Country seeks to protect 1.2 million women of childbearing age and more than 240,000 babies born each year

Port-of-Prince, Haiti, 27 April 2013 (PAHO/WHO) — Haiti today kicked off a new campaign to vaccinate women of childbearing age against tetanus during a launching event for the 11th Vaccination Week in the Americas.

On hand for the launch were representatives of Haiti’s Ministry of Public Health and Population, the Pan American Health Organization/World Health Organization (PAHO/WHO), UNICEF, the GAVI Alliance, and the U.S. Centers for Disease Control and Prevention.

The tetanus vaccination campaign, which will be carried out April 29 to May 5, seeks to protect some 1.2 million women aged 15 to 49 against tetanus and to protect more than 240,000 Haitian babies born each against neonatal tetanus, an often fatal disease that globally claims over 58,000 babies lives each year.

At the launch, held in the Carrefour commune of metropolitan Port-of-Prince, Minister of Health of Haiti Florence D. Guillaume said, “Vaccination has always been a priority for prevention and improving health and today we are reaffirming that commitment.” She said the campaign would help accelerate Haiti’s progress in reducing its infant mortality rate, which is among the highest in the Americas.

L-R Helen Evans, deputy CEO of the GAVI Alliance, Minister of Health of Haiti Florence D. Guillaume and PAHO/WHO Director Carissa F. Etienne.

“Thanks to its political will, Haiti has achieved a great deal in immunization in recent years,” said PAHO/WHO Director Carissa F. Etienne. She noted that Haiti is in the process of being certified free of measles and rubella and in recent years has reported no cases of polio.

To protect these achievements, Haiti will also carry out routine immunization during Vaccination Week, with special efforts to reach children under 1 in areas of low coverage and communities along the border with the Dominican Republic.

Minister of Health Guillaume announced that Haiti will be introducing rotavirus vaccine during the second half of 2013, targeting children under age 1. Rotavirus causes diarrhea and can result in hospitalization and death. In the Americas, more than 26 countries and territories have incorporated rotavirus vaccine into their routine immunization programs.

Helen Evans, deputy CEO of the GAVI Alliance, said “GAVI has been a partner of Haiti’s for 12 years and has worked with the country to prepare for the introduction of rotavirus vaccine, following its adoption of pentavalent vaccine last year.” Evans said GAVI’s support is aimed at ensuring that Haitian children have “a healthy start in life.”

Etienne noted that “with the introduction of new vaccines in the national schedule, Haiti has begun a new era in vaccination.” Haiti also plans to begin vaccinating against pneumococcus in 2014.

PAHO/WHO has been supporting efforts in Haiti to improve maternal-child health, strengthen routine vaccination, and develop a culture of prevention within the population.

Other participants in the launch of Vaccination Week in the Americas, whose theme this year is “Vaccination: a shared responsibility,” included representatives of the Brazil-Cuba-Haiti Tripartite Project, the Canadian International Development  Agency (CIDA), and the Haitian Red Cross, among others.

Vaccination Week in the Americas is the largest international health effort in the Western Hemisphere. Since 2003, it has taken the benefits of vaccines to more than 411 million people of all ages, including more than 140 million children under 5 and nearly 139 million senior citizens. The initiative’s success helped inspire the launch in 2012 of World Immunization Week, which is being celebrated again this year by more than 180 countries worldwide.

PAHO, founded in 1902, is the oldest international public health organization in the world. It works with its member countries to improve the health and the quality of life of the people of the Americas. It also serves as the Regional Office for the Americas of WHO.

Links

• Vaccination Week in the Americas
• http://www.paho.org
• http://www.facebook.com/PAHOWHO
• http://www.youtube.com/pahopin 
• http://twitter.com/pahowho #vaccination #GetVax ##vwa
• ImmunizationFacebook
• Immunization Twitter
• Gallery of photos of Vaccination Week in Haiti

Media Contacts:
Leticia Linn, linnl@paho.org, Tel. + 202 974 3440, Mobile +1 202 701 4005, Donna Eberwine-Villagran, eberwind@paho.org, Tel. +1 202 974 3122, Mobile +1 202 316 5469, Sebastián Oliel, oliels@paho.org, Phone +1 202 974 3459, Mobile 202 316 5679, Knowledge Management and Communications, PAHO/WHO–www.paho.org

Message of PAHO’s Director Carissa F. Etienne

“It gives me great pleasure as Director of the Pan American Health Organization, to congratulate the Haitian government for an impressive achievement—the presentation of a national plan of action for eliminating the transmission of cholera. I know that great commitment and effort have gone into the development of this plan, which is ambitious yet achievable. When fully implemented, it will bring improvements in water and sanitation infrastructure and health system capacity that will help ensure that neither cholera nor any other waterborne disease will ever again produce a major public health crisis in Haiti.

