The UN coca leaf review and indigenous peoples’ rights: can the WHO meet the moment?

The World Health Organization (WHO) bears significant institutional responsibility for the historical error of classifying the coca leaf as a Schedule I narcotic under the United Nations 1961 Single Convention on Narcotic Drugs. In 1950, the UN Commission of Enquiry on the Coca Leaf released a racially prejudiced report intent on demonstrating the harms purportedly inflicted by coca chewing. While 1950 report ultimately refrained from concluding that coca chewing was a form of addiction, it nonetheless called for the gradual reduction of coca chewing ‘until complete suppression is achieved within fifteen years.’ But in 1952 and again in 1954, the WHO deliberately disregarded the 1950 report’s finding that coca chewing ‘does not constitute an addiction (toxicomania), but a habit,’ and instead asserted that coca chewing was a form of ‘addiction’ and ‘cocainism’. Based on the deeply biased 1952 and 1954 WHO rulings, the 1961 Single Convention listed coca leaf alongside cocaine in Schedule I and called for the abolition of coca chewing within 25 years.

Across millennia, coca has been central to the spiritual lives and cultural and traditional medicinal practices of many Indigenous Peoples in the Andean-Amazonian region. These communities continue to be especially stigmatized and harmed by coca’s ongoing unwarranted status as a Schedule I narcotic drug under international law.

At Bolivia’s initiative, supported by Colombia, the WHO’s Expert Committee on Drug Dependence (ECDD) is now conducting the first ever ‘critical review’ of the coca leaf’s status in the UN drug treaty system. Based on its findings, the WHO may recommend changes in coca’s classification, with options ranging from: (a) keeping the coca leaf in Schedule I of the Single Convention; (b) transferring it to Schedule II (recognizing medical uses, with less stringent controls than required for Schedule I substances); or (c) removing the coca leaf from the treaty schedules altogether.

The ECDD has enlisted four teams of independent researchers to assess a variety of topics related to the coca leaf. The four teams’ investigations encompass five clusters: chemistry, pharmacology, toxicology, therapeutic/traditional use, and epidemiology. The ECDD will compile the research teams’ findings in a report slated to be released on September 20, 2025. That report will then support deliberations regarding coca at the Expert Committee’s meeting scheduled for October 20-24, 2025. (Due to cuts to WHO’s overall budget, the ECDD’s October meeting will probably take place virtually, rather than in-person, as is typically the case.)