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# 					2020 Trafficking in Persons Report			

Office to Monitor and Combat Trafficking in Persons

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													Message From The Secretary of State											

            -  Message From The Secretary of State   
            -  Message From The Ambassador-at-Large   
            -  Looking Back on Twenty Years of the Trafficking in Persons Report   
            -  Topics of Special Interest                -  Trauma Bonding in Human Trafficking 
              -  Accountability for UN Peacekeepers 
              -  Faith-Based Efforts To Combat Human Trafficking 
              -  Human Trafficking of Athletes 
              -  Extraterritorial Commercial Child Sexual Exploitation and Abuse: Evolving Information and Improving Responses 
              -  Reengineering Health Care for Survivors of Human Trafficking 
              -  The Intersection of Human Trafficking and Addiction 
            -  Child Soldiers Prevention Act List   
            -  Methodology                -  Tier Placement 
              -  A Guide to the Tiers 
              -  Funding Restrictions for Tier 3 Countries 
            -  Global Law Enforcement Data   
            -  Trafficking Victims Protection Act: Minimum Standards for the Elimination of Trafficking in Persons   
            -  Victim Stories                -  Colombia | Domestic Servitude 
              -  Romania-Italy | Sex Trafficking 
              -  India | Forced labor 
              -  Cambodia | Debt Bondage 
              -  Nigeria-Ghana | Sex Trafficking 
              -  Vietnam-United Kingdom | Forced Labor 
              -  Philippines-United States | Forced Labor 
              -  Tanzania | Domestic Servitude 
              -  Canada | Sex Trafficking 
              -  United States | Sex Trafficking 
            -  2020 TIP Report Heroes                -  Karma Rigzin | Bhutan 
              -  Reda Shoukr | Egypt 
              -  Ary Varela | Cabo Verde & Natalino Correia | Cabo Verde 
              -  Patricia Ho | Hong Kong 
              -  Nina Balabayeva | Kazakhstan 
              -  Sophie Otiende | Kenya 
              -  Lāsma Stabiņa | Latvia 
              -  Maxwell Matewere | Malawi 
              -  Oxana Alistratova | Moldova 
            -  Tier Placements and Regional Maps                -  Tier Placements 
              -  Regional Maps 
            -  How To Read a Country Narrative   
            -  Relevant International Conventions   
            -  Stopping Human Trafficking and Sexual Exploitation and Abuse by International Peacekeepers and Civilian Personnel   
            -  International, Regional, and Sub-Regional Organizations Combating Trafficking In Persons                -  Multilateral Organizations Combating Trafficking in Persons 
            -  Annual Report on the Use of Child Soldiers                -  Sections 405(c) and (d) of the Child Soldiers Prevention Act (CSPA) of 2008 (22 U.S.C. 2370c-2(c) and (d)) 
            -  Glossary of Abbreviations   
            -  Photo Credits   
            -  Acknowledgments   
            -  Country Reports                -  Africa (Sub-Saharan) 
              -  East Asia and Pacific 
              -  Europe and Eurasia 
              -  Near East (Middle East and North Africa) 
              -  South and Central Asia 
              -  Western Hemisphere 

							Message From The Secretary of State					

Dear Reader:

For 20 years, the Trafficking in Persons Report (TIP Report) has demonstrated the United States’ conviction that human trafficking is a global threat necessitating a global response. Traffickers are denying nearly 25 million people their fundamental right to freedom, forcing them to live enslaved and toil for their exploiter’s profit. This report arms governments with the data they need to increase the prosecution of traffickers, provide victim-centered and trauma-informed protection for victims of trafficking, and prevent this crime altogether.

As this 20th anniversary report is released, we and our allies and partners find ourselves confronting a crisis that has reached previously unimagined proportions. While urgency has always marked the fight against human trafficking, the implications of the COVID-19 pandemic have magnified the need for all stakeholders to work together in the fight more than ever. We know that human traffickers prey upon the most vulnerable and look for opportunities to exploit them. Instability and lack of access to critical services caused by the pandemic mean that the number of people vulnerable to exploitation by traffickers is rapidly growing.

To turn the tide, action must accompany words. Among other steps, governments must end state-sponsored forced labor; they must increase prosecutions of human traffickers; and they should expand their efforts to identify and care for trafficking victims, while ensuring they are not punished for crimes traffickers compelled them to commit.

The opportunity for impact in the days ahead is great. I am so proud of all who lead us forward in this work, especially our TIP Report Heroes who model the courageous leadership we need for the road ahead. I am grateful for the Trump Administration’s unending commitment to this cause, and for my colleagues at the State Department who have delivered this impressive report under extraordinary circumstances.

We are leading by example as we encourage governments, survivors, NGOs, industry leaders, communities of faith, and advocates in every country to remain steadfast in the protection of human dignity and the pursuit of freedom. Let’s all continue this fight together.

Sincerely,

Michael R. Pompeo

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							Message From The Ambassador-at-Large					

Dear Reader:

There has never been a more important moment to engage the fight for freedom. Now, more than ever, we must collectively commit to stopping human traffickers and protecting victims. We will not be deterred from dismantling this crime down to its very foundations and ensuring the protection of future generations.

This year, the TIP Report looks into the evolution of the report itself over the past 20 years. Since the passage of the Trafficking Victims Protection Act (TVPA) in 2000, we have faced many challenges as a global community, and the TIP Report has been produced throughout all of them. As we now launch this 20th anniversary report in the midst of the COVID-19 emergency, we are making it clear: neither terrorism nor financial crisis nor a pandemic will stop us from pursuing freedom for victims.

As we have continued our work during the COVID-19 pandemic, traffickers have continued as well. Traffickers did not shut down. They continue to harm people, finding ways to innovate and even capitalize on the chaos. The ratio between risk and reward is expanding in their favor. And so, we press on all the more. As the vulnerable become more vulnerable, we remain resolved in our pursuit of freedom for every victim of human trafficking and accountability for every trafficker.

This 20th anniversary TIP Report is a powerful tool forged to advance the global community’s commitment to put freedom first. I am grateful to State Department officers around the world, ambassadors, and the Secretary for prioritizing the production of this report. To my intrepid colleagues at the Office to Monitor and Combat Trafficking in Persons (TIP Office), thank you for your perseverance and grit in every detail of this work. You are truly remarkable.

Despite the schemes of traffickers, the reality is this: governments across the world, survivors, NGOs, faith communities, and advocates are still at work. For 20 years we have determined that we will not grow weary in our fight for freedom, and we have only just begun. Hope lies ahead.

Sincerely,

John Cotton Richmond

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							Looking Back on Twenty Years of the Trafficking in Persons Report					

This year marks a major milestone—the 20th anniversary of the TIP Report. Twenty years ago, when the United States Congress passed the TVPA mandating this report, it signaled the U.S. government’s resolve to fight human trafficking and marked a pivot from indignation to positive action. Whether used to raise awareness, spark dialogue, spur action, or create a system of accountability, the TIP Report has served to reinforce global anti-trafficking norms and ideals. At a time when many governments denied the existence of human trafficking in all its forms, the TIP Report became a standard-bearer for the principles enshrined in the TVPA and the UN Trafficking in Persons Protocol (Palermo Protocol).

Throughout the last two decades, and as the availability of information on human trafficking has expanded, the TIP Report has grown in both its breadth and depth of analysis. It has consistently documented the efforts of an increasing number of governments to prosecute traffickers, protect victims, and prevent human trafficking crimes. The report has drawn attention to trends and emerging issues, highlighted promising practices, and tracked the progression of important developments, such as the passage of comprehensive anti-trafficking laws and improvements in victim identification efforts.

Over the years, the methodology, content, and design of the TIP Report have evolved, reflecting in many ways the broader anti-trafficking movement’s progress in understanding the crime. The message at the heart of each edition, however, has been steadfast: there is no excuse for human trafficking, and governments must address it with bold action.

Most of all, the TIP Report has been, and continues to be, a critical tool in bringing governments to the table and encouraging them to prioritize human trafficking. Diplomats and advocates apply pressure on governments around the world to ensure they maintain focus and hear the voices of those directly affected. Today, the vast majority of governments acknowledge the devastating effects of human trafficking, and most governments have taken steps to combat it.

The introduction this year will provide a look back at the evolution of the TIP Report. It is a celebration of 20 years documenting progress in combating human trafficking and, as always, a candid reminder of the work yet to be done.

**Background**

Human trafficking became a topic of public concern in the 1990s due, in part, to the fall of the former Soviet Union, the resulting migration flows, and the increasing concern about the growth of transnational criminal organizations operating globally. Intelligence reports pointed to sex trafficking and forms of forced labor as some of these organizations’ largest sources of profit. The first efforts to address trafficking in persons focused heavily on combating the sex trafficking of women and girls. Academic reports and news articles illustrated the effect traffickers were having on individuals and communities around the world. In 1994, the  Department of State began to monitor human trafficking as part of the Department’s Annual Country Reports on Human Rights Practices, focusing exclusively on sex trafficking of women and girls. As the understanding of human trafficking expanded, the U.S. government, in collaboration with NGOs, identified the need for specific legislation to address how traffickers operate and to provide the legal tools necessary to combat trafficking in persons in all its forms.

The 106th Congress of the United States passed the TVPA in 2000, the first comprehensive federal law designed to protect victims of sex and labor trafficking, prosecute traffickers, and prevent human trafficking in the United States and abroad. The TVPA requires the Secretary of State to submit an annual report to Congress that ranks governments’ efforts to combat trafficking in persons. The original three-tier ranking system was created to indicate how well other governments complied with the minimum standards for the elimination of trafficking laid out in the law.

In July 2001, the Department of State published the first TIP Report. While the TVPA only called for a ranking of governments, those involved in the preparation of the first report included a brief explanation for the tier rankings to provide clarity and context to the report. The first TIP Report included 82 country narratives based on information received from embassies and consulates abroad, which gathered information including from host governments and law enforcement officials, NGOs, U.S. agencies, and journalists. It was only 103 pages long and included brief two-paragraph descriptions of each country’s efforts to combat human trafficking.

The report’s production in the early years was a monumental task for the newly established TIP Office. It required the small staff to create simultaneously both a methodology for the report and processes for gathering data, drafting narratives, and assessing government efforts. Perhaps most challenging for the TIP Office and posts overseas was the effort to gather data from other governments, many of which had never developed systematic measures for collecting human trafficking data nor shared such data before. In addition, the report would be the first of its kind to rank countries publicly on their efforts to combat human trafficking, a crime newly denounced by the international community.

At the time, inclusion in the report depended on whether there was evidence of a “significant number” of victims in a given country, though the U.S. Congress did not specify what it considered to be a “significant number.” Once the drafters of the first report received reporting from all the U.S. embassies, which included information on the estimated number of victims in each country, they determined that 100 or more victims would be the threshold number, taking into account that for small countries this would be a high threshold but for large countries a low one. The report pointed to a dearth of reliable information to explain the exclusion of so many countries and called attention to the need for more governments to develop mechanisms to detect and report on human trafficking.

**The Evolution of the TIP Report**

Since 2001, the TIP Report has continued to evolve in both substance and design. Stylistically, the 2003 TIP Report went through one of the most noticeable visual transformations. This report was the first to feature a colorful front cover with the signature eyes and a letter from the Secretary of State, as well as compelling photos and images, victim stories, and a list of international “promising practices” in combating human trafficking. The narrative text of the introductory section evolved from providing minimal explanation of human trafficking and the purpose of the report, to covering a variety of human trafficking issues and current trends. Over time, the introduction began to cover concrete themes and a collection of special topics interspersed throughout. Though not mandated by Congress, the introduction has in many ways become a public outreach tool in and of itself.

In addition, the report methodology and content changed as the years progressed. Congress made many of these alterations through amendments to the TVPA and its reauthorizations. Others reflect policy priorities and efforts to provide clarification and justification for the tier rankings and country narratives. Some of the most important changes are listed on pages 6-7.

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***The Evolution of the TIP Report***

**2000 –**The TVPA passed, creating the TIP Office and mandating the annual TIP Report.

**2001 –**The first TIP Report ranked countries on one of three tiers and briefly described 82 governments’ efforts to combat human trafficking.

**2003 –**TIP Report narratives began using the “3P” paradigm – prosecution, protection, and prevention – to assess and describe government efforts.

Pursuant to the TVPA, countries ranked on Tier 3 faced for the first time potential restrictions that included the loss of certain types of U.S. assistance.

Thirty new countries were included in the report, with 116 in total, marking a major increase in the amount of information available on governmental efforts to combat human trafficking.

**2004 –**Another 15 countries were added to the report, jumping from 116 to 131, as a result of an increase in the volume of information generated from a greater understanding of human trafficking around the world.

