Haiti: UN’s new approach on cholera puts people at heart of the response

The response to cholera in Haiti will be a “long and thorough battle,” but the United Nations will stand by the Haitian people and authorities, Stéphane Dujarric, the Spokesperson for the Secretary-General, said on the eve of the launch of the world body's new approach to tackling the epidemic in the country.

The new approach on cholera was announced last August and will be launched by Secretary-General Ban Ki-moon to the UN General Assembly on Thursday, 1 December. It includes action such as rapid interventions in areas where cases are reported and the prevention of future high-risk public health crises, and focuses on support for those Haitians directly affected by the disease.

Haiti has been dealing with a cholera outbreak since October 2010, some nine months after it suffered a major and deadly earthquake. The outbreak has affected an estimated 788,000 people and claimed the lives of more than 9,000. Concerted national and international efforts, in which the UN has played a key role, have resulted in a 90 per cent reduction in the number of suspected cases.

While the number of those affected remains high, and recent outbreaks – partly heightened by the impact of Hurricane Matthew – show the continued vulnerability of the population to the disease, UN officials have said the challenge is not insurmountable. A recent vaccination campaign, backed by the Pan American Health Organization (PAHO)/ UN World Health Organization (WHO), reached more than 729,000 people in Haiti’s areas devastated by the hurricane.

Track 1

Specifically, the new approach has two tracks. The first consists of a greatly intensified and better-resourced effort to respond to and reduce the incidence of cholera in Haiti, though addressing short- and longer-term issues of water, sanitation and health systems and improved access to care and treatment.

Cholera patients receive treatment at a centre in Cap-Haïtien in Haiti. Photo: UNICEF/Maxence Bradley

This is expected to involve intensifying efforts to mobilize adequate funding for an increased number of rapid response teams; strengthened epidemiological surveillance; the rapid detection, reporting and treatment of cases; the combined use of cholera vaccinations with targeted water and sanitation interventions; more focused geographical targeting; improved communication and behavioural change strategies; and strengthened support to longer-term water and sanitation services.

“This is an approach that goes to the root of the problem with long-term investments in the sanitation facilities that the country needs to eradicate cholera; short-term investments to halt the progression of cholera; and, most importantly, putting people and communities affected by cholera at the heart of our efforts,” Mr. Dujarric said in an interview with the UN Stabilization Mission in Haiti (MINUSTAH) FM Radio.

Funding will be key for this track. For the past six years, both the immediate response and longer-term efforts have been severely hampered by limited and inconsistent funding, which has made it impossible to fully treat or eliminate what is generally a treatable and preventable disease.

Track 2

The second track of the new approach is the development of a package of material assistance and support to those Haitians most directly affected by cholera. It is expected that it will also involve consulting with affected individuals and communities in the development of the package.

“The United Nations must listen to the Haitian people, must listen to the communities that have been affected by this disease,” he stated. “Only communities will be able to explain what they need and how we can help them.”

The new strategy will examine the feasibility of an individual approach, the Spokesman continued, noting that such an approach would require precise identification of the victims of cholera and their family members, as well as an adequate amount of funding.

“We know very well, and the Secretary-General knows very well, that the United Nations has a moral responsibility to the people most affected by the cholera epidemic. We regret the terrible suffering endured by the Haitian people as a result of the epidemic,” said Mr. Dujarric.

The ability of the UN to fulfil this moral responsibility will depend on the financial and political support of Member States, UN officials have previously indicated.

According to UN estimates, the programme is expected to cost about $400 million over the next two years. “It is not an insurmountable sum, and the Secretary-General is very hopeful that the General Assembly and the international community will show solidarity and will be there to help Haiti at a time when aid is needed,” the Spokesperson said.

“The most important in the long term is a sustained investment in the health network in Haiti to ensure that water distribution is at a level where water saves and feeds and water no longer poisons, as we have seen with cholera,” he added, while also noting the moral aspects to the world body's efforts.