• Germany imported more than 72 metric tons of medical cannabis in 2024—31 tons in Q4 alone.
• Colombia exported over $11 million worth of cannabis to Europe, Australia and Israel.
• Israel is projected to reach 242,000 registered medical cannabis patients by 2027.
• Lesotho, Morocco and South Africa are all rolling out export-driven cannabis strategies.
• Meanwhile, the U.S. market, valued at $31.4 billion, remains locked in a state-by-state mess, federally illegal and fragmented.

As the rest of the world ramps up, American investors mostly watch from the sidelines—cautious, burned and unsure how (or if) they should engage. But if this caution continues, it may soon turn into something much more costly: irrelevance.

Europe’s Steady Hand

While the U.S. built its market around buzzwords and billboards, Europe quietly built infrastructure. Its model is slower, stricter and shaped by healthcare—not hype.

“The irony of the U.S. reticence to enter Europe is there are real opportunities with real operators making real money,” says Jamie Pearson, CEO of New Holland Group, a global advisory firm that helps cannabis companies expand into European and international markets. “Great deals with fair terms and excellent teams attract money effortlessly. The solution is getting the deal pitched to the right investors at the right time. Timing plays a huge role.”

And that window may already be narrowing. “We are living in uncertain times and investors are hoarding cash,” Pearson adds. “U.S. investors have lost big in the sector and are understandably gun-shy. Mistakes were expensive — and many were just bad timing and bad luck with regulators.”

Globally, innovation is booming. Just not in the U.S. (or at least, not where it matters most). “Some of the biggest tech and research innovations have come out of Asia and Israel, for example,” Pearson notes. “The U.S.’ Schedule 1 draconian laws make research and innovation nearly impossible unless you’re talking about ancillary products like hardware or packaging.”

In contrast, Europe’s cannabis infrastructure is deeply tied to its healthcare systems: prescriptions, pharmacies, insurance coverage and lab testing. And nowhere is that more evident than in Germany.

Ivan Garev, founder and CEO of Drapalin Pharmaceuticals, a Germany-based manufacturer and distributor of EU-GMP–certified medical cannabis, describes a system rooted in patient care. “The full therapeutic potential of medical cannabis is still far from being realized. The ability to prescribe under medical supervision remains essential.” He highlights the removal of prior authorization for specialist prescriptions under public insurance as “a major breakthrough” that “significantly improved patient care.”

While cannabis clubs are now being introduced, Garev emphasizes that “patient access through pharmacies and insurance remains the cornerstone.” In his view, “insurance coverage and medical supervision aren’t optional — they’re what make the German model resilient and safe.” Still, he warns, “Germany has reset the course — but the journey is far from over.”

Chris Day, co-founder of the Global Cannabis Network Collective, which connects cannabis executives across more than 40 countries, sees that evolution as crucial: “Europe, while pragmatic and smaller at the moment, has the most elements necessary — capital, banking, regulations that can be followed and are being adapted over time — to foster successful long-term growth.”

Economist Beau Whitney backs it up with data: more than 115 countries now allow some form of legal cannabis access. In the U.S., he says, “the bifurcation of hemp versus higher THC cannabis has created externalities… confusing consumers and investors alike.” Europe, by contrast, regulates cannabis based on product intention, not arbitrary THC thresholds.

Whitney’s formula is clear as day: “U.S. = high risk, low return. EU = slow growth, lower risk, greater predictability.”

Latin America’s Reset—And Brazil’s Role

If Europe is defined by structure, Latin America is defined by untapped potential. The region has every natural advantage—sun, land, labor and local demand—but still struggles to convert it into consistent exports or domestic access.

Chris Day recalls how early Canadian overinvestment gave the region whiplash. “Those players pulled out and crashed much of the market through their hubris. That stigma continues to linger.”

Colombia is slowly shedding that past. Its exports are increasing and companies are refining product quality, consistency and traceability. It is also said that domestic flower sales (currently prohibited) could soon be allowed. Peru is progressing toward broader reform. But barriers remain.

“You can’t generalize Latin America,” says Lucas Nosiglia, a veteran of the region with years of operational experience. “The opportunity depends on achieving volumes that allow for economies of scale.” He adds that both the U.S. and Europe could become viable markets—if Latin America can meet their regulatory and pharma expectations.

Brazil, the region’s largest economy, is showing both promise and limitations. According to BLAZ, the Brazilian medical cannabis market surpassed R$853 million (~$140 million) in 2023 and is projected to exceed R$1 billion by 2025. Patient counts reached an estimated 672,000 last year—a 56% jump from 2023—making Brazil one of the most active medical cannabis markets in the world.

