WHO plans to regain public trust through new safeguarding measures

Last month, the European Union suspended €20.7 million ($24 million) in funding to the World Health Organization’s operations in the Democratic Republic of Congo due to concerns over the agency’s handling of the sexual abuse scandal in the country.

The EU Commission told Reuters that it expected partners to have "robust safeguards to prevent such unacceptable incidents as well as to act decisively in such situations."

The suspension comes a month after WHO shared findings from an independent commission’s investigation into the allegations of sexual abuse. The investigation found that the organization failed to prevent and tackle widespread sexual abuse, and took over a year to establish the commission despite having knowledge about the allegations.

But the agency’s acting director of prevention and response to sexual exploitation, Dr. Gaya Gamhewage, said the organization will regain public trust by tackling sexual exploitation and abuse, or SEA, head on. She added that the organization has already taken a number of actions to support survivors and reform structures.

The top priority has been ensuring victims and survivors are taken care of, and representatives of the WHO at various levels have met with victims, identified the support needed, and are providing this support, she said.

The agency’s plan prioritizes supporting survivors and their families; completing investigations; taking urgent managerial action and launching a series of internal reviews and audits; and reforming WHO structures and culture.

In the next 15 months, it is expected to establish and operationalise a victim- and survivor-centered approach; ensure WHO personnel and leaders are accountable for prevention, detection, and response to SEA; and initiate an overhaul of WHO’s policies, procedures, and practices to increase safeguards against SEA in its programs and operations.

“One thing that victims and survivors confirmed was that they had immediate medical and psychosocial support [needs],” Gamhewage said. “But now, because some time has passed, they are really looking for three things: they're looking for safe spaces where they can come and find information. Some of them need more psychosocial support. And thirdly, they would really like to move on with their lives.”

For some of the victims, “moving on” entails some training to start a livelihood — learning a trade and getting some support in the form of equipment with which they can get on with their lives. And for those with children, they are also asking that their children be supported, she said.

Victims' rights advocates and other existing networks have been providing the support requested but internal investigations found that support services in Goma are still insufficient. A United Nations delegation will be visiting Goma in the coming weeks to assess the needs and services, Gamhewage said.

Dealing with perpetrators

Gamhewage said the report identified 83 cases and 21 perpetrators from the WHO whose contracts have now been terminated. She however noted that the process was delayed due to challenges in compiling case files as some of the information they had was incomplete — with some of the perpetrators being identified by just their first name or last name.

“We are also giving all the files to the U.N. investigation services, because there are 60 more cases that could be related to other agencies, and they will help us review all of this and inform the other agencies,” she said.

The organization is also directing its workers to report suspicions of sexual abuse or misconduct by creating an accountability framework where failure to report misconduct can result in disciplinary action.

In his remarks at the World Health Assembly, Dr. Tedros Adhanom Ghebreyesus, WHO’s director-general, said the agency would introduce cashless payment and direct transfer to deal with the power dynamics that drive sexual abuse and exploitation.

The organization confirmed that they will support WHO country offices “to set up a robust system that enables fast and reliable payments directly to frontline workers using mobile money and/or other available technologies,” in a statement to Devex.

Gamhewage said that cash significantly increases the risk of sexual abuse and exploitation especially in communities that are very economically vulnerable.

Looking ahead

WHO is making a big change in its engagements by putting victim and survivor centered approach into consideration —  “from awareness, to alert, to response” — and reviewing and revising its full end-to-end systems and policies, from how an alert is managed and all the way to investigation and disciplinary action, Gamhewage said.

She added that the major lesson from the investigations was the need for WHO and the U.N. to do more on risk assessment.

Though there has been a lot of focus on allegations in Africa because a lot of the outbreaks the organization responds to are in Africa, she said her office will address SEA in all the countries they operate in.

I don't think it is an Africa-specific issue. It's a vulnerability and power differential issue,” she said. “It's about the power differential between people who come to help and the communities and we know there is a lot of poverty vulnerability in African countries. But … sexual exploitation and abuse can happen anywhere.”

The agency through the Inter-Agency Standing Committee has identified the ten highest risk countries, including DRC, Venezuela, Afghanistan, Pakistan, and Myanmar, and is working with the governments from these countries to introduce risk assessment and mitigation policies. But this is a complex endeavor as there is lack of legal consensus regarding what constitutes rape, sexual abuse and/or sexual exploitation across the 150 countries and regions where the WHO is actively involved.

In the short-term, Gamhewage said the WHO is requiring that its officials and contractors abide by its codes of conducts, even when what it outlaws is legally permissible in some regions. She noted that the agency is now striving to ensure that the people it serves trusts that its safeguarding measures are as good as its public health program.

“I think trust is not a word, trust is an action. If we show that we are taking all the safeguards, trust will be built over time,” she said. “It will take time, and we are committed to doing it.”