in-south-africa">the stigma</a> attached to people using drugs. </p>
<p>At the same time, there are hopeful signs of change in public opinion. And there are positive indications of a quest for evidence-based policy and treatment solutions. An example is the case of <a href="https://www.hsrcpress.ac.za/books/opioids-in-south-africa">harm reduction approaches</a> to opioid addiction.</p>
<h2>What’s needed</h2>
<p>The promises of pharmaceutical technologies are evident. So are the challenges. In today’s global world, we need the evidence offered by history to develop more informed, nuanced and less reactionary responses.</p>
<p>The <a href="https://www.tandfonline.com/toc/rshj20/current">special issue</a> ‘Drug Regimes in Southern Africa’ is proof of a growing body of work on the histories of drugs – illegal and legal – across the continent. </p>
<p><em>The information that ‘Snyman’ is used as a word for drug dealer was provided by Msawenkosi Gibson Nzimande, a University of Johannesburg Masters student currently doing research on substance use in Johannesburg.</em></p>
<p><em>This is the first article in a <a href="https://theconversation.com/africa/search?utf8=%E2%9C%93&q=DRSA">series</a> on drug regimes in southern Africa. They are based on research done for a special edition for the <a href="https://www.tandfonline.com/toc/rshj20/current">South African Historical Journal</a>. Read the full paper over <a href="https://www.tandfonline.com/doi/full/10.1080/02582473.2019.1681073">here</a>.</em></p><img src="https://counter.theconversation.com/content/128246/count.gif" alt="The Conversation" width="1" height="1" />
<p class="fine-print"><em><span>Thembisa Waetjen receives funding from the National Research Foundation (NRF).</span></em></p><p class="fine-print"><em><span>Julie Parle receives funding from the National Research Council (NRF).</span></em></p><p class="fine-print"><em><span>Rebecca Hodes receives funding from the Medicines Research Council and the Human Sciences Research Council of South Africa, the Medical Research Council of the United Kingdom, the Fogarty International Centre and the National Institute of Mental Health at the National Institutes of Health, United States, the European Research Council, and the Desmond Tutu HIV Foundation.</span></em></p>From colonial poppy fields to pharmatrash, southern Africa offers a fascinating history of drug regimes – one that helps us make sense of drug policies and legislation today.Thembisa Waetjen, Associate Professor of History, University of JohannesburgJulie Parle, Honorary Professor in History, University of KwaZulu-NatalRebecca Hodes, Director, AIDS and Society Research Unit, University of Cape TownLicensed as Creative Commons – attribution, no derivatives.