$100 Million for AIDS in Haiti
According to the Haitian government’s Post Disaster Needs Assessment (PDNA), the earthquake that hit Haiti on January 12, 2010 destroyed 46 hospitals and clinics and severely damaged 38 more. At least $373 million in infrastructure, supplies, and human resources was lost. An estimated $1.5 billion is needed by the health sector to respond to this need. (Read the PDNA)
The Obama administration has proposed a 2010 Supplemental Request of $1.641 billion to replenish Department of State and USAID accounts used for earthquake response to date, including $893 million in new funding designated for recovery and reconstruction. These funds will address needs such as community stabilization; rebuilding the capacity of the Haitian Government; citizen participation in recovery efforts; rebuilding infrastructure such as shelter, energy, agricultural and industrial sectors; health care, including health services to displaced populations, security, governance, justice reform and human rights.
Not included in this supplemental is funding to the State Department to help rebuild the HIV/AIDS response through PEPFAR. Given the limited attention within the PDNA and lack of funding in the U.S. supplemental there is concern that HIV/AIDS will be overlooked in the recovery efforts.
Haiti had been an example of smart, coordinated services in which HIV programs had been integrated—as imagined in the President’s Global Health Initiative—with key services like maternal and child health. We recommend that the Supplemental include an additional $100 million to address the needs of people living with HIV/AIDS in Haiti through bilateral and multilateral mechanisms such as UNAID.
U.S. Funding to Fight AIDS in Haiti
According to the most recent available public information, approximately $20 million in additional PEPFAR funding is available in Haiti over the slightly more than $100 million spent last year. This was funding that was to be made available upon completion of the country’s Partnership Framework, which was interrupted by the earthquake.
$20 million, however, is an insufficient contribution to meet the increased post-earthquake needs for reconstruction of physical infrastructure, recruitment and employment of health workers, and purchase and distribution of commodities such as condoms and drugs to return Haiti’s AIDS response to health. We recommend that an additional $100 million in supplemental funds be included for FY10 for:
- Rebuilding 20 destroyed clinics and the laboratory infrastructure needed to support these clinics.
- Physical reconstruction of AIDS service organization non-clinic facilities destroyed in the earthquake.
- Workforce development (training and hiring of doctors, nurses, social workers and other personnel) including contributions to the recruitment and employment of 2,5000 community health workers estimated to be needed by the Ministry of Health to address HIV/AIDS in the country.
- The creation of mental health services for Haitians living with HIV/AIDS, who are suffering from both the shock of the earthquake and the persistent stigma against and marginalization of people living with HIV/AIDS.
- Urgent emergency HIV prevention programs for displaced persons including condom distribution and education programs as well as rebuilding of national HIV prevention programming.
- Funding for second and third line AIDS drugs which were largely unavailable before the earthquake and will be increasingly needed post-earthquake where treatment interruptions of first-line drugs necessitate transition of many new regimens that are costlier.
Ensuring People with HIV Receive Services
Knowing that safe housing and access to food and water are essential elements of both AIDS care and prevention of HIV transmission, it is imperative that a plan be created to ensure that each category of rebuilding and recovery (“shelter”, “health care,” “energy,” etc.) emphasizes the needs of people living with HIV as key especially “vulnerable” populations. Addressing all aspects of Haitian society is the only way to ensure that disaster relief efforts help and do not hinder efforts to combat Haiti’s AIDS epidemic.
Specifically plans should be made to ensure:
- Permanent shelter for people living with HIV, which has been shown to be an effective HIV prevention intervention.
- Nutrition and food security for people living with HIV, which is much needed to ensure HIV treatment is effective and prevent treatment interruption.
