PAHO/WHO and partners say more support is needed to save lives, prevent cholera's spread
Washington, D.C., 31 May 2013 (PAHO/WHO) — Members of an international coalition today announced new financial support for efforts to eliminate cholera from Haiti and the Dominican Republic, through major investments in water and sanitation and health systems strengthening. The support was announced in a meeting of the Regional Coalition to Eliminate Cholera Transmission in Hispaniola, held at the Pan American Health Organization/World Health Organization (PAHO/WHO) in Washington, D.C.
The funds announced at the meeting include $20 million from the World Bank, $5 million from UNICEF and $3.1 million from PAHO/WHO—all members of the Regional Coalition—plus $1 million from the United Nations Development Program (UNDP). In addition, the International Federation of Red Cross and Red Crescent Societies (IFRC) said it would launch a new donation drive whose proceeds would go exclusively to support anti-cholera efforts.
The announced funds will support the implementation of national action plans to eliminate cholera from Haiti and the Dominican Republic. Haiti's plan, launched in February 2013, calls for $2.2 billion in investments over the next 10 years, including $443.7 million over the next two years and $18 million over the next six to eight months. The Dominican Republic's plan calls for $77 million in investments over 10 years, including $33 million over the next two years.
Today's $29.1 million in pledges brings the total funds committed to support the national plans to $209.4 million, less than half the amount needed over just the next two years.
Marie Raymond, Director-General in Haiti's Ministry of Health and Population (MSPP), said bridging this funding gap is an issue of immediate concern.
"The rainy season is upon us. Alas, our resources are not as available as they need to be. We must take urgent and bold steps to meet these needs."
"We must challenge governments and partners to come up with the funds that are needed to get the job done," said PAHO Director Carissa F. Etienne. "The goal is not just eliminating cholera. It is to ensure that every man, woman and child has access to safe water and sanitation. This is basic to the dignity of every human being."
Since cholera broke out in Haiti in 2010, more than 657,000 people have fallen ill and over 8,000 have died from the disease (as of May 22). In the Dominican Republic, more than 30,000 have fallen ill and 440 have died, said Rafael Schiffino, Vice-Minister of Health.
In January 2012, the governments of Haiti and the Dominican Republic—jointly with PAHO/WHO, UNICEF and the U.S. Centers for Disease Control and Prevention (CDC)—issued a "call to action" for the international community to help eliminate cholera from Hispaniola by bringing Haiti up to regional levels of water and sanitation coverage.
Currently, Haiti has the lowest levels of water and sanitation coverage of any country in the Americas. Just 69% of the population has access to improved drinking water, and only 29% have access to improved sanitation, said Raymond. In the poorest 20% of the population, only 1% has access to an improved source of water, and 90% practice open-air defecation.
By contrast, 93% of people in Latin America and the Caribbean have access to improved drinking water, and 80% have access to improved sanitation (data for 2008). Haiti's 10-year plan seeks to bring access to drinking water up to at least 85% and access to improved sanitation to at least 90%.
The 10-year timeframe for cholera elimination in Haiti is based in part on the experience of a cholera epidemic in the 1990s that began in Peru and spread to more than 21 countries in the Americas in just two years. With support from the international community, investments in water and sanitation infrastructure contributed to the virtual elimination of cholera from Central and South America within a decade.
In Haiti, "investments in water and sanitation are absolutely essential to eliminate cholera transmission, but they will also have other spin-off benefits," said PAHO Deputy Director Jon K. Andrus. "They will reduce other water-borne illnesses and contribute to stronger economic growth, national security, healthier families and communities, improved agricultural production of fruits and vegetables, and in general increase productivity by improving the health of the population."
Paul Farmer, U.N. Special Adviser for Community-based Medicine and Lessons from Haiti, joined in calling for increased funding but also urged international partners to show "pragmatic solidarity" with Haiti. He said donor agencies could help more by assuming some of the burden of processing and accountability with regard to external financial resources.
During today's meeting, UNICEF's representative, Enrique Paz, said his agency would reprogram more than $9 million toward cholera prevention and take lead responsibility for the operation of a national trust fund to channel resources to cholera elimination. In addition, several other agencies—including the U.N. Stabilization Mission in Haiti (MINUSTAH), Brazil's National Health Foundation (FUNASA), the Caribbean Water and Wastewater Association (CWWA), the Inter-American Association of Sanitary and Environmental Engineering (AIDIS), WASH Advocates and others—pledged technical cooperation, human resources, equipment, advocacy and other in-kind support for anti-cholera efforts.
The lead agencies responsible for Haiti's anti-cholera efforts are the Ministry of Health and Population (MSPP) and the National Directorate for Water Supply and Sanitation in the Ministry of Public Works (DINEPA). In the Dominican Republic, the Ministry of Health is overseeing these efforts with support from the National Water and Sanitation Institute (INAPA).
The Regional Coalition for Water and Sanitation to Eliminate Cholera Transmission in Hispaniola was launched in June 2012 by PAHO/WHO, UNICEF and the CDC. Its other members are the Spanish Agency for International Development Cooperation (AECID), the Association of Haitian Physicians Abroad (AMHE), the Caribbean Community (CARICOM), CWWA, Catholic Relief Services (CRS), FUNASA of Brazil, AIDIS, Inter-American Development Bank (IDB), IFRC, Partners in Health / Zanmi Vasant, the World Bank, WASH Advocates, the Veolia Environment Foundation, and the Millennium Water Alliance (MWA). Two new members of the Coalition were announced today: the American Society of Tropical Medicine and Hygiene (ASTMH) and World Vision. PAHO/WHO serves as the secretariat of the Coalition.