Yet, nearly half of all cannabis-based medicinal products are still imported and flower remains off the table entirely. “Flower is a real, inescapable demand embedded in Latin American culture,” says Nosiglia. “Instead of trying to ban it, countries should build models that educate and regulate it—with traceability, physician guidance and standards.”

Recent court rulings have opened the door for hemp cultivation and the import of seeds, and new regulations from ANVISA, the local regulator, are expected soon—steps that could help local production finally catch up with demand.

He points to Argentina’s REPROCANN as an example of a more culturally responsive approach. Though new registrations are now on pause, the program allows patients access to medical flower through prescriptions—bridging the gap between pharma and lived experience. “It laid the groundwork for a system built on evidence and access,” he says.

Former Argentine congressman and cannabis entrepreneur Facundo Garretón, founder and CEO of holding company Terraflos, agrees—and sees the opportunity widening.

“Latin America is well‑positioned to become a major hub for cannabis‑derived pharmaceutical ingredients, yet much of its potential remains underutilized,” he explains. “Colombia has benefited from being an early mover in establishing a robust regulatory framework for cultivation and production — positioning itself ahead on the learning curve. This has allowed the country to become a key supplier not only to highly regulated markets like Brazil and Australia, but also to countries with emerging frameworks and limited local manufacturing capacity, such as Argentina and Peru.”

He sees the next competitive advantage in execution. “The challenge is no longer just agronomic—it’s about bridging regulatory gaps, building trust in product quality and proving consistency in delivery.”

Other markets are quietly advancing, too. Mexico, despite delays in adult-use regulation, remains one of the largest potential markets in the world. Paraguay, already a regional exporter of medical cannabis, has seen growing political debate around full legalization—with whispers of an adult-use bill gaining traction in 2025. As global demand rises, Latin America’s next breakthrough may come from unexpected corners.

Israel, Asia And The Innovation Gap

While others scale fields, Israel is scaling labs.

The country’s medical cannabis framework, active since the 1990s, combines clinical trials, academic research and industry collaboration. It’s a model built for data, not just dollars.

As of 2017, the country had more than 110 clinical trials involving cannabis underway, according to Michael Dor, a senior medical adviser at the Israeli Health Ministry. What’s more, between 2010 and 2023, Israel accounted for approximately 6.8% of all cannabis-related clinical trials globally, ranking fourth after the U.S., U.K. and Canada. With the market projected to reach over $300 million in revenue by 2025, the country continues to invest in robust cannabis research, positioning itself as a global leader in clinical innovation.

Elsewhere in Asia, R&D is picking up momentum. Thailand has leaned into cannabis science through state-supported projects and universities. South Korea, though tightly regulated, allows limited medical access and is supporting cannabinoid research for rare diseases. Even China—despite strict bans on consumption—is home to a growing hemp industry and early-stage cannabinoid biotech tied to CBD extraction. In fact, China’s industrial hemp market was valued at $970.12 million in 2023, it is anticipated to reach $6.7 billion by 2032, driven by rising demand for sustainable and eco-friendly products across various industries

Meanwhile, U.S. researchers, who technically lead in the number of cannabis-related clinical trials, mostly remain limited in scope due to federal restrictions. With cannabis still classified as a Schedule I drug, researchers face complex approval processes, limited access to quality study materials and funding barriers. As a result, countries like Israel, where cannabis research is supported by coordinated national policy, continue to produce more impactful, streamlined clinical insights.

Germany: Adult-Use, But Not Like You Think

Yes, Germans can now carry up to 25 grams, grow three plants at home and join cannabis clubs. But this isn’t California 2.0. There’s no retail blitz, no green rush. Just pilot programs, phased rollouts, and regulation-heavy experimentation.

Pearson sees the nuance: “Germany took cannabis off the narcotics list and that has been a game changer.”

Behind the headlines, the system remains deeply medical. Cannabis is prescribed via telemedicine, filled at pharmacies and reimbursed by insurance—a stark contrast to the out-of-pocket, dispensary-driven model in the U.S.

In a podcast interview, Sanity Group’s Finn Hänsel noted that fewer than 1% of cannabis users in Germany have accessed the legal system, a figure that underscores how vast the unregulated market remains.

Germany has an estimated 8.5 million cannabis users, but only a fraction have transitioned into legal channels. If even a small percentage converts to the formal system, the market could see explosive growth—without the chaos that often follows unregulated commercialization.