The TIP Report ranked 42 countries on the Tier 2 Watch List. The 2003 reauthorization of the TVPA mandated this new ranking.

The report also applied new criteria pursuant to the 2003 reauthorization in determining if governments were making sufficient efforts to eliminate trafficking, including whether they made “appreciable progress” as compared to the previous year.

The TIP Report featured a new section on TIP Report Heroes to highlight the importance of individual action to combat human trafficking.

**2008 –**The William Wilberforce Trafficking Victims Protection Reauthorization Act of 2008 widened the scope of countries in the TIP Report by striking the requirement that a “significant number” of victims be documented for a country to be listed. The report grew from analyzing 154 countries in 2008 to 173 countries the following year.

In an effort to incentivize continuous improvement, the reauthorization limited the number of consecutive years a country could remain on the Tier 2 Watch List to two consecutive years, after which it would be automatically downgraded to Tier 3 should it fail to make improvements that would warrant an upgrade. Countries could receive a waiver to remain on the Tier 2 Watch List for two additional years if they had a written action plan and resources dedicated to its implementation.

The 2008 reauthorization also included the Child Soldiers Prevention Act (CSPA), mandating the inclusion of a list in the TIP Report of foreign governments that had been found to have unlawfully recruited or used child soldiers.

Beginning in the 2008 TIP Report, all country narratives included recommendations for governments to improve their anti-trafficking efforts—a vital component of the report today.

**2010 –**To ensure it held itself to the same standards it applied to all other countries, the TIP Report included a ranking of the United States for the first time. Before 2010, the TIP Report had included a separate section on the United States, summarizing its efforts to combat trafficking in persons.

**2011 –**The CSPA List was included for the first time in the annual TIP Report and included six countries: Burma, Chad, Democratic Republic of the Congo, Somalia, Sudan, and Yemen.

The automatic downgrade provision called for in the 2008 reauthorization applied for the first time in 2011 to 20 countries that had been ranked on Tier 2 Watch List for both 2009 and 2010. Seven of those countries were ranked Tier 3 in 2011, and 13 of them received waivers to remain on the Tier 2 Watch List.

**2013 –**Governments that received waivers to remain on Tier 2 Watch List in both 2011 and 2012 faced the automatic downgrade for the first time in 2013. The Department ranked China, Russia, and Uzbekistan on Tier 3 that year.

**2014 –**TIP Report assessments integrated the changes of the 2013 reauthorization and added new factors to be considered as indicia of efforts to eliminate trafficking, including efforts to prevent human trafficking perpetrated or facilitated by diplomats or peacekeepers deployed abroad and to prosecute such public officials, as well as efforts to engage in effective government partnerships with a range of civil society and other actors.

**2017 –**A Government Accountability Office report (as noted on page 27 of the 2017 TIP Report) issued on December 5, 2016, included several recommendations to improve the clarity and usefulness of the TIP Report. These included recommendations to explain more clearly country tier rankings – which led to moving the tier justification paragraph to the beginning of each narrative – as well as new language to highlight more explicitly the factors that support a given tier ranking.

**2019 –**Two laws enacted in 2019 as part of the most recent TVPA reauthorization package called for a number of changes to the TIP Report ranking process. First, one law reduced the availability of the automatic downgrade waiver to one year (from two years).

A second law amended the TVPA to limit a country to one year on the Tier 2 Watch List after that country received a waiver to stay on the Watch List and was subsequently downgraded to Tier 3. Another provision directed the Secretary of State to consider, as proof of a country’s failure to make significant efforts, a government policy or pattern of certain listed forms of human trafficking.

Another provision amended the CSPA to provide that the restriction on military assistance applies to a government whose “police or other security forces” (in addition to “governmental armed forces” and “government-supported armed groups”) recruit or use child soldiers.

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**An Inside Look:**

*Annual TIP Report Process*

The Secretary of State typically releases the TIP Report at a public event and welcomes members of the anti-trafficking stakeholder community, survivors of human trafficking, White House officials, and Members of Congress. That event marks the culmination of an entire year of activity dedicated to diplomatic engagement built around the tier rankings and country narrative recommendations, as well as the production of the report itself.

Although diplomatic engagement on human trafficking occurs year-round, the process for drafting the TIP Report begins in the fall, when the Department of State’s TIP Office requests information from U.S. embassies regarding the profile of human trafficking in that country and efforts of the government to combat it. Foreign service officers and locally employed staff collect information throughout the year related to law enforcement activity, victim identification and protection efforts, and anti-trafficking policies and practices, among others. This information is sent to analysts in the TIP Office who use it, in combination with other sources such as media reports, academic studies, in-country engagement, and information from the public, to inform the TIP Report tier rankings, country narratives, and recommendations.

Once the Secretary approves the report and determines tier rankings, the Department submits it to Congress in June and releases it to the public. (Details on the tier ranking process can be found on pages 39-41.)

**The Impact of the TIP Report**

*Diplomatic Engagement*

Throughout the year, the report serves as a roadmap for diplomatic engagement with governments around the world on human trafficking. Each TIP Report country narrative lays out a justification for the tier ranking followed by prioritized recommendations for how the government can better meet the TVPA minimum standards. Department of State officials from U.S. embassies and consulates, as well as the TIP Office, use the TIP Report when they meet with foreign government officials across a variety of agencies to draw attention to human trafficking, discuss policy recommendations, and work toward solutions.

Beyond meetings with government officials, embassies find other ways to raise awareness about human trafficking, reinforce the TIP Report recommendations, and highlight promising practices. In many cases, these activities serve to empower NGOs and other local actors and to drive partnerships between governments and civil society.

*For example:*

In 2012, Embassy Skopje in **North Macedonia** organized an award ceremony for Ministry of Labor social workers, praising their outstanding commitment to providing protection, care, and assistance to victims of trafficking.

In 2014, Embassy Santiago in **Chile** organized an ongoing anti-trafficking working group comprising NGOs, international organizations, and foreign embassies. The working group raised the profile of trafficking in persons within Chile and gave civil society the opportunity to participate in the Chilean government’s development of a national action plan.

In 2019, U.S. Ambassador to **Liberia** Christine Elder gave an address as part of the African Methodist Episcopal University (AMEU) Graduate Program Fifth Lecture Series, which brings together students and special subject matter experts to discuss and suggest solutions to the most urgent problems in society. Ambassador Elder emphasized the pervasive nature of forced child labor cases, which occur in all areas of the country, including border, rural, and urban areas, and are often purely domestic in nature.

In 2019, Embassy Banjul in **The Gambia** worked with the Gambian government and multi-sector stakeholders to implement that country’s national action plan to combat human trafficking. Efforts focused on training both government and private sector actors and raising awareness. U.S. representatives from the Department’s Bureau of African Affairs visited Banjul to meet with local representatives from IOM, members of a government-run shelter that houses human trafficking victims, and a local NGO. Members of the NGO, which is composed of trafficking survivors, shared their experiences with trafficking issues in The Gambia.

These types of activities can help increase the general understanding of what constitutes human trafficking and spur new institutional approaches for combating it.

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***Human Trafficking Defined***

The TVPA defines “severe forms of trafficking in persons” as:

- sex trafficking in which a commercial sex act is induced by force, fraud, or coercion, or in which the person induced to perform such an act has not attained 18 years of age; or
- the recruitment, harboring, transportation, provision, or obtaining of a person for labor or services, through the use of force, fraud, or coercion for the purpose of subjection to involuntary servitude, peonage, debt bondage, or slavery.

A victim need not be physically transported from one location to another for the crime to fall within this definition.

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*Tier 3 Restrictions*

The TVPA states that the United States shall not provide nonhumanitarian, nontrade-related foreign assistance to any government of a country that is ranked on Tier 3 for failure to comply with minimum standards for the elimination of trafficking or make significant efforts to bring itself into compliance with such standards.

Ninety days after the submission of the TIP Report to Congress, the TVPA requires the President to make a determination on whether and to what extent to impose such foreign assistance restrictions on Tier 3 governments. Presidential determinations address applicability of assistance restrictions, including those on nonhumanitarian and nontrade-related assistance, funding for cultural exchanges and education, and voting on loans provided by multilateral development banks. In some cases, the President may also waive restrictions for one or more projects, programs, or activities. Foreign assistance not for the benefit the governments of countries listed on Tier 3, such as to support the people of Tier 3 countries through civil society organizations, is generally not restricted under the TVPA.

The chart to the right reflects the number of full restrictions, partial waivers, and full waivers provided annually since 2014.

*Tracking Data*

Since 2005, the TIP Report has collected from governments anti-trafficking law enforcement data, which provide insight into trends over time. The importance of data in measuring the effectiveness of anti-trafficking efforts cannot be overstated and, thanks to the effort of governments to enact comprehensive laws and educate government officials and communities, there is now more data available to evaluate global anti-trafficking efforts than ever before.

Other indicators point to significant improvement in the past 20 years. For example, in 2001, just four countries (Bulgaria, Monaco, Nigeria, and Serbia) had ratified the Palermo Protocol. As of June 2020, all but 15 countries included in the TIP Report are party to the Palermo Protocol. The TIP Report has consistently included a recommendation in country narratives that the remaining governments ratify the Palermo Protocol and has tracked progress on this over the years.

The data submitted for the report by governments and other actors reflect an enhanced understanding of human trafficking, a growing commitment to transparency, and an increasing willingness to work together in addressing a challenge that affects all countries.

*Increasing Public Understanding And Empowering Anti-Trafficking Stakeholders*

The TIP Report represents a credible source of information that civil society uses to advocate for new anti-trafficking policies. The Department of State relies on the information anti-trafficking stakeholders provide each year to effectively evaluate and rank countries’ anti-trafficking efforts. Similarly, anti-trafficking stakeholders rely on the TIP Report to better understand the realities in a given country and use the report as a tool for advocacy. Most NGOs concentrate their efforts on specific aspects of anti-trafficking policies—from protection for victims to law enforcement training and public outreach campaigns. The TIP Report provides a comprehensive view of what the government is doing to combat trafficking in persons. It allows NGOs, advocates, and other individuals in the anti-trafficking movement to take a holistic approach when considering new programs and government partnerships.

The TIP Report also provides stakeholders a useful basis on which to engage with governments that seek to act on recommendations through tangible government policies. The TIP Report not only serves as a warning for governments with weak anti-trafficking policies, it offers a road map for governments, NGOs, advocates, and other stakeholders to engage and create public-private partnerships. Anti-trafficking stakeholders that work in the field have first-hand knowledge of the issues stated in the TIP Report. As a result, they serve as excellent partners to both influence and support implementation of the TIP Report recommendations.

**TIP Report Heroes**

In 2004, the TIP Report started highlighting the efforts of extraordinary individuals combating human trafficking, recognizing TIP Report Heroes for the first time. That year, the report emphasized the importance of the actions taken by “ordinary citizens around the world.” Since then, the TIP Report has featured 146 heroes from more than 75 countries, and it has become clear that these are not just ordinary citizens – they are individuals with an extraordinary passion and commitment to a world where freedom prevails.

Over the years, there have been TIP Report Heroes who are survivors of trafficking, doctors, lawyers, social workers, police officers, religious and business leaders, and journalists, among many others. Heroes have been strong advocates – a first lady, a queen, a pop star, and a former senator. Heroes also have been personally affected by trafficking: a mother whose daughter was kidnapped by the Lord’s Resistance Army; a fisherman forced to work at sea for four years; a former *talibé* who now provides shelter to street children; and an activist who secured the release of ISIS captives. TIP Report Heroes have cared for victims, demanded legal and social change, held governments to account, and educated the public about human trafficking in their countries and around the world. Often working at great personal expense and risk, the TIP Report Heroes are an incredible testament to the idea that the efforts of a single person can make all the difference in the individual lives of victims and the broader fight against human trafficking.

Since 2010, the Department has invited the Heroes to Washington, DC, for the launch of the TIP Report and to receive an award from the Secretary of State. In addition, starting in 2011, the Department’s Bureau of Educational and Cultural Affairs has hosted an International Visitor Leadership Program for the Heroes. Heroes have traveled to cities across the United States to meet with experts at the federal, state, and local levels to exchange information on anti-trafficking efforts. Due to COVID-19 restrictions, the Department honored the 2020 TIP Report Heroes virtually.

**Conclusion**

For the last 20 years, the TIP Report has continuously documented the growing movement against human trafficking and provided a roadmap for governments to address the crime, laying out realistic and actionable policy priorities and insisting on continuous improvement. It has tracked the seriousness with which governments take this issue, not just in verbal commitments but also in concrete action. For two decades, the TIP Report has kept a spotlight focused on a crime many may have preferred to ignore.