The Haitian people are resourceful and resilient. In the quake’s aftermath, we recognize that it was Haitians themselves who responded first and saved many lives. But I also believe that the overwhelming response of people, organizations and other countries around the world—including your devoted neighbor, the Dominican Republic—was one of the finer displays of international solidarity in recent history.

Today, the Haitian government is giving us the opportunity to do what needs to be done. This plan when implemented can and will finally halt cholera transmission in Haiti and ensure that any future introduction of the disease can be quickly controlled.

But for the plan to be implemented, Haiti’s friends in the international community must align their efforts and harmonize around this plan and provide the necessary financial resources.

I applaud the efforts of the Haitian authorities and in the name of PAHO we  pledge half a million dollars to support the installation of water and sanitation connections in a number of primary health care centers in priority zones.

We further reiterate our commitment to support the government and people of Haiti in National health development.

We will work with Coalition partners to implement this plan. And I call on the entire international community to play your part in protecting and promoting the health and well-being of our Haitian brothers and sisters.

Thank you.

Message available in French and Portuguese

Washington, D.C., 14 March 2013 (PAHO/WHO) —

The Millennium Water Association is a coalition of charities working to bring clean, safe drinking water and sanitation to developing nations in Africa, Asia and Latin America.  Members include CARE, Catholic Relief Services, Food For the Hungry, Global Water, IRC – International Water and Sanitation Centre, Lifewater International, Living Water International, Pure Water for the World, WaterAid America, Water For People, Water Missions International, Water.org. and World Vision.

The association’s executive director, Rafael Callejas, met with PAHO’s deputy director, Jon Andrus, and representatives of other coalition members to exchange ideas on future cooperation to improve water and sanitation on the island.

Andrus said that improving water and sanitation infrastructure in Haiti is an urgent challenge that the coalition is seeking to address in the coming years. He also noted that ensuring medical care for cholera patients has recently become more challenging in Haiti because of the departure of many organizations that were providing such care.

Callejas praised the Regional Coalition’s long-term commitment and pledged his association’s support for its actions.

Nearly 650,000 people in Haiti have been sickened by cholera since 2010, and 8,000 have died. The disease’s spread has slowed since the beginning of the epidemic, when over 18,000 new cases on average were reported each week (2010). But Haiti continues to record new cases, on average more than 1,500 per week so far this year.

In June 2012, PAHO/WHO, UNICEF and the U.S. Centers for Disease Prevention and Control (CDC) joined with other organizations to create the Regional Coalition on Water and Sanitation to Eliminate Cholera Transmission in the Island of Hispaniola, to provide technical expertise and resource mobilization for cholera elimination. The coalition’s 18 members also include the Spanish Agency for International Development Cooperation (AECID), the Inter-American Development Bank (IDB), the World Bank, the Caribbean Community (CARICOM), the International Federation of Red Cross and Red Crescent Societies, WASH Advocates, Partners in Health, Veolia Environment Foundation, Zanmi Lasante, Catholic Relief Services, Caribbean Waste Water Association, and now the Millennium Water Association. PAHO serves as the coalition’s secretariat.

Links

• www.mwawater.org

Funds will help improve care for cholera patients following departure of international NGOs

Washington, D.C., 5 March 2013 (PAHO/WHO) — The Pan American Health Organization/World Health Organization (PAHO/WHO) will provide $500,000 from its technical cooperation resources to finance the installation of water and sanitation connections in primary healthcare centers in Haiti, under Haiti’s new National Plan for the Elimination of Cholera 2013-2022.

PAHO Director Carissa F. Etienne announced the new funding during Haiti’s official launch of the plan last week. The plan outlines $2.2 billion in investments in water and sanitation infrastructure, epidemiological and microbiological surveillance, health-care management, and health promotion and hygiene over the next 10 years. It budgets $485.9 million in investments over the next two years (2013-2015).

“This plan, when implemented, can and will finally halt cholera transmission in Haiti and ensure that any future introduction of the disease can be quickly controlled,” said Etienne. “But for the plan to be implemented, Haiti’s friends in the international community must align their efforts and harmonize around this plan and provide the necessary financial resources.”

PAHO/WHO’s contribution of $500,000 will support efforts to improve health care for cholera patients, a particularly urgent challenge due to the departure of many nongovernmental organizations and because of an increase in new cases in early 2013, following heavy rains from Hurricane Sandy. The number of specialized cholera treatment centers has declined 42% over the past year, and many remaining centers lack fundamental water and sanitation connections, which can contribute to the further spread of cholera.

Over the next two years, Haiti plans to expand the number of primary health-care centers from 241 to 500 by 2015, construct special areas within primary centers to treat acute diarrheal cases, and implement special norms and procedures for infection control.

Since the beginning of the cholera epidemic, PAHO has provided technical cooperation worth an estimated US$1.5 million and has received and spent some US$25.3 million from other sources to support cholera-related efforts in Haiti. In addition to the $500,000 announced this week, PAHO is allocating $2.3 million annually from its regular budget to support cholera elimination through technical cooperation in water and sanitation, alert and response, health systems improvements, and health and hygiene promotion.

In addition, PAHO serves as the secretariat of the Regional Coalition on Water and Sanitation to Eliminate Cholera Transmission in the Island of Hispaniola, which supports Haiti with technical expertise and resource mobilization. The coalition’s 18 members include the CDC, UNICEF, the Spanish Agency for International Development Cooperation (AECID), the Inter-American Development Bank (IDB), the World Bank, the Caribbean Community (CARICOM), the International Federation of Red Cross and, WASH Advocates, and others.

Links:

• PAHO/WHO calls for international funding of new Haiti cholera plan
• National Plan for the Elimination of Cholera in Haiti
• National Plan for the Elimination of Cholera in Haiti 2013-2022 – Short term plan 2013-2015
• PAHO/WHO country office in Haiti
• http://new.paho.org/paho110/
• http://www.paho.org  
• http://www.facebook.com/PAHOWHO
• http://www.youtube.com/pahopin   
• http://twitter.com/pahoeoc
• http://twitter.com/pahowho
• http://twitter.com/opsoms

Media Contacts:   

Leticia Linn, linnl@paho.org, Tel. + 202 974 3440, Mobile +1 202 701 4005, Donna Eberwine-Villagran, eberwind@paho.org, Tel. +1 202 974 3122, Mobile +1 202 316 5469, Sebastián Oliel, oliels@paho.org, Phone +1 202 974 3459, Mobile 202 316 5679, Knowledge Management and Communications, PAHO/WHO–www.paho.org

Haitian government reveals $2.2 billion blueprint for water and sanitation investments to eliminate cholera transmission over the next 10 years

Port-au-Prince, Haiti, 27 February 2013 (PAHO/WHO) — The Pan American Health Organization/World Health Organization (PAHO/WHO) today called on the international community to provide financing for a new $2.2 billion plan from the Haitian government to eliminate cholera transmission over the next 10 years through major investments in water and sanitation.

“Today, the Haitian government is giving us the opportunity to do what needs to be done,” said PAHO Director Carissa F. Etienne in welcoming the plan, which was announced by Haitian officials today in Port-au-Prince. “For the plan to be implemented, Haiti’s friends in the international community must align their efforts and harmonize around this plan and provide the necessary financial resources.”

The new National Plan for the Elimination of Cholera in Haiti provides a blueprint for increased investments in water and sanitation infrastructure, water-quality monitoring systems and water and sanitation management. It also includes health measures for prevention, surveillance, and case management; interventions for community-based behavior change; and vaccination for targeted groups against cholera.

The plan calls for US$485.9 million in investments during the next two years.

In revealing the new plan, Haitian Minister of Public Health and Population Florence Guillaume said it reflected “an integrated effort of the entire international community” and called for continued support from Haiti’s partners to help mobilize the resources needed for its implementation.

Cholera has sickened nearly 650,000 people in Haiti and claimed more than 8,000 lives since October 2010. The disease’s spread has slowed since the start of the epidemic, when over 18,000 new cases on average were reported each week (2010). But Haiti continues to record new cases, on average more than 1,500 per week so far this year.

