The Vatican has been urged to “immediately remove” all clergy from the Catholic Church who are known or suspected child abusers.
The demand comes in an unprecedented and scathing report by the United Nations’ Committee on the Rights of the Child.
It accuses church officials of imposing a so-called code of silence to cover up crimes.
The head of the committee, Kirsten Sandberg, said: “The main finding of the committee was that the Holy See has adopted policies and practices which have led to the continuation of the abuse by the perpetrators.”
The UN also calls on the Holy See to hand over to local authorities an archive of evidence about the abuse of tens of thousands of children, and take measures to prevent a repeat.
The exceptionally blunt report followed the UN committee’s public grilling of Vatican officials last month.
The Vatican, responding to the report, said the Roman Catholic Church was committed to “defending and protecting the rights of the child”.
A statement said the Vatican would submit the UN report to “thorough study and examination”.
But the main focus of the response was on the report’s criticism of the Catholic Church’s positions on homosexuality, contraception and abortion.
Archbishop Silvano Tomasi, head of the Holy See’s delegation to the United Nations in Geneva, told Vatican Radio that the world body cannot ask the Church to change its “non-negotiable” moral teachings.
He said non-governmental organisations which favour gay marriage probably influenced the UN Committee on the Rights of the Child to reinforce an “ideological line” in the report.
Pope Francis has called sexual abuse of children “the shame of the Church” and has vowed to continue procedures put in place by his predecessor Benedict XVI.
The UN said a commission the pontiff created in December should invite outside experts and victims to participate in an investigation of abusers “as well as the conduct of the Catholic hierarchy in dealing with them.”