International Partners Back Investment in Water and Sanitation to Eliminate Cholera From the Island of Hispaniola

7 Jun 2012

Salvador, Bahia, 7 June 2012 (PAHO/WHO) - Representatives of several international organizations pledged this week to promote investments in water and sanitation infrastructure as key steps toward the elimination of cholera from Haiti and the Dominican Republic. The pledges were made during the launch of a new Regional Coalition on Water and Sanitation for the Elimination of Cholera in the Island of Hispaniola, on June 4 in Salvador, Bahia, Brazil.

The members of the new coalition are the Pan American Health Organization/World Health Organization (PAHO/WHO), UNICEF, the Centers for Disease Control and Prevention (CDC), the Spanish Agency for International Development Cooperation (AECID) and the Inter-American Association of Sanitary and Environmental Engineering (AIDIS). They pledged to support efforts by the governments of Haiti and the Dominican Republic to harmonize and streamline international assistance and investments in water and sanitation infrastructure aimed at eliminating cholera from the island. They also issued a declaration urging other governments and international organizations to support these efforts.

"By becoming signatories to this coalition and the accompanