Months after an earthquake devastated Haiti in 2010, a deadly new crisis began to unfold: Cholera spread through the wretched tent cities that had become home to thousands of displaced families.
Scientists traced the outbreak to a base housing United Nations peacekeepers sent from Nepal to assist with the recovery efforts. But for years, the U.N. refused to accept responsibility for introducing a disease that has killed at least 9,100 people, sickened hundreds of thousands more and continues to claim victims across the small Caribbean nation.
Now for the first time the U.N. is acknowledging that it played a role. On Thursday, a spokesman for Secretary-General Ban Ki-moon said that over the last year the world body has "become convinced that it needs to do much more regarding its own involvement in the initial outbreak and the suffering of those affected by cholera."
Officials are considering a series of options and plan to unveil a "significantly new set of U.N. actions" within the next two months, the spokesman, Farhan Haq, told reporters in New York.
The U.N. stopped short of saying it caused the epidemic. But its acceptance of some responsibility, first reported by the New York Times, was welcomed by lawyers representing Haitian cholera victims.
"This is a groundbreaking first step towards justice," said Beatrice Lindstrom, a staff attorney at the Boston-based Institute for Justice & Democracy in Haiti. "But promises will not stop cholera's killing or compensate for the damage to poor families in Haiti. The real test is in what comes next."
The group is among several organizations that have filed a federal class action lawsuit in New York seeking compensation for thousands of cholera victims who blame the U.N. for bringing the disease to their country. It is also demanding that the U.N. issue a public apology and ensure that cholera is eradicated in Haiti by investing in water and sanitation infrastructure.
Haq declined to say what steps the U.N. is considering, but suggested that reparations were not among them.
An appeals court is considering whether to allow the lawsuit to proceed. U.N. officials have long argued that the organization's charter provides diplomatic immunity, and Haq said its legal position had not changed.
The stance has drawn sharp criticism from some U.N. staff members. In October, a group of five special rapporteurs, who serve as internal watchdogs, wrote a letter to the secretary-general arguing that the lack of an effective remedy for cholera victims "challenges the credibility of the organization as an entity that respects human rights."
"The response to date in terms of efforts to fully eradicate cholera, to ensure safe water and adequate sanitation provision, and to mobilize sufficient funding for these purposes appears to be clearly insufficient," the letter said.
Haq's statement Thursday came after the U.N. was provided a draft copy of a report on the U.N.'s handling of the outbreak that was written by one of the advisors who signed the letter.
The report by Philip Alston, special rapporteur on extreme poverty and human rights, will probably be released to the public in late September and presented to the General Assembly in October, Haq said in an emailed statement.
He did not elaborate on its contents but said "we wanted to take this opportunity to welcome this vital report."
Before the outbreak that began around mid-October 2010, cholera had never been documented in Haiti. In fact it had been eliminated from much of the Western Hemisphere.
The bacterial disease, which is spread through contaminated food or water, can quickly overwhelm areas with inadequately treated sewage and drinking water, a common problem after a natural disaster strikes. Symptoms include diarrhea, vomiting and dehydration.
Scientists concluded that the strain circulating in Haiti could be traced to Nepal, where cholera is endemic. Evidence suggested that the disease was introduced into Haiti's largest river through sewage from the U.N. peacekeeping base.
The epidemic is now estimated to have affected 780,000 people, according to figures released by the U.N. At least one study has suggested that the death toll could be much higher than the official figures.
At the end of 2012, Ban announced a $2-billion initiative to help eradicate cholera in Haiti and neighboring Dominican Republic, which share the island of Hispaniola. But the U.N. has struggled to raise the necessary funds.
Although the number of cases has dropped significantly since the start of the epidemic, cholera still sickens thousands every year and claimed more than 320 lives in 2015.
6:25 p.m.: This article was updated with details about the current caseload.