UN rapporteurs say WHO failed DRC sexual abuse victims

The World Health Organization had an “inadequate response” to allegations of sexual exploitation and abuse during an Ebola outbreak in the Democratic Republic of Congo, based on publicly available information and intelligence received by a team of United Nations rapporteurs.

A letter written to WHO Director-General Tedros Adhanom Ghebreyesus said the agency’s response 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.”

Among the criticisms was a failure to support criminal investigations in DRC, provide reparations to victims, and properly protect confidentiality of victims, according to the letter. The investigation has also been marred by delays.

The letter was sent in mid-March but made public Monday as WHO convened World Health Assembly meetings in Geneva. It was signed by Reem Alsalem, U.N. special rapporteur on violence against women; Tlaleng Mofokeng, U.N. special rapporteur on the right to the highest attainable standard of physical and mental health; and Melissa Upreti, chair-rapporteur of a U.N. working group on discrimination against women and girls.

WHO said in a written reply that it takes responsibility for failing to prevent exploitation and abuse but said it has gone to “extraordinary lengths” to support victims and hold those responsible to account.

Alsalem called on the World Health Assembly and member states to “rigorously monitor the progress made by WHO and others in implementing the commitments made to date,” according to a press statement Monday.

A series of failures

In September 2020, reports emerged of alleged sexual abuse during the Ebola response from 2018 to 2020 in DRC’s North Kivu and Ituri provinces. They included accusations against WHO personnel and contractors, among others. Allegations included officials exchanging sex for jobs and then forcing abortions on those who became pregnant.

WHO established an independent commission to examine the allegations and found the acts amounted to sexual exploitation and abuse. The commission documented at least nine rapes, and some 125 people said they had been sexually exploited or abused by WHO personnel or contractors during the period.

The commission published a report in September 2021. WHO provided administrative support and resources but did not participate in the investigation.

Eighty-three people who had accusations against them were identified, and the commission established “with certainty” that these were WHO employees in 21 cases — both Congolese nationals and foreigners. Four staff members who were still employed with the agency had their contracts terminated following release of the report.

WHO doesn't have jurisdiction to hold criminal proceedings, so its investigation was an administrative, fact-finding mission, with an expectation that the agency would refer the information to national authorities for criminal proceedings, according to the letter.

Given the scale of the apparent abuse “and the alleged implication of members of WHO senior management,” a criminal investigation in DRC should have taken place simultaneously, the letter said. WHO has not made public any plans to facilitate an in-country investigation by handing over evidence to national authorities nor made monetary or other reparations to survivors.

In January 2021, Tedros instructed the director of WHO’s Office of Internal Oversight Services to “defer any internal investigation” of an agency staff member until the publication of the commission's report.

“These decisions, it could be argued, constitute a failure to take immediate action in the face of the seriousness of the allegations and may have resulted in a negative consequence for the victims,” the letter stated.

Beyond national criminal charges, the violations could fall “within the purview of international criminal law,” according to the letter.

The confidentiality of the victims was not adequately protected in the report, leaving them vulnerable to further victimization, as they could be easily identified by family and community members, according to the letter.

The rapporteurs also raised questions in the letter about the composition of the independent commission, noting that Tedros directly appointed two of the co-chairs and no publicly available and stand-alone terms of reference for the commision were made available.

“Procedural fairness requires not only that decision makers act objectively and in good faith but are also perceived to do so,” the letter stated.

Widespread reforms

Upon the release of the report last year, Tedros publicly apologized to the victims in DRC for their “ongoing suffering” and lamented that they had to relive their experiences in testimony to the commission.

Dated Saturday, a reply to the rapporteurs written by Dr. Gaya Gamhewage, director of prevention and response to sexual misconduct at WHO’s Office of the Director-General, said the agency had undertaken widespread changes following the allegations.

These include a new policy on sexual abuse and exploitation, reforming investigation services, and increasing staff training — with a budget of $50 million to take on this work.

WHO said it signed an agreement with a legal aid organization in Goma, located in eastern DRC, to provide free aid for victims to pursue legal action and has a hotline that raises awareness of these services.

U.N. rules prevent WHO from paying monetary reparations, but Tedros has called for a $2 million assistance fund to provide support. Some $350,000 has been transferred to service providers in DRC to support victims, including legal aid and socioeconomic support, Gamhewage wrote.

The fund does not replace the need for reparations, and the U.N. must develop a policy around this, Alsalem said, but she still urged states to invest in the fund and help WHO manage it effectively.

“Support provided by the UN is not understood as a reparative element that emanates from assuming criminal responsibility for wrongs committed,” she told Devex, adding that it's not clear if victims were consulted about services they would receive.

The agency recognizes its weaknesses in conducting investigations. In a report for the World Health Assembly, WHO acknowledged that “the institutional capacity for investigation of sexual exploitation and abuse and sexual harassment remains fragile.”

WHO’s reply letter said confidential case files were transferred to the Office of Internal Oversight Services of the United Nations and WHO is now waiting for it to complete its investigations. This was done to “complete the investigations with complete functional independence from WHO,” the letter said, adding that it will “take additional appropriate action” once these investigation reports are available.

While the oversight office does not have criminal jurisdiction either, this investigation is meant to determine whether the alleged misconduct constitutes criminal conduct for referral to a national authority for prosecution, Alsalem told Devex.

But the investigation has been characterized by delays, she said. The commission was given a year to carry out a thorough investigation, in which WHO leadership halted other investigations.

And it's still unclear whether the U.N. has referred any cases to the national authorities in DRC, but the agency’s response is a “good basis for a continued discussion on these issues,” Alsalem said.