Illustration by Anđela Janković
Illustration by Anđela Janković
Nearly 75 years after the United Nations called for the abolition of traditional uses of the coca leaf, the world will have a new opportunity to correct this grave historic error. The World Health Organization (WHO), at Bolivia’s initiative, will conduct a ‘critical review’ of the coca leaf over the next year. Based on its findings, the WHO may recommend changes in coca’s classification under the UN drug control treaties. The WHO recommendations would be submitted for approval by the UN Commission on Narcotic Drugs (CND), with voting likely in 2025.
Changing coca’s status in the drug treaties can vindicate the rights of Indigenous peoples and open legal international markets for natural coca products, fortifying Andean economies while bringing coca’s benefits to increasing numbers of people around the world. The coca review process can also help modernize a drug treaty system still mired in the colonialist biases and racial prejudices from which it arose in the mid-twentieth century. The Washington Office on Latin America (WOLA) and the Transnational Institute (TNI) will be monitoring the coca review process closely and examining key aspects of the debate. In this first issue of the Coca Chronicles, we discuss four basic questions.
The WHO itself played a crucial role in the original decision to designate coca as a Schedule I substance in the 1961 UN Single Convention on Narcotic Drugs. That fateful choice has condemned a millennia-old Andean-Amazonian culture, criminalized many thousands of coca farmers, traders and consumers, and prevented countless others from sharing coca’s benefits.
In the ‘Supporting Dossier’ substantiating its request for a WHO critical review, Bolivia’s government describes the severely flawed process that led to the decision to classify the coca leaf as a Schedule I drug, concluding that the “primary institutional responsibility for this historical error … lies with the WHO itself.” A 1950 report from the UN Commission of Enquiry on the Coca Leaf found that coca chewing “does not constitute an addiction (toxicomania), but a habit,” and that “no abstinence symptoms are seen.” But in 1952 and again in 1954, the WHO disregarded the conclusions of the 1950 report and instead argued that coca chewing was a form of ‘addiction’ and ‘cocainism.’ Based on this judgment, the Single Convention listed coca leaf in Schedule I and called for the abolition of coca chewing within 25 years.
Although the 1950 report by the UN Commission on the Enquiry of the Coca Leaf ultimately refrained from concluding that coca chewing was a form of addiction, the overall tenor of the report was deeply biased and racially prejudiced, intent on demonstrating the harms purportedly inflicted by coca chewing. In a 1949 interview with a Peruvian newspaper as the UN study mission was getting underway, mission leader Howard B. Fonda (a vice-president of the American Pharmaceutical Association) was candid about what he saw as the Commission’s aim. For Fonda, coca chewing was:
“not only definitely harmful and deleterious, but is the cause of the racial degeneration of many population groups and of the decadence which is obvious in many native inhabitants, and even the half-castes, of certain regions of Peru and Bolivia. Our studies will confirm the truth of our statements, and we hope to be able to submit a rational plan of action based on the realities of the situation and on experience in the field, to secure the total eradication of this pernicious habit.”
Fonda was far from alone in these views. UN official Pablo Osvaldo Wolff (of Argentina) prepared materials to support the Commission of Enquiry. In 1952 and 1954, Osvaldo Wolff served as Secretary of the WHO Expert Committee that took the fateful decisions leading to the coca leaf’s designation as a Schedule I drug in the 1961 Single Convention. Like Fonda, Osvaldo Wolff left little doubt as to his outlook. Given his outsized role in ensuring coca’s vilification and criminalization in the UN drug treaty system, it is worth quoting Osvaldo Wolff at length from a 1949 lecture in which he reflected on his preparatory work for the Commission on Enquiry:
“The indio who does not chew coca leaves is clear-sighted, intelligent, and light-hearted, willing to work, vigorous, and resistant to diseases; the coquero, on the contrary, is abulic, apathetic, lazy, insensitive to his surroundings, his mind is befogged; his emotional reactions are rare and violent, he is morally and intellectually ‘anaesthetized,’ socially subdued, almost a slave. […] Moral degeneration accompanies the physical; lying is one of the outstanding characteristics, probably due to lack of moral equilibrium. Criminality is high, and barbaric forms of homicide can only be explained by a certain moral insensibility. There is no doubt that the habit of chewing coca leaves is one of the most powerful reasons for the backwardness and misery of the Indian population.”
