The cholera epidemic in Haiti has highlighted the international community's historic lack of attention to water and sanitation. Water and sanitation coverage in Haiti has stagnated for decades and is the lowest in the Western Hemisphere, far behind the average of other countries in Latin America and the Caribbean. One third of the people lack access to safe water and only a quarter have private latrines. Without these services, the cholera quickly spread following the outbreak in October 2010, affecting more than 719,000 people and causing 8,700 deaths.
Yet this is not a question of lack of solidarity. The international community has been generous with Haiti in the last ten years, particularly following the 2010 earthquake. According to Global Humanitarian Assistance, the country received more than $10.5 billion in development assistance and humanitarian aid between 2003 and 2012. Outpour after the earthquake provided billions more dollars to support areas including agriculture, health care, housing for displaced populations and reconstruction.
This has helped to reduce extreme poverty, childhood malnutrition and HIV/AIDS rates and increased access to education. However, international cooperation has repeatedly forgotten two key elements in Haiti's development -water and sanitation- and have left these areas underfunded.
Paradoxically, the cholera emergency now gives us the opportunity to focus on durable solutions for water and sanitation. The Government of Haiti's 10-year National Plan for the Elimination of Cholera requires $2.2 billion, of which approximately 90% supports water and sanitation. By strengthening these infrastructures, we will eliminate cholera and also other waterborne diseases, such as acute diarrhoea, a major killer of children under five in Haiti.
And the benefits may be even greater. When Latin American countries faced a major cholera epidemic in the 1990s, there was tremendous resolve to invest in water and sanitation. Ten years later, they not only eliminated the disease, but recorded significant improvements in reducing child mortality and malnutrition, and in increasing school enrolment and economic productivity.
The UN has made eliminating cholera in Haiti a key priority and has also been helping to mobilize resources for the National Plan for the Elimination of Cholera. To date, more than $407 million in pledges have been received. But this figure is still not enough. It is good start and similar to the total amount raised for the Haiti Reconstruction Fund.
Along with investments in water and sanitation, the great challenge in Haiti is to strengthen its institutions. Distribution of international aid relegates the Government to a secondary role, in favour of multilateral agencies, NGOs and foreign contractors. Of the $6 billion in humanitarian and recovery aid between 2010 and 2012, only 9% was disbursed to the Government of Haiti. New Prime Minister Paul Evans recently called attention to this matter when he said: "You want to give me food, but not the right to decide what I want to eat".
Limited by scarce financial and human resources, the National Water and Sanitation Directorate, DINEPA, has been confronted with many challenges in managing and implementing programs. But rather than use this as a pretext to slow investments to Haiti, the international community -especially regional partners in Latin America and the Caribbean- must take up this challenge and align priorities with Haitian institutions through technical assistance and support for South-South Cooperation.
Peacebuilding and statebuilding goals, supporting country leadership and ownership and pushing for better utilisation of international and domestic resources are part of the 'New Deal for Engagement in Fragile States', endorsed by Haiti. These values and principles should inspire international cooperation towards the country in the coming years. Haiti deserves an opportunity.