The TIP Report urges governments to come to the table to fight this global crime. Its efficacy depends on consensus around the idea that everyone has inherent value and human dignity requires that they be free. When traffickers interfere with this freedom, they weaken the foundation of free and just societies.

The last 20 years have shown that criminalizing all forms of human trafficking and providing victims with access to comprehensive care require commitment and time. Yet, when governments take action and lead, progress toward a world free from human trafficking is possible. One pressing need is for governments to end the practice of state-sponsored forced labor. Other global priorities for governments are to increase labor trafficking prosecutions; to repeal laws that require force, fraud, or coercion for child sex trafficking; and to stop penalizing victims for unlawful acts their traffickers compel them to commit. These and other priorities are integral to the pursuit of freedom. For the next 20 years and beyond, the TIP Report will continue to serve these ends.

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							Topics of Special Interest					

### Trauma Bonding in Human Trafficking

*The following is a product of the Human Trafficking Expert Consultant Network funded by the TIP Office. The purpose of the Network is to engage experts, particularly those with lived experience, to provide expertise and input on Department of State anti-trafficking policies, strategies, and products related to human trafficking, both in the United States and abroad. The authors have a range of expertise related to human trafficking, marginalized communities, and trauma.*

In human trafficking cases, the relationship between victim and trafficker may involve trauma bonding, a phenomenon that is beginning to receive increased attention. In research on the topic, trauma bonding is commonly referred to as “Stockholm Syndrome,” and the terms may be used interchangeably. However, there is no medical standard for diagnosis of either, nor any agreed upon definition of trauma bonding. In addition, there is no definitive understanding of trauma bonding’s prevalence within trafficking situations and not all trafficking victims experience it. Current research is mostly limited to the United States and focused almost exclusively on sex trafficking of women and girls. These research gaps create uncertainty regarding the prevalence and full impact of trauma bonding on all human trafficking victims globally.

Although definitions vary, the most common meaning of trauma bonding is when a trafficker uses rewards and punishments within cycles of abuse to foster a powerful emotional connection with the victim. Traffickers may take on a role of protector to maintain control of the victim, create confusion, and develop a connection or attachment, which may include the victim feeling a sense of loyalty to or love for the trafficker. This connection, or traumatic bond, becomes especially intense when fear of the trafficker is paired with gratitude for any kindness shown. Additionally, trauma bonding, including in cases of trafficking, may occur within familial relationships in which the perpetrator could even be a parent.

**Understanding Biology**

To understand the complexities of trauma bonding in human trafficking, it is critical to consider the biological impact of trauma and the effects of psychological coercion on the brain. The foundations for trauma bonding are laid at the neurobiological levels. During a single incident of trauma, the limbic system, the brain’s emotion center, over-activates and the prefrontal cortex, the brain’s logic center, shuts down.

Repeated trauma exposure can negatively affect brain development and the way a person thinks, often resulting in a victim becoming numb and disconnected from themselves. Therefore, in order for them to feel something, it must be intense. For example, a trafficker’s repeated abuse and the related trauma exposure may result in a trafficking victim returning to the trafficker due to the intensity, familiarity, and routine provided by the relationship. At times, this relationship may also decrease the psychological impact of the trauma as moments of love and care from the trafficker offset experiences of anxiety or fear.

**Understanding Psychological Coercion**

Psychological coercion may increase the likelihood of trauma bonding. When a victim perceives a threat to their physical and psychological survival at the hands of their trafficker, trauma bonding may occur. Traffickers may isolate and threaten victims, induce exhaustion, and interfere with their believed or real ability to escape. A victim may eventually feel helpless and respond to any form of “help” or “kindness” from their trafficker with gratitude and attachment in order to survive.

Inaccessibility to other sources of support or comfort can increase the power of psychological coercion within a trauma bond. Describing the bonding that occurs in the face of danger, psychiatrist and trauma expert Bessel Van der Kolk explains, “Pain, fear, fatigue, and loss of loved ones and protectors all evoke efforts to attract increased care. When there is no access to...other sources of comfort, people may turn toward their tormentors.” Therefore, a victim’s social and economic circumstances may contribute to their developing a sense of trust and loyalty towards a trafficker. For example, lack of access to housing, healthcare, employment, income, education, or asylum may increase the likelihood of a trauma bond developing.

**Impact on Service Delivery**

When a trafficking victim who has experienced trauma bonding seeks assistance, government officials and service providers must recognize that survivors may behave in ways that seem incongruous with typical expectations of victimization. Within human trafficking, trauma bonding may cause coerced co-offending, perceived ambivalence, delayed or inaccurate reporting, or unwillingness to cooperate with law enforcement.

Services available to survivors of human trafficking, especially those who have experienced trauma bonding, need to be responsive to the impact of the survivor’s relationship with their trafficker. A trauma bond may help a victim feel balanced due to the sense of predictability the relationship provides. Within the relationship, there is familiarity and consistency, while leaving the relationship presents the risk of the unknown. The control in a trauma bond may help a person mentally make sense of the world, whereas escaping the trauma bond and trying to make independent decisions may feel overwhelming.

By leaving a trauma bond, a survivor may risk experiencing intense anger and sadness, numbness, negative expectations about the future, and internal disorder. When providers deny access to services due to a victim’s interaction with the perpetrator, it may result in re-victimization through engagement in high-risk survival activities. Stages of “relapses” wherein the victim returns to the trafficker should therefore be considered in treatment planning. Finally, organizations must be cautious not to replicate trauma bonding within their own programs, wherein the service provider assumes the simultaneously protective and coercive role the trafficker previously played in the survivor’s life.

**Looking Ahead**

More research is needed on trauma bonding in human trafficking alongside development of evidence-based and trauma-informed service delivery.

- Rigorous, methodologically sound, and impartial research into the frequency of trauma bonding will support improved understanding among practitioners and more effective policies and services.
- Standardization for assessing trauma bonding can help identify red flag indicators and establish response protocols.
- Systemic inaccessibility to stability is noted frequently among human trafficking survivors. Examination of the relationship between socioeconomic factors and the occurrence of trauma bonding is necessary.
- Adult-focused interventions require additional empirical research on the role of trauma bonding.
- Significant exploration regarding trauma bonding among labor trafficking victims is needed.
- Because there are no consistent criteria for identifying trauma bonding, the label should be used carefully until clear criteria are established.
- Programs need to recognize when trauma bonding has occurred and enhance a victim’s agency. Patience and consistency with service responses may increase a victim’s ability to break the trauma bond.

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### Accountability for UN Peacekeepers

Through the TIP Report’s minimum standards, the TVPA recognizes that countries that send troops to participate in peacekeeping missions should be responsible for training their troops on human trafficking and holding those troops accountable if they engage, while on such missions, in inappropriate behavior, including human trafficking. Unfortunately, accountability for peacekeepers complicit in human trafficking has persisted as a serious challenge for governments and the international community.

As early as 2004, the UN drew attention to this issue in its report on sexual exploitation by UN peacekeepers in the Democratic Republic of Congo, highlighting the lack of compliance by troop-sending countries with the UN’s official policy against sexual exploitation and abuse. In some cases, peacekeepers have sexually abused or sexually exploited women and girls, including in sex trafficking, such as by threatening their access to food and other necessities to coerce them into sex. Victims in such cases also face enormous pressure not to report these crimes and abuses or the peacekeepers who committed them, and local authorities rarely have the capacity proactively to identify victims of these crimes. The UN and international community have attempted to address the challenges in holding peacekeepers accountable for sexual exploitation and abuse since reports of abuse emerged in the early 2000s.

Between 2007 and 2019, the UN received 1,033 allegations of sexual exploitation and abuse, including instances of sex trafficking, by UN peacekeeping mission members. During the 13-year stabilization mission in **Haiti**, peacekeepers allegedly coerced women and girls into sex in exchange for necessities such as food. Reports implicate UN personnel from 13 countries. In 2017, media alleged peacekeepers exploited nine Haitian children in a sex trafficking ring. There were reports that soldiers deployed as UN peacekeepers to **Liberia** sexually exploited women and children, including in sex trafficking, from 2003-2017. In 2015 and 2016, the UN and NGOs reported peacekeepers from 10 countries coerced internally displaced persons into sex in exchange for food and necessities while participating in the UN peacekeeping force in**Central African Republic (CAR).**

Over the years, the UN has adopted several important measures to seek to prevent and address allegations of sexual exploitation and abuse, yet the process of holding perpetrators accountable is often opaque and ineffective. Although the UN may investigate allegations and withdraw peacekeepers, only troop- or police-contributing countries may pursue criminal accountability. And while the UN has the authority to dismiss offending personnel from missions, complicit peacekeepers rarely face a formal criminal justice process. The UN investigates whether allegations are substantiated; however, it does not have the authority to hold individual perpetrators accountable and must ultimately rely on the troop- and police-contributing countries to do so according to that country’s laws. Troop- and police-contributing countries rarely initiate and complete criminal proceedings against alleged perpetrators and, as a result, complicit peacekeepers largely act with impunity. Between 2007 and 2019, troop- and police-contributing countries prosecuted and sentenced to prison 51 peacekeepers for sexual abuse and exploitation. In an effort to increase accountability, the UN began publishing the nationalities of peacekeepers alleged to have committed sexual abuse and exploitation offenses in 2015.

In 2016 and 2018, the UN Security Council adopted two resolutions to strengthen the UN’s response to peacekeeper abuses, including a provision supporting the repatriation of the entire country unit in cases of alleged sexual exploitation and abuse where the relevant government has not taken appropriate steps toward accountability, and a provision calling for evaluation of peacekeeping personnel and greater transparency in how such evaluations ensure accountability. Since then, the UN has taken additional steps to withhold payments for accused uniformed personnel, maintain a transparent website that identifies the nationalities of uniformed peacekeepers accused of sexual exploitation and abuse, and share updates on investigations and actions taken by the UN and troop- and police-contributing countries. This information allows other countries to press governments for investigations and accountability against the perpetrators. Further, UN performance reviews of allegations of sexual abuse and exploitation have resulted in the withdrawal of contingents and the use of other mitigating measures. Additionally, the UN Secretary-General has requested countries establish on-site court martial proceedings when allegations arise involving military contingents to improve access to justice for victims. As of December 2019, **Egypt, Bangladesh,** and **South Africa**had conducted such on-site court martial proceedings.

In recent years, the UN Secretary-General has sought to improve the UN’s response to victims of sexual exploitation and abuse. Staff serving as victim rights advocates are now posted in high-risk peacekeeping operations to provide victims with adequate protection, appropriate assistance, and reliable recourse to justice. In 2019, these advocates worked with other UN entities, served as the primary interlocutor with victims of sexual exploitation and abuse, and initiated a pilot mapping exercise to identify best practices, gaps, areas of overlap, and lessons learned in victims’ rights approaches and available services. The results of this study will identify existing gaps in service provision and provide recommendations for improvement.

Even though the lack of accountability for public officials complicit in sexual exploitation and abuse is not limited to peacekeepers, the international community must increase pressure on governments to hold accountable those who participate in multinational forces to maintain peace and protect vulnerable populations under the auspices of the UN, NATO, or other organizations. The UN and other organizations carrying out peace operations, and troop- and police-contributing countries must reflect on peacekeepers’ positions of power and privilege relative to the host population and the myriad ways this dynamic contributes to sexual exploitation and abuse. Troop- and police-contributing countries must review, amend, or develop laws to allow prosecution of such crimes when committed by their personnel while serving overseas. Holding individuals accountable for the exploitation of vulnerable populations will bring new trust and honor to peacekeeping missions. The current culture of impunity threatens to tarnish irreparably the important mission of peacekeepers. **(Page 549 of this report includes a summary of actions taken by the UN to prevent human trafficking and sexual exploitation by international peacekeepers.)**

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### Faith-Based Efforts To Combat Human Trafficking

In 2014, Pope Francis joined with 11 other religious leaders representing the Muslim, Jewish, Orthodox, Anglican, Buddhist, and Hindu faiths to commit to work together and within their respective communities to inspire spiritual and practical action to help eradicate human trafficking worldwide. In a historic step, these religious leaders of the world’s major religions gathered and proclaimed in unison that their sacred texts do not support human trafficking.

As perhaps this momentous occasion demonstrated, faith-based communities, organizations, and congregations are powerful and necessary forces in the fight against human trafficking. Unlike governments, faith-based organizations are not limited by jurisdiction, election cycles, or political will. Nor are faith communities hemmed in by borders. By contrast, faith-based organizations serve in many different cities, provinces, and countries. They reach across international borders, spanning continents with a powerful network of followers with tremendous reach – from remote villages to capital cities and the seats of power. This unique nongovernmental reach allows faith-based organizations a flexibility that governments cannot exercise.

