Women in the Democratic Republic of the Congo seeking an experimental vaccine against the second-largest-ever Ebola epidemic are being sexually exploited, according to reports swirling around a pioneering WHO vaccination program.

Participants in an Ebola vaccine study and aid workers alike have raised alarms that women are being asked for "sexual favors" in exchange for the vaccine and other "Ebola-related services," part of a rising tide of gender-based violence that has paralleled the epidemic, according to research presented at a national task force meeting in Beni and reported by the Guardian.

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"This region of DRC has a long history of sexual violence and exploitation of women and girls. Though shocking, this is an issue that could have been anticipated," said Trina Helderman, a senior health and nutrition adviser at aid NGO Medair, calling out "humanitarian actors" for failing to institute more comprehensive safety measures to protect women and girls. Women are being blamed for failing to prevent the spread of Ebola, according to research by the International Rescue Committee.

The Congolese Health Ministry put out a public call for residents to report anyone offering treatment or vaccination in exchange for money and acknowledged that there were rumors women working on the Ebola response had received their jobs in exchange for sexual favors, urging those seeking such jobs to only meet with recruiters with official badges – but they did not address the sex-for-vaccine rumors in the Thursday announcement.

The WHO is being urged to issue a global alert regarding the six-month outbreak, which has infected 811 people and killed 510 since August. It is the largest outbreak since the 2014-2015 epidemic, which killed over 11,000, and governments – including the US – have withdrawn diplomatic personnel out of fear for their safety.

While they call the Ebola vaccine "highly, highly efficacious," the WHO acknowledged there is a "very high risk" of the virus spreading to Uganda, Rwanda, and South Sudan and the route of transmission is "unclear" in an alarming 80 percent of cases. In a paper published in the Lancet, experts list outside factors – political instability, conflict, and heavy regional and cross-border migration – that may exacerbate the epidemic. While over 66,000 doses of the vaccine have been administered since August, the process of doling them out – called "ring vaccination" because it targets the first and second-degree contacts of infected people to form a "ring" around the infection – only works if transmission passes along predictable routes.

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Mistrust of authorities has compounded the difficulty of responding to the outbreak, according to aid workers, though they acknowledge the risk of exploitation is a "grave concern."