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Peru has reopened a criminal investigation against ex-President Alberto Fujimori on charges he and three of his former aides led a 1990s government program that forcibly sterilized thousands of poor indigenous women to reduce the country’s birth rate.

The reopening of the probe is the latest attempt by prosecutors to investigate what is believed to be one of the largest government-sanctioned involuntary sterilizations programs in recent history.

According to an official report, more than 300,000 women and some 20,000 men — many of them impoverished and illiterate indigenous Peruvians —were sterilized from 1995 to 2000 under a program that largely targeted the country's rural poor. Rights groups say at least 2,000 of the women were coerced into operations, and possibly as many as 200,000.

Peruvian andean women victims of forced sterilizations during the administration of Peru's former President Alberto Fujimori, protest in Lima on February 13, 2014. AFP PHOTO/ERNESTO BENAVIDES (Photo credit should read ERNESTO BENAVIDES/AFP/Getty Images)
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Peruvian prosecutor Luis Landa Burgos ordered the reopening of the probe more than a year after a previous investigation ended on the grounds that no crimes against humanity were committed. Last year, judicial officials said there was insufficient evidence to show women were systematically forced to have sterilizations.

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That decision was appealed by human rights groups, which now welcome the reopening of the case.

“The Peruvian government robbed thousands of women of their dignity and rights to build a family,” said Monica Arango, regional director for Latin America and the Caribbean at the Center for Reproductive Rights. “Now, more than a decade later, we are nowhere near justice being served.”

In this photo taken on Nov. 22, 2011, Cuzco Congresswoman Hilaria Supa, left, speaks with Serafina Illa, center, and Aurelia Paccohuanca after an interview in Lima, Peru. Illa and Paccohuanca were victims of forced sterilization during a 1995-2000 program created by then-President Alberto Fujimori to dramatically lower Peru's birth rate. Paccohuanca now heads the Association of Women Affected by Forced Sterilization in Cuzco. (AP Photo/Martin Mejia)
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Fujimori, who served as Peru’s president from 1990 to 2000, is currently in jail for corruption and human-rights abuses. He claims all of the sterilizations were voluntary.

But some women who submitted to sterilizations say they were threatened with jail, pressured or coerced by health officials to sign consent forms and undergo the operations. Rights groups say the sterilizations were often conducted in unsanitary conditions, and less than half of the procedures involved an anesthesiologist or follow-up care. Some health workers were given sterilization quotas.

Activists claim Fujimori was personally behind the forced sterilization campaign and ordered three of his former health ministers to carry them out. Fujimori praised the sterilization program repeatedly after he left office, saying it helped lowered Peru’s birth rate from 3.7 children per woman in 1990 to 2.7 children a decade later.

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There is some legal precedent. In 2003, Peru agreed to pay $100,000 to the survivors of Mamerita Mestanza, a 33-year-old mother of seven who died after being pressured into a tube-tying operation.

The new criminal probe comes as Fujimori's daughter, Keiko Fujimori, who served as the country's honorary "first lady" during the sterilization campaign, leads the polls in the country's 2016 presidential race.