Faith-based organizations are well-positioned by their familiarity with local threats, their stake in keeping their communities safe, and their ability to develop context, build trust, establish relationships, and provide protection before a trafficker ever acts. They can issue calls to action that cut across borders, cultures, ethnicities, and economic classes.

Faith-based efforts to combat human trafficking take many forms and operate in different ways, adapting to a particular context or sector, or to the culture of the communities and countries in which they serve. Some of the entities involved have raised awareness, made concrete commitments, established networks, or developed tools and guidance to help eradicate human trafficking, as well as assisted with the reintegration of survivors in their community. The following are but a few examples of faith-based anti-trafficking efforts.

**The Interfaith Center on Corporate Responsibility (ICCR)** based in the United States uses a multi-faith approach from a different angle. A coalition of more than 300 global institutional investors with more than $500 billion in managed assets, it uses the power of shareholder advocacy to engage companies to identify, mitigate, and address social and environmental risks associated with corporate operations, including human trafficking. ICCR members call on companies they hold to adopt policies banning human trafficking as a key part of their core business polices, and to train their personnel and suppliers to safeguard against these risks throughout their supply chains. ICCR’s *Statement of Principles & Recommended Practices for Confronting Human Trafficking & Modern Slavery* provides guidance to companies to protect their supply chains from sex and labor trafficking.

**In Senegal**, religious leaders and local authorities in several municipalities are engaged in efforts to reduce and eradicate forced child begging. Forced child begging is one of the main forms of trafficking found in Senegal, where children, commonly known as *talibés* have been forced to beg in the streets as part of their studies in Quranic schools, called *daaras*.  While the majority are Senegalese, many of these children also come from neighboring countries in West Africa such as **The Gambia, Guinea, Guinea-Bissau, Mauritania, and Mali.**Over the past few years, the government has increased its engagement with religious leaders from all of Senegal’s five dominant religious brotherhoods and the national federation of Quranic teachers to raise concerns regarding forced begging and secure their commitments to end this practice in its current form. With support from the international community, some targeted projects have sought to raise awareness and sensitize local authorities and religious leaders on the issue of forced child begging. One such project conducted over the past few years by UNODC is also facilitating the creation of local associations of Quranic teachers and is working with prominent leaders to raise awareness during radio programs, clearly stating that forced child begging is child trafficking and is against Islamic principles. As a result, several Quranic schools have committed to no longer send their children to beg, and the National Federation of Quranic Teachers is working with the Ministry of Family and Child Protection to push for the adoption of the Daara Modernization Law by the National Assembly. While much more needs to be done given the size of the problem, these faith-based efforts are nonetheless very promising. UNODC also published a paper in 2010, titled *Combating Trafficking in Persons in Accordance with the Principles of Islamic Law.*

**Talitha Kum** (or the International Network of Consecrated Life Against Trafficking in Persons), is a project based in Rome, **Italy**, and founded in 2009 by the International Union of Superiors General, in collaboration with the Union of Superiors General. It functions as a network of networks to connect women religious in more than 92 countries to facilitate collaboration and the exchange of experiences and to help strengthen efforts to combat human trafficking. Network members work with local communities to raise awareness and recognize the indicators of human trafficking, advocate for the effective implementation of existing laws, and work closely with victims to provide them with guidance and support, including access to shelters, safe houses, counseling and legal assistance, and vocational training. In the Mediterranean region, a priority area of Talitha Kum, women of Christian and Muslim faith are working together against human trafficking.

**T’ruah** is a nonprofit organization bringing together more than 2,000 rabbis and cantors, together with all members of the Jewish community, to act on the Jewish imperative to respect and protect the human rights of all people. A leader in the Jewish community’s fight against modern slavery, T’ruah has partnered since 2011 with the Coalition of Immokalee Workers (CIW) to expand the Fair Food Program, bringing human rights and higher wages to farmworkers in Florida and up the East Coast and eliminating the root causes of human trafficking in the tomato industry. More than 100 of T’ruah’s “#tomatorabbis” have led broader faith efforts to support CIW, bringing their communities to join farmworker campaigns, sharing sermons and other faith resources, and putting tomatoes on their Seder plates each Passover in honor of the farmworkers who picked them. In 2018, T’ruah was the first Jewish organization to join the Alliance to End Slavery and Trafficking.

Finally, there are a number of resources, such as UNICEF’s *Interfaith Toolkit to End Trafficking,*to help educate faith leaders and faith-based organizations on the issue of human trafficking and to empower them with the resources they need to take action in a way that prevents further harm to victims.

Organizations called by their faith to help address human trafficking can play an important role both locally and around the world. Given their unique reach, they are well positioned to inspire spiritual and practical action to help respond to and prevent human trafficking.

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### Human Trafficking of Athletes

Many people around the world dream of becoming professional athletes, drawn by the fame, multi-million-dollar contracts, lucrative brand sponsorships, and opportunities to travel around the world. The growing number of young players aspiring to become professional athletes and the potential to sign the next greatest deal inevitably draws human traffickers looking to profit from the exploitation of players’ dreams. The often insufficient oversight by sport governing bodies and lack of government enforcement further allows unscrupulous agents to operate.

Most often, sports agents approach poor or rural families with an offer to arrange for a child to train at a street-side academy, sports club, or school, with the promise of signing the child with a professional team. Many of these families will do whatever it takes to meet the agent’s price. In cases where the agent does arrange for the children’s admittance and travel to a club or school, typically for a fee of thousands of dollars, the children often find themselves in situations that increase their vulnerability to predatory behaviors. Some unscrupulous agents immediately abandon the children while in transit or after arrival at the destination. Other agents, who are actually traffickers, have a longer-term scheme, where they vie to establish themselves within young athletes’ circle of trust and instill a sense of dependency as early as possible. If players fail to advance to the next level in the sport, the agent abandons them without means to return home. If abandoned abroad, players often remain in the country undocumented not knowing how to contact family and friends or too afraid to do so because of a strong sense of shame and self-blame. This lack of resources, guidance, and social support increases their vulnerability to traffickers.

For players offered a position on a team, the traffickers posing as agents have already established a relationship with the athlete and are well-positioned to control the course of the athlete’s career. In numerous cases, the traffickers have compelled or tricked athletes into signing exploitative contracts with major kickback schemes that bind the athletes to the agent. These agents often maintain control of athletes’ travel and identity documents to prevent them from leaving, or they exploit a debt amassed from previous fees or interest on loans to keep the athlete in a state of debt-based coercion. For the athletes who have dedicated their lives to sign a contract, the fear of losing the opportunity by questioning the terms of that contract or their so-called agent can be insurmountable. Once the contract is signed, the trafficker finally has the control needed to extort as much as possible from the athlete. Even after becoming more established, athletes may feel it is too risky to challenge the terms of a contract or seek other representation out of fear their situation would cause shame, ruin their reputation, or jeopardize their future.

While traffickers tend to target children and youth, they also approach young adults. In these instances, traffickers follow the same plan of signing an exploitative contract if the player is selected or abandonment upon failure. In either scenario, the player is at heightened risk of human trafficking. When legal migration avenues to countries with premier leagues are difficult or do not exist, the draw of a trafficker’s promise of success is even more compelling.

A number of human trafficking cases in sports have been reported by news outlets and in documentaries. Within Europe’s soccer industry alone, it is estimated there are 15,000 human trafficking victims each year. The migration patterns vary by sport, but the exploitative scheme of recruiting, building trust and dependency, and taking control upon a job offer is universal. The confluence of athletes’ desire to play, their families’ hopes of escaping poverty, agents’ desire to profit, leagues’ interest in marketing competitive players and games, and teams’ eagerness to find young talent all create an environment that, if left unregulated, could be ripe for traffickers to exploit.

Yet neither governments nor international sports federations or national sports leagues have successfully addressed the growing incidence of human trafficking of athletes. As professional sports leagues have become increasingly globalized, multilateral and regional bodies have started incorporating protection of athletes in sports integrity and anticorruption initiatives; however, government and industry efforts to regulate an expanding web of migration and recruitment routes have proven insufficient. Though some national sports associations and individual government officials have taken interest in addressing the exploitation of athletes, the global nature of the sports industry and decentralized structure of many associations and leagues calls for a more systematic and standardized approach. Greater pressure on teams and their scouts is needed to conduct more due diligence on the agents they work with to ensure their talent acquisition is free of exploitation. While sports federations have precautions and safeguards in place against unwarranted interference from external parties, governments should acknowledge when their national sport leagues or associations in their country are not adequately protecting athletes and investigate cases where agents violate anti-trafficking and labor statutes. Governments could consider: increasing coordination between their youth or child services programs and their sports programs; training consular officers on common indicators or schemes traffickers use within student or sports visas programs; and pursuing partnerships or dialogues with sports agencies and leagues to begin to address this form of human trafficking, such as through nationwide public awareness initiatives.

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***Case Study on Challenges: FIFA’s Efforts To Monitor Player Recruitment***

As with labor recruiters for other industries, sport agents are an important bridge connecting players to clubs and a lack of regulation or oversight of agents creates favorable conditions for human trafficking. The highest governing body of the most popular sport in the world, FIFA, has immense power and responsibility to protect the integrity of the sport and protect its millions of players. However, reports of human trafficking in organized soccer under FIFA, including cases involving children, continue to surface. In 2008, FIFA issued regulations on agents and required all to be licensed by a sports association. In 2010, after FIFA learned of several players who had paid exorbitant fees to join a team, it mandated teams and anyone connecting players to them to register all international player transfers with FIFA’s online system.

Enforcement of these regulations proved challenging. Some associations refused to work only with licensed agents (estimates claimed licensed agents comprised only 25 to 30 percent of active agents); some agents and clubs failed to report transactions at all; and discrepancies proliferated between countries’ national regulations on recruitment. To address these shortcomings, FIFA released a new set of regulations in 2015 that decentralized monitoring of agents, who previously had needed to pass an exam and register with a national governing body. The new regulations also empowered member associations to establish their own criteria and registration system for any intermediary representing players or clubs in employment contract and transfer agreement negotiations. Deregulation of the recruitment industry and a decline in transparency and accountability resulted in an increase in the number of intermediaries. The 2015 regulations also removed limits on the duration of representation contracts, which opened the door to young players unwittingly binding themselves to long-term representation with a certain agent and losing their ability to leave a job. To mitigate some of these consequences, FIFA established a task force to recommend regulatory changes for intermediaries, including a potential return to a central licensing system through FIFA and creation of a clearing house to process payments associated with player transfers, such as agent commissions. Such a move could improve oversight of an industry that has resisted regulation despite being linked to crimes, including human trafficking.

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### Extraterritorial Commercial Child Sexual Exploitation and Abuse: Evolving Information and Improving Responses

Extraterritorial child sexual exploitation and abuse occurs when perpetrators engage in sex acts with children, or produce child sexual abuse material, outside their country of citizenship. Extraterritorial commercial child sexual exploitation and abuse concerns child sex trafficking, specifically when a perpetrator travels to another country and engages in a commercial sex act with a child.

Historically, these types of crimes were referred to as “child sex tourism.” Today, the anti-trafficking community is moving away from using that term in favor of the terms “extraterritorial child sexual exploitation and abuse” and “extraterritorial commercial child sexual exploitation and abuse.” These emphasize the significant harm inflicted on children without referencing the perpetrator’s reason for being in the foreign country.

Indeed, while some perpetrators may be in the foreign country for tourism, others may be volunteers or expatriates who have permanently moved abroad. Some perpetrators may access children through relationships to families overseas, and others use the appearance of being in a position of trust to gain unsupervised access to children. Still other perpetrators are “situational abusers” who do not travel specifically to commit child sexual exploitation and abuse, but take advantage of an opportunity if it arises.

International travel has increased to historic levels as it has become more accessible and inexpensive. Some countries are attractive destinations for perpetrators who take advantage of weak rule of law, poverty, or the opportunity to engage in “voluntourism.” A relatively new form of extraterritorial commercial child sexual exploitation and abuse involves the use of livestreaming, chat, and payment platforms. Perpetrators send an electronic payment to a person in another country who then livestreams the sexual abuse of a child in that country back to the “customer.”

Per the reauthorization of the TVPA in 2008, the TIP Report has assessed governments’ efforts to prevent the participation in extraterritorial commercial child sexual exploitation and abuse by their nationals. In the 2019 TIP Report, at least 53 country narratives cited concerns or reported cases of foreign perpetrators committing this type of child sexual exploitation and abuse in their country or of their nationals engaging in the crime abroad. For example, some countries report that foreign perpetrators commit extraterritorial commercial child sexual exploitation and abuse in their country by offering to pay for children’s school fees or financially support orphanages to gain access to children.

