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“The World Health Organization (WHO) has committed an egregious mistake,” insisted David Choquehuanca, former Bolivian Vice-President, his anger and frustration just below the surface. “For six decades we have had our sovereignty as indigenous peoples violated by the United Nations’ international prohibition on the coca leaf. For six decades we have suffered discrimination against our legitimate rights to use our sacred coca leaf for nutrition, healing and rituals.”
Choquehuanca was reacting to a recent WHO refusal to recommend that coca’s international classification be separated from its refined derivative, cocaine. Coca leaf— which contains 1 percent or less of the cocaine alkaloid—still finds itself in the same company as heroin and fentanyl.
Bolivia and Colombia hoped that the international organization would recognize that coca had no place alongside substances that can be abused or are easily convertible into illicit drugs.
The determination by the WHO’s Expert Committee on Drug Dependence (ECDD) came in response to a 2023 request initiated by Bolivia— and later backed by Colombia—to reconsider coca leaf’s status in the UN 1961 Single Convention on Drugs, which currently establishes regulations for 138 different substances and has been ratified by 186 countries. Bolivia and Colombia hoped that the international organization would recognize that coca had no place alongside substances that can be abused or are easily convertible into illicit drugs.
“This WHO review was a key opportunity to correct the historical wrongs of the past,” said Marie Nougier of the International Drug Policy Consortium (IDPC). “It spectacularly failed to do so.”
Sixty-five years ago, under intense U.S pressure, coca leaf was added to one of the strictest UN drug lists. “The original inclusion of coca leaf lacked scientific evidence, reflected openly racist attitudes, and failed to acknowledge the plant’s social, cultural, spiritual and nutritional value,” explained Nougier.
Across the Andes and Amazon, coca leaf has been used by local peoples for at least 8,000 years, and the leaf is an essential element in most Andean-Amazonian Indigenous cultures. Approximately five million people consume coca as a herbal medicine and mild pick-me-up, similar to tea or coffee. “Without coca, we would not have survived invasion and colonization,” said Choquehuanca. “Not only is it present in every ritual and event in our lives, from birth to death, it is our guide.”
The WHO Report
Bolivia and Colombia’s 2023 petition triggered a process which, according to the WHO, was strictly limited to the criteria laid out in the 1961 Convention: evidence that coca can be abused and the ease of its convertibility to a prohibited drug.
“This narrow focus created significant constraints in what the WHO review considered,” said John Walsh, Director for Drug Policy and the Andes at the Washington Office on Latin America. “This meant that the WHO remains stuck in the colonialist position of the past, unable to incorporate the UN’s own expanded criteria around indigenous rights.”
Regarding potential abuse of coca, the report states that no coca-related health problems have yet been identified. It adds that “it may be of more interest to discover whether there are positive health effects from coca leaf chewing, and whether these effects are transferable from traditional settings to other countries and cultures.”
The report acknowledges coca’s antioxidant, anti-inflammatory, antimicrobial and anticancer properties while roundly criticizing the War on Drugs promoted by the United States, condemning “the substantial public health harms associated with coca control strategies.”
Since the report found no systematic abuse associated with coca, the WHO recommendation against re-classification zeroed in on the second criteria—how easily coca leaf can be converted to refined cocaine. WHO technical officer Dilkushi Poovendran described that process as “quite easy to do,” adding that “it doesn’t take big volumes of coca leaf or require a lot of chemicals.”
The highly contested convertibility argument masked what appears to have been the WHO’s real concern: recent increases in coca leaf and cocaine production.
Many drug policy experts disagree. Analysts often describe the three-step procedure for manufacturing cocaine as complex, lengthy and labor-intensive.
Converting coca tea or flour to cocaine “would be completely out of the question for someone interested in trafficking cocaine because far more efficient strategies for making the refined drug exist,” explained Walsh. Although the conversion rate varies due to soils, climate and variety of coca, a metric ton of dried leaf can be turned into a little less than a kilo of 85 percent pure cocaine—a ratio just under 1,000 to one, according to the WHO’s own figures.
The highly contested convertibility argument masked what appears to have been the WHO’s real concern: recent increases in coca leaf and cocaine production. “Rising cocaine manufacture and escalating cocaine markets around the world clearly cast a shadow over the review process, likely reinforcing the bias toward banning coca internationally,” Walsh added.
The Decision Sparks Outrage
At present, the world cocaine market is oversupplied, which has driven down prices and increased availability. Deus Mubangizi, Director of WHO Medicines and Health Products Policies and Standards Department, told a public forum on the WHO recommendation that,“the increase in [coca] cultivation came with an increase in the production of cocaine. So with this evidence, it’s not time to say we will remove the controls. In fact, I would say that we need to strengthen them.”
Speaker after speaker at the forum, denounced the decision.
Representatives of the UN High Commissioner for Human Rights declared: “The coca leaf has been stigmatized and criminalized due to its association with cocaine, resulting in violations of cultural identity, traditional medicine, and self-determination as recognized in the 2007 UN Declaration on the Rights of Indigenous Peoples,” they told the public forum.
Peru’s former drug chief Ricardo Soberón rejected the WHO inference that legalizing coca leaf would result in more cocaine, “Representatives of all countries understand that legally changing coca’s status does not weaken their obligations to prevent its diversion into illicit economies.”
Anyi Ballesteros, an artisan from the Colombian organization Agroarte in Cauca—one of the regions where most of Colombia’s coca is grown—testified that “the recommendation perpetuates a vicious cycle that condemns entire communities to marginalization, while denying the world the ancestral and potential benefits of our sacred plant.”
“There was a complete lack of coherence between the WHO report and its final recommendations on coca’s status,” added Isabel Pereira of the Colombian think tank DeJusticia, which worked closely with Gustavo Petro’s government on the petition to the WHO.
Legalization is Only a Partial Panacea
The possibility of international recognition of the coca leaf is not without potential winners and losers within Andean countries. “Given that crops like tea, coffee, oranges, or pineapples earn such low prices, coca’s relative ease of production and transport, as well as its comparatively higher price as an illicit crop, grants coca farmers a comparative advantage,” explained Tom Grisaffi, an anthropologist at the University of St. Gallen, Switzerland who has researched coca growers for decades. “Growers tell me they fear that legalization could result in a price drop.”
Another group wary of changes in coca’s international status are lowland indigenous peoples. They have been forced off their lands over decades by often impoverished Andean highland and valley farmers lured by coca’s desirability as a cash crop. These coca growers have pushed deep into the semi-tropical lowlands, expanding the agricultural frontier. As a result, local indigenous peoples, some of whom have no medicinal or cultural ties to the coca leaf, face tremendous insecurity from the incursion of the coca/cocaine economy, a process which has steadily undermined their livelihoods, culture and capacities for self-governance.
The Slow Road Towards Legalization
The latest review is not the first time the WHO has studied coca in depth. A 1995 investigation was suppressed by the United States, the world’s strongest advocate against modifying coca’s status. The review’s conclusions were the same as the latest study. “Use of coca leaves appears to have no negative health effects and has positive therapeutic, sacred and social functions for indigenous Andean populations,” it stated.
In 2013, Bolivia successfully petitioned the UN for an exception to the 1961 Single Convention. The special exemption recognized Bolivians’ right to consume the leaf domestically, after fifty years of UN insistence that coca leaf consumption should be completely eradicated worldwide.
Coca’s stigmatization is indisputable with a closer examination of the UN Schedules.
Another move towards modernization of drug laws came in 2020, when the UN’s Commission on Narcotic Drugs (CND) relaxed international controls on cannabis on a recommendation from the WHO. This change raised hopes that the coca leaf could be similarly reclassified, or even declassified. However, even though cannabis has been removed from the world’s most dangerous drugs list, known as Schedule 4, it retains the classification for the next most dangerous set of drugs, Schedule 1—the same as coca.
Coca’s stigmatization is indisputable with a closer examination of the UN Schedules. Other plants, which also have traditional uses but unlike coca leaf have been demonstrated to be actively harmful to human health, such as khat and betel nut, remain unregulated by the UN. And ephedra, which is the chief ingredient in methamphetamine as coca is in cocaine, is not scheduled at all.
This time around direct U.S. influence was less apparent. By the time the WHO made its recommendation, the United States, its most important funder, had already withdrawn all of its financing to the international health body. “U.S. defunding clearly reinforced the WHO’s own tendency to maintain the leaf in the same narcotics drug category,” said Walsh.
Bringing Coca Leaf to the World
For coca producing countries, the practical crux of the reclassification issue lies in gaining permission to sell coca leaf products internationally. The demand for the leaf is certainly there. “Every week a flood of international Internet requests come in asking for coca tea,” said Ricardo Hegedus, manager of Bolivia’s largest tea producer, Windsor Tea. “Our long-standing dream is to grow the legal market. In its natural state, the leaf is a marvelous gift of nature, providing a moderate stimulant—like coffee without the jitters—that also packs a generous dose of vitamins and minerals.”
“If we can’t sell our coca legally in international markets, producers are inevitably pushed into the illegal market in order to make a living,” said Daynor Choque, president of the regional coca growers marketing organization from east of La Paz, Bolivia, where coca has been grown for thousands of years. “We want to be able to sell our coca products worldwide,”
However, while the WHO’s critical review encourages more rigorous scientific investigation, coca’s complicated legality has made studies difficult to carry out. The recent ruling will mean that this history of sporadic research will persist, limiting the ability of scientists to discover and develop healthy uses for the leaf.
The chances that a third country will step forward to appeal the WHO decision to the UN Economic and Social Council seem slim. “With a new government in Bolivia, and with Colombia coming to the end of Gustavo Petro’s term, the topic is losing whatever momentum it once had,” said Isabel Pereira of DeJusticia. That inertia is only exacerbated by the Trump administration’s tumultuous and violent acceleration of the U.S.-led “War on Drugs.”
“The critical review was a crucial test to see if the UN drug control system could align itself with international human rights law,” explained IDPC’s Marie Nougier. “The outcome shows that the current UN drugs control system is irrevocably broken.”
Linda Farthing is a journalist and independent scholar who has co-authored four books on Bolivia. She has written extensively on Latin America, including for the Guardian, the Nation, Al Jazeera, and Ms. Magazine.