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globally. Victims trafficked for sexual exploitation comprised 59 per cent of the detected victims in 2016. One victim out of three detected was trafficked for forced labour, and seven per cent of detected victims were trafficked for other purposes. The detected forms of exploitation vary widely across the different subregions. In 2016, trafficking for the purpose of forced labour was the most frequently detected form in Southern, East and West Africa, and the countries of the Middle East. In South Asia as well as in Central Asia, trafficking for forced labour and for sexual exploitation were detected in near-equal proportions. Trafficking for the purpose of sexual exploitation was the most detected form in all European subregions, in North and Central America and the Caribbean, and in East Asia and the Pacific. In North Africa, other forms of exploitation, such as exploitative child begging, were more frequently detected than other forms. As for other forms of exploitation, trafficking for the removal of organs remains very limited in terms of numbers of detected victims. About 100 victims of trafficking for organ removal were detected and reported to UNODC during the 2014-2017 period. Victims were all adults. This is related to the nature of that type of trafficking, which targets adult bodies with fully developed organs. Some two thirds of these victims were men. Most of these victims were reported by countries in North Africa and the Middle East, but cases have also been recorded in Western, Central and Eastern Europe, as well as in Central and South America. The data collected also refer to other forms of exploitations not specifically listed in the UN Trafficking in PerFig. 20 Number of detected trafficking victims, by form of exploitation and region of detection, 2016 (or most recent) Source: UNODC elaboration of national data. 0 1,000 2,000 3,000 4,000 5,000 6,000 7,000 8,000 Europe and Central Asia South Asia, East Asia and the Pacific The Americas Africa and the Middle East Trafficking for sexual exploitation Trafficking for forced labour Trafficking for organ removal Trafficking for other purposes sons Protocol, but considered by national legislations or jurisprudence as forms of trafficking. UNODC has categorized these other forms as labelled by the national authorities. Data for 2016 indicate that some 2 per cent of the victims detected globally were trafficked for ‘mixed forms of exploitation’, such as victims exploited both sexually and in forced labour, or exploited in begging as well as in criminal activity (often carrying out petty crimes). Pregnant women trafficked to sell their new-born GLOTiP_2018_BOOK.indb 29 17/12/2018 19:49:12 30 GLOBAL REPORT ON TRAFFICKING IN PERSONS 2018 Scarred for life: patterns of traffick- ing in persons for organ removal Compared to the most frequently detected cases of trafficking in persons for sexual exploitation and forced labour, there are relatively few detected cases of trafficking in persons for organ removal. Over the last 13 years, UNODC has collected information on about 700 victims of trafficking in persons for removal of organs detected in 25 countries as compared to 225,000 victims of trafficking in persons for all other purposes. In general, the pace of the crime is dictated by the shortage of organs on the global market as the availability of donated organs is limited and overshadowed by demand. Estimates suggest that five to ten per cent of all kidney and liver transplantations are conducted with illegally obtained organs.a These estimates include the illicit trade in organs. However, if the donor does not consent to the removal of organ, or this consent is obtained by means of coercion, deception, abuse of vulnerability, or any other means included in the trafficking in persons definition,b the organ transplant is the result of trafficking in persons for organ removal, which is the form of trafficking discussed in this box. Evidence suggests that traffickers are skilful when working across borders, leveraging low economic development in some countries and available medical expertise in others. Traffickers operate in increasingly sophisticated ways, making use of corrupt environments and fraudulent measures, exploiting people caught in destitution, poverty and hardship. One emerging feature is how trafficking in persons for the removal of organs is perpetrated by highly organized criminal networks. Examples of cases investigated by national authorities show that traffickers may operate over prolonged periods of time with high numbers of victims, before being caught. One case showed that one trafficking group conducted up to 500 kidney operations in different private homes and hospitals over a period of seven years.c In another case, traffickers organized the pairing of donors with recipients in an advanced logistical operation involving language interpretation for foreigners arriving at local hospitals, medical screenings for ensuring compatibility between donor and recipient, medical procedures, and postsurgery treatment.d Typical for the organisation of the networks involved in trafficking persons for organs removal is the ability to operate across borders. In one case, internationally based organisers and local brokers worked together. The latter received US$2,000 for each of the 12 recruited victims, using online advertisements asking for “kidney donors”. The broker arranged for medical screenings of the newly recruited vicMap 3 Shares of detected trafficking victims, by form of exploitation, by subregion of detection, 2016 (or most recent) Source: UNODC elaboration of national data. Note: The boundaries and names shown and the designations used on this map do not imply official endorsement or acceptance by the United Nations. Sexual exploitation Forced labour Other purposes Sexual exploitation Forced labour Equal detection of sexual exploitation and forced labour or main detection of other purposes Main form of exploitation detected: The boundaries and names shown and the designations used on this map do not imply official endorsement or acceptance by the United Nations. Central Asia 48%45%7% South Asia 50%49%1% Southern Africa 17%83% 28%3%69% North Africa West Africa 36%55%8% East Africa 18%82% East Asia and the Pacific 60%38%2% South America 58%32%10% Central America and the Caribbean 87% 5% 8% North America 71%24%5% Western and Southern Europe 66%27%7% Eastern Europe 56% 33%11% Central and SouthEastern Europe 70% 17%13% Gulf Cooperation Council 32%66%2% Rest of Middle East 34%39%27% GLOTiP_2018_BOOK.indb 30 17/12/2018 19:49:13 31 Global Overview I tims, shared the results with the organisers, and arranged transport for the victims to a third country where the removal of the organ was carried out.e Another emerging pattern concerns how traffickers collude with medical professionals, relying on corrupt and fraudulent practices.f Traffickers make use of medical staff for different purposes, including gaining access to laboratories to test the compatibility between donor and recipient, conduct medical procedures such as removing the organs or providing post-surgery recovery or treatment. While some cases may include direct collusion of medical staff, in other cases medical staff are deceived into believing a given arrangement is legitimate, underlining the sophisticated ways of manipulation of perception exercised by traffickers. Other examples show how medical licenses may be obtained illegally or traffickers may deceive donors into signing documents falsely stating they are related to the donor with the purpose of circumventing legislation prohibiting the commercial sale of organs.g In other cases, traffickers have deceived victims in other ways, telling them they were to receive a routine medical check-up or that the donation of their organs was for altruistic reasons.h A final aspect concerns how perpetrators abuse severe levels of vulnerability. Traffickers may persuade victims that trading one of their kidneys is the only way to cope with poverty. Traffickers abuse these vulnerabilities, specifically targeting unemployed rural workers or homeless people who are in desperate situations, and deceive them into trading their organs for money that will not be paid at the end of the surgery.i Along similar lines, traffickers have targeted persons who cope with other forms of hardship, such as recruiting people from refugee camps with false promises of receiving payments and/or transport to safer locations. Specific examples of this have been identified by the United Nations Special Rapporteur on trafficking in persons, especially affecting women and children. During one country visit, it was revealed how asylum seekers, refugees and persons living in poverty were targeted