That these were the openly held views that animated key figures in the decision to criminalize the coca leaf is sobering. Yet until now, the status of the coca leaf in the Single Convention has not been formally reconsidered, despite the obvious biases that pervaded the considerations of the WHO in the 1950s. In 1992, the only other moment that the coca leaf appeared on its agenda, the WHO Expert Committee on Drug Dependence (ECDD, or Expert Committee) simply concluded—without any new documentation—that the coca leaf was appropriately scheduled because “cocaine is readily extractable from the leaf.” The rationale for designating coca as a Schedule I substance in the first place was not questioned in any way. Since that time, Indigenous peoples’ rights have become more firmly embedded in national and international law, especially with the 2007 UN Declaration on the Rights of Indigenous People. Bolivia’s recent activation of the WHO critical review is in fact long overdue.
Illustration by Anđela Janković
The leaves of the coca bush contain 20 known alkaloids, including tiny amounts of cocaine (depending on the coca species and variety, between 0.1 and 0.8 percent). Chewing coca leaves or drinking tea infused with the leaves results in minute levels of cocaine concentrations in the bloodstream and produces a mild stimulating effect, without causing dependence. The millions of Indigenous people and others who regularly use coca leaves value their significant health benefits, such as increasing stamina and avoiding hypoglycemia, which prevents altitude sickness. Coca leaves are therefore especially useful in the mountainous Andean region. As Bolivian President Luis Arce explained in his formal notification to UN Secretary-General António Guterres in June 2023, the coca leaf has “age-old traditional medicinal, nutritional and phytotherapeutic uses that cause neither dependence nor any harmful effect on health.” These valuable properties of the coca leaf are not a new discovery: humans have been consuming coca for more than 8,000 years, and the leaf has come to play a central cultural role in the Andean-Amazonian region. In short, millions of people have been safely and beneficially consuming coca leaves for millennia, and as President Arce noted in his notification letter, “none of them have had to turn to health services for the treatment of dependence or harmful effects of toxicity.”
While coca bush varieties have been cultivated for millennia, the cocaine alkaloid—a potent stimulant—was first isolated from coca leaves in 1860. Since then, coca leaves have served as the raw material for the chemical manufacture of cocaine hydrochloride (its powder form), whereby cocaine is extracted from large quantities of coca leaves. The latest research in Colombia by the UN Office on Drugs and Crime (UNODC) indicates that a metric ton of fresh coca leaves is required to produce 1.45 kilograms of cocaine (80 percent purity).
In the late nineteenth century, cocaine won fame as a local anesthetic and was featured in numerous commercial formulas as a healthy elixir. Controls imposed in the twentieth century eventually narrowed cocaine’s legal ambit to strictly medical and scientific uses, per the general obligations of the 1961 Single Convention. New pharmaceuticals gradually replaced cocaine, and today the global medical use of cocaine amounts to some 400 kilograms, legally manufactured and exported by Peru. But the effort to eliminate recreational uses of cocaine by banning it and imposing criminal sanctions faltered from the outset. Cocaine’s popularity as a recreational drug boomed beginning in the 1970s, and the burgeoning illegal market has been enriching drug trafficking organizations and criminal syndicates ever since. Illegal cocaine production is now reportedly at an all-time high, estimated in UNODC’s latest World Drug Report at 2,300 metric tons.
For 2021, total land area under coca cultivation was estimated at around 200,000 hectares in Colombia, 80,000 in Peru and 30,000 in Bolivia, including coca crops cultivated for licit purposes. The Single Convention, while limiting the use of coca leaf to medical and scientific purposes and banning traditional uses like coca chewing, made exemptions for “the use of coca for the preparation of a flavouring agent, which shall not contain any alkaloids” (the ‘Coca-Cola’ exemption) and for certain industrial products like dyes or fertilizers. Licit coca production thus already exists, primarily for domestic consumption but also for licit export for medical purposes (cocaine) and soft drinks (de-cocainised leaves). Export of natural coca leaf, coca tea or coca flour, however, remains strictly prohibited.
The first step in the process that Bolivia has initiated will be a study undertaken by the WHO Expert Committee, based on the available scientific literature, inputs from treaty Parties (including the dossier that Bolivia already submitted) and contributions from civil society organizations. Depending on the findings of its study, the Expert Committee will then submit any recommended changes in coca’s classification to the Commission on Narcotic Drugs (CND), the Vienna-based UN drug policy body. The 53 countries that comprise the CND would then vote on the recommendations, with a simple majority required for approval.
