After seven days of wrenching testimony from 156 victims, former USA Gymnastics and Michigan State University physician Larry Nassar was sentenced to 40 to 175 years in prison on Wednesday on seven counts of criminal sexual conduct. Nassar, who is currently serving a separate 60-year sentence on child pornography charges, sexually abused countless athletes in his care for more than two decades. His sentencing is the first of many steps that must be taken to provide some semblance of justice for his victims. But there are still far too many people in power who knew about Nassar’s actions and did nothing — and are going unpunished.

A timeline of Nassar’s career and the allegations against him compiled by the Indianapolis Star shows how Michigan State officials’ ongoing failure to act enabled his serial abuse. The university had an opportunity to investigate Nassar after a student reported abuse to other coaches in 1998 but failed to do so, according to a lawsuit. In 2000, the same year Nassar attended the Olympics with USA Gymnastics, another student reported him to university officials. In 2014, the university cleared Nassar of any wrongdoing after yet another student accused him of abuse, despite previous allegations against him. Michigan State had the opportunity to launch a comprehensive investigation, akin to the Freeh Report at Penn State after it was revealed that an assistant football coach had been molesting boys on the school’s campus for 15 years, into Nassar's crimes and how they were allowed to occur for so long. Instead, the university covered his tracks for years. As has been the case with Penn State, the Michigan State officials who knew about Nassar’s serial abuse and failed to act should be prosecuted.

So far, all but one member of the university’s board of trustees have expressed their support of university president Lou Anna Simon, who has held the post since 2004. Notably, Michigan State officials have asked a federal judge to dismiss the lawsuit against the university earlier this month, claiming it “retains absolute immunity from liability” in the case against Nassar. If the university was interested in justice for Nassar’s victims, Simon and other officials would accept responsibility instead of trying to save what’s left of the university’s reputation. Other members have doubled down on their support for Simon. In an interview with the radio show Staudt on Sports this week, Michigan State board member Joel Ferguson said Simon shouldn’t resign because of “this Nassar thing,” adding that he was a lone actor who was “on an island by himself.” The university is now under investigation by the National Collegiate Athletic Association, which Simon chaired from 2012 to 2014. Instead of commissioning an independent investigation, the university’s board has asked the Michigan Attorney General to investigate the university — a move that board members think will clear them of any wrongdoing. If an investigation were to be launched against Simon and other administrators, Ferguson said yesterday, it would reveal that “our senior people were not complicit to what this victim did.”

Freeman’s statement doesn’t align with victim testimonies. During her testimony, Rachael Denhollander, a former gymnast who reported Nassar to the police and Michigan State officials in 2016, called out university officials who failed to act. “They did not listen in 1997 or 1998 or 1999 or 2000 or 2004 or 2014,” Denhollander said. “Victims were silenced, intimidated, told they were receiving medical treatment, and at times sent back to be further abused.” MLive.com spoke to nine of Nassar’s victims, including Denhollander, all of whom said they reported the abuse they faced at different times. One Michigan State gymnast said that Katie Klages, a university gymnastics coach, dissuaded her from filing a complaint against Nassar in the late ‘90s. Three other victims said they complained about Nassar's behavior — including one instance in which a runner said Nassar was treating her injured hamstring by penetrating her vagina with his hands — only to have their concerns dismissed. One victim said a member of the university’s athletic staff told her Nassar “knew what he was doing” because he was “an Olympic doctor.”

For the past 14 years, Simon has led a university whose culture prioritized athletics and fundraising over protecting students from sexual abuse.

Klages retired last year amid mounting allegations against Nassar. Another university doctor, Brooke Lemmen, reportedly resigned from her position in 2015 after she learned that the university was considering firing her for failing to report abuse allegations to law enforcement or campus authorities. It doesn’t matter whether Simon, the university president, knew about each individual cover-up or excuse made on Nassar’s behalf; the fact is that for the past 14 years, she has led a university whose culture prioritized athletics and fundraising over protecting students from sexual abuse. She should resign.

USA Gymnastics is also guilty — not only of employing Nassar and giving him access to countless victims, but also of an egregious failure to act on his victims’ behalf. The Indianapolis Star reported last year that USA Gymnastics staff waited five weeks after first hearing that Nassar was abusing gymnasts at the Karoyli Ranch, the team’s official training center, in 2015. Though Nassar retired from his position as USA Gymnastics Medical Coordinator the previous year, he continued to serve as the women’s gymnastics physician, and the ranch continued to serve as the women’s gymnastics team’s headquarters until this month. BuzzFeed reported yesterday that Texas law enforcement is now investigating the facility. It’s unclear what, if anything, USA Gymnastics coaches Bela and Marta Karolyi knew about Nassar’s behavior, but it’s worth noting that the couple was previously accused of physically and psychologically abusing gymnasts in Romania. During her testimony against Nassar, 25-year-old gymnast Mattie Larson said Nassar presented his office as a reprieve from the “prison-like mentality” of the ranch by giving the gymnasts snacks and junk food after coaches placed them on restrictive diets. Larson said the abuse she experienced at the ranch was so unbearable she hurt herself in order to get out. “I was taking a bath when I decided to push the bath mat aside, splash water on the tiles, get on the floor and bang the back of my head against the tub hard enough to get a bump so it seemed like I slipped,” she said. “My parents immediately took me to the hospital because they thought I had a concussion. I was willing to physically hurt myself to get out of the abuse that I received at the ranch.”

In an interview with ESPN’s Outside the Lines, gymnast Aly Raisman said USA Gymnastics cared more about “their reputation, the medals they win, and the money they make off of us” than about Nassar’s victims. Gymnast McKayla Maroney said she was forced to sign a nondisclosure agreement with USA Gymnastics in December 2016 and threatened with a $100,000 fine if she spoke out against Nassar, a silencing tactic that surely prevented other victims from coming forward.

Nassar's victims have been coming forward for more than 20 years. The fact that the dozens of allegations against him have only now led to a trial and conviction is indicative of a diseased culture that prizes just about everything — sports, prestige, reputation — over the lives and traumas of young women. At best, every adult who ignored warnings about Nassar was unwittingly complicit in the abuse of hundreds of women; at worst, they were engaged in a deliberate, elaborate cover-up. Without a full investigation into each person who allowed Nassar’s career to flourish and gave him access to an unlimited number of victims, it will be impossible to achieve anything close to real justice.

Update, May 16, 2018: Michigan State University reached a $500 million settlement with Nassar’s victims, $425 million of which will be distributed among 332 women who came forward. The additional $75 million is being placed in a trust fund to protect “any future claimants,” CNN reported. Earlier this month, a member of MSU’s board called for a new independent investigation of the Nassar case, as well as for the firing of employees who “acted contrary to our values.” MSU President Lou Anna Simon resigned in January.