Africa and WHO Lead Global Charge to Embed Accountability Against Sexual Misconduct in Health Systems

The framework provides a voluntary yet scalable system that guides ministries of health in strengthening safeguarding processes during joint operations with WHO.

The World Health Organization (WHO), in collaboration with 42 African Member States, has launched a groundbreaking initiative aimed at embedding accountability systems for Preventing and Responding to Sexual Exploitation, Abuse, and Harassment (PRSEAH) across joint health operations. This milestone effort was formalized during the African Strategic Conference on Prevention and Response to Sexual Misconduct, held in Pretoria from 17–20 November 2025. The initiative marks one of the most comprehensive regional approaches to safeguarding in the global health sector and may become a model for worldwide implementation.

This action draws momentum from the PRSEAH Accountability Framework for Member States, endorsed at the 78th World Health Assembly in May 2025. The framework provides a voluntary yet scalable system that guides ministries of health in strengthening safeguarding processes during joint operations with WHO. Unlike previous global standards, it uniquely integrates protections against sexual harassment alongside exploitation and abuse—closing a critical gap in international safeguarding protocols.

Core Foundations of the Framework

The PRSEAH Accountability Framework focuses on three key pillars:

• Clear Policies and Codes of Conduct Countries will implement minimum and binding standards for behavior in health settings, ensuring that all workers understand expectations and consequences related to misconduct. These standards also require alignment with national laws and international human rights conventions.

• Mandatory and Specialized Safeguarding Training Training modules will be applied across various tiers of the health workforce, including emergency responders, frontline clinicians, logistics teams, and local partners. Additional training will be developed for survivor support teams and system administrators responsible for risk prevention.

• Robust Incident Reporting and Accountability Systems This includes confidential reporting channels, survivor-centered response mechanisms, increased access to psychosocial services, and investigations grounded in due process. Misconduct will trigger disciplinary measures, contract termination, or legal prosecution depending on severity and jurisdiction.

Together, these measures aim to not only respond to misconduct but prevent harm before it occurs—ensuring safety without exception.

Africa Setting a Global Example

With over 160 public health emergencies occurring annually across the region, African Member States emphasized urgency, operational readiness, and structural reform during the Pretoria conference. Delegates shared success stories, gaps, and challenges in implementing safeguarding systems, resulting in agreed-upon regional action principles and implementation pathways.

This leadership is particularly significant given the vulnerability of emergency-affected populations, particularly women, children, and displaced groups, who are disproportionately exposed to sexual exploitation and power-based abuse.

“Preventing and responding to sexual misconduct is inseparable from our collective commitment to gender equality, human rights, social justice, and inclusion,” said Dr. Alia El-Yassir, WHO Director for Gender, Rights, Equity and Sexual Misconduct Prevention. “When women and communities are safe and respected, societies thrive.”

A Global Shift in Health Governance

The initiative coincides with the 16 Days of Activism Against Gender-Based Violence, reinforcing that health systems must represent safety, dignity, and trust—not fear or discrimination.

WHO plans to scale this model globally, supporting ministries of health in strengthening national policies, integrating real-time monitoring tools, establishing reporting systems, and creating continent-wide learning networks. Future plans include annual accountability reviews, a digital early-warning reporting platform, regional peer-learning labs, and standardized survivor support protocols.

The overarching vision: a world where every health worker is accountable, every survivor is supported, and every community is protected.