Cholera Outbreak In Haiti Is No Surprise
Statement by Abbey Gardner and Jéhane Sedky, Co-Directors, Science of Implementation Initiative
NEW YORK, October 17, 2022 – On October 1st, the Haitian Ministry of Health (Ministère de la Santé Publique et de la Population) confirmed the resurgence of cholera in Haiti. The current dire security and humanitarian crisis has further weakened the already vulnerable water, sanitation and health systems. Without the necessary investment in Haiti’s water and sanitation systems over the past decades, the resurgence of cholera is no surprise.
In 2010 when cholera was introduced to Haiti by United Nations peacekeepers, our team – then working at the UN – was tracking aid to Haiti post-2010 earthquake. We subsequently added donor funding toward cholera elimination to our portfolio. For the next eight years, we tracked all cholera funding to Haiti – both humanitarian and development, including funding for cholera relief after Hurricane Matthew struck southwestern Haiti in 2016.
The focus of our tracking was on the National Plan for the Elimination of Cholera in Haiti, a ten-year plan developed by the Haitian Ministry of Health and the Directorate of Potable Water and Sanitation (DINEPA) in partnership with the international community. The 2013-2022 National Plan for the Elimination of Cholera was fully costed at $2.2 billion. We tracked all donor funds toward the National Plan. Here are the key facts:
- The National Plan for the Elimination of Cholera was costed at $2.2 billion for ten years.
- $420 million was disbursed toward the plan, representing 18.92% of the total requirements.
- According to the World Bank, less than 50% of Haitians have access to clean drinking water and less than one-third have access to basic sanitation.
As we have seen, time and time again, the Haitian public sector is doubly penalized. In the case of cholera elimination, the Ministry of Health and DINEPA did not receive adequate funding and support while simultaneously being blamed for a lack of capacity.
The immediate need is of course to address the outbreak: First, all those with symptomatic cholera, including those in prisons, must be diagnosed and treated. Second, oral cholera vaccine must be made available to millions of Haitians. And third, while public health messaging is critical at this time, communities cannot adhere to the recommended guidance if they do not have access to the basic supplies that are needed. People in affected communities cannot drink potable water if none is accessible, and they cannot wash their hands if there is no soap or running water readily available. All those working on the cholera humanitarian response must ensure as much as possible that potable water, free soap, clean water hand washing stations, as well as adequate supplies to stay home including food and other staples are widely available and affordable or free of cost.
The longer-term priority remains, as soon as is possible, to remedy Haiti’s water insecurity and improve sanitation by fully funding the National Plan for the Elimination of Cholera.
Without supporting the infrastructure that all agreed was critical, the international community did not create the necessary conditions to eliminate cholera. The current political and security crisis has placed enormous stress on the already precarious public health situation in Haiti. Without a national water and sanitation system in place, acute-on-chronic crises like a cholera outbreak are inevitable. Haiti urgently requires the necessary pragmatic solidarity to overcome the current devastating situation it is facing. As soon as possible, with evidence-based approaches and donor commitment to the National Plan, we can and must support our Haitian partners toward improved health and well-being.
About the Science of Implementation Initiative:
The Science of Implementation Initiative (SII) was established by Dr. Paul Farmer to build upon the work of his team at the United Nations Office of the Special Envoy for Haiti (2009-2012) and the United Nations Office of the Secretary-General’s Special Adviser on Community Based Health and Aid Delivery (2013-2019). SII gathers data, conducts research, tracks funding, and provides analysis with the goal of making official development assistance more effective, equitable, transparent, and accountable from the perspective of partner countries. SII is supported by private foundation grants.
Learn more at: www.siidata.org
Additional SII statements in regard to Haiti:
https://siidata.org/its-time-to-do-the-right-thing-for-haiti/
https://siidata.org/dont-blame-haiti-for-failed-aid-science-of-implementation-initiative/