The Prosecutorial Remedies and Other Tools to end the Exploitation of Children Today (PROTECT) Act, enacted in 2003, broadened the United States’ ability to address extraterritorial child sexual exploitation and abuse by making it a crime for U.S. nationals to travel abroad and engage in illicit sexual conduct with children, including child sex trafficking. Currently, the U.S. Angel Watch Center seeks to identify individuals previously convicted of child sexual exploitation or abuse offenses, including child sex trafficking, who intend to travel abroad. The Angel Watch Center uses publicly available sex offender registry information and passenger travel data to strategically alert foreign law enforcement of a convicted child sex offender’s intent to travel to their country. With that notification, foreign law enforcement officials can choose whether to allow entry into their country. In FY 2019, the U.S. government provided 3,564 notifications to 127 countries.

While actions, policies, and laws have increasingly addressed this crime, all governments must do more to implement frameworks and take action to bring an end to extraterritorial child sexual exploitation and abuse.

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### Reengineering Health Care for Survivors of Human Trafficking

Internationally, experts recognize both the short- and long-term health consequences as well as the public health burden of human trafficking. Indeed, the Palermo Protocol encourages states to provide medical and psychological assistance to survivors of human trafficking.

Medical and behavioral health professionals already caring for populations at high risk for human trafficking are incorporating training on human trafficking to enhance prevention and quality of care. Health care providers are also learning to use trauma-informed, survivor-informed, and culturally and linguistically appropriate services to build trust, strengthen screening, provide improved quality medical care, and reduce the risk of retraumatization. In addition, hospital networks have integrated responses to human trafficking into other health care violence prevention efforts. Public and private health care institutions, universities, and community organizations have been developing innovative partnerships and practices to provide specialized and comprehensive health care to survivors.

Here are some suggested promising practices that can be followed:

- Provide trauma-informed care  by understanding, respecting, and appropriately responding to how human trafficking and other types of trauma affect a survivor’s life, behavior, and sense of themselves.   - Clinics should aim to provide a safe environment for survivors in which all staff are trained on survivor engagement, acknowledge their rights and responsibilities, and disclose confidentiality and reporting policies.
  - The presence of a trafficker can affect the patient’s ability to speak openly with medical professionals, so providers should have procedures in place to separate a patient from a potential trafficker.
  - If needed for language purposes, the provider should use a professional interpreter trained to interpret information appropriately, and without judgment, to ensure information is accurate and non-stigmatizing when applicable.
  - Clinics should be aware of ways medical care can re-traumatize a survivor, such as through invasive procedures, removal of clothing, embarrassing or distressing personal questions, the gender of the health care provider, and the power dynamics of the doctor/patient relationship. 
- Empower patients by discussing informed consent , making it clear that clinical services are voluntary, and clarifying that patients have the right to accept or decline care recommendations. Treatment for survivors should support agency, healing, and recovery, and not simply impose a treatment.
- Understand that survivors of trafficking may require additional wraparound services. Health care providers should be prepared to  refer survivors to a network of resources  to support non-medical needs, such as food, shelter, money management, and legal aid.
- Survivors come from all national, cultural, religious, and linguistic backgrounds. To treat survivors, providers should  provide culturally and linguistically appropriate services  by accounting not just for interpretation/translation challenges, but also varying communication styles, expectations of health care, power dynamics, and levels of trust. As human trafficking can take place domestically or transnationally, providers should account for the survivor’s unique geographic background.
- Provide a comprehensive health assessment  whenever possible and with the survivor’s consent. Ensure the survivor receives comprehensive information in advance of an exam or treatment plan.   - There should be clarity as to what will be done with the patient’s health record and who will have access to it.
  - As this may be the only time a survivor sees a medical professional, provision of a baseline-level of health assessment can be critical.
  - Extra time should be allocated to examine the medical issues identified by the patient. 

Finally, national ministries of health can help build the capacity of health care services to respond to human trafficking. For example, they can provide funding to support the provision of medical services to victims of human trafficking. They can also promote standard operating procedures for health officials, develop formal guidance on victim identification and assistance, and offer online or other forms of training for health, behavioral health, public health, and social work professionals.

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***In the United States, an increasing number of medical centers and NGOs are recognizing the value of providing specialized care to survivors of trafficking and training for those who work with them:***

- In Florida, the Trafficking Health care Resources and Interdisciplinary Victim Services and Education (THRIVE) Clinic at the University of Miami Miller School of Medicine provides the resources of a world-class research hospital to trafficking survivors across the Southeast. The clinic recognizes that human trafficking can be both a physical and psychological trauma, and it seeks to reduce the risk of retraumatization by minimizing waiting times (especially in waiting rooms with strangers), having a single site of care across all specialists, and taking a single health history.
- Dignity Health Systems, in California, strives to ensure all medical and professional staff receive training to approach survivor care consistently in a survivor-informed manner. An evidence-based universal education model helps empower survivors through opportunities to share their experiences while building trust with providers. Dignity Health developed the PEARR Tool in consultation with survivors and community organizations to train medical professionals to provide privacy, educate, ask, respect, and respond to survivor’s needs.
- Health, Education, Advocacy, Linkage (HEAL) Trafficking, together with the Laboratory to Combat Human Trafficking, developed a tool for medical providers to assess the comprehensiveness of training programs and identify areas of improvement. The assessment tool and related survivor-informed training are available online to health care professionals on HEAL Trafficking’s website.

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### The Intersection of Human Trafficking and Addiction

*The following is a product of the Human Trafficking Expert Consultant Network funded by the TIP Office. The purpose of the Network is to engage experts, particularly those with lived experience, to provide expertise and input on Department of State anti-trafficking policies, strategies, and products related to human trafficking, both in the United States and abroad. The author has a range of expertise related to human trafficking, marginalized communities, substance use disorder, and trauma, including as a clinician.*

Substance use disorder and addiction are terms used here to describe the stage of the condition where a person’s brain and body are chemically dependent on a substance. While the term “substance use disorder” may carry less stigma, the term “addiction” is used, not pejoratively, in legal and criminal justice cases and by medical experts to describe this complex condition.

The complex relationship between addiction and both labor and sex trafficking is recognized by the United States criminal justice system. Successfully prosecuted cases have proven that the role of substance use disorder in human trafficking is powerful and pervasive; addiction can increase a person’s vulnerability to being trafficked, can be initiated and manipulated by the trafficker as a means of coercion and control, and can be used by the victim/survivor as a means of coping with the physical and psychological traumas of being trafficked both during captivity and after exiting the trafficking situation.

People with substance use issues are especially vulnerable to trauma and victimization by human traffickers. Some traffickers recruit directly from detox and addiction treatment facilities.  Similar to traumatic stress effects on the brain, substance use disorder involves biochemical changes to the brain and adds an additional layer of risk, especially for survivors with post-traumatic stress disorder. Although addiction is scientifically understood as a medical condition and not a moral weakness, the societal stigma surrounding both the condition and the sufferer is pervasive, and the negative stereotype persists of the chemically dependent person as morally deficient and lacking in willpower. Societal stigma can prevent health care providers, law enforcement officials, prosecutors, and other professionals from identifying victims of human trafficking when they see only the manifestations of substance use disorder and consequently dismiss red flags. In addition, societal stigma and self-stigma may deter an individual from seeking help.

Within the past several years, the United States has prosecuted multiple sex trafficking cases in which the perpetrator used addiction as a tool of coercion. In these cases, perpetrators entrapped victims with existing substance use issues, or initiated dependency in victims with no prior addiction history. They then used the threat of withdrawal—which causes extreme pain and suffering and can be fatal without medical supervision—to control the victims and coerce them to engage in commercial sex, compounding the victims’ trauma. Individuals with substance use issues seeking recovery have been exploited in addiction treatment situations for sex trafficking and forced labor. In one recent case, the owner of a chain of sober living facilities was convicted of sex trafficking individuals in such facilities. In another case still pending before a U.S. civil court, traffickers allegedly targeted people with substance use issues who were court-mandated to recovery facilities in lieu of prison sentences and forced them to work in chicken processing, sheet metal fabrication, and other dangerous work.

**Recommendations:**

**Identification and referral.** Whenever trafficking survivors with substance use issues are identified, referral to safe, ethical treatment programs and facilities is essential. Trauma-informed care prevents re-exploitation and retraumatization and promotes recovery. The danger of retraumatization as a trigger during early recovery can precipitate a survivor’s re-exploitation. Post-traumatic stress disorder and substance use disorder are related; each disorder can mask the symptoms of the other, and both need to be treated to attain long-term recovery outcomes. Health care professionals can coordinate efforts to identify victims and survivors who are vulnerable to substance use, or present with substance use issues. Emergency room admissions for overdose also present opportunities to screen for human trafficking. Specific training of medical and mental health staff aimed at reducing stigma and establishing standards of non-judgmental and trauma-informed care are also highly recommended.

**Safe housing.** Safe housing is essential for survivors; a lack of safe housing options increases vulnerability to further trauma. As mentioned earlier, some traffickers recruit directly from addiction treatment facilities, targeting people coming out of detox and inpatient programs, knowing they can exploit the vulnerabilities of these individuals. This is similar to how traffickers target children aging out of foster care. Lack of safe shelter is a significant vulnerability for human trafficking, and in such situations, perpetrators take advantage.

**Trauma-informed prosecutions and special task forces are key.**In the United States, specialized, multi-disciplinary task forces have been key to the successful investigation and prosecution of human trafficking cases involving addiction. To explain the power of drug-based coercion, survivors have testified during criminal trials to the extreme pain of withdrawal and other types of suffering related to addiction. Trauma-informed victim advocates worked closely with prosecutors and law enforcement to support those survivors as they participated in the criminal justice process. Prosecutors also called drug counselors and other expert witnesses to inform the jury of how addiction affects the brain and body and of the dangers of withdrawal.

**Listen to survivors.** The prosecutorial successes in the above-mentioned cases were achieved because the prosecutors, law enforcement, and judges listened to survivors, respected their needs, and valued their lived experience in describing the torment of drug-based coercion. The courage and resilience of victims and survivors cannot be overstated. NGOs, hospitals, government entities, and other stakeholders can build partnerships with survivors who have lived experience of substance use disorder and recovery, with survivor experts in diverse fields, and with survivor-led organizations, and can support survivors who are raising awareness about this issue.

**Significant progress is already under way in addressing these issues.**Certainly, more work remains in the areas of global research, education, and the willingness to create policies that reduce stigma and protect vulnerable populations.

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							Child Soldiers Prevention Act List					

Section 402 of the CSPA requires publication in the annual TIP Report of a list of foreign governments identified during the previous year as having governmental armed forces, police, or other security forces, or government-supported armed groups that recruit or use child soldiers, as defined in the CSPA. These determinations cover the reporting period beginning April 1, 2019 and ending March 31, 2020.

For the purpose of the CSPA, as amended in 2019 (Pub. L. 115-425), and generally consistent with the provisions of the Optional Protocol to the Convention on the Rights of the Child on the involvement of children in armed conflict, the term “child soldier” means:

(i) any person under 18 years of age who takes a direct part in hostilities as a member of governmental armed forces, police, or other security forces;

(ii) any person under 18 years of age who has been compulsorily recruited into governmental armed forces, police, or other security forces;

(iii) any person under 15 years of age who has been voluntarily recruited into governmental armed forces, police, or other security forces; or

(iv) any person under 18 years of age who has been recruited or used in hostilities by armed forces distinct from the armed forces of a state.

The term “child soldier” includes any person described in clauses (ii), (iii), or (iv) who is serving in any capacity, including in a support role, such as a “cook, porter, messenger, medic, guard, or sex slave.”

**The 2020 CSPA List Includes Governments in the Following Countries:**

AfghanistanBurmaCameroonDemocratic Republic of the CongoIranIraqLibyaMaliNigeriaSomaliaSouth SudanSudanSyriaYemen

Governments identified on the list are subject to restrictions, in the following fiscal year, on certain security assistance and commercial licensing of military equipment. The CSPA, as amended, prohibits assistance to governments that are identified in the list under the following authorities: International Military Education and Training, Foreign Military Financing, Excess Defense Articles, and Peacekeeping Operations, with exceptions for some programs undertaken pursuant to the Peacekeeping Operations authority. The CSPA also prohibits the issuance of licenses for direct commercial sales of military equipment to such governments. Beginning October 1, 2020, and effective throughout FY 2021, these restrictions will apply to the listed countries, absent a presidential waiver, applicable exception, or reinstatement of assistance pursuant to the terms of the CSPA. The determination to include a government in the CSPA list is informed by a range of sources, including first-hand observation by U.S. government personnel and research and credible reporting from various UN entities, international organizations, local and international NGOs, and international and domestic media outlets.

