From Big Medical Encyclopedia

CONVENTIONS THE INTERNATIONAL MEDICAL — the international agreements establishing the mutual rights and obligations of the states for acceptance of homogeneous measures for the prevention of spread of the most dangerous infectious diseases, drug addiction, illegal production and drug traffic and the organization of fight against them.

The convention medical and sanitary

Danger of distribution of epidemics demanded development of a quarantine — system of actions on the borders directed to the prevention of distribution inf. diseases from one country in another (see. Karantin, karantinization ). However acceptance of uncoordinated prohibitive measures on borders became frequent the tool of economic and political struggle in this connection to the middle of 19 century began to undertake measures for streamlining of these questions internationally. The first international dignity. the conference for the purpose of development of collective measures of fight against epidemic of cholera in Europe (1848 — 1850) took place in 1851 in Paris. Problems of a conference included also achievement of the international agreement on standardization of the quarantine measures directed to prevention of import of plague and yellow fever (smallpox was included in international medical - a dignity. conventions only in 1926). Representatives And the European states, including Russia took part in work of a conference; also Turkey was presented.

At a conference the agreement concerning the text of the project a dignity was reached. convention and project international dignity. the rules consisting of 137 articles. However these projects did not impose responsibility on the governments of the countries presented at a conference, and the conference did not develop the effective measures obligatory for member countries. But the fact of holding a conference showed that introduction of measures for the prevention of distribution quarantine diseases (see) — plagues, cholera, yellow fever, natural smallpox, etc. — the problem deserving discussion at the international level.

Dignity. a conference in Paris (1859), and then a conference in Constantinople (1866) and in Vienna (1874) were also convoked for the purpose of development of measures for fight against cholera. As a result of work of the Parisian conference of 1859 Austria, Great Britain, Spain, the Papal States, Portugal, Russia, Sardinia and France signed version of the preliminary agreement on measures of fight against cholera (Greece and Turkey refrained). However later any of the participating countries did not ratify the agreement. At the Constantinople conference the question of precautionary measures on the ways of a drift of cholera from the East to Europe was for the first time raised and quarantine rules were in details discussed. In work as the fourth international a dignity. the conference which took place in Vienna representatives of 21 countries, from them Luxembourg, Romania, Serbia and Switzerland for the first time took part. The main task of conferees was in studying conclusions of the Constantinople conference of 1866 and to decide to what degree they are proved. Participants unanimously confirmed that cholera extends only from India and that its flashes in other countries are always a consequence of delivery. It was the first international a dignity. the conference, edges was in character close to modern as on the term (it lasted exactly a month), and from the point of view of adoption of rules of conducting a meeting for regulation of discussions. In 1881 in Washington the 5th international conference took place, on a cut measures for protection of borders against a drift of yellow fever were considered. Due to strengthening of epidemic of cholera in 1885 in Rome the conference was convened. Russia was presented by two delegates, including N. V. Ekk. Formation in Russia of the special commission «on fight against the increased incidence and mortality and on improvement of the country» under the chairmanship of S. P. Botkin was result of this conference, in particular. However all these conferences did not lead to development of obligations of the international character. On a dignity. conferences in Venice (1892) were reconsidered all earlier accepted recommendations and the first is developed international a dignity. convention. This convention was ratified by the governments of interested countries in 1893, including and Russia.

After the new outbreaks of cholera in Europe (1891 — 1892) two international conferences were convened: in Dresden (1893) and Paris (1894). At these conferences it was offered to expand the international measures for protection of means of communication and, besides, actions for establishment special a dignity were planned. the mode for ports of the Red Sea and the Persian Gulf through which there passed many Muslim pilgrims to Mecca and Medina. Resolutions of these conferences received then force of the international agreement. The large outbreaks of plague which began since the end of the 90th of 19 century in India were the cause of convocation of a new international conference on fight against plague (Venice, 1897). The convention which is completely devoted to a problem of plague and signed with all participating countries except for Denmark, Norway, Sweden and the USA was a result of its work. In 1903 at the Parisian conference the International sanitary convention including 184 articles was signed, in a cut provisions of the convention of 1897 were modified and partially replaced, and the international quarantine requirements were brought into accord with the last scientific achievements. It was the first international convention providing extermination of rats on board the vessels as a preventive measure of fight against plague. The convention was devoted to questions of cholera and plague; the exception was made by one short article, edges only formally concerned a problem of yellow fever. This convention known under the name of the Convention of 1903 was ratified also by Russia. Before World War I the Parisian conference 1911 — 1912 tg. accepted the new text of the convention which combined in one general a dignity. the convention all previous agreements 1892, 1893, 1897 and 1903 of. The new text of the convention till 1926. According to the resolution of Council of People's Commissars of the USSR of 27.X 1925 the USSR joined this international a dignity. conventions.