Even prior to the 2010 earthquake, Haiti had the lowest rates of water and sanitation coverage of any country in the Americas. Only 63% of residents had access to improved water sources in 2008, and only 17% had access to improved sanitation. These conditions led to the rapid spread of cholera throughout the country.

The US$485.9 million in proposed investments for the next two years (2013-2015) includes US$81 million for rehabilitation, expansion, and maintenance of drinking water systems, and measures for water quality and emergency preparedness; US$60 million for wastewater and excreta disposal; and US$74 million for capacity building for the National Water and Sanitation Department (DINEPA).

The new plan, developed by DINEPA and the Ministry of Public Health and Population, grew out of a “Call to Action for a Cholera-Free Hispaniola” launched in January 2012 by the presidents of Haiti and the Dominican Republic with support from PAHO/WHO, UNICEF and the U.S. Centers for Disease Control and Prevention (CDC). In June 2012, PAHO/WHO, UNICEF and CDC joined with other organizations to create the Regional Coalition on Water and Sanitation to Eliminate Cholera Transmission in the Island of Hispaniola, to provide technical expertise and resource mobilization for cholera elimination. The cholera call to action received another boost last December, when United Nations Secretary-General Ban Ki-moon announced US$23.5 million in U.N. funds to support these efforts.

In welcoming the new elimination plan today, PAHO Director Etienne pledged US$500,000 in funds from PAHO/WHO to install water and sanitation connections in primary health care facilities, strengthen care for cholera patients, and promote oral rehydration at the community level.

“We will work with coalition partners to implement this plan, and I call on the entire international community to play your part in protecting and promoting the health and well-being of our Haitian brothers and sisters,” said Etienne in a taped message for the plan’s launch.

PAHO Deputy Director Jon K. Andrus said the new cholera plan is one of several “good news stories in Haiti,” including the introduction of the pentavalent vaccine into the national immunization schedule and progress toward universal immunization coverage. He said the success of the cholera elimination plan would have “a spin-off effect on national economic development, tourism, agricultural production, and overall productivity arising from improvements in the health of the population in general.”

PAHO serves as the secretariat of the Regional Coalition on Water and Sanitation to Eliminate Cholera Transmission in the Island of Hispaniola, whose 18 members include the CDC, UNICEF, the Spanish Agency for International Development Cooperation (AECID), the Inter-American Development Bank (IDB), the World Bank, the Caribbean Community (CARICOM), the International Federation of Red Cross and, WASH Advocates, and others.

Since the beginning of the cholera epidemic, PAHO has provided technical cooperation worth an estimated US$1.5 million and has received and spent some US$25.3 million from other sources to support cholera-related efforts in Haiti. In addition to the US$500,000 announced today, PAHO is allocating US$2.3 million annually from its regular budget to support cholera elimination through technical cooperation in water and sanitation, alert and response, health systems improvements, and health and hygiene promotion.

Links:

• Remarks of PAHO Director Carissa F. Etienne on Haiti cholera elimination plan
• National Plan for the Elimination of Cholera in Haiti
• Photos: Launch of National Plan for the Elimination of Cholera in Haiti (Picasa)
• Experts Call for Major Investments in Water and Sanitation to End Cholera in Haiti and the Dominican Republic
• International Health Leaders Pledge to Work Together to Eliminate Cholera in Haiti and the Dominican Republic
• PAHO/WHO country office in Haiti
• http://www.paho.org
• http://www.facebook.com/PAHOWHO
• http://www.youtube.com/pahopin
• http://twitter.com/pahowho

Media Contacts:  Leticia Linn, linnl@paho.org, Tel. + 202 974 3440, Mobile +1 202 701 4005, Donna Eberwine-Villagran, eberwind@paho.org, Tel. +1 202 974 3122, Mobile +1 202 316 5469, Sebastián Oliel, oliels@paho.org, Phone +1 202 974 3459, Mobile 202 316 5679, Knowledge Management and Communications, PAHO/WHO–www.paho.org

Washington, D.C., 11 December 2012 —

Secretary-General Ban Ki-moon announced $23.5 million in new funds from the United Nations and $215 million in existing bilateral and multilateral funds to support the ongoing cholera elimination efforts. Just over the next two years, $500 million will be needed in Haiti alone. The announced funding will reinforce the broader “Call for Action for a Cholera-free Hispaniola” launched in January 2012 by the Presidents of Haiti and the Dominican Republic with support from the Pan American Health Organization/World Health Organization (PAHO/WHO), the United Nations Children’s Fund (UNICEF), and the United States Centers for Disease Control and Prevention (CDC).

