Politics
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.