Since the main danger of a drift of infections came from the countries of Asia and was connected with maritime routes of the message, the main actions of the convention provided hl. obr. protection of sea borders and only partially overland. Conditions under which ports or sea vessels shall be considered infected or suspicious on an infection were defined. With adoption of the convention the system of quarantines on borders was cancelled. Instead of them isolation of patients and medical observations for the terms corresponding to an incubation interval of plague, cholera and yellow fever are entered. The resolution on need of medical examination of all passengers adjoining to patients was accepted and its technique is developed.

After World War I natural smallpox, parasitic typhus and flu («Spaniard») in this connection again proposals on introduction of so-called sanitary cordons on borders of the countries struck with epidemics were made was widely adopted. In 1922 at the initiative of Poland with technical assistance of the League of Nations the Warsaw European sanitary conference was convened, in a cut representatives of 26 countries, including Soviet republics took part. At a conference it was discussed epid, the situation in Eastern Europe and was developed and offered the system of actions directed to the termination of epidemics of parasitic typhus, cholera and natural smallpox. In the decision of a conference paramount importance protivoepid was noted. the events held at the national level directly in epid, the centers.

In 1925 the USSR joined the decision international a dignity. conventions, signed in Rome in 1907, about establishment of the International bureau of public hygiene. Collecting and bringing to data of member countries of the facts and documents of the general character concerning public health and, in particular, everything that belongs to infectious diseases, hl were the main objective of Bureau. obr. to cholera, plague and yellow fever, and also to the measures taken against these diseases.

In 1926 in Paris another, 13th International sanitary conference took place, the delegation of the USSR led by N. A. Semashko took part in work a cut. It was the first large international forum after the end of World War I marking the beginning of recovery of the uniform principles international a dignity. politicians. Review of the International sanitary convention of 1912 was an official problem of a conference that had not only big a dignity., but also economic value. The conference came to the end with signing new international a dignity. conventions, edges after ratification by its most the states became effective under the name «Sanitary Convention of 1926». The Central Election Commission of the USSR ratified it in 1929, having emphasized at the same time that «everything in this act will be observed inviolably».

According to N. A. Semashko, the convention of 1926 represented undoubted progress in comparison with the convention of 1912 not only concerning use for fight against infectious diseases «modern scientific achievements, but also from the point of view of bringing sanitary stesneniye to a possible minimum».

The convention of 1926 contains an introductory part where definitions of the terms which are found in the convention are given; it consists of 5 departments and appendices.

The department of I includes the general resolutions treating the rules which are subject to observance by the governments from the moment of emergence in the territory of their country of plague, cholera, yellow fever and some other infectious diseases and also a statement of measures of fight against these conventional diseases. The department of II contains special resolutions for the Suez Canal and neighboring countries. The department of III is devoted to special resolutions concerning a pilgrimage. The department of IV states the rights and obligations of the Egyptian sanitary sea and quarantine council. The department of V contains the general resolutions on an order of ratification and accession of the states to this convention.

Except earlier provided actions concerning plague, cholera and yellow fever, this convention provides also carrying out the measures directed to fight against natural smallpox and a sapropyra. The duty of the notice of the International Bureau of Public Hygiene (IBPH) on emergence of these diseases is established depending on them epid, distribution. The convention provided obligatory performance of periodic researches of rats in ports on infectiousness by plague and carrying out 1 times in 6 months. deratization (see) all vessels. The convention for the first time regulated obligation in necessary cases of anticholeraic inoculations, and also introduced requirements about compulsory universal vaccination and a revaccination against natural smallpox.

Resolutions of the convention differ in flexibility of separate formulations and give the chance to the states to work in necessary cases independently and to take in exceptional cases special measures in relation to the persons which are not representing sufficient a dignity. guarantees. These measures the organization on borders of observation over the mentioned persons is among and if it is necessary, them observation (see).

The international convention on questions of a mutual guarantee from fever of a dengue (Paris, 1934) provided actions for the prevention of a drift of this disease. The convention obliged a dignity. bodies of ports at detection at passengers of vessels or at crews of diseases or at suspicion of fever of a dengue to subject them to isolation for 5 days (in the conditions unavailable to hit of mosquitoes), beginning from the moment of a disease, and also to establish over passengers and members of teams medical observation for a period of 8 days, beginning from the moment of the last day when specified persons underwent risk of a disease. This convention was ratified by the Government of the USSR on June 23, 1934.

In 1934 in Paris two international agreements which are valid the international conventions were signed: about cancellation a dignity. patents and about cancellation of consular visas on a dignity. patents. These agreements facilitated international relations and shipping of loads from those countries which joined these agreements. The government of the USSR joined them in December, 1934. Agreements became effective in April, 1935.