Over the next 10 years, the Cholera-free Hispaniola initiative calls for $2.2 billion in investments in water and sanitation infrastructure, health system strengthening, and health communication in Haiti, and for US$71 million for related efforts in the Dominican Republic. A detailed bi-national plan of action developed by the two governments within the initiative is scheduled to be officially launched in January 2013.
Today’s announcement was made at U.N. headquarters in New York, with Prime Minister Laurent Lamothe and Minister of Health Florence Guillaume of Haiti and Minister of Health Lorenzo Wilfredo Hidalgo of the Dominican Republic in attendance. PAHO Director Roses said the U.N. support should be seen as recognition of the two governments’ efforts.

“Today, we have a unique opportunity to acknowledge the months of work dedicated to eliminating cholera transmission on the island of Hispaniola by the governments of Haiti and the Dominican Republic,” said Dr. Roses. “PAHO salutes Prime Minister Lamothe and President Medina and their governments for their outstanding leadership role in spearheading this initiative.”

Haiti’s cholera epidemic, which began in October 2010, is the largest epidemic ever recorded in a single country. More than 615,000 people in Haiti have fallen ill and more than 7,500 have died. The Dominican Republic has reported more than 28,700 cholera cases and over 450 deaths during the same time period. The majority of cases have been people living in areas without access to safe drinking water, proper sanitation, or hygiene. The Cholera-free Hispaniola initiative addresses these deficiencies with proposed investments in water and sanitation, improvements in surveillance and health care, and health communication campaigns.

Following the launch of the “Call for Action for a Cholera-Free Hispaniola” in January, PAHO/WHO, UNICEF, and CDC joined together with other organizations to form the Regional Coalition for Water and Sanitation to Eliminate Cholera Transmission in the Island of Hispaniola, for which PAHO serves as secretariat. The Coalition’s role is to bring together technical expertise, raise new funds, and mobilize previously committed pledges to support the governments of Haiti and the Dominican Republic in improving access to water and sanitation and to strengthen their health systems.

In addition to PAHO/WHO, CDC, and UNICEF, the Coalition’s members include the Spanish Agency for International Development Cooperation (AECID), the Inter-American Development Bank (IDB), the National Health Foundation (FUNASA) of Brazil, the Association of Haitian Medical Physicians Abroad, the Inter-American Association of Sanitary and Environmental Engineering (AIDIS), the World Bank, the Caribbean Community (CARICOM), the International Federation of Red Cross and Red Crescent Societies, WASH Advocates, Partners in Health, Veolia Environment Foundation, Zanmi Lasante, and Catholic Relief Services.

In welcoming the announced U.N. support, PAHO Director Roses said PAHO and other Coalition members “will continue to engage in advocacy efforts to underscore the message that the most important public health intervention in the island of Hispaniola is to steadily increase water and sanitation coverage together with health system strengthening.”

Since the beginning of the cholera outbreak, PAHO has provided direct technical cooperation worth an estimated US$1.5 million to fight cholera in Hispaniola and has received and spent some US$ 25.3 million from other sources to support the government on cholera-related efforts.

PAHO, which celebrates its 110th anniversary this year, is the oldest international public health organization in the world. It works with its member countries to improve the health and the quality of life of the people of the Americas. It also serves as the Regional Office for the Americas of the World Health Organization (WHO) and is part of the United Nations System.

Links:

• United Nations press release
• www.paho.org/paho110/
• www.paho.org
• facebook
• youtube 
• twitter pahoeoc
• twitter pahowho
•  twitter opsoms


Contacts:

Leticia Linn, linnl@paho.org, Tel. + 202 974 3440, Móvil +1 202 701 4005, Donna Eberwine-Villagran, eberwind@paho.org, Tel. +1 202 974 3122, Móvil  +1 202 316 5469, Sebastián Oliel, oliels@paho.org, Tel. +1 202 974 3459, Móvil: 202 316 5679, Gestión del Conocimiento y Comunicaciones, OPS/OMS – www.paho.org

Washington, DC, 17 October 2012  —

The announcement was made during an expert-led symposium co-sponsored by the Center for Strategic International Studies (CSIS) and the Pan American Health Organization (PAHO) to discuss the ambitious efforts of the Coalition.

