Via NEJM, Dr. Louise Ivers writes: Eliminating Cholera Transmission in Haiti. The conclusion:
One million doses of OCV [oral cholera vaccine] were requested by the Haitian Ministry of Public Health and Population and authorized as part of the emergency response to Hurricane Matthew. Two shipments of 500,000 doses arrived in Haiti on October 24 and 25, 2016, and the vaccines have been deployed by the Ministry of Health and its partners for urgent use.
We of the Special Consulting Group to the Minister of Health and Population of Haiti commend the mass-vaccination approach in the hurricane-affected areas of the south of Haiti as one part of a comprehensive emergency response. In light of recent data on vaccine efficacy, the feasibility of vaccinating in outbreak settings, and the increased availability of safe, effective, and low-cost vaccines, we urge, in addition to an emergency response to cholera in the hurricane-affected communities, that intense and reinvigorated support be provided to the government’s National Plan for the Elimination of Cholera in Haiti, including a nationwide two-dose oral cholera vaccination campaign.
Over the past six decades, several public health programs in Haiti (e.g., those focused on HIV care and treatment and control of neglected tropical diseases) have provided models for the world. The increased availability of OCVs and their rollout in a national program could provide an opportunity for the government of Haiti and the international community to demonstrate another successful strategy: comprehensive national OCV coverage combined with targeted water, sanitation, and hygiene interventions could eliminate the transmission of cholera in Haiti over the next 3 to 5 years at an affordable cost (some estimates suggest approximately $66 million). This goal is surely one to aspire to, given the human cost of maintaining the status quo.
Eliminating cholera transmission in Haiti with a combined, integrated approach at the population level would be a major achievement for the government and people of Haiti. It would also have broad implications for the control of cholera in other affected populations around the world. The time for ambitious action on cholera control and elimination in Haiti is now.