In 1933 in the Hague the International sanitary convention on air navigation was signed. The states undertook obligations for the organization in airfields a dignity. the service meeting the current requirements of prevention. In the convention the recommended organization a dignity is in detail described. services of airfield, are specified its functions and equipping.

The International Bureau of Public Hygiene (IBPH) which was in Paris in connection with creation of the World Health Organization (WHO) was abolished, its functions were transferred to service a dignity. conventions and quarantines of WHO.

The IV World assembly of health care (1951) made the decision instead of all existing earlier international a dignity. conventions to enter international a dignity. rules which will provide actions against conventional diseases.

The first international dignity. the rules developed by WHO became effective in 1952. In the first year of use of these rules arose many difficulties connected with interpretation of some definitions a dignity. documents. The committee of WHO experts on the international quarantine regularly reconsiders use a dignity. governed and makes necessary amendments and additions.

Acting a dignity. rules were accepted by the XXII World assembly of health care in 1969 and came into force since January 1, 1971. These rules are developed on the basis of the program epidemiol, supervision and approach to methods of controlling and the prevention inf. diseases in the world. In addition to cholera, plague, yellow fever and natural smallpox, international epidemiol, supervision extends to five other diseases: sapropyra, typhinia, viral flu, paralytic form of poliomyelitis and malaria. New rules give to the governments of the countries the right to receive with the minimum delay the help from WHO for carrying out researches and actions for fight against serious flashes inf. diseases that is especially important for developing countries. More strict requirements to a dignity. - protivoepid, aim to provide to the actions which are carried out in ports and the airports more reliable health protection of passengers. International dignity. rules work, behind a small exception, worldwide, and supervision of their observance is a prerogative of WHO. About all registered cases of the diseases taking place in any country of the world, WHO, in turn, is obliged to notify member countries of WHO quickly.

In the territory of the USSR since January 1, 1974 rules on sanitary patrolling of the USSR from delivery and spread of quarantine and other infectious diseases», the approved M3 of the USSR and made taking into account a dignity are enacted on October 18, 1973 «. - epid, the requirements provided in international a dignity. rules (see. Sanitary patrolling ). These rules contain general provisions: a procedure in points of crossing of frontier of the USSR of sanitary and quarantine actions (including special measures for the prevention of a drift of plague, cholera, natural smallpox and yellow fever), and also actions for prevention inf. diseases which developing and distribution can be connected with a drift from abroad (sypny and returnable typhus, malaria, a malignant anthrax, a brucellosis, a foot-and-mouth disease, sap, a melioidosis, rage, a psittacosis). As the independent section the order of holding the main actions for elimination of the centers of quarantine diseases is allocated.

Conventions on drugs

the Problem of fight with drug addiction (see), illegal production and trade in drugs gained for a long time the international character in this connection the governments of interested countries reached a number of the agreements directed to settlement of these questions. The first international convention on control of distribution of opium was signed in the Hague in 1912. She played an important role in fight against smuggling and abuse of drugs.

For the purpose of more effective restriction of production of drugs and establishment of more close check and observation over international trade it was decided to fill up and strengthen provisions of the convention of 1912. In this regard in Geneva in 1925 the convention was also adopted, according to a cut contracting parties undertook to issue the laws and resolutions providing efficient control over production, distribution and export of opium raw, to limit the number of the cities, ports or other settlements through which export or import of opium raw, and also leaves of the cook will be allowed. Contracting parties undertook the obligation to provide internal control over production of medical opium, morphine, diacetyl-morphine, cocaine raw, ecgonine, cocaine and their salts, and also pharmaceutical and not pharmaceutical drugs containing more than 0,2% of morphine or more than 0,1% of cocaine. It belongs to all drugs containing diatsetilmorfin to galenovy drugs from the Indian hemp, and also to all other drugs put under the international control.

Contracting parties undertook the obligation to issue the laws or resolutions directed to that production, import, sale, distribution, export and use of drugs were intended only for the medical and scientific purposes. The parties declared need to cooperate among themselves in the direction of elimination of a possibility of use of these means with other purposes.

Participants of the agreement undertook to limit production of drugs, and also made the decision that only the persons authorized on that who owe all records about expenses and receipts of drugs of a message in special books can make, import, distribute and take out drugs. Doctors and pharmaceutical workers shall keep special account of recipes on drugs.

Each case of export or import of any of drugs shall be issued by special permission and the certificate. It was obligatory for the countries which are importing and taking out drugs and for the countries across which territory the load follows.