The Coalition was originally launched in June 2012 to bring together technical expertise, raise new funds, and mobilize previously committed pledges to support the governments of Haiti and the Dominican Republic in improving access to water and sanitation. The Coalition evolved from a call to action that the governments of Haiti and the Dominican Republic put forward last January. This call to action was originally supported by a core partnership of PAHO, the Centers for Disease Control and Prevention (CDC), and UNICEF. Efforts since have focused on expanding the partnership, thus resulting in the more formal Coalition of 17 partners.

Experts participating in the symposium described the opportunities presented by regional collaboration on water, sanitation, and hygiene (WASH) activities, and identified opportunities for greater engagement on cholera elimination by the non-government sector.

Since the start of the cholera outbreak nearly two years ago, approximately 600,000 people have fallen ill due to cholera in Haiti with more than 7,500 deaths. The Dominican Republic has reported more than 25,000 cases and approximately 350 deaths from cholera over the same time period.

Individuals in resource-poor areas, like those that exist throughout Haiti, without access to safe drinking water, proper sanitation, and hygiene constitute the majority of cholera cases. Drinking unsafe, cholera-infected water or eating contaminated food heighten the spread of the disease, leaving entire communities vulnerable to acute diarrheal disease, undernutrition and other related diseases.

WASH infrastructure and behavior change are the foundation for preventing illness and death associated with cholera. For example, simple handwashing with soap can reduce diarrheal disease by 45 percent. The application of culturally appropriate and economically feasible technologies is also fundamental for long-term success.

Dr. Jon Andrus, Deputy Director of PAHO, stated, “Today, we have a unique opportunity to expand the Regional Coalition by reaching out more extensively to the private sector and NGOs. This work is a priority and is grounded in the overarching strategy of safe water and sanitation for all the citizens of Haiti and the Dominican Republic. By implementing this strategy, water and sanitation as basic human rights will finally be accessible to everyone.”

Dr. Jordan Tappero, Director of Health Systems Reconstruction Office at CDC, noted that a long term strategy is needed to expand the number of sanitary workers, especially to check and recheck the sources of water. “Few countries have declining access on WASH services as Haiti,” he said, “and the earthquake only made things worse.”

Kathleen Krackenberger, Senior Health and Human Resource Policy Advisor at the World Bank talked about their work on capacity building for the Ministry of Health of Haiti. She said that to enhance water and sanitation in the country was a key priority for the World Bank and also a way to create opportunities. “Building capacity is something we need to do all the time—not only for water and sanitation, but in every area,” she added.

The coalition’s other members are PAHO/WHO, UNICEF, the Centers for Disease Control and Prevention (CDC), the Spanish Agency for International Development Cooperation (AECID), the Inter-American Development Bank (IDB), Brazil’s National Health Foundation (FUNASA), the Association of Haitian Medical Physicians Abroad, the Inter-American Association of Sanitary and Environmental Engineering (AIDIS), the World Bank, the Caribbean Community (CARICOM), the International Federation of Red Cross and Red Crescent Societies, and WASH Advocates.

Links:

• Information on the Regional Coalition

Media Contacts:

PAHO/WHO: Leticia Linn, linnl@paho.orgThis e-mail address is being protected from spambots. You need JavaScript enabled to view it, Tel. + 202 974 3440, Mobile +1 202 701 4005, www.paho.orgWASH Advocates: Cecilia Snyder, csnyder@WASHadvocates.orgThis e-mail address is being protected from spambots. You need JavaScript enabled to view it, Tel +1 202 293 4003, www.washadvocates.orgCSIS: Julia Nagel, jnagel@csis.orgThis e-mail address is being protected from spambots. You need JavaScript enabled to view it, +1 202 775 3215, www.csis.org

Washington, D.C., 18 September 2012 (PAHO/WHO) –

The coalition’s other members are PAHO/WHO, UNICEF, the Centers for Disease Control and Prevention (CDC), the Spanish Agency for International Development Cooperation (AECID), the Inter-American Development Bank (IDB), Brazil’s National Health Foundation (FUNASA), the Association of Haitian Medical Physicians Abroad, and the Inter-American Association of Sanitary and Environmental Engineering (AIDIS).