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							Methodology					

The Department of State prepared this report using information from U.S. embassies, government officials, nongovernmental and international organizations, published reports, news articles, academic studies, research trips to every region of the world, and information submitted to tipreport@state.gov. This email address provides a means by which organizations and individuals can share information with the Department of State throughout the year on government progress in addressing trafficking.

U.S. diplomatic posts and domestic agencies reported on the trafficking situation and governmental action to fight trafficking based on thorough research that included meetings with a wide variety of government officials, local and international NGO representatives, officials of international organizations, journalists, academics, and survivors. U.S. missions overseas are dedicated to covering human trafficking issues year-round. The 2020 TIP Report covers government efforts undertaken from April 1, 2019 through March 31, 2020.

### Tier Placement

The Department ranks each country in this report on one of four tiers, as mandated by the TVPA. Such rankings are based not on the size of a country’s problem but on the extent of government efforts to meet the TVPA’s minimum standards for the elimination of human trafficking (see pages 45-46), which are generally consistent with the Palermo Protocol.

While Tier 1 is the highest ranking, it does not mean that a country has no human trafficking problem or that it is doing enough to address the problem. Rather, a Tier 1 ranking indicates that a government has made efforts to address the problem that meet the TVPA’s minimum standards. To maintain a Tier 1 ranking, governments need to demonstrate appreciable progress each year in combating trafficking. Indeed, Tier 1 represents a responsibility rather than a reprieve.

Tier rankings and narratives in the 2020 TIP Report reflect an assessment of the following:

- enactment of laws prohibiting severe forms of trafficking in persons, as defined by the TVPA, and provision of criminal punishments for trafficking offenses;
- criminal penalties prescribed for human trafficking offenses with a maximum of at least four years’ deprivation of liberty, or a more severe penalty;
- implementation of human trafficking laws through vigorous prosecution of the prevalent forms of trafficking in the country and sentencing of offenders;
- proactive victim identification measures with systematic procedures to guide law enforcement and other government-supported front-line responders in the process of victim identification;
- government funding and partnerships with NGOs to provide victims with access to primary health care, counseling, and shelter, allowing them to recount their trafficking experiences to trained social counselors and law enforcement in an environment of minimal pressure;
- victim protection efforts that include access to services and shelter without detention and with legal alternatives to removal to countries in which victims would face retribution or hardship;
- the extent to which a government ensures victims are provided with legal and other assistance and that, consistent with domestic law, proceedings are not prejudicial to victims’ rights, dignity, or psychological well-being;
- the extent to which a government ensures the safe, humane, and to the extent possible, voluntary repatriation and reintegration of victims;
- governmental measures to prevent human trafficking, including efforts to curb practices identified as contributing factors to human trafficking, such as employers’ confiscation of foreign workers’ passports and allowing labor recruiters to charge fees to prospective migrants; and
- governmental efforts to reduce the demand for commercial sex acts and international sex tourism.

Tier rankings and narratives are NOT affected by the following:

- efforts, however laudable, undertaken exclusively by nongovernmental actors in the country;
- general public awareness events—government-sponsored or otherwise—lacking concrete ties to the prosecution of traffickers, protection of victims, or prevention of trafficking; and
- broad-based law enforcement or developmental initiatives.

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### A Guide to the Tiers

***Tier 1***

Countries whose governments fully meet the TVPA’s minimum standards for the elimination of trafficking.

***Tier 2***

Countries whose governments do not fully meet the TVPA’s minimum standards but are making significant efforts to bring themselves into compliance with those standards.

***Tier 2 Watch List***

Countries whose governments do not fully meet the TVPA’s minimum standards but are making significant efforts to bring themselves into compliance with those standards, and for which:

a) the estimated number of victims of severe forms of trafficking is very significant or is significantly increasing and the country is not taking proportional concrete actions;

b) there is a failure to provide evidence of increasing efforts to combat severe forms of trafficking in persons from the previous year, including increased investigations, prosecution, and convictions of trafficking crimes, increased assistance to victims, and decreasing evidence of complicity in severe forms of trafficking by government officials.

***Tier 3***

Countries whose governments do not fully meet the TVPA’s minimum standards and are not making significant efforts to do so. The TVPA, as amended, lists additional factors to determine whether a country should be on Tier 2 (or Tier 2 Watch List) versus Tier 3:

- the extent to which the country is a country of origin, transit, or destination for severe forms of trafficking;
- the extent to which the country’s government does not meet the TVPA’s minimum standards and, in particular, the extent to which officials or government employees have been complicit in severe forms of trafficking;
- reasonable measures that the government would need to undertake to be in compliance with the minimum standards in light of the government’s resources and capabilities to address and eliminate severe forms of trafficking in persons;
- the extent to which the government is devoting sufficient budgetary resources to investigate and prosecute human trafficking, convict and sentence traffickers; and obtain restitution for victims of human trafficking; and
- the extent to which the government is devoting sufficient budgetary resources to protect victims and prevent the crime from occurring.

In addition, a 2019 amendment to the TVPA directs the Secretary of State to consider, as proof of a country’s failure to make significant efforts to fully meet the TVPA’s minimum standards, a government policy or pattern of: trafficking; trafficking in government-funded programs; forced labor (in government-affiliated medical services, agriculture, forestry, mining, construction, or other sectors); sexual slavery in government camps, compounds, or outposts; or employing or recruiting child soldiers.

A 2008 amendment to the TVPA provides that any country that has been ranked Tier 2 Watch List for two consecutive years and that would otherwise be ranked Tier 2 Watch List for the next year will instead be ranked Tier 3 in that third year. This automatic downgrade provision came into effect for the first time in the 2013 TIP Report. Pursuant to a 2019 amendment to the TVPA, the Secretary of State is authorized to waive the automatic downgrade only once, in that third year, based on credible evidence that a waiver is justified because the government has a written plan that, if implemented, would constitute making significant efforts to meet the TVPA’s minimum standards for the elimination of trafficking and is devoting sufficient resources to implement the plan. The following year, a country must either go up to Tier 2 or down to Tier 3. Governments subject to the automatic downgrade provision are noted as such in the country narratives. Finally, another 2019 amendment to the TVPA limits a country to one year on the Tier 2 Watch List after that country received a waiver to stay on the Watch List and was subsequently downgraded to Tier 3.

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### Funding Restrictions for Tier 3 Countries

A 2008 amendment to the TVPA provides that any country that has been ranked Tier 2 Watch List for two consecutive years and that would otherwise be ranked Tier 2 Watch List for the next year will instead be ranked Tier 3 in that third year. This automatic downgrade provision came into effect for the first time in the 2013 TIP Report. Pursuant to a 2019 amendment to the TVPA, the Secretary of State is authorized to waive the automatic downgrade only once, in that third year, based on credible evidence that a waiver is justified because the government has a written plan that, if implemented, would constitute making significant efforts to meet the TVPA’s minimum standards for the elimination of trafficking and is devoting sufficient resources to implement the plan. The following year, a country must either go up to Tier 2 or down to Tier 3. Governments subject to the automatic downgrade provision are noted as such in the country narratives. Finally, another 2019 amendment to the TVPA limits a country to one year on the Tier 2 Watch List after that country received a waiver to stay on the Watch List and was subsequently downgraded to Tier 3.

*Restrictions on Assistance for Governments of Tier 3 Countries*

Pursuant to the TVPA, governments of countries on Tier 3 may be subject to certain restrictions on foreign assistance, whereby the President may determine not to provide U.S. government nonhumanitarian, nontrade-related foreign assistance as defined in the TVPA. In addition, the President may determine to withhold funding for government official or employee participation in educational and cultural exchange programs in the case of certain Tier 3 countries. Consistent with the TVPA, the President may also determine to instruct the U.S. Executive Director of each multilateral development bank and the International Monetary Fund to vote against and use their best efforts to deny any loans or other uses of the institutions’ funds to a designated Tier 3 country for most purposes (except for humanitarian, trade-related, and certain development-related assistance). Alternatively, the President may waive application of all or part of the foregoing restrictions upon a determination that the provision to a Tier 3 country of such assistance would promote the purposes of the TVPA or is otherwise in the national interest of the United States. The TVPA also authorizes the President to waive funding these restrictions if necessary to avoid significant adverse effects on vulnerable populations, including women and girls, and children.

Applicable assistance restrictions apply for the next fiscal year, which begins October 1, 2020.

No tier ranking is permanent. Every country, including the United States, can do more. All countries must continually increase efforts to combat trafficking.

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***Countries in the 2020 TIP Report that are not Party to the Protocol to Prevent, Suppress and Punish Trafficking In Persons, Especially Women and Children, supplementing the United Nations Convention against Transnational Organized Crime***

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							Global Law Enforcement Data					

The 2003 reauthorization of the TVPA added to the original law a new requirement that foreign governments provide the Department of State with data on trafficking investigations, prosecutions, convictions, and sentences in order to fully meet the TVPA’s minimum standards for the elimination of trafficking (Tier 1). The 2004 TIP Report collected this data for the first time. The 2007 TIP Report showed for the first time a breakout of the number of total prosecutions and convictions that related to labor trafficking, placed in parentheses.

*The above statistics are estimates derived from data provided by foreign governments and other sources and reviewed by the Department of State. Aggregate data fluctuates from one year to the next due to the hidden nature of trafficking crimes, dynamic global events, shifts in government efforts, and a lack of uniformity in national reporting structures. The numbers in parentheses are those of labor trafficking prosecutions, convictions, and victims identified.*

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							Trafficking Victims Protection Act: Minimum Standards for the Elimination of Trafficking in Persons					

**Trafficking Victims Protection Act of 2000, Div. A of Pub. L. No. 106-386, § 108, as amended.**

- The government of the country should prohibit severe forms of trafficking in persons and punish acts of such trafficking.
- For the knowing commission of any act of sex trafficking involving force, fraud, coercion, or in which the victim of sex trafficking is a child incapable of giving meaningful consent, or of trafficking which includes rape or kidnapping or which causes a death, the government of the country should prescribe punishment commensurate with that for grave crimes, such as forcible sexual assault.
- For the knowing commission of any act of a severe form of trafficking in persons, the government of the country should prescribe punishment that is sufficiently stringent to deter and that adequately reflects the heinous nature of the offense.
- The government of the country should make serious and sustained efforts to eliminate severe forms of trafficking in persons.

**Indicia of “Serious and Sustained Efforts”**

- Whether the government of the country vigorously investigates and prosecutes acts of severe forms of trafficking in persons, and convicts and sentences persons responsible for such acts, that take place wholly or partly within the territory of the country, including, as appropriate, requiring incarceration of individuals convicted of such acts. For purposes of the preceding sentence, suspended or significantly reduced sentences for convictions of principal actors in cases of severe forms of trafficking in persons shall be considered, on a case-by-case basis, whether to be considered an indicator of serious and sustained efforts to eliminate severe forms of trafficking in persons. After reasonable requests from the Department of State for data regarding investigations, prosecutions, convictions, and sentences, a government which does not provide such data, consistent with a demonstrably increasing capacity of such government to obtain such data, shall be presumed not to have vigorously investigated, prosecuted, convicted or sentenced such acts.
- Whether the government of the country protects victims of severe forms of trafficking in persons and encourages their assistance in the investigation and prosecution of such trafficking, including provisions for legal alternatives to their removal to countries in which they would face retribution or hardship, and ensures that victims are not inappropriately incarcerated, fined, or otherwise penalized solely for unlawful acts as a direct result of being trafficked, including by providing training to law enforcement and immigration officials regarding the identification and treatment of trafficking victims using approaches that focus on the needs of the victims.
- Whether the government of the country has adopted measures to prevent severe forms of trafficking in persons, such as measures to inform and educate the public, including potential victims, about the causes and consequences of severe forms of trafficking in persons, measures to establish the identity of local populations, including birth registration, citizenship, and nationality, measures to ensure that its nationals who are deployed abroad as part of a diplomatic, peacekeeping, or other similar mission do not engage in or facilitate severe forms of trafficking in persons or exploit victims of such trafficking, a transparent system for remediating or punishing such public officials as a deterrent, measures to prevent the use of forced labor or child labor in violation of international standards, effective bilateral, multilateral, or regional information sharing and cooperation arrangements with other countries, and effective policies or laws regulating foreign labor recruiters and holding them civilly and criminally liable for fraudulent recruiting.
- Whether the government of the country cooperates with other governments in the investigation and prosecution of severe forms of trafficking in persons and has entered into bilateral, multilateral, or regional law enforcement cooperation and coordination arrangements with other countries.
- Whether the government of the country extradites persons charged with acts of severe forms of trafficking in persons on substantially the same terms and to substantially the same extent as persons charged with other serious crimes (or, to the extent such extradition would be inconsistent with the laws of such country or with international agreements to which the country is a party, whether the government is taking all appropriate measures to modify or replace such laws and treaties so as to permit such extradition).
- Whether the government of the country monitors immigration and emigration patterns for evidence of severe forms of trafficking in persons and whether law enforcement agencies of the country respond to any such evidence in a manner that is consistent with the vigorous investigation and prosecution of acts of such trafficking, as well as with the protection of human rights of victims and the internationally recognized human right to leave any country, including one’s own, and to return to one’s own country.
- Whether the government of the country vigorously investigates, prosecutes, convicts, and sentences public officials, including diplomats and soldiers, who participate in or facilitate severe forms of trafficking in persons, including nationals of the country who are deployed abroad as part of a diplomatic, peacekeeping, or other similar mission who engage in or facilitate severe forms of trafficking in persons or exploit victims of such trafficking, and takes all appropriate measures against officials who condone or enable such trafficking. A government’s failure to appropriately address public allegations against such public officials, especially once such officials have returned to their home countries, shall be considered inaction under these criteria. After reasonable requests from the Department of State for data regarding such investigations, prosecutions, convictions, and sentences, a government which does not provide such data, consistent with a demonstrably increasing capacity of such government to obtain such data, shall be presumed not to have vigorously investigated, prosecuted, convicted, or sentenced such acts.
- Whether the percentage of victims of severe forms of trafficking in the country that are non-citizens of such countries is insignificant.
- Whether the government has entered into effective, transparent partnerships, cooperative arrangements, or agreements that have resulted in concrete and measurable outcomes with

