World Health Organization Won’t Ease Coca Leaf Ban, Even As Review Found Prohibition Is More Dangerous Than The Plant

*“It’s unacceptable for humanity to demonize a sacred medicinal plant. It
was more of a political decision than a scientific one.”*

*By Mattha Busby, Filter*

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.

“The risks of cocaine powder or smoked crack cocaine, creations of the
global North, which is also by far the biggest market for both, are
demonstrably of a different order to traditional coca use, chewed or in
tea, which occurs exclusively in the global South,” Rolles added. “It is
the global South where the burden of both the failed war on cocaine, and
the criminalization of entire cultures is most acutely felt.”

In 2020, following a WHO recommendation, the UN’s Commission on Narcotic
Drugs voted narrowly to relax international controls on cannabis,
acknowledging its medical value after decades of “reefer madness.” For
reform advocates, that decision appeared to signal a slow and overdue shift
toward evidence-based scheduling. Therefore there were hopes that the UN
system could also distinguish between the coca leaf—containing less than 1
percent cocaine alkaloid—and the refined powder that fuels global demand.

Yet coca will continue to be treated as though it has the same risk profile
as cocaine—even after the WHO review affirmed that traditional coca chewing
has caused no documented fatalities, is not associated with significant
dependence or “abuse” potential, and has possible therapeutic applications
ranging from anti-inflammatory effects to modest improvements in post-meal
glucose.

“The WHO’s decision is deeply disappointing and profoundly troubling,” Ann
Fordham, executive director of the International Drug Policy Council, said
in a press release. “This was not a routine review—it was a critical test
of the UN drug control system. The Committee has shown it cannot
objectively assess evidence or consider the human rights consequences of
prohibition. Instead, it has chosen to reinforce the racist and colonial
foundations of international drug control. This decision makes clear that
the system is broken and resistant to meaningful reform.”

Experts have long argued that the logic behind the coca ban is selective
and ignores existing treaty precedents. Plants such as ephedra, which is
used to manufacture methamphetamine, psilocybin-containing mushrooms and
mescaline-producing cacti all remain unscheduled at the plant level,
despite being used to produce controlled substances.

While open persecution of coca-chewers in the Andes has waned, prohibition
still shapes daily life in parts of the region—from farmers who lose crops
to stop-start aerial fumigation campaigns, to communities caught between
eradication forces and the networks that dominate the illegal cocaine
trade. In the September review, the independent group of experts contracted
by the WHO noted research that showed exposure to harmful glyphosate-based
pesticides like Roundup, found to be a probable carcinogen, from
authorities’ aerial spraying of coca crops “increased the number of
miscarriages and the number of medical consultations related to
dermatological and respiratory illnesses in targeted communities.”

The review 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.”

Villafaña and other Indigenous leaders have warned that these pressures
amount to a form of cultural violence. Coca is central to Andean
communities’ spiritual practice, conflict resolution, work, ceremony and
community health—yet its use outside narrow “traditional” exemptions places
people at risk of criminal sanctions.

“It would be a relief for us as a culture,” Villafaña said, “if the world
recognized it as a sacred plant and didn’t demonize it.” But, he added, the
decision would not otherwise affect his community, whose members will
continue chewing coca as they always have done.

*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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