To ensure that the WHO conducts its scientific review in as comprehensive, inclusive and multi-disciplinary manner as possible, Bolivia’s ‘Supporting Dossier’ highlights numerous dimensions that the review process must be sure to address. Given the centrality of coca in the cultural, ceremonial and traditional medicinal practices of many Indigenous peoples in the Andean-Amazonian region—and given the grotesquely prejudiced accounts of Indigenous peoples that drove the initial decision to classify coca as a narcotic drug—the dossier underscores the imperative of ensuring ample inclusion of Indigenous peoples in the review process, as well as experts on ‘traditional medicine.’
The WHO’s critical review is expected to be completed by the end of 2024, setting the stage for voting as early as the March 2025 session of the CND. The ideal outcome, in the Bolivian government’s view, would be for the WHO to recommend removing coca entirely from the schedules of the Single Convention. The WHO could in principle recommend moving coca to the less restrictive Schedule II, alongside codeine and other milder opioids. But a Schedule II designation would mean that coca leaf would still be limited to medical and scientific purposes, albeit subject to lower levels of administrative control. Any recommendation for changing coca’s current Schedule I status is likely to face stiff headwinds in the CND, where assembling the necessary votes to enact a change in coca’s status would likely encounter significant obstacles.
Click to view full-size graphic.
A decade ago, when Bolivia exited from and then succeeded in rejoining the Single Convention with a reservation defending the traditional use of the coca leaf within Bolivia, the United States was staunchly opposed. President Barack Obama’s government spearheaded a campaign to block Bolivia’s reservation. In lodging its formal objection, the Obama Administration highlighted U.S. concerns that “Bolivia’s reservation is likely to lead to a greater supply of available coca, and as a result, more cocaine will be available for the global cocaine market, further fueling narcotics trafficking and related criminal activities in Bolivia and the countries along the cocaine trafficking route.” All G8 countries and several other European countries joined the U.S. government in its objection. Ultimately, the U.S.-assembled coalition fell far short of preventing Bolivia from re-acceding to the treaty, and since then both Mexico and the Netherlands have formally withdrawn their original objections. But the U.S. rationale for opposing Bolivia’s reservation back in 2012 will almost certainly re-emerge as debates ignite around the WHO’s critical review of coca. Especially in Europe, new concerns have emerged about rising cocaine consumption and increasing levels of violence associated with the illicit cocaine trade.
As President Arce emphasized in his June letter to UN Secretary-General Guterres, Bolivia’s “intention is not to diminish in any way the international control of coca cultivation and of the use of coca leaves for the illicit production of cocaine.” Even if the coca leaf were to be deleted entirely from the schedules of the Single Convention, the treaty contains specific articles that would still require Parties to take measures to prevent coca leaf from being used as a raw material in the illicit production of cocaine. Moreover, as the accompanying dossier argues, the “fear that a legal international retail market in coca tea, coca flour, ypadú/mambe, and other coca-based products could become a source of clandestine cocaine production, is completely misplaced.” The process of extraction is too complicated to even consider using a kilo of tea bags or mambe to extract a gram of cocaine, and as a matter of economics, such effort simply wouldn’t pay.
Thus far two countries—Colombia and Mexico, both of which are CND members—have publicly expressed support for the review process initiated by Bolivia. Any eventual recommendation by the WHO to reschedule the coca leaf, or to remove it entirely from the Single Convention, will need backing from a much larger group of countries in order to be approved by the CND. The CND itself has become an increasingly polarized space in recent years, and the coca review can be expected to trigger highly contentious debates.
The UN High Commissioner for Human Rights recently warned that the current drug control model “perpetuates existing patterns of discrimination, including against people of African descent, women and indigenous peoples,” calling to end the ‘war on drugs’ and to “focus on transformative change, crafting drug policies which are based on evidence [and] which put human rights at their centre.” An evidence-based review of the classification of the coca leaf is an important step toward transforming a treaty system that appears frozen in time. The review now getting underway provides an extraordinary opportunity to undo a grave historical injustice, resolve the undeniable conflict between the Single Convention and Indigenous rights, generate licit livelihood opportunities for coca growers, contribute to peacebuilding in the Andean region, and allow the rest of the world to partake in the coca leaf’s beneficial properties.