The coalition was originally launched in June of this year to bring together technical expertise, raise new funds, and mobilize previously committed pledges to support the governments of Haiti and the Dominican Republic in improving access to water and sanitation.

More than half a million people are estimated to have been sickened by cholera in Haiti between October 2010 and mid-September 2012, with more than 7,500 deaths. The Dominican Republic has reported more than 21,000 cases and over 400 deaths from cholera.

PAHO Deputy Director Dr. Jon K. Andrus noted that the “massive response” of the Haitian and Dominican governments on the ground, which was supported by the international community, had significantly reduced the number of new cases and deaths from cholera. However, “in order to stop cholera and be able to build back better, water and sanitation must be ensured,” he said.

Even before the 2010 earthquake, only 69% of Haiti’s residents had access to safe drinking water, and access to sanitation had dropped from 26% of the population in 1990 to 17% in 2010. In the Dominican Republic, 86% of the population had access to improved drinking water sources, and 83% had access to improved sanitation in 2010.

In the1990s, a cholera epidemic spread to over 20 countries in Latin America, but investments in water and sanitation infrastructure and health promotion helped stem the epidemic and contributed to the near elimination of cholera from Central and South America within eight years.

The coalition has been supporting the development of a plan of action on water and sanitation in Haiti and the Dominican Republic. It will be examined at an October 2 meeting of a special technical advisory group (TAG), which will provide independent technical input for the plan’s improvement.

Dr. Andrus said the declaration signed by the four new coalition partners today represents “a commitment for partners to join and support—to the extent that they can—a long-term strategy to eliminate transmission of cholera from Hispaniola.”

PAHO, which celebrates its 110th anniversary this year, is the oldest public health organization in the world. It works with all the countries of the Hemisphere to improve the health and quality of life of the people of the Americas and serves as the Regional Office for the Americas of WHO.

Links:

• International Partners Back Investment in Water and Sanitation to Eliminate Cholera from the Island of Hispaniola
• PAHO/Call to Action: A Cholera-Free Hispaniola
• PAHO/Haiti

[[Show as slideshow]]

A Technical Advisory Group (TAG) on Water and Sanitation – composed of a small core of international experts – has been established to make recommendations to the Coalition Secretariat and Government of Haiti as to how the proposed strategies, activities and budget line items of the water and sanitation components of the National Plan of Action for Cholera Elimination may be strengthened. Recommendations are also aimed at fostering the confidence of new funding partners to increase investments in this key component of the National Plan of Action for Cholera Elimination. In particular, the remit of the TAG is to make recommendations on water and sanitation infrastructure development, water sector management and cost recovery approaches in Haiti, based upon lessons learned and experience gained internationally.

Coordinated by Dr Jon Andrus, Deputy Director of PAHO and chaired by Dr Jordan Tappero, CDC, the TAG on Water and Sanitation met with the Ministry of Health in Haiti and DINEPA in Port-au-Prince, Haiti on 2nd October 2012. The TAG was privileged to obtain elucidations on the rationale for and content of the draft National Plan of Action for Cholera Elimination by the representatives of the Ministry of Health in Haiti and DINEPA.

The TAG acknowledges DINEPA is a relatively new organization which has done a remarkable job particularly in the face of the 2010 earthquake and subsequent cholera outbreak by protecting the displaced population against diarrheal diseases such that the risk of death from disease has dropped from 6% to 1%–remarkable accomplishment!

The TAG recognizes the outstanding work that has already gone into the development of the national cholera elimination plan and commends efforts for integration with the Dominican Republic aimed at the development of a Binational plan. In an effort to help make the plan even more appealing to potential donors, the TAG respectfully makes the following recommendations:

