GENEVA – Faced with a chorus of demands for accountability from member nations, Dr Tedros Adhanom Ghebreyesus again pledged greater efforts by the World Health Organization’s (WHO) leadership to eliminate sexual exploitation and abuse by its staff and contractors at the World Health Assembly on Wednesday. 

The discussion followed the recent publication of a letter sent to Tedros in March 2022 by three UN Special Rapporteurs regarding the “inadequate response” by the WHO to allegations of sexual exploitation and abuses during the Ebola response in the Democratic Republic of the Congo (DRC) from August 2018 to June 2020.

A number of weaknesses may have “prevented a fair and thorough investigation of crimes of sexual harassment, exploitation, and abuse” and “weakened the accountability for these crimes allowing perpetrators of these crimes to go unpunished”, according to the letter signed by Rapporteurs on violence against women, the right to the highest attainable standard of physical and mental health, and the Working Group on discrimination against women and girls, Reem Alsalem, Tlaleng Mofokeng, and Melissa Upreti.

The Rapporteurs also criticised the WHO for failing to explain how it would ensure criminal accountability for any sexual abuse committed by WHO personnel, beyond stating its existing policy of “referring cases that constitute a crime to national authorities for criminal investigation”, and committing to providing “support for legal action through the UN and national stakeholders”.

The Rapporteurs, who had information about 125 women, girls and men, also said the WHO had not adequately protected the identities of those abused.

An independent commission set up by the WHO found that 83 emergency responders in the DRC’s 2018-2020 Ebola outbreak, including 21 WHO employees and consultants, had raped nine women and likely abused dozens of women and men, obtaining sex in exchange for promises of jobs.

Member states want more action

During a discussion on the issue at the WHA on Wednesday, the African region represented by Cameroon, called on the WHO to establish a sub-committee within its health emergency programme “to consider how the organization’s current policies and procedures on prevention of and response to sexual exploitation and abuse and harassment could be improved”. 

The Africa group also welcomed the appointment of a regional coordinator on the prevention of sexual exploitation, abuse and harassment, who started work in March 2022 and called for adequate funds “to ensure capacity”.  

Meanwhile, the Geneva Group of Friends to Eliminate Sexual Harassment, made up of 56 member states and the EU, noted with concern that the Rapporteurs’ correspondence “was made public only this week”. Netherlands, on behalf of the group, called for regular updates from the WHO leadership and ongoing exchanges between the WHO and other UN organisations to strengthen the “zero tolerance” approach for sexual exploitation, abuse and sexual harassment. 

Norway also referred to the Rapporteurs’ concerns and said that these needed to be reflected in WHO’s management response plans.

“We stress the importance of providing the UN Office of Internal Oversight Services (OIOS) with unhindered access to all information and staff throughout its investigations,” said Norway.

Waiting for UN  investigation

In a response to the Special Rapporteur, dated 20 May, WHO said that the investigation of the allegations currently underway by the UN’s OIOS need to be completed before it takes further action against any of the WHO staff or former staff alleged to have committed the sexual exploitation and harassment. 

“All investigations related to the 10th Ebola outbreak in the Democratic Republic of the Congo are investigated by UN OIOS, not WHO,” said the WHO in an eight-point response to the Rapporteurs signed by Gaya Gamhewage, WHO’s director of prevention and response to sexual misconduct.   

It added that any criminal charges filed with the DRC government authorities would have to be filed with the consent of the victims – and so far that hadn’t been received. 

“WHO takes a victim- and survivor-centred approach and prioritizes their protection, wishes and needs. This requires obtaining consent from the survivor to share their personal information. As this has not yet been received, WHO has asked UN Investigators to seek such consent.” 

Speaking to Health Policy Watch, outside of the chambers, Gamhewage added that WHO had also offered 25 women in the DRC who were victims of abuse financial support for any cases that they wished to pursue in local courts there. 

‘Long. long way to go’

“We appreciate the attention you have given this,” Dr Tedros said in soft tones to delegates seated in one of the 194-nation World Health Assembly’s round chambers.

He acknowledged the criticism of bureaucratic delays, multi-year backlogs in investigations and concerns about the quality of WHO’s work, acknowledging that “we have a long, long way to go”.

Despite the hurdles, Tedros sought to highlight some progress WHO has made in creating a culture of zero tolerance for sexual abuse, exploitation and harassment. This includes holding weekly meetings, discussing possible actions and taking steps to put greater focus on prevention and care for the victims and survivors. 

He said WHO is sensitive to complaints about its investigation backlogs — and delays in delivering justice.

“And they are right, because some of the investigations have taken two years, three years, four years, five years, even more. I know some of the investigations that came after seven or eight years. So that’s why the backlog is now being finished,” he said, adding that WHO set a new 120-day deadline for all such investigations to be completed. 

“This is the first time we’re trying it in the UN system and we see advantages to it because it brings accountability,” Tedros said. “Of course, there are some concerns from some colleagues about the quality of it. But I assure you that quality will not be compromised, because quality will be at the centre.”

However, it took Tedros more than two months to respond to the Rapporteurs’ letter. In the WHO reply of 20 May, Tedros apologized for the delay, which he blamed on an “administrative error.” 

He assured Alsalem nonetheless that he feels a “profound, personal commitment to addressing the issues of sexual exploitation and abuse, and violence and discrimination against women and girls in all its forms.”

Also responding to the Rapporteurs in the WHO letter, Gamhewage said that the UN system is still working to find agreement on how best to focus its efforts around victims and survivors.

“I want to assure you that we are working with women-led organizations trusted by communities to support victims, but also to get their voices into the strategy that we’re developing,” she said.