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The leaves of the Erythroxylum “coca” plant are a well-known food, beverage, and nutraceutical in their native Andean region. A decade ago, the European non-profit “Amigos de la Hoja de Coca” (Friends of the Coca Leaf) operated a short-lived fair-trade in raw coca leaves between Bolivia and the European Union. The chronicles of this initiative can be insightful, as interest in natural, wellness, and self-care products continues rising in Europe.

Historical review of the inception, and documentation of the organisation of the scheme and its outcome, via all primary sources available.

From the 1990s to the early 2010s, civil society groups organised several campaigns to normalise coca leaf in Europe, finding echo at the European Parliament, culminating in 2012-2013 when a periodical distribution system was set-up: growers in Bolivia shipped 150 g. coca leaf packets directly to Friends of the Coca Leaf members in Europe. Initially, most parcels reached their recipients without issue but after technical hurdles and reduced political support, the scheme was eventually discontinued.

European civil society campaigns surrounding coca have been poorly documented. Historically, Friends of the Coca Leaf emerged alongside Cannabis social clubs, but only the latter has prospered. While Friends of Coca Leaf was short-lived, its political outcomes (both at the institutional level and via a fair and do-it-yourself trade initiative) may prove inspirational to current drug policy reform discussions.

“Cannabis” and “cannabis resin” are derived from the Cannabis plant, used as herbal medications, in traditional medicine and as active pharmaceutical ingredients. Since 1961, they have been listed in Schedule IV, the most restrictive category of the single convention on narcotic drugs. The process to scientifically review and reschedule them was launched by the World Health Organisation (WHO) on 2 December 2016; it survived a number of hindrances until finally being submitted to a delayed and sui generis vote by the UN Commission on Narcotic Drugs on 2 December 2020, withdrawing “cannabis” and “cannabis resin” from Schedule IV.

To evaluate WHO’s scheduling recommendations, the process leading to the Commission vote and subsequent implications at global, national and patient/clinician levels. Narrative account of the four-year proceedings; review of the practical implications of both rejected and accepted recommendations.

The process was historically unprecedented, of political relevance to both medical Cannabis and evidence-based scheduling generally. Procedural barriers hampered the appropriate involvement of civil society stakeholders. The landscape resulting from accepted and rejected recommendations allow countries to continue creating decentralised, non-uniform systems for access to and availability of “cannabis” and “cannabis resin” for medical purposes.

Perspective of accredited observers; highlight of institutional issues and the lay of the land; contrast of stakeholders’ interpretations and engagement.