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.

Dr. Jon Andrus, PAHO DD, Ing. Jacquers Rousseau, Minister of TPTC, Nigel Fisher, UN Representative, Dr Florence Duperval Guillaume, Minister of Health and Polpulation, John Vertefeuille, CDC Haiti and Dr. Marie Guirlaine Raymond Charite, Directrice Générale du MSSP

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.



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