WHO needs to reform lines of authority and responsibility across all aspects of its emergencies response operations in order to effectively prevent, report, and take measures against sexual exploitation and harrassment.  

Those were the highlights of a final report by an Independent Oversight Advisory Committee (IOAC) of the WHO Health Emergencies Programme, examining the claims of sexual exploitation and harrassment that first emerged in connection with WHO’s 2018-2020 Ebola response in the Democratic Republic of Congo. 

The report, presented in a Friday afternoon session of the WHO Executive Board, marked another milestone in the follow-up to reports of sexual exploitation and abuse claims by some 75 Congolese women against 25 WHO workers deployed to the Democratic Republic of Congo’s 2018-2020 Ebola response – which was first reported by the New Humanitarian in 2020. 

Following the reports, WHO initiated an independent investigation, as well as initial internal reforms to improve staff training in the prevention of sexual exploitation and harrassment (PRSEH); deployment of more training staff; and new recruitment standards that also consider any exploitation and abuse issues in a candidate’s background, the IOAC report states.

But there remains “ deep, lingering frustration expressed by Member States and staff about the lack of transparency, delays in responding to incidents and holding perpetrators accountable, and the defensiveness with which the Organization has dealt with SEAH in the past,” states the report, presented to the EB. 

And more comprehensive cultural and structural changes need to occur across WHO to reduce the risks of abuse from ever occurring in the first place, said Felicity Harvey, co-chair of the IOAC committee, in her presentation of the report to the WHO Executive Board on Friday. 

“The second edition of The WHO Emergency Response framework should be further revised to provide greater clarity on the accountabilities and lines of authority across offices, regional offices and headquarters with explicit roles and responsibilities given to each player and updated procedures for all hazards emergency risk management,” she said. 

The IOAC report outlines five priority areas where more action is needed. Those include: 

• Clarifying the lines of responsibility and delegation of authority across the three levels of the organization; Strengthening the accountability framework for emergency response and other field teams; 
• Reform the organization’s PRSEH management structure, and accelerate  organizational capacity to implement a “victim survivor-centered” approach to PRSEH; 
• Financial investment in PRSEH programmes as an essential WHO function – and particularly in field operations, where WHO is currently responding to some 80 emergencies around the world; 
• Periodic assessments of PRSEH in acute emergency response settings, including a mapping of community and local resources; identification of trusted local partners for PRSEH incident management; ensuring that field operations include a balance of  experienced male and female personnel. 
• Building a culture of equity, diversity and transparency 

“WHO needs to promote or advocate for institutionalized culture change to strengthen PRSEH,  including greater gender and racial diversity, improved performance management, and a renewed commitment to WHO values – to build a culture of equity, diversity and transparency,” said Harvey, a former director-general of international health in the United Kingdom Department of Health.  

DG Proposal – separate line of investigation for sex abuse complaints

Responding to the IOAC report, WHO Director General Dr Tedros Adhanom Ghebreyesus noted that WHO has recently engaged an external investigator to follow up on further on the abuse allegations – and their perpetrators.

“This is the first time a UN Organization has installed an independent investigation, opening up to an external investigator,” he noted.  

“One of the things that our member states emphasized is transparency; we are doing that, and we will continue to do more. We will continue to build on this, because more should be done,” Tedros said. 

Tedros also asked the EB to approve a draft decision that would create a separate line of authority to the investigator heading up the Organization’s investigations of sexual exploitation and abuse allegations – and reporting directly to the Director General.  

All sexual exploitation and abuse allegations would thus be treated separately from other WHO internal justice investigations, at least temporarily, according to the draft WHO proposal. 

The WHO DG also noted that in the last two weeks, the Organization had received three new complaints of alleged sexual harrassment and exploitation from the Central African Republic, DR Brazzavile, and the Democratic Republic of Congo (DRC) – the latter where Tedros also said that WHO was creating a model for rehabilitation and support to victims, helping them access livelihoods as well as other means of support. 

“We support zero tolerance and we will do everything to build a better culture,” he said. 

The DG’s proposal to create a separate chain of authority for sexual exploitation and harrassment cases churned up some initial resistance among some EB members – who said that it should have been discussed even before the EB convened, at a meeting of member states’ Planning and Budget Advisory Committee (PBAC).  

Harvey, however, said that the IOAC would “strongly endorse the decision to keep the PRSEH Investigation Unit separate from general investigations,” att least for the moment until progress has been made on the investigations still ongoing in the DR Congo and elsewhere.  

The EB members deferred debate on the draft WHO decision until Saturday morning.

Country responses commend WHO and emphasize survivor-centered approach and ‘zero tolerance’ policy

Representatives across Member States otherwise commended the WHO for its efforts towards prevention of sexual exploitation, abuse, and harrassment, with some emphasing the need to adopt a survivor-centered approach in responding to the allegations. 

“It is important that we create an environment conducive to effectively preventing sexual exploitation and abuse, and that means asking ourselves hard questions about responsibility,” said Tunisia, on behalf of the WHO Eastern Meditterean Region. 

Tunisia, and many other Member States noted that a zero tolerance policy is needed, and proposed that a common UN database be created. The database would be consulted before staff recruitment, ensuring that the necessary checks can be made. 

“We need to do this, making effective and efficient use of the resources we have available on gender equality.”

France, on behalf of the European Union, echoed these sentiments, and also reiterated the need for “accountable culture within the organization.”

“We think it is better to have people providing the information because peace is being swept under the carpet.”

Concern and clarification needed on transparency and accountability 

However, some representatives continued to express their concern regarding the WHO’s work on sexual exploitation and abuse, including China and the United States. 

China noted the need for clarification from the WHO on the interim report and “transparency and accountability of the related work.”

“We hope that WHO will further clarify on how it will communicate on concrete action taken both within and outside of the organization.” 

The US representative, Bathsheba Nell Crocker, acknowledged the recent progress of the WHO, but added that “broader organization reforms are needed, as well as the dedicated effort now required to translate division laid out for WHO’s work in this area into concrete results on the ground.”

She also pointed out that WHO’s efforts to increase awareness, conduct training, and fill capacity are “essential but insufficient.” 

“[There is] absence of investment in evidence-driven survivor centered prevention, risk mitigation, and response protocols.”  

Crocker noted that WHO must encourage prompt reporting and delivery of survivor centered services. 

“Organizational change starts at the top with leadership. We call on WHO to ensure that roles and expectations are clear and to enforce whistleblower protections.”

Image Credits: Flickr: World Bank / Vincent Tremeau, WHO EB 150.