Following a comprehensive scientific assessment, the World Health Organization (WHO)’s Expert Committee on Drug Dependence (ECDD) recommended that coca leaf remain under Schedule I of the 1961 Single Convention on Narcotic Drugs, while three harmful new psychoactive substances linked to fatalities – one synthetic cannabinoid and two potent synthetic opioids – be placed under international control.
The 48th ECDD meeting, held in Geneva from 20–22 October, concluded that although traditional coca-leaf chewing and tea consumption do not pose major public-health risks, the leaf should remain under a strict level of international control. This framework allows for legitimate medical, scientific, and traditional use in countries where it is produced and used, while controlling diversion for purposes of the production of non-medical cocaine.
The Committee’s rationale included:
- convertibility to cocaine: cocaine can be easily and profitably extracted from coca leaf – meeting the Convention’s criterion for convertibility into a controlled drug; and
- rising global concerns: current data show sharp increases in coca cultivation and cocaine production worldwide, alongside growing public-health concerns.
The Committee recognized coca leaf’s cultural and therapeutic significance for Indigenous peoples and other communities and therefore did not recommend coca leaf to be placed under the strictest level of international control, which would prohibit its use for these purposes.
“WHO’s responsibility under the United Nations drug conventions is clear: to provide an impartial, rigorous, scientific evaluation of psychoactive substances and their risks,” said Deus Mubangizi, Director of WHO Medicines and Health Products Policies and Standards Department. “The Committee recognized the deep cultural significance of coca leaf use in some regions, while also acknowledging current evidence gaps and the serious public-health risks posed by unchecked cocaine production. Our commitment is to ensure that every recommendation reflects science, protects health, and upholds human rights.”
The critical review followed a formal request by Bolivia, supported by Colombia, for WHO to reassess coca leaf’s international regulatory status. While acknowledging the longstanding cultural and traditional value of coca use, particularly in the Andean region, the Committee emphasized that scientific evidence on dependence, long-term safety, and potential therapeutic applications that would justify broader international trade of coca leaf for medical and scientific use remains limited at this time.
In its conclusion, the Committee emphasized that existing national exemptions for traditional or cultural use remain unaffected and encouraged more rigorous scientific research, including through the WHO Global Traditional Medicine Centre.
As mandated by the international drug control conventions, WHO, through the ECDD, serves as the only treaty-designated scientific advisory body tasked with assessing the dependence potential, health risks, and possible therapeutic value of psychoactive substances, and advising whether they warrant international control.
For more than two years, WHO coordinated a comprehensive rigorous and transparent review through a multi-step process – collecting submissions from Member States, commissioning critical review reports from external scientific experts, publishing drafts for public consultation, and incorporating data from toxicology, pharmacology, epidemiology, and national health systems. The ECDD, an independent scientific advisory body, then deliberated in a closed session to reach consensus recommendations strictly on medical and scientific grounds, which will inform the UN’s drug policy-making body, the Commission on Narcotic Drugs (CND), on these matters. WHO’s role is limited to health evidence and does not take into account political, economic, or enforcement considerations, ensuring the neutrality, technical integrity, and independence of the process.
These recommendations have been transmitted by the WHO Director-General to the United Nations Secretary-General and forwarded to the CND for consideration. No vote will be required on coca leaf as WHO did not recommend any change to its status.
A consolidated technical report, including technical documents that informed the Committee’s findings, is expected to be published by WHO in early 2026.
Notes to editors:
The review of coca leaf marks the first critical review conducted by WHO’s ECDD since the early 1990s. More than 75 years after its inclusion under Schedule I of the 1961 Convention, the ECDD concluded that the scientific basis for such scheduling remains valid.
WHO’s mandate in international drug control:
Under the 1961, 1971 and 1972 United Nations drug control treaties, WHO is the sole authoritative body responsible for:
- assessing a substance’s abuse liability, dependence risk, and therapeutic value;
- reviewing toxicology, pharmacology, and epidemiological data;
- receiving Member State and public submissions; and
- issuing scheduling recommendations based exclusively on scientific and public-health considerations.
The ECDD’s recommendations are independent and evidence-driven; they do not consider criminal-justice or market-regulation dimensions, which lie within the mandate of Member States and the Commission on Narcotic Drugs.
Related
Expert Committee on Drug Dependence (48th Expert Committee on Drug Dependence documents)
Forty-eighth Expert Committee on Drug Dependence