a)  domestic civil society organizations, private sector entities, or international nongovernmental organizations, or into multilateral or regional arrangements or agreements, to assist the government’s efforts to prevent trafficking, protect victims, and punish traffickers; or

b)  the United States toward agreed goals and objectives in the collective fight against trafficking.

- Whether the government of the country, consistent with the capacity of such government, systematically monitors its efforts to satisfy the criteria described in paragraphs (1) through (8) and makes available publicly a periodic assessment of such efforts.
- Whether the government of the country achieves appreciable progress in eliminating severe forms of trafficking when compared to the assessment in the previous year.
- Whether the government of the country has made serious and sustained efforts to reduce the demand for –

a)  commercial sex acts; and

b)  participation in international sex tourism by nationals of the country.

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							Victim Stories					

The victim stories included in this report are meant to be illustrative. They characterize the many—though not all—forms of human trafficking and the wide variety of places in which they occur, although each could take place almost anywhere in the world. Many are based on real experiences and the victims’ names have been changed as a result. In most cases, the photographs that accompany the stories are not images of confirmed trafficking victims. Still, they illustrate the myriad schemes human traffickers use and the variety of situations in which trafficking victims are exploited.

### Colombia | Domestic Servitude

Veronica left her indigenous community in Colombia for a domestic service position in the capital city, Bogotá. After arriving, her employer told her she would need to work for two months without a salary to repay her relocation expenses. Later, her employer forced Veronica to work for two years without pay as punishment for breaking a decorative vase in the home. She had to work 12-hour days and her movements were constantly restricted. After she escaped and a prosecutor brought charges against Veronica’s employer, the court ruled that Veronica was a victim of domestic servitude and a survivor of human trafficking.

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### Romania-Italy | Sex Trafficking

Sofia was optimistic as she landed in Italy with her new fiancé, excited for the luxuries her rural Romanian village did not afford her. Soon after arriving, Sofia’s fiancé handed her an itemized bill for every meal, trip, and gift he had ever purchased for her. He told her she needed to reimburse him by engaging in commercial sex. He forced her to do so through threats, physical violence, and destroying her personal property. Sofia escaped back to Romania and is now receiving support at a shelter for trafficking survivors.

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### India | Forced labor

Madhu was thrilled when recruiters arrived in his Northern Indian village offering him easy, flexible work at a factory in Bangalore. After moving, he quickly realized the factory owners had lied about what his role and work conditions would be. Forbidden from leaving his work site, Madhu had no choice but to work 12-hour shifts packaging chemicals under hazardous conditions. While the factory owners paid Madhu a small daily salary, they physically threatened him, forced him to work when ill, and restricted all his movements for four years. When local police learned he was not allowed to return home or travel without consent from his employer, they required the factory owners to release him. Madhu returned to his village, but law enforcement have not pressed charges against the factory.

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### Cambodia | Debt Bondage

Needing money to help purchase a home and start a family, Kim’s parents accepted a small loan from the owner of the brick kiln where they worked. For years thereafter, the kiln owner used the debt to coerce and manipulate Kim’s family to continue to work. When Kim was 12, she began working with her parents to help pay off the debt. Twenty years later, her family’s debt has grown to more than twice their average annual income, which has left Kim with no option but to put her own 11-year-old son to work at the kiln as well. Kim fears her family will never escape their trafficker.

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### Nigeria-Ghana | Sex Trafficking

When Patience’s parents passed away, she took on the burden of caring for her six younger siblings and needed to find a job. A recruiter convinced her to leave Nigeria for better opportunities in Ghana. Once she arrived in a major city in Ghana, the recruiter demanded $1,500 for the cost of transportation and turned her over to a madam who used a local fetish priest to perform a ritual that obligated her to repay the debt. The trafficker then forced Patience to engage in commercial sex to repay her so-called debt for her travel to Ghana. She was threatened and told that if she refused, the priest would place a curse on her and she would be killed.

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### Vietnam-United Kingdom | Forced Labor

As a 17-year-old orphan living on the streets of Ho Chi Minh City, Huy sold lottery tickets and slept outdoors in unsanitary conditions. An older acquaintance offered him a well-paying job abroad, which he declined. Despite his refusal, the man seized and bound Huy and transported him to a windowless warehouse in China. There men beat and tortured Huy; when he tried to escape, a guard poured boiling water over his chest and arms. After three months, Huy’s captors smuggled him to the United Kingdom and forced him to work without pay for an illegal cannabis garden. The traffickers physically abused and starved him when he did not meet his quota. Huy eventually escaped by breaking a second story window, jumping out of the house, and running until he found a train station.

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### Philippines-United States | Forced Labor

Maria felt very lucky when she was recruited from her northern island in the Philippines to an eldercare position in Southern California. After she arrived, a trafficker confiscated her passport and insisted she pay off a previously undisclosed fee of more than $10,000. The trafficker ordered Maria to work off the debt by laboring 18-hour days for only a few dollars an hour. An observant neighbor of the eldercare facility reported the situation to law enforcement after seeing that Maria worked long hours, never had a day off, and was constantly tired and disheveled. While she was initially fearful of speaking with law enforcement, officers were able to investigate the crime with Maria’s help. Maria received the medical and psychological support she needed from a nonprofit organization. She is now a survivor leader in her community.

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### Tanzania | Domestic Servitude

When Mary was in second grade, she stopped attending school just before final exams. The school principal was worried, so he asked her teacher, Mr. Baraka, to check with Mary’s family. Mr. Baraka reported that her family did not know where she was. The principal became suspicious and asked Mary’s mother to come to the school for a parent-teacher meeting, during which she reported that Mary had returned home, but she did not know where Mary had been. When Mary returned to school, the principal encouraged her to speak about her experience and Mary admitted that her teacher, Mr. Baraka, had taken her to live with his daughter, who needed someone to care for her baby and had paid Mary’s mother $9 in exchange. Mr. Baraka told Mary she had no choice but to work for his daughter’s family.

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### Canada | Sex Trafficking

Elena’s boyfriend lured her across Canada and forced her to engage in commercial sex. He abused her emotionally and physically. Elena was able to escape and is now receiving comprehensive services from a local NGO to work through the trauma of her experience and adjust to her new life. Her trafficker was sentenced to prison for human trafficking, among other crimes.

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### United States | Sex Trafficking

When Ted was 10, his mother began dating a new man. This man seemed perfect, supplementing his mother’s income, buying Ted presents, and adding stability to their family. After a few months, however, it became clear he was using Ted’s mother to get closer to Ted. Ultimately, he succeeded in forcing Ted to engage in commercial sex. He coerced Ted by threatening his mother, drugging him, and physically abusing him. Ted only reported his abuse after a failed suicide attempt several years later.

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							2020 TIP Report Heroes					

Each year, the Department of State honors individuals around the world who have devoted their lives to the fight against human trafficking. These individuals include NGO workers, lawmakers, government officials, survivors of human trafficking, and concerned citizens. They are recognized for their tireless efforts—despite resistance, opposition, and threats to their lives—to protect victims, punish offenders, and educate stakeholders about human trafficking trends in their countries and abroad.  For more information about current and past TIP Report Heroes, please visit the TIP Report Heroes Global Network at www.tipheroes.org.

### Karma Rigzin | Bhutan

Lieutenant Colonel Karma Rigzin, a former UN peacekeeper, serves as Additional Superintendent of the Royal Bhutan Police (RBP) Woman and Child Protection Division. Colonel Karma Rigzin has been a leading advocate for increasing efforts to combat trafficking in Bhutan. She has elevated the investigation of human trafficking issues to a central objective of the Woman and Child Protection Division she leads.

Colonel Rigzin has developed innovative practices for compiling human trafficking-related data and was responsible for establishing a human trafficking awareness program for Bhutanese citizens traveling overseas for employment. In 2006, Colonel Rigzin stood up Bhutan’s first specialized unit within the Woman and Child Protection Unit to handle all issues relating to women and children, including human trafficking, and provide victims a more secure environment to report human trafficking crimes. In 2007, this unit identified and prosecuted Bhutan’s first criminal case involving human trafficking charges. Colonel Rigzin played a central role in efforts to amend the Bhutan Penal Code to align its legal definition of human trafficking with international standards.

Over the years, Colonel Rigzin has trained immigration officials, senior police officers, and non-commissioned officers on identification of trafficking victims and investigation techniques and has successfully advocated for increased funding for trafficking victim services.

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### Reda Shoukr | Egypt

Reda Shoukr has dedicated her career to improving the lives of human trafficking survivors. Since founding the Al-Shehab Institute for Promotion and Comprehensive Development (Al-Shehab) in 2002, Shoukr has assisted more than 15,000 women and girls vulnerable to domestic servitude due to previous experiences with sexual exploitation, violence, or HIV/AIDS. Through Al-Shehab, she helps hundreds of vulnerable women and human trafficking survivors every year transition from their life of exploitation by providing them with legal aid, social services, psychological support, and vocational training.

Shoukr formed Al-Shehab based on listening sessions she held with vulnerable women in Cairo’s slums to better understand their problems, why they felt exploited, and how she could practically help them.

Al-Shehab’s legal aid services maintain relationships with police stations in greater Cairo and throughout Egypt in order to identify and to release wrongfully charged victims of human trafficking. Through this close partnership with local police, Al-Shehab has provided legal services to 800 victims each year and secured the release of 400 victims due to lack of evidence.

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### Ary Varela | Cabo Verde & Natalino Correia | Cabo Verde

Ary Varela and Natalino Correia are instrumental figures in holding human traffickers criminally accountable and assisting victims in attaining justice in Cabo Verde. Varela, a public prosecutor, and Correia, a member of the Judiciary Police, have persistently pursued human trafficking cases within the country.

Most notably, in late 2018, they initiated an investigation into a forced labor case with great professionalism that involved four victims forced to work in a retail shop. In their official capacities, Varela and Correia handled the case with extreme sensitivity and caution, working closely with an international organization to ensure the victims were protected and their teams conducted the investigation correctly.

Varela and Correia demonstrated tremendous diligence in carrying out their investigation, working despite pressure to drop the case and overt hostility from the traffickers’ networks and their peers. In addition, thanks to their efforts, the victims were safely repatriated. This was Cabo Verde’s first official case of human trafficking where the government prosecuted defendants for human trafficking crimes, representing a critical milestone in the country’s understanding of and response to human trafficking. Throughout the course of the investigation, Varela and Correia showed an impressive level of perseverance in the face of immense difficulties, including foreign interference and threats to their personal safety, to pursue Cabo Verde’s first forced labor prosecution.

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### Patricia Ho | Hong Kong

Patricia Ho’s unwavering leadership has been a driving force in increasing awareness of human trafficking in Hong Kong. As the Founder of Hong Kong Dignity Institute, Ho defends and advances the rights of human trafficking victims and minority groups in Hong Kong by challenging government policies and law.