1. Install a high level national intersectoral steering committee charged with: governing the process of implementing the plan; advocating for stronger legal and regulatory frameworks; expediting an effective decision-making process; harmonizing management and administrative functions; monitoring and reporting on progress, and identifying barriers. (include Ministries of Health, Public Works Transport and Communications, Agriculture, Environment, Industry, Commerce and Finance, etc.)
2. At the operational level, continue to use and maximize the inter-sectoral approach, particularly between MTPTC (DINEPA and SMRCS) and MSPP.  PAHO, CDC UNICEF and TAG members will be pleased to facilitate the approach.
3. Considering describing DINEPA’s experience from the cholera control campaign of the past two years, in sufficient detail such that technical professionals in each field can assess the content, which would thus (1) greatly strengthen the case for increased financial support from international sources and (2) contribute to the quality of the plan’s implementation into new areas beyond emergency response.
4. Better Identify short-term, medium, and long-term objectives, including priority targets.  Examine what priority and other milestones might be accomplished in 2 yrs, 5 yrs, and 10 yrs so as to facilitate the monitoring and evaluation of progress and costs in the implementation of actions. A matrix of specific priorities and timelines will help donors identify which areas they could potentially support. Take advantage of your present and management processes and use thee to better reflect the plan for donor.  Also, this will allow for identifying successes to showcase in the early years.
5. Provide more detailed references to the rules, regulations and engineering development plans informing the national plan of action to eliminate cholera. Also make these materials available to the TAG so that more detailed and helpful comments might be provided.
6. Continue GIS mapping of priority intervention areas which show greatest risk for cholera transmission.  Use data from MSPP and DINEPA (like population density, cholera attack rates, access to WATSAN to create the maps.
7. Implement a monitoring system for water quality and broader WATSAN indicator which measures impact on cholera rates and other water borne diseases and measures the impact on absenteeism at school and work places.
8. Better define the roles of the public sector, private sector and civil society in the implementation of the National plan to eliminate cholera. These roles should be made explicit and their rationale should be illustrated.
9. Consider providing continuous opportunities for public participation in decision making on water and sanitation at different levels: planning and budgeting; management and operations; regulation and compliance, monitoring and evaluation. This would strengthen governance and contribute to the development of a sense of ownership and responsibility.
10. Capacity development is vital for the successful and sustainable implementation of the National Plan to eliminate cholera. Elaborate further the strategy for complementary innovative partnerships for capacity development.
11. Prioritize components of solid waste management that would impact the elimination of cholera.  For example focusing on household waste, infectious or hospital waste, has an impact on cholera transmission.
12. Sanitation is an enormous and important issue, so consider focusing on direct links with reduction of cholera risk and as mentioned in the plan, the improvement of current systems. Consideration should be given to investing in household connections to conventional sewerage systems while recognizing the need for flexibility in how to improve household sanitation – e.g. by examining options like community septic systems and or sewage systems depending upon topography and household conditions.
13. Consider making a high quality documentary film which highlights and shows the problems and accomplishments made and communicate the WASH needs to the donor community (this film should be short and impactful).
14. Ensure strong bi-national coordination as agreed to on March 13, 2012 between the Governments of Haiti and Of the Dominican Republic for implementation of the national strategy for cholera elimination.
15. Highlight the environmental aspects of WASH and how they affect the watershed and living environment in future planning efforts. Environmental awareness is important for identifying how surroundings are used and the impact of that use on human health and quality of life.

The Tag submits the above recommendations for the consideration of MSPP and DINEPA.  Members will be pleased to provide additional feedback or clarification on these recommendations.

One final but critical note: To ensure success of the national plan for cholera elimination and the improvement of water, sanitation and hygiene for Haiti it will be essential to maintain accountability, transparency, and stable financial mechanisms. Perhaps the steering committee identified in recommendation #1 could assist in addressing the administrative issues as mentioned.

PAHO/WHO has activated its Institutional Plan at Level One, with four teams in Haiti and one in the Dominican Republic. PAHO/WHO offices in Haiti and the Dominican Republic have activated their contingency plans and maintain close contact with health partners, United Nations System agencies, and the Health Cluster in Haiti. Additional staff and Regional Response Team members are currently on standby. Health Emergency kits donated by Canada have been pre-positioned at PROMESS.

It is expected that Tropical Storm Isaac will strengthen as it approaches La Hispaniola, causing heavy rainfall. Given the likelihood of flood, preventative measures and response actions should focus on ensuring adequate water sanitation and management, minimizing instances of disease related to poor hygiene, and reducing health risks to evacuees and others affected by the emergency.

Tropical Storm Isaac – PAHO/WHO Situation Report – 23 August 2012

Useful information

• Information on cholera in disaster situations
• Sanitary Guidelines for Camps and Settlements