865 days after Haiti’s cholera epidemic first began, with over 8,000 dead and some 650,000 sickened, the government of Haiti, with international support, officially launched a ten-year cholera eradication plan today after months of delays.
The plan calls for an investment of $2.2 billion in clean water and sanitation infrastructure, with some $485.9 million needed for the next two years. Currently 31 percent of the population does not have access to potable water, while 83 percent lack access to adequate sanitation. By 2022, the plan aims to deliver potable water and improved sanitation services to 85 and 90 percent of the population, respectively.
The plan notes that in the short term, “actions will focus on preventing the transmission of cholera from one person to another through the use of drinking water disinfected with chlorine, and the promotion of hand washing, good sanitary practices, and food hygiene.” Resources will also go to capacity building and training for the relevant government agencies, in particular the health ministry (MSPP) and the water agency (DINEPA).
Over the long-term, some $650 million will go to DINEPA to build water supply systems in the 21 largest cities in the country, though most of this would start after the next two years. A breakdown of funding needs by sector, program and time-frame can be seen below. Overall, about 70 percent of the needed funds are to go to water and sanitation provision, though just over 10 percent of that is planned to be spent in the first two years.
The objectives, in terms of cholera specifically, are to reduce the incidence rate to below 0.5 percent by 2014, below 0.1 percent in 2017 and below 0.01 percent by 2022. This compares to an incidence rate of over 1.1 percent in 2012, which translates to about 110,000 cases for that year.
The plan also envisions a strengthening of the public health sector and of the coordination between NGOs and the government. To this end, the government plans to “integrate their support into the national health system.”
Through investments in training, capacity building and by channeling funds through the domestic institutions in charge of each sector, the plan aims to create a stronger public sector overall. This could be especially significant given that aid for the cholera response (and for the overall relief and reconstruction effort) has largely bypassed the Haitian government.
According to data from the U.N. Special Envoy, only 2.5 percent of humanitarian spending for cholera went through the Haitian government. As noted in the plan, the “lack of investment coming directly from the country’s fiscal budget represents a threat to the stability of the” water and sanitation sector.