Haiti, DR to Launch Ten Year $2.2 Billion Plan to Eliminate Cholera

According to Trenton Daniel and Martha Mendoza, a ten year $2.2 billion dollar plan to eliminate cholera in Haiti and the Dominican Republic will be released shortly.  The plan will be government-led with support from the U.S. Centers for Disease Control and Prevention (CDC), the United Nations Children’s Fund (UNICEF) and the WHO/Pan American Health Organization (PAHO).  It is yet to be determined who will fund the plan and to what extent although the World Bank has indicated it will contribute.  Although it will take years, eliminating cholera is neccesary both for protecting public health and promoting investment. 

PORT-AU-PRINCE, Haiti — Haiti and the Dominican Republic will require $2.2 billion over the next 10 years for an ambitious plan to eliminate cholera, an official from the U.S. Centers for Disease Control and Prevention said Wednesday. The plan is due to be rolled out in a week or two and it outlines a government-led effort backed by the CDC, the Pan American Health Organization and UNICEF. It's still unclear who will pay for what would be the biggest endeavor yet to develop Haiti's barely existent water and sanitation system. "This is the greatest public health intervention that could be implemented in Haiti, but it's a long-term strategy, it's not a fix tomorrow," said Dr. Jordan Tappero, director of the Health Systems Reconstruction Office for the CDC's Center for Global Health. "Our goal is to eliminate transmission of cholera."

Short-term goals include building water supply systems, sewer systems and wastewater treatment plants, as well as improving access to latrines, especially in schools. The tattered state of Haiti's infrastructure has contributed to the flow of cholera since the disease was likely introduced in October 2010 by a unit of peacekeepers from Nepal, where cholera is endemic. The disease is easily preventable through proper hygiene but it has killed more than 7,600 people in Haiti and more than 420 in the neighboring Dominican Republic, health officials say. The plan warns that the disease could spread to the rest of the hemisphere if left unchecked and produce an "economic catastrophe" because of a heavy impact on agriculture, tourism and private sector investment. The need is obvious. Haiti's access to sanitation has been declining for the past two decades and is the worst in the hemisphere. Today about half of the people in this country of 10 million have no bathroom whatsoever. "If you don't have a place to defecate, where solid waste can be cleaned up then you openly defecate," Tappero said.

The plan, at this point, is unfunded. Organizers said getting a plan, with costs, was the first step. They will now ask international donors for support. So far, the World Bank plans to contribute $5 million, unspent money from a $15 million grant that went toward the health ministry and government's water department, said Maryanne Sharp, a Haiti project manager for the World Bank. "We're looking at this plan to figure out what we're doing with the rest," Sharp said. The plan also calls for moving cholera treatment into regular hospitals. Much is now done in tent facilities with rows of cots where patients go to be rehydrated. The idea is to make better use of hospital workers and curb stigmatization, Sharp said.