(This article initially ran as part of our Daily Drug War Digest on October 13, 2026.)

The Transnational Institute's Martin Jelsma has authored an autopsy on the World Health Organization's review of coca's continued status as a Schedule I controlled substance under the 1961 Single Convention on Narcotic Drugs. In 2023, Bolivia, one of South America's key coca-producing countries, formally requested a review of the coca leaf's status. Colombia signed onto the request a year later.

The move had support within the United Nations bureaucracy, with the UN Special Rapporteur on the rights of Indigenous Peoples saying it "would represent a significant step toward aligning the international drug control system with the dignity and rights of Indigenous Peoples."

Under the treaty, the World Health Organization (WHO) is responsible for conducting such assessments. It did so, and then determined to the disappointment of many that it would not recommend any change in coca's status.

As Jelsma puts it in his original analysis in Health and Human Rights Journal, "The coca review was a failed litmus test of the UN regime’s ability to repair historical injustices and resolve growing tensions with scientific evidence and human rights. The outcome casts a shadow on the independence of the WHO review procedure and has revealed a disconnect within WHO between its drug control treaty mandate and the commitment of other departments to promote traditional medicine and Indigenous health. It has also laid bare inconsistencies in the treaty system and incoherence in the application of control measures to psychoactive plants, extracted alkaloids, and convertible precursors.

"With its conclusion, the ECDD effectively closed the door -- at least for the coming years -- on ending the 60-year-old UN coca ban, as the CND can change the 1961 schedules only in accordance with a WHO recommendation. The chances that a descheduling recommendation would have survived a CND majority vote -- in the case of the 1961 Single Convention requiring the support of a simple majority of the 53 CND members present and voting -- seem unlikely given active US and European opposition and the escalation of cocaine interdiction operations. However, voting positions would likely not have fallen solely along the traditional prohibitionist-liberal divide that has marked debates around harm reduction, decriminalization, and cannabis regulation; they would also have been influenced by the North-South divide.

"In conclusion, a number of lessons can be drawn from the process, and the following steps should be considered to move the debate forward:

1. After this WHO review, the justification for maintaining coca leaf in Schedule I rests on the "ease of cocaine extraction" rather than on coca leaf being considered a dangerous narcotic drug in itself. This allows for a more flexible interpretation of the treaty provisions governing preparations and industrial uses. Countries can now explore possibilities for legal trade in coca-based herbal medicines, food supplements, vitamin preparations, or energy drinks.
2. WHO, the EU, and the United States have all claimed that concerns about Indigenous rights and traditional uses can be accommodated without changing coca’s current treaty classification. Those statements can be read as an invitation to address the legal gaps regarding reservations and national exemptions -- for example, by considering inter se agreements through which like-minded countries could modify certain treaty requirements among themselves and open opportunities for international trade.
3. Andean-Amazonian Indigenous Peoples should move forward with legal protections against corporate capture, biopiracy, and the misappropriation of intellectual property rights. Existing mechanisms for the protection of Indigenous rights, genetic resources, cultural heritage, and equitable benefit-sharing can be used to protect international trade in the future. The review outcome gives more time to put basic safeguards in place before opening international markets, a legitimate concern expressed by Indigenous representatives.
4. WHO should evaluate its problematic history within the UN drug control system and the difficulties encountered during the coca review. The aim should be to strengthen the synergy among WHO departments; to incorporate basic principles of human rights, traditional medicine, and Indigenous health into WHO’s scheduling considerations; and to update the Guidance on the WHO Review of Psychoactive Substances for International Control.
5. A proper consultation mechanism needs to be established to enable Indigenous Peoples to participate in drug policy decisions that may affect them. It should be designed in collaboration with the Permanent Forum on Indigenous Issues, the Expert Mechanism on the Rights of Indigenous Peoples, the Special Rapporteur on the rights of Indigenous Peoples, and the OHCHR. Currently, the CND, WHO/ECDD, INCB, and UNODC all lack specific mechanisms for Indigenous participation, consultation, and dialogue.
6. The UN review panel should discuss the systemic deficiencies identified through the coca review and make recommendations for aligning the UN drug control system with Indigenous Peoples’ rights and resolving inconsistencies in the scheduling criteria and control measures for plant materials, extracted alkaloids, preparations, and convertible precursors."