That’s the bet Germany is making: a slower, more structured approach focused on public health, safety and patient access first. For policymakers in other countries, it’s a model worth watching.

Meanwhile, legacy cannabis capitals like the Netherlands and Spain are undergoing transformations of their own. In late 2023 and early 2024, the Netherlands launched a long-awaited pilot program to legalize cannabis production and sales in select municipalities—moving beyond decades of tolerated but technically illegal coffeeshop culture. In contrast, Barcelona, once a hotspot for cannabis social clubs, has seen increased regulatory pushback, casting uncertainty over the legal status of its hundreds of private associations. Both cases highlight the growing pressure across Europe to shift from informal tolerance to structured, accountable systems—something Germany’s model is now aiming to formalize.

A Pharmaceutical Model With Continental Scale

One of Europe’s strongest long-term assets is its alignment with pharma.

EU-GMP certification is the standard. Doctors write prescriptions. Insurance picks up the tab. Cannabis is dispensed alongside antibiotics and insulin, not next to energy drinks and vape cartridges.

This model may lack the flashy appeal of big-brand dispensaries, but it’s built for endurance. Consistent oversight, medical infrastructure and cross-border trade potential offer investors the kind of predictability the U.S. still struggles to match.

Meanwhile, U.S. patients remain stuck in a costly, disconnected patchwork of state-by-state rules with no insurance coverage in sight.

Still, not everyone agrees Europe’s pharma-first path is working across the board. Rubén Valenzuela, CTO of Valenveras—a Spanish firm that develops portable cannabis analysis tools and co-organizer of the C-Days cannabis science summit—warns that excessive bureaucracy is choking progress in key markets like Spain.

“What’s missing in Europe for a real medical cannabis market is clear regulation that allows markets to operate,” he explains. “Current production challenges around medical channels and EU-GMP—especially through agencies like the AEMPS in Spain—stem from excessive bureaucracy imposed by government agencies, making them less competitive globally.”

Valenzuela adds that this rigidity may not be accidental. “Without a doubt, the European pharmaceutical model and its lobbying forces are pushing for regulation to be shaped in a way they can control and ultimately benefit from.”

Africa’s Quiet Surge

Africa may be the least discussed, but it’s not far behind. Lesotho was first to legalize medical cannabis exports. Morocco has approved cultivation for medical and industrial use and South Africa is expanding both domestic frameworks and international pipelines.

Chris Day puts it clearly: “The longer-term threat to the Latin American market will be Africa as a more natural European trade partner for agriculture.” Cheaper labor, closer geography and increasing political will could make African nations the suppliers of choice for Europe’s growing demand.

That demand is real. As EU nations ramp up imports and require EU-GMP–certified product, several African governments are designing policies explicitly aligned with export markets. Ghana and Uganda, for example, have passed laws that prioritize medical cannabis cultivation and overseas sales, bypassing recreational debates altogether.

Peter-John Pywell, CEO of South Africa–based Uncle Rooneys, says the continent’s future hinges on building trust, not chasing volume.

“As global cannabis markets evolve, volatility has become a key challenge — from fluctuating demand to oversupply,” he says. “One of the biggest disruptions has come from Canada, where an unchecked boom has led to the global dumping of cheap, low-quality cannabis. While this may serve short-term needs, it damages trust and undermines the industry’s credibility.”

Pywell believes Africa offers a different story: “South Africa, a nation built on generations of farming excellence — from citrus and wine to rooibos and maize — is now applying that same care and precision to cannabis. With ideal growing conditions, competitive costs and proven export experience, Africa is uniquely positioned to become a reliable global supplier.”

He adds that with Germany’s cannabis reform raising the bar on compliance, quality will matter more than price. “We’re not chasing trends, we’re building a future rooted in consistency, quality and community upliftment.”

As the cannabis industry matures, Pywell says, “Africa won’t just participate; we’ll lead.”

The U.S. Can Lead—If It Decides To

Germany’s reforms. Colombia’s exports. Israel’s research. Africa’s readiness. Asia’s innovation.

The global cannabis boom isn’t hypothetical; it’s happening. And the U.S.—still the world’s largest consumer market—is being outpaced in everything but hype, retail sales and public company listings.

“So much of all of this hinges on raising the level of maturity and understanding of global economics within the industry itself,” says Day. Investors need better science, better context and better global vision.

Pearson agrees: “Each company expands to Europe for different reasons… your best decision is to get boots-on-the-ground expertise… to avoid unnecessary and expensive and avoidable mistakes.”

There’s still time to catch the wave. But the rest of the world isn’t waiting.