WASHINGTON - Saudi Arabia and Cuba are now on a list of countries the United States considers derelict in their responsibilities to combat human trafficking, raising the risk of sanctions against those countries.

In its annual report on human trafficking, the State Department accused ally Saudi Arabia of widespread violations involving foreign laborers and denounced Cuba for allegedly engaging in trafficking through its program that exports doctors abroad.

"If you don't stand up to trafficking, America will stand up to you," Secretary of State Mike Pompeo told reporters Wednesday in Washington, shortly after the report's release.

The annual Trafficking in Persons Report (TIP Report) assesses what countries are doing to combat what Pompeo describes as "one of the most heinous crimes on Earth."

The top U.S. diplomat said traffickers are currently victimizing nearly 25 million people worldwide.

The State Department designated Saudi Arabia and Cuba as Tier 3 countries, the report's lowest possible ranking. China, North Korea, Russia and Venezuela have also been designated as such.

The U.S. said the Saudi kingdom has done little to help victims, choosing to, instead, jail, fine or deport them after accusing them of immigration violations or prostitution.

Cuba, a long-time U.S. adversary, has threatened or coerced physicians to participate in its overseas medical program, the report said.

Some 8,300 Cuban medical workers who had been stationed in Brazil departed the country after President Jair Bolsonaro complained earlier this year the Cuban government keeps most of the wages paid to the workers, whom he described as "slave labor."

FILE - Brazil's President Jair Bolsonaro.

Tier 3 countries are subject to U.S. actions, including partial or total elimination of support from the International Monetary Fund or other international support organizations.

The U.S. president, however, can waive sanctions against Tier 3 countries with the hope it will encourage them act more aggressively against traffickers.

Pompeo said the U.S. took actions last year against 22 Tier 3 countries.

The State Department report, which assesses 187 countries, concluded many world governments have enacted laws to hold traffickers accountable since the 2000 adoption of the United Nation's Palermo Protocol. The pact requires countries to codify human trafficking as a crime both within and between countries.

But the report calls on countries to do more to ensure protections for victims within their borders. Greater protections requires "political courage" to investigate "official power structures," for example, and to "ending impunity for crimes that have long been seen as accepted local and cultural practices."

"Acknowledging human trafficking within the borders of a country is not easy," the report declared. "Governments should be willing to admit its existence and rise to their responsibility to address it."