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David Furnish

David Furnish

Posted: February 3, 2010 03:17 PM

In Rebuilding Haiti, Fighting HIV/AIDS Must be a Top Priority

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The recent earthquake in Haiti reminds us of the fragility of human life. In one instant, an entire city can be reduced to rubble, taking the lives of tens of thousands of people and devastating millions more. We can't stop natural disasters like earthquakes. But we can prevent another disaster - the HIV/AIDS pandemic - from causing undue suffering and tragic loss of life.

With the horror of the earthquake foremost in our minds as relief efforts continue, it's easy to forget Haiti's longtime struggle against HIV/AIDS. In the 1980s, the AIDS epidemic was expected to take the lives of more than one-third of the Haitian population. The stigma surrounding the disease was so severe that the US Centers for Disease Control had listed "Haitians" in addition to "homosexuals" and "heroin users" as leading risk factors in contracting HIV. As recently as 2001, 30,000 Haitians were dying of AIDS each year, leaving hundreds of thousands of children orphaned.

This grim picture changed in recent years, thanks to a coordinated international response. The prevalence of HIV/AIDS in Haiti has decreased dramatically, from a calamitous six percent of the population in 2001 to around two percent today. Before the earthquake, new infection rates were considered to be under control. And while 120,000 Haitians were estimated to be living with the disease before the earthquake, fatalities had begun to decrease dramatically. There were 7,500 deaths from AIDS in 2007, a four-fold reduction from 2001.

This progress is due to the work of a number of committed organizations in Haiti and around the world, which together have dramatically increased access to HIV/AIDS prevention, testing, and treatment services for Haitians. The Elton John AIDS Foundation (EJAF) has been proud to enable this progress by funding innovative direct care, stigma reduction, and support programs to address the widespread HIV/AIDS epidemic in the Caribbean -- the worst outside of sub-Saharan Africa.

Over the years, we've targeted our grants in Haiti to improve overall health systems and reach underserved populations. Four particularly effective organizations have been our close partners in this work. Partners In Health (PIH) has delivered patient care in Haiti for over 20 years, through a network of hospitals, clinics, and more than 120 doctors. The Clinton Health Access Initiative (CHAI) has provided technical and programmatic support to the government of Haiti to strengthen the systems required for delivering primary healthcare services. Through the Caribbean Broadcast Media Partnership on HIV/AIDS and its local partner, CECOSIDA, media professionals have integrated HIV-prevention and treatment themes across news, talk, and entertainment formats - efforts that have reduced stigma and saved lives. We have also proudly supported amfAR's MSM Initiative, which funds HIV/AIDS services and advocacy in Haiti for men who have sex with men.

The earthquake left nothing untouched in Haiti, including the significant progress that has been made in fighting AIDS. Treatment and testing clinics were leveled. Many staff at medical facilities were tragically killed, and survivors were forced to flee the capital. Equipment and medicines are scarce. Blocked and congested roads have made it difficult for what life-saving supplies remain to reach the people who need them.

In the weeks to come, there will be additional health and logistical challenges to manage. The immune systems of those living with HIV/AIDS are particularly vulnerable to new disease when access to water, food, sanitation, and essential medicines is limited, as they are today. And because displaced people may have only limited access to condoms, we must also be prepared for an increase in new infections.

To mitigate these short-term challenges, EJAF provided both PIH and CHAI with emergency grants of $100,000 in the immediate aftermath of the earthquake to move antiretroviral treatments to facilities still standing, take on increased patient loads, and manage already under-resourced hospitals in Port-au-Prince and the Dominican Republic. PIH is handling patient triage at one of the few hospitals not destroyed by the earthquake. CHAI is managing overall operations at the hospital, in addition to moving HIV/AIDS medicines as well as medical and surgical supplies to PIH over land and by air. Leveraging its network of journalists and media partners, CECOSIDA is getting out regular and reliable information about local relief operations and health services via radio and text, with messages specifically targeting HIV-positive Haitians. And community organizations supported by the amfAR MSM Initiative, such as SeroVie, Kore La Vie, and Association Citoyenne Contre le VIH, are doing their best to regroup and rebuild.

Through regular communication with our grantees, we have been inspired by their handling of this unprecedented crisis, the speed at which they have moved to marshal resources, and how tirelessly they are working to help HIV/AIDS patients at immediate risk and in need of urgent care. We are committed to assessing the immediate future needs in Haiti and further assisting our partner organizations to strategically deploy resources and assistance where it is needed most.

But in the months ahead, after we meet the short-term needs of the Haitian people, we must focus on the long-term process of rebuilding Haiti's health infrastructure. And while much progress has been made in combating AIDS over the past decade, even before the earthquake, much work was needed to improve the nation's healthcare system. Nearly 40 percent of Haitians had no access to basic health services. Clinics lacked the capacity to distribute antiretroviral drugs to all those who needed them. Voluntary HIV/AIDS counseling and testing was not widespread, and stigma and discrimination kept many from learning their status and obtaining treatment.

In this way, the process of rebuilding Haiti is an opportunity - an opportunity not only to rebuild homes, businesses, and hospitals, but also to address the longstanding health and social challenges that have resulted in still-too-high infection rates. Without confronting these challenges, HIV/AIDS prevalence could increase to previous levels and compromise all other rebuilding and recovery efforts.

Today, the challenge of lifting an entire nation from the rubble is beyond description. But it is not beyond hope. It was only ten years ago that the HIV/AIDS epidemic in Haiti seemed insurmountable. Since that time, the resilience of the Haitian people and the dedication of international organizations saved tens of thousands of lives that would otherwise have been lost. Not even an earthquake can shake that solid foundation on which we can and will help the Haitian people rebuild.