As a public law practitioner, Ho began representing a survivor of human trafficking in 2015 to challenge the Hong Kong government’s failure to protect him as a victim of human trafficking. During the past five years, while representing the survivor, Ho raised awareness of the dire need for a human trafficking law in Hong Kong and uplifted the survivor’s voice in advocating for better treatment of victims in Hong Kong.

In addition to her important litigation work, Ho provides critical legal and strategic advice to several NGOs and works with local and international bodies to advocate for the rights of marginalized groups, including refugees, asylum seekers, and victims of human trafficking in Hong Kong. Ho provides trainings and seminars to the legal community in Hong Kong on ways to protect trafficking victims. She is also a major advocate for and is well-trained in the trauma-informed approach to client management.

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### Nina Balabayeva | Kazakhstan

Nina Balabayeva has dedicated her life and career to combating trafficking in persons and helping trafficking victims, both foreign and Kazakhstani, before there were even laws on the books in Kazakhstan to provide them access to justice. She is highly regarded by her peers and those within the government as one of the leading human trafficking experts in the country.

With a background in psychology and education, Balabayeva has deftly navigated bureaucracy to establish and fund an NGO dedicated to the issue and a shelter for victims of human trafficking. She has also provided trainings to colleagues and government officials on human trafficking as part of her tireless work to strengthen anti-trafficking efforts in the country.

As the founder and director of Rodnik, an NGO located in Almaty, Balabayeva has been instrumental in leading the organization’s work to provide psychological and legal support to victims of trafficking in multiple regions of the country. Over the past two decades, her organization has assisted more than 16,000 people.

Through Rodnik, Balabayeva opened the first shelter in Kazakhstan for victims of human trafficking in March 2006, providing individualized support to residents and serving as a model for shelters across the country. In 2004, Balabayeva led Rodnik to stand up a human trafficking hotline, which it still operates.

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### Sophie Otiende | Kenya

Sophie Otiende is a champion for victims of human trafficking, advocating for their rights and elevating human trafficking as a priority, in Kenya. Her expertise, patience, and bravery have positioned her as a source of inspiration and a confidant for other survivors of trafficking she meets and serves. For the last ten years, she has worked with grassroots organizations in Kenya to provide services to trafficking victims and survivors, building Kenya’s victim assistance infrastructure and capacity.

Otiende was responsible for setting up the structures and systems for the first shelter exclusively for victims of trafficking in Kenya and led the development of regional principles of practice for assisting victims of trafficking. Otiende has been responsible for the development of curriculum to train women on entrepreneurship, and has coauthored manuals on victim services and child trafficking as well as a toolkit for raising awareness among local communities.

She is currently a board member and survivor advisor at Awareness Against Human Trafficking (HAART), where until recently she worked as a Program Consultant. While at HAART, she was responsible for assisting more than 400 victims of trafficking since 2014 and helped identify victims both within and outside of Kenya. In her role as advisor, she continues to provide critical support and guidance to HAART’s victims’ assistance program. She is currently the Africa Region Operations Manager for the NGO Liberty Shared and provides technical support to anti-trafficking organizations across Africa.

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### Lāsma Stabiņa | Latvia

For years, Lāsma Stabiņa has driven Latvia’s anti-trafficking response. She has served as the Latvian government’s National Trafficking in Persons Coordinator since 2014, advocating for human trafficking reforms inside the government and building critical relationships with NGOs. She expanded partnerships and networks that have raised human trafficking awareness among Latvian and international audiences.

Stabiņa led the development and implementation of two large international anti-trafficking projects. Through these projects, Latvia helped increase the EU’s scrutiny of human trafficking in the form of sham marriages, an overlooked but widespread issue within the EU. Stabiņa organized much-needed training programs to help local officials recognize sham marriages. Her programs brought together consular staff and law enforcement officials, including judges, prosecutors, and police.

She found innovative funding sources for anti-trafficking work in Latvia, allowing such work to continue even under severe budget constraints. She also improved communication between different organizations and improved standard anti-trafficking protocols. Using her mandate to stop all forms of human trafficking and abuse, Stabiņa worked within current systems to reduce labor exploitation and ensure victims had care and were protected during law enforcement processes.

Stabiņa also secured the Latvian government’s support for national and regional public awareness campaigns. These campaigns improved the government’s and public’s understanding of human trafficking crimes.

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### Maxwell Matewere | Malawi

Maxwell Matewere is a proven anti-trafficking activist in Malawi. For over two decades, he has advanced Malawi’s anti-trafficking movement and is recognized nationally as a leading and trustworthy subject matter expert. Matewere is a proponent of trafficking survivors and their families, personally engaging with many of them to understand their needs and ensuring each survivor he encounters is able to connect to and receive the necessary services.

In 1998, Matewere founded Eye of the Child, an NGO dedicated to advocacy, research, and protection of children’s rights in Malawi. He was the driving force behind the passage of the Trafficking in Persons Act in 2015 and continues to tirelessly advocate for its full implementation. As the civil society representative on the National Coordination Committee Against Trafficking in Persons, he successfully lobbied for the formal opening of the government’s anti-trafficking fund to provide services to trafficking victims and train law enforcement and victim protection officers.

In 2018, Matewere helped spur a fruitful collaboration between the Malawi government’s National Trafficking in Persons Coordinator and the Ministry of Homeland Security, resulting in trainings and awareness campaigns across the country. With Matewere’s support, this partnership has also led to the drafting and successful adoption of several key initiatives, including new human trafficking regulations, guidelines for law enforcement officials, and a police recruit training manual.

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### Oxana Alistratova | Moldova

As a young teacher, Oxana Alistratova nearly became a victim to a human trafficking ring in 1992. Since 2003 she has devoted her life’s work to helping women realize their own agency and power and develop as leaders. While overcoming government threats early on and innumerable other obstacles throughout her career, she has demonstrated resilience and further committed to women’s empowerment and anti-trafficking efforts.

More than 18 years ago, Alistratova established the first NGO to raise awareness of human trafficking in Transnistria, which is an extraordinary feat to achieve in a territory where women have limited rights or access to assistance and thus are extremely vulnerable to human trafficking. Through her NGO, Interaction, Alistratova played a key role in convincing local authorities of the need to adopt laws to prevent human trafficking. Alistratova later adapted Interaction to serve not only victims of trafficking but also victims of domestic violence. She manages a hotline for trafficking victims and concerned family members, established in 2006, and another for victims of domestic violence since 2009. These hotlines have fielded more than 20,000 calls since their inception. Alistratova has also dedicated herself to establishing an informal referral framework for local authorities, teachers, social service providers, and NGOs to provide legal, psychological, and other critical support to vulnerable women and their children.

Along the way, she has forged and nurtured a network of human rights advocates in Transnistria and the rest of Moldova. Through her community outreach and awareness raising campaigns, she has provided critical services to her community while continuing to inspire a new generation of human rights leaders throughout the region.

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							Tier Placements and Regional Maps					

### Tier Placements

**Tier 1**

ArgentinaAustraliaAustriaThe BahamasBahrainBelgiumCanadaChileColombiaCyprusCzech RepublicEstoniaFinlandFranceGeorgiaGuyanaIsraelKorea, SouthLithuaniaLuxembourgNamibiaNetherlandsNew ZealandNorwayPhilippinesPortugalSingaporeSloveniaSpainSwedenSwitzerlandTaiwanUnited KingdomUnited States of America

**Tier 2**

AlbaniaAngolaAntigua and BarbudaBangladeshBeninBoliviaBotswanaBrazilBulgariaBurkina FasoCabo VerdeCentral African RepublicCongo, Republic of theCosta RicaCote d’IvoireCroatiaDenmarkDjiboutiEcuadorEgyptEl SalvadorEswatiniEthiopiaGabonGermanyGhanaGreeceGuatemalaHaitiHondurasHungaryIcelandIndiaIndonesiaIraqItalyJamaicaJapanKenyaKosovoKuwaitLaosLatviaLebanonLiberiaMadagascarMalawiMaltaMauritiusMexicoMicronesiaMoldovaMongoliaMontenegroMoroccoMozambiqueNepalNigerNorth MacedoniaOmanPalauPanamaParaguayPeruPolandQatarRwandaSaint LuciaSt. Vincent and the GrenadinesSerbiaSierra LeoneSt. MaartenSlovakiaSolomon IslandsSouth AfricaSurinameTajikistanThailandTogoTongaTrinidad and TobagoTunisiaTurkeyUkraineUnited Arab EmiratesUruguayVanuatuZimbabwe

**Tier 2 Watch List**

ArmeniaArubaAzerbaijanBarbadosBelizeBhutanBosnia and HerzegovinaBruneiCambodiaCameroonChadCongo, DemocraticRepublic of theCuraçaoDominican RepublicEquatorial GuineaFijiThe GambiaGuineaGuinea-BissauHong KongIrelandJordanKazakhstanKyrgyz RepublicMacauMalaysiaMaldivesMaliMarshall IslandsMauritaniaNigeriaPakistanRomaniaSaudi ArabiaSenegalSeychellesSri LankaSudanTanzaniaTimor-LesteUgandaUzbekistanVietnamZambia

**Tier 3**

AfghanistanAlgeriaBelarusBurmaBurundiChinaComorosCubaEritreaIranKorea, NorthLesothoNicaraguaPapua New GuineaRussiaSouth SudanSyriaTurkmenistanVenezuela

**Special Case**

LibyaSomaliaYemen

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### Regional Maps

**Africa**

*The above statistics are estimates derived from data provided by foreign governments and other sources and reviewed by the Department of State. Aggregate data fluctuates from one year to the next due to the hidden nature of trafficking crimes, dynamic global events, shifts in government efforts, and a lack of uniformity in national reporting structures. The numbers in parentheses are those of labor trafficking prosecutions, convictions, and victims identified.*

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**East Asia and Pacific**

 

*The above statistics are estimates derived from data provided by foreign governments and other sources and reviewed by the Department of State. Aggregate data fluctuates from one year to the next due to the hidden nature of trafficking crimes, dynamic global events, shifts in government efforts, and a lack of uniformity in national reporting structures. The numbers in parentheses are those of labor trafficking prosecutions, convictions, and victims identified.*

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**Europe**

 

*The above statistics are estimates derived from data provided by foreign governments and other sources and reviewed by the Department of State. Aggregate data fluctuates from one year to the next due to the hidden nature of trafficking crimes, dynamic global events, shifts in government efforts, and a lack of uniformity in national reporting structures. The numbers in parentheses are those of labor trafficking prosecutions, convictions, and victims identified.*

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**Near East**

*The above statistics are estimates derived from data provided by foreign governments and other sources and reviewed by the Department of State. Aggregate data fluctuates from one year to the next due to the hidden nature of trafficking crimes, dynamic global events, shifts in government efforts, and a lack of uniformity in national reporting structures. The numbers in parentheses are those of labor trafficking prosecutions, convictions, and victims identified.*

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**South and Central Asia**

*The above statistics are estimates derived from data provided by foreign governments and other sources and reviewed by the Department of State. Aggregate data fluctuates from one year to the next due to the hidden nature of trafficking crimes, dynamic global events, shifts in government efforts, and a lack of uniformity in national reporting structures. The numbers in parentheses are those of labor trafficking prosecutions, convictions, and victims identified.*

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**Western Hemisphere**

*The above statistics are estimates derived from data provided by foreign governments and other sources and reviewed by the Department of State. Aggregate data fluctuates from one year to the next due to the hidden nature of trafficking crimes, dynamic global events, shifts in government efforts, and a lack of uniformity in national reporting structures. The numbers in parentheses are those of labor trafficking prosecutions, convictions, and victims identified.*

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							How To Read a Country Narrative					

This page shows a sample country narrative. The tier ranking justification for each country in this year’s report appears in the first paragraph of each country narrative and includes language that explicitly highlights the factors supporting a given tier ranking. The Prosecution, Protection, and Prevention sections of each country narrative describe how a government has or has not addressed the relevant TVPA minimum standards (see pages 45-46), during the reporting period. This truncated narrative gives a few examples.

 [107 KB]*[Click image for larger PDF version [107 KB]]*

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							Relevant International Conventions					

The chart below shows the Ratification, Accession (a), or Acceptance (A) of relevant international conventions for those countries that have ratified, acceded to, or accepted any such conventions between April 2019 and March 2020. A complete list that includes all of the countries covered by the 2020 Trafficking in Persons Report is available at: https://www.state.gov/international-conventions-relevant-to-combating-trafficking-in-persons/.

*[Scroll bar is available at the bottom of the table; or download PDF version [41 KB].]*