The four-day summit was called to address the scandals that have ravaged the Catholic Church’s credibility.
A leading cardinal acknowledged the global scale of the child sex abuse scandal in the Roman Catholic Church on Friday, on the second day of a landmark summit at the Vatican on tackling paedophilia in the clergy.
The refusal by some bishops -- notably in Asia and Africa -- to admit clerical paedophilia was an issue in their countries was unacceptable, Indian Cardinal Oswald Gracias told the extraordinary summit.
"The point is clear. No bishop may say to himself, 'This problem of abuse in the Church does not concern me, because things are different in my part of the world'," he said.
His comments came after Pope Francis opened the global summit on Thursday -- the first of its kind -- calling on the 114 top bishops present to forge "concrete measures" to deal with sex abuse cases in the Church.
The pope has been under sustained pressure to tackle abuse issues in the beleaguered institution after numerous stories of paedophilia emerged in countries across the world.
The Church has been accused of covering up crimes committed by priests.
"Although the experience of abuse seems dramatically present in certain parts of the world, it is not a limited phenomenon," Gracias said.
"The entire Church must take an honest look, undertake rigorous discernment, and then act decisively".
A hard-hitting address by Cardinal Jose Horacio Gomez on Thursday told the gathering the Church had to "recognise that the enemy is within".
"The damage caused is so deep, the pain inflicted is so profound, the consequences of the abuses that have taken place in the Church are so immense that we will never be able to say that we have done all that can be done," he said.
The pope's desired code of conduct will clearly spell out what abuse means and how perpetrators will be punished, he said.
But victims groups insisted the centuries-old institution should get on with punishing all abusers and enablers.
"We have heard these words before," survivors' network SNAP said in a statement Thursday.
The group also accused Francis of allowing cardinals and bishops "who have had an active role in covering up" sex abuse to attend the summit, saying it showed they were "able to openly flout the very policies designed to hold them accountable".
Survivors have flocked to Rome in an effort to pressurise those in the Church who deny child clerical abuse is a major problem.
"There are too many people who commit suicide because of paedophilia," one Italian, who wished to remain anonymous, said as he wiped away his tears during a sunset vigil next to the Vatican.
"There are too many of us victims, it must stop. And they can make it stop," he said.
'Children still in danger'
Gomez, the Archbishop of Bogota in Colombia, slammed the age-old mentality that the Church was above the law.
He also denounced those clerics who turn a blind eye to assault or try to distract from the Church's guilt by pointing to abuse taking place in other parts of society.
"We often proceed like the hirelings who, on seeing the wolf coming, flee and leave the flock unprotected," he said.
Britain's Peter Saunders, a victim who resigned from a Vatican advisory commission on combating abuse, said there were "still children in danger today... and that is something the pope can do something about".
Any new agreed measures on clerical abuse are not expected to come until well after the summit, which winds up Sunday with a speech by Francis.