Getting to Zero: Working Towards an HIV-Free Generation in Haiti

Getting to Zero: Working Towards an HIV-Free Generation in Haiti

2012 World AIDS Day event in Port au Prince, Haiti. From left to right: Pamela White, Ambassador of the United States to Haiti; Michel Sidibe, Executive Director of UNAIDS; Sophia Martelly, First Lady of Haiti; Florence Duperval Guillaume, Minister of Public Health and Population; and Guirlaine Raymond, Director General of the Ministry of Public Health and Population. {Photo credit: C.Gilmartin/MSH.}Photo credit: C.Gilmartin/MSH.

In recent years, Haiti has endured some of the greatest misfortunes in its history, including hurricanes, floods, the devastating 2010 earthquake, and the cholera epidemic that followed. These natural disasters and public health crises have added to the harm already caused by the country’s widespread poverty, social and political unrest, and under-resourced health system. Haiti’s fragile population is further plagued by the highest HIV prevalence in the Western Hemisphere at 1.9 percent, which translates to roughly 120,000 HIV-positive individuals and 93,000 children who have lost their parents to AIDS (UNAIDS, 2011).

In the face of such challenges, the country’s commitment to reducing new HIV infections has remained unwavering, and national interventions have had a dramatic pay off. Over the last decade, for example, the rate of new HIV infections in Haiti fell by 54 percent, and, between 2005 and 2011, AIDS-related deaths dropped by 47 percent. Among the country’s greatest achievements is access to life-saving antiretroviral therapy (ART) for 58 percent of those infected with HIV.

While in Haiti’s capital, Port au Prince, for the 2012 World AIDS Day commemoration ceremony, UNAIDS Executive Director Michel Sidibé met with President Michel Martelly to discuss the country’s successes and way forward.

“It would be a very beautiful success story if we could pull off an HIV-free generation,” Martelly said to Sidibé.

Agreeing with Martelly, Sidibé emphasized this year’s World AIDS Day theme, Getting to Zero. “Two children are born with HIV in Haiti each day. Think of what it would mean if we could leave behind a generation that was born HIV-free,” Sidibé said.

The Governments of Haiti and the United States, in partnership with a cadre of local civil society organizations, have been at the forefront of efforts to turn the dream of an HIV-free generation into a reality.

Since 2007, the PEPFAR- and USAID-funded Santé pour le Développement et la Stabilité d’Haïti (SDSH) Project, led by Haiti’s Ministry of Health and Management Sciences for Health (MSH), has provided HIV testing and counseling to over 700,000 individuals. In response to the estimated 57,000 people living with HIV in Haiti, SDSH has also enrolled more than 5,000 individuals on ART, introduced antiretroviral services at 11 health centers, and increased the capacity of the centers’ laboratories to screen for tuberculosis. To reduce the incidence of mother-to-child HIV transmission, SDSH tested more than 250,000 pregnant women and provided ART to 3,000 women who tested positive. The project has also provided prevention of mother to child transmission (PMTCT) skills training for 161 health workers.

This year, USAID also asked SDSH to address service gaps in relation to gender-based violence (GBV), which, in many cases, is closely linked to HIV transmission. The project has responded by scaling-up GBV services at 30 health centers so survivors can receive health care, ART, referrals for legal support, and psychosocial counseling. To reduce further incidents of GBV, SDSH is also providing financial support and technical assistance to civil society organizations that promote GBV awareness. These organizations also educate communities on GBV case identification and referrals.

In just a few years, Haiti has made significant progress in reducing the burden of HIV & AIDS and, today, 4.3 million Haitians now have access to these basic health services. Humbled and inspired by these achievements, SDSH is committed to continue working alongside local counterparts in realizing an HIV-free generation in Haiti.

For over three decades, MSH has been helping to strengthen Haiti’s health system while building leadership, management, planning, and service delivery skills at the national level through the Ministry of Health and Population, at the departmental and local levels, and in over two dozen service delivery non-governmental organizations. SDSH has supported these efforts since 2007, helping to improve access to and use of health services in 164 health facilities, which serve 43 percent of the Haitian population.

Colin Gilmartin is a technical officer at MSH’s Center for Health Services.