Coca Chronicles: Monitoring the UN Coca Review Issue #1: Bolivia Challenges UN Coca Leaf Ban

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.

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 Antonio 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.