World Health Organization (WHO) staff committed acts of sexual abuse during an Ebola outbreak in DR Congo from 2018 to 2020, an independent commission appointed by the global health body to probe the allegations said on Tuesday.

In a 35-page report, the panel cited “clear structural failures” and “individual negligence that may amount to professional misconduct” in its findings after interviewing dozens of women who were offered work in exchange for sex, or who were victims of rape.

“The scale of incidents of sexual exploitation and abuse in the response to the 10th Ebola outbreak, all of which contributed to the increased vulnerability of ‘alleged victims’ who were not provided with the necessary support and assistance required for such degrading experiences,” the report said.

WHO Director General Tedros Adhanom Ghebreyesus said the report “makes for harrowing reading.”

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At a press conference on Tuesday, Tedros apologised to “the victims and survivors of the sexual exploitation and abuse in DRC.” WHO Africa chief Matshidiso Moeti said: “As WHO leadership we apologise to these people, to the women and girls.”

The panel also pointed to a “perception of impunity of the institution’s staff on the part of alleged victims.”

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The panel probed nine allegations of rape and said women interviewed by it had said the perpetrators used no birth control, resulting in some pregnancies. Some women were even forced have abortions, Malick Coulibaly, a panel member, said during a media briefing Tuesday.

Tedros appointed the panel’s co-chairs to investigate the claims last October after media reports claimed unnamed humanitarian officials sexually abused women during the Ebola outbreak.

Tedros had said he was “outraged” and any staffers connected to the abuse would be dismissed immediately. Four people have been fired and two placed on administrative leave, Associated Press quoted diplomatic sources as saying.

The review team was able to obtain the identity of 83 alleged perpetrators, both Congolese nationals and foreigners. In 21 cases, the review team was able to establish with certainty that the alleged perpetrators were WHO employees during the Ebola response.