With an estimated 20 million victims of human trafficking today, all governments must step up their enforcement efforts, a new report by the State Department insists.

"We are all confronted with a choice: Do nothing or do something," Ambassador Susan Coppedge of the State Department's Office to Monitor and Combat Trafficking in Persons said Tuesday at a press conference launching the 2017 Trafficking in Persons report.

"When it comes to human trafficking, everyone has a role to play and an obligation to act," she added. "We must choose to do something to end modern slavery."

The annual Trafficking in Persons report was released by the State Department on Wednesday, over 400 pages in length and detailing the state of human trafficking around the world.

There are an estimated 20 million persons being trafficked today, Secretary of State Rex Tillerson noted on Tuesday at the launch of the report. This number includes children. Trafficking takes many forms, including sex slavery, debt bondage, forced marriage, and involuntary servitude.

"Human trafficking is as old as humankind. Regrettably, it's been with us for centuries and centuries," Secretary Tillerson stated. However, he added, "it is our hope that the 21st century will be the last century of human trafficking, and that's what we are all committed to."

Ivanka Trump, daughter of President Donald Trump and senior advisor to the president, was present at the launch of the TIP report on Tuesday. "On a personal level, as a mother, this is much more than a policy priority. It is a clarion call to action in defense of the vulnerable, the abused, and the exploited," she said.

"Last month, while in Rome, I had an opportunity to talk firsthand with human trafficking survivors," she said, recalling her meeting with trafficking victims at the Community of Sant'Egidio in Rome after President Trump met with Pope Francis on May 24.

"They told me their harrowing stories, how they were trapped in this ugly, dark web, how they survived, how they escaped, and how they are very slowly reconstructing their lives," she said.

Pope Francis, during a November audience with RENATE, a network of European religious who fight trafficking and exploitation, emphasized that "much more needs to be done on the level of raising public consciousness and effecting a better coordination of efforts by governments, the judiciary, law enforcement officials and social workers."

The TIP report is required to be compiled and released annually by the State Department to document how foreign governments are "prosecuting traffickers, protecting victims, and preventing the crime." It was mandated by the Trafficking Victims Protection Act of 2000, of which Rep. Chris Smith (R-N.J.), who chairs the House global human rights subcommittee, was the prime author.

The 2000 law also set up a tier ranking system for foreign countries based on their commitment and success in fighting human trafficking. Tier 1 countries are those that are abiding by "the minimum standards" of fighting trafficking, which were set by the Trafficking Victims Protection Act (TVPA).

Meanwhile, Tier 2 countries do not meet those minimum standards "but are making significant efforts to bring themselves into compliance with those standards," the TIP report explained. A Tier 2 Watch List is for countries with more serious trafficking problems which are nonetheless making sufficient efforts to curb trafficking and meet the minimum standards of the TVPA.

Tier 3 countries are the worst trafficking offenders, because they have been determined to be not even working to meet the minimum standards for fighting trafficking.

To hold these countries accountable for their poor records on trafficking, the U.S. can take actions against these countries as allowed by the TVPA, like withholding non-humanitarian, non-trade related assistance or voting to bar them from loans by the International Monetary Fund.

China was downgraded to Tier 3 status in the most recent report, and Rep. Smith had "high praise" for the administration for recognizing China's "shameful complicity in sex and labor trafficking."

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"They turn women into commodities for sale," Smith said of trafficking of women from nearby Burma, Cambodia, and Vietnam for commercial sex or forced marriages in China. Goods made from Chinese slave labor are also in the supply chains of U.S. businesses, he insisted.

During a Tuesday press conference at the State Department, Ambassador Coppedge outlined some other concerns with China's record on trafficking. According to reports from NGOs, trafficking victims have not been cared for sufficiently.

Rep. Smith stated his desire for the designation to be utilized in the future to push China toward reform of its notorious trafficking record.

"Hopefully, the new tier ranking coupled with robust diplomacy – including the imposition of sanctions authorized under Tier 3 – will lead to systemic reforms that will save women and children's lives and ensure that Chinese exports are not made with slave labor."

Also, many North Koreans are also working in China in slavery, with their wages effectively going to the North Korean government, Smith noted.

"The North Korean regime receives hundreds of millions of dollars per year from the fruits of forced labor," Secretary Tillerson stated on Tuesday. "Responsible nations simply cannot allow this to go on, and we continue to call on any nation that is hosting workers from North Korea in a forced labor arrangement to send those people home."

Of the 187 countries considered for the tier system, 40 were listed as Tier 1 countries, 80 as Tier 2, 45 were placed on the Tier 2 Watch List, and 23 were designated as Tier 3 countries, Coppedge said. Twenty-one of the countries were downgraded in status in the 2017 report, while 27 countries were upgraded.

Many countries do not prosecute trafficking as they should, Ambassador Coppedge noted, and this leads to greater impunity for traffickers to continue working. This was the theme of the 2017 TIP report, the need for governments to more strongly enforce laws against human trafficking.

"In addition to protecting victims from retribution or re-victimization, an effective criminal justice response brings traffickers to justice both to punish them for their crimes and to deter others," the report stated.

Yet, at times, governments can be actively colluding with traffickers, Ambassador Coppedge said.

"We still see instances of government officials protecting brothels, taking bribes from traffickers, and obstructing investigations for profit, and while we still see governments criminalize and penalize victims for crimes their traffickers force them to commit," she said.

"Trafficking in persons is a hidden crime rooted in deception," she added. "Victims are coerced or intimidated into silence, and they often fear that if they do come forward they will be punished. When governments enact and enforce strong, comprehensive anti-trafficking laws, they send an unmistakable message to criminals: We will not tolerate this."

The report also quoted Archbishop Bernardito Auza, Permanent Observer of the Holy See to the United Nations, as saying that today, "wars and conflicts have become the prime driver of trafficking in persons."

"They provide an enabling environment for traffickers to operate, as persons fleeing persecutions and conflicts are particularly vulnerable to being trafficked," the archbishop said. "Conflicts have created conditions for terrorists, armed groups and transnational organized crime networks to thrive in exploiting individuals and populations reduced to extreme vulnerability by persecution and multiple forms of violence."