The World Health Organization had a historic opportunity to ease a strict global ban on the coca leaf—a prohibition, campaigners said, with “racist and colonial” roots. But the agency has chosen not to do so.
The WHO’s own expert review had detailed in September how millions of people across the Andes consume the coca leaf daily as part of a longstanding cultural practice without any significant negative effects—and that, conversely, coca control strategies are associated with substantial public health harms.
And yet on December 2, the WHO’s Expert Committee on Drug Dependence (ECDD) recommended that the plant be kept in Schedule I of United Nations drug treaties—the most restrictive category of control—because coca leaves can relatively easily be converted into cocaine.
“The simplicity of extracting cocaine from coca leaf and its high yield and profitability are well known,” the ECDD wrote. “The Committee also reviewed evidence of a marked increase in coca leaf cultivation and in the production of cocaine-related substances, in the context of significant, increasing public health concern about cocaine use. In that context, the Committee considered that reducing or removing existing international controls on coca leaf could pose an especially serious risk to public health.”
The committee noted that a 34 percent year-on-year increase in cocaine production was reported in 2023, with some countries reporting historically high levels. But reform advocates emphasize that coca is not cocaine. They insist that the WHO’s review acknowledged both the plant’s medical potential and the lack of evidence of problematic coca leaf use anywhere in the world—two key criteria a drug must satisfy to be placed in a less restrictive schedule.
“It’s unacceptable for humanity to demonize a sacred medicinal plant,” Jaison Perez Villafaña, a wisdom keeper or mamo from Colombia’s Arhuaco community, told Filter. “It was more of a political decision than a scientific one. The coca leaf (el ayu) is not itself to blame for being converted into cocaine by humans with economic interests.”
The ECDD said it recognized that “coca leaf has an important cultural and therapeutic significance for Indigenous peoples and other communities and that there are exemptions for traditional use of coca leaf in certain national frameworks.” A coalition of Indigenous coca leaf producers and consumers wrote to the WHO in October urging the UN body to “clearly differentiate” between traditional coca use and issues associated with cocaine.
Steve Rolles, senior policy analyst at Transform Drug Policy Foundation, called the WHO’s suggestion that keeping coca in Schedule 1 would restrict cocaine production “ridiculous,” saying the decision exposed “the moral and scientific bankruptcy pervading the entire system” of global drug control.
“Whilst we may expect decisions like this to emerge from political bodies subsumed within entrenched ‘war on drugs’ narratives, there was a hope that the more objective, scientific, and nominally independent corners of the UN would maintain a degree of pragmatism and principle—even if their recommendations were later rejected by UN political entities,” he wrote on LinkedIn.
Hellbound and Down 
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