The system dates from the early part of the 20th century. Its central elements are four international agencies: (1) the Council on Narcotic Drugs, (2) the International Narcotics Control Board, (3) the United Nations Drug Control Program, and (4) the World Health Organization's Program on Substance Abuse. The Commission on Narcotic Drugs started with 11 countries as members and had 53 members in 1991. The system is still not quite global. Therefore, many efforts focus on persuading countries to accede to three conventions developed in 1961, 1971, and 1988. The 1990's have experienced the triumph of free-market ideology and of the doctrine of consumer sovereignty and international trade agreements and treaties that place economic and free-trade considerations ahead of public health considerations. Drug conventions take the opposite approach by overriding trade agreements and establishing a managed economy. The United States has a dominant role in the drug control system. The system has failed to suppress drug trafficking, although it has had some success in the control of legal markets in psychoactive medications. However, supporters call for redoubling the same repertoire of efforts and have used arguments ranging from rousing rhetorical appeals to efforts to make the issues less sensational. Table and 34 references (Author abstract modified)