Addition to the international conventions signed in the Hague in 1912 and in Geneva in 1925 was the convention on restriction of production and on a regulation of distribution of drugs (Geneva. 1931). This convention provided extension of the list of the drugs which are subject to control. The convention obliged to limit production of drugs to the quantity necessary for the medical and scientific purposes, including the quantity necessary for production of drugs and maintenance of reserve warehouse stocks at the level determined by calculations for each this year. This convention prohibited also export and import diacetyl-morphine and its salts, and also drugs. them containing. Contracting parties undertook to create the special body monitoring use of provisions of the convention, to regulate trade in drugs, to organize fight against drug addiction, taking all measures necessary for suppression of its development, and also fight against illicit trafficking by drugs.

In 1946 in Leyk-Saksesse (USA) the protocol making changes to the agreements mentioned above is signed. Functions of the League of Nations on earlier signed to agreements and to agreements in the field of fight against drug addiction were transferred to the UN. In 1948 in Paris the protocol, rasprostraniyushchy international control on the pharmaceuticals which are not getting under operation of the convention of 1931 and the protocol of 1946 is signed. In 1953 in New York the protocol on restriction and a regulation of cultivation of poppy, production of opium, the international wholesale trade with it and its uses is signed. Conventions of 1925, 1931, and also protocols 1946 and 1948 of were ratified by the USSR.

According to the decision of Economic and social council of the UN from January 24 to March 25, 1961 in New York the conference of plenipotentiaries of member countries of the UN for the purpose of development and adoption of the uniform convention on drugs, questions of control over them and establishment of control over production of narcotic raw materials took place. Representatives of 73 states, including the USSR, and also BSSR and USSR took part in work of a conference. The conference accepted and opened the Uniform convention on drugs which replaced the numerous conventions and agreements existing on this matter for signing. Proceeding from interests of health and wellbeing of mankind and including drug addiction serious social and economic danger, the convention underlines that against abuse of drugs coordinate and universal measures, possible are necessary for effective fight at broad international cooperation.

Original positions of the convention provide implementation by the states in their territories of a close check behind production, distribution, export and import of drugs, their use only in the medical and scientific purposes, and also submission of the corresponding data to the International committee on control over drugs elected by Economic and social council of the UN. Control authority behind implementation of the convention is the Commission on drugs created at Economic and social council of the UN. The international committee on control of drugs watches the movement of the international market, and in case of danger of drug trafficking takes the measures provided by the convention. The committee has the right to request explanations from the government of the country or the territory allowing disturbances of the convention and if finds it unsatisfactory, can draw the attention of Council and Commission to this circumstance.

The important section of the convention is the list of the drugs which are under the international control.

The convention provides obligatory limitation of the output of drugs (only for the medical and scientific purposes). At the same time the mechanism which gives the chance on the basis of requests of the governments to establish the outputs in each state for the purpose of control and prevention of overproduction is defined. According to the convention all commercial and noncommercial transactions connected with import and export of drugs shall be made out by special documents — certificates on the right of import and export, system of confirmation on receipt of loads; information on it shall come to Commission on drugs of the UN.

The convention provides quarterly and annual reports of the governments on export and import of drugs, on the outputs, on a condition of illicit trafficking, on measures of limitation and consumption of drugs, and also on measures of the prevention of drug addiction and on the organization of treatment of addicts. The relevant articles of the convention provide measures for replacement of dangerous drugs with other products. A number of articles of the convention provides the recommended measures of criminal penalty from the states — participants of the convention for disturbance of an order of production, import and export and not medical use of drugs. At the same time it is specified that national legislations can be more, but not less, strict, than the measures demanded on the basis of the present convention. A specific place is held by questions of control of crops of opium poppy and a plant of the cook.

According to the convention the International committee on control over drugs analyzes data of government reports on the output of drugs and publishes them. The convention provides issue of licenses to those enterprises, the Crimea the government grants the right of production of drugs.

Special articles of the convention stipulate regulations on an amendment procedure, system of leading under control of new drugs. Component of the convention are lists in which all drugs constituting social danger are listed. Separate articles of the convention determine regulations on the rights of the International committee on control over drugs and the Commissions at Economic and social council of the UN by drugs within this convention.

As of January 1, 1977 participants of the uniform convention on drugs of 1961 are 107 states, including the USSR.

In 1972 the protocol containing a number of amendments to the convention of 1961 on control measures of hl was adopted. obr. over opium drugs. This protocol became effective for the countries ratifying it in 1975.

Bibliography: Baroyan O. V. Destiny of conventional diseases, M., 1971, bibliogr.; About in and r d-D about N with N. The international sanitary conferences 1851 — 1938, Geneva, WHO, 1976; Semashko N. A. The international sanitary conference (Paris 10/V — 21/VI 1926), Vestn, sovr, medical, No. 9, page 17, 1926; Sysin A. N. International sanitary organizations, Doctor, business, No. 23-24, page 1879, 1927.

O. P. Shchepin.