Nine years ago, the first case of cholera was diagnosed in Haiti. Today, we can finally report that for the past nine months, there have been zero laboratory-confirmed cases of cholera in the entire country.
Taming cholera in a nation without proper water, sanitation or health infrastructure is a momentous achievement. The scale of the epidemic, with more than 18,500 suspected cases per week at the peak of the outbreak, was another major challenge.
Haitian authorities have worked tirelessly to reach this milestone, and not always with the full support they required. This accomplishment is all the more remarkable in that it has taken place during a time of multiple national crises, supply chain breakdowns and during a transition in the U.N.’s presence. I congratulate the Haitian authorities for the tenacity of their fight and for their resolve.
If Haiti is now in the homestretch of defeating the cholera epidemic, the battle is not yet won. As the country continues to face unrest and a difficult political situation, we must protect the gains realized for the men, women and children of Haiti.
We have to keep working toward an objective that is now within reach: making Haiti cholera-free.
When U.N. Secretary-General Antonio Guterres took office in 2017, he lamented that the United Nations, which has apologized for its role in the epidemic, simply did not do enough at the onset of the crisis and should have responded more effectively and quickly. We have since worked overtime to be the full partners that Haiti has deserved.
Our U.N. colleagues, along with international and local partners have worked side by side with Haitian authorities to develop a unified approach and financial strategy that underpins the efforts of the hundreds of cholera heroes who have made this important benchmark towards elimination possible. Since 2010, U.N. member states and international partners have invested over $700 million —both bilaterally and through the United Nations — to combat cholera in Haiti and get behind the Haitian government’s strategy.
Reaching this critical milestone of zero laboratory-confirmed cases, which has been officially reported by the government of Haiti and confirmed by the United Nations, was only possible through a remarkable and innovative strategic partnership between the government, the United Nations and key stakeholders. This partnership helped enact several innovative approaches that have led to this milestone. The first was achieving unified buy-in on a detailed comprehensive three-year strategy to end the epidemic signed by the prime minister and myself with the backing of a full range of implementers, experts and stakeholders. Such a plan is often missing in tackling epidemics, but I found it vital that all involved follow the same battle plan.
A second was the design and deployment of an innovative approach to tame an epidemic in a nation without adequate healthcare infrastructure. Led by the Ministry of Health and UNICEF since 2014, a group of cholera heroes designed and deployed a network of rapid response teams, covering all cholera-affected areas. Staffed entirely by Haitians trained to identify, decontaminate, treat and contain cholera cases, these teams stopped the lion’s share of transmissions and deaths. They demonstrated that cholera can be brought under control by intervening directly through an effective alert-response system at the community level. I believe this model can be effective in other epidemics throughout the world.
A third critical gap addressed was in testing and surveillance. Haiti’s Ministry of Health, working with the Pan-American Health Organization/ World Health Organization and UNICEF, has created an effective surveillance and suspected-case-investigation network down to community level, and improved national laboratory capacity and specimen transport capacity so that up to 98% of suspected cases, and a significant number of non-suspected cases are now tested.
Still we must not let down our guard. As we enter the last mile of the cholera epidemic, we must ensure that Haitians continue to have access to the robust surveillance system and response capacity we have jointly developed. We also need to keep building the country’s capacity to tackle other pervasive water borne diseases.
We are focused on ensuring that resources are in place to see this response through to the end. We currently face a roughly $20 million funding gap through 2022 to ensure cholera transmissions remain at zero, and so that we can officially declare cholera eradicated from Haiti. I call on friends and partners of Haiti to continue to support it to expand its water, health and sanitation infrastructure and to bring the fruits of development to all Haitians.
We must never forget the Haitians who have lost family members or suffered from this disease. While nothing can erase the tragedy or replace loved ones lost, we must end this chapter with dignity and with certainty. Our efforts to support affected communities continues.
I truly believe that Haiti’s cholera heroes can inspire the world with their determination and innovation and have shown us that no obstacle can stand in the way if we are united.
Josette Sheeran is U.N. special envoy for Haiti.