Coca Prohibition Is More Harmful Than The Plant Itself, World Health Organization Review Concludes

*“The research record does, however, robustly document the substantial
public health harms associated with coca control strategies at all scales.”*

*By Mattha Busby, Filter*

The consumption of the coca leaf in its raw form by millions daily across
the Andes carries no significant risks, but official coca control
strategies are associated with “substantial public health harms,” according
to a review commissioned by the World Health Organization.

*Filter* viewed an advance copy of the report that was distributed to
members of the WHO’s Expert Committee on Drug Dependence (ECDD).

Coca, the mildly stimulating and medicinal leaf that is the base ingredient
of cocaine, was banned globally by the UN in 1964 after its investigators
claimed coca leaf chewing is “definitely harmful” and “the cause of racial
degeneration of many population groups.” A WHO paper also described the use
of the calcium-rich plant as “a social evil.”

But despite U.S.-backed militarized efforts to eradicate coca leaf
production in Colombia, Peru, Bolivia and Ecuador throughout the
decades-long drug war, the consumption of the plant—which for many
Indigenous communities holds profound spiritual value—has remained
stubbornly prevalent, with production in Colombia at all-time highs.

“Research reviewed for this report did not reveal evidence of clinically
meaningful public health harms associated with coca leaf use,” states the
comprehensive scientific review commissioned by the ECDD. “The research
record does, however, robustly document the substantial public health harms
associated with coca control strategies at all scales.”

The review is currently in draft form and subject to copyediting. It was
commissioned amid growing international calls to end the blanket
prohibition of coca, as *Filter* previously reported.

In October, the ECDD will discuss the report, which was prepared by an
international group of independent contracted experts, and consider whether
to recommend a change to coca’s current Schedule I status—the most
restricted category, meaning researchers often find it impossible to source
the understudied leaves.

Any recommendations would be presented in December to the Commission on
Narcotic Drugs, which has a rotating membership of 53 United Nations member
states. In March 2026, the CND would vote on any recommendations. It could
reschedule or even deschedule the coca leaf—which would have huge
ramifications, ending the criminalization of its use and potentially
providing a major economic boon for Latin American producer countries.

“We don’t yet have a recommendation from the committee but based on this,
it would be hard to see how they could possibly recommend coca stay in
Schedule I,” Steve Rolles, senior policy analyst at Transform Drug Policy
Foundation, a charity campaigning for the legal regulation of drugs, told
*Filter*.

“It’s quite likely that [the ECDD] might actually recommend descheduling,
which is what Colombia, Bolivia and many people in civil society are hoping
for,” he continued. “Leaving coca in any schedule does implicitly
criminalize millions of people who use it traditionally.”

However, should the WHO make a descheduling recommendation, Rolles expects
the CND—which currently counts the United Kingdom, Saudi Arabia and China
among its members—to vote it down. “The prohibitionist countries would
rally around and overturn any descheduling to keep it banned just because
they’re so paranoid about cocaine,” he said.

In February, Colombia’s President Gustavo Petro made widely reported
remarks calling for the legalization of cocaine, which he described as “no
worse than whiskey.” Bolivia’s outgoing left-wing and Indigenous-led
government has called for an end to “decades of the colonization of the
coca leaf,” but it is unlikely that the incoming right-wing government will
pursue reform.

The WHO-commissioned paper noted research that showed exposure to harmful
glyphosate-based pesticides like Roundup, found to be a probable
carcinogen, from the aerial spraying of coca crops by authorities
“increased the number of miscarriages and the number of medical
consultations related to dermatological and respiratory illnesses in
targeted communities.”

It added that another study showed that forced coca eradication
incentivized coca farmers to intensify production through increased use of
toxic agro-chemicals “in remaining or subsequent coca plots, increasing
their exposure to those chemicals.”

In the 1990s coca farmers had their crops destroyed and were arrested and
prosecuted even when they were growing the plant only for traditional uses.
“Chronic exposure to agro-chemicals increases any health risks associated
with their use, including neurological damage, organ failure, and
reproductive health problems,” the paper said. “Pesticides and other
agrochemicals commonly used in the cultivation of unregulated crops may
influence both the safety profile and health risks associated with plant
use.”

Indigenous people in sprayed areas have also complained of “flu-like
symptoms including nausea, dizziness, vomiting, diarrhea, respiratory
problems, and skin rashes”, according to a 2001 report by the Transnational
Institute, a progressive think tank.

“At least, it seems that the debate will be driven by science and evidence,
rather than prejudice,” Ricardo Soberón, a former president of DEVIDA,
Peru’s official drug control commission, who now campaigns for coca
growers’ rights, told *Filter*. “I hope Latin American states, as well as
the 53 members of the CND, should understand that descheduling the plant
will strengthen our fight against criminal gangs.”

Martin Jelsma, a program director at the Transnational Institute, said
that the review report “clearly establishes” that there is no evidence of
meaningful public health harms or dependence associated with coca leaf
use. “With regard to the medicinal uses, the evidence is still preliminary
but the potential is considered to be of ‘great interest for future
developments to establish efficacy and safety for use in human medicine’,”
he told *Filter*. “Those basic conclusions take away the original
justification for its inclusion in Schedule I.”

The only reason left to keep coca leaf there would be the “ease of
conversion” into cocaine, Jelsma added, “and it’s important that the report
notes that cocaine can be produced from coca leaf by means of ‘solvent
extraction’ rather than a process of ‘conversion’ which implies a chemical
transformation of the molecule.”

The report refers to the cultural significance of coca, as well as its use
as a herbal medicine, but the question of Indigenous rights and human
rights violations is “deliberately avoided in the section on the impacts of
current controls,” he said.

The review does not comment on the health consequences of militarized
enforcement strategies to eradicate coca and disrupt the trafficking supply
*, *which many experts say fuel violence.

Compounding the issues resulting from the prohibition of coca, conservation
campaigners have said that eradication efforts often force growers to
deforest areas further from law enforcement inspections.

The report comes as use of coca in food, drinks like energy
tonics and beer, cosmetic products that claim anti-aging properties and
textiles is also increasing.

Despite noting a lack of meaningful public health harms associated with
coca leaf use, the report said that “in contrast to the abundant literature
on the botanical, historical, and cultural aspects of coca leaves,
adequately designed studies evaluating their clinical effects are scarce.”
Nonetheless, it said, “there is no evidence … of a fatal coca leaf overdose
in humans.”

*This article was originally published by Filter, an online magazine
covering drug use, drug policy and human rights through a harm reduction
lens. Follow Filter on Bluesky, X or Facebook, and sign up for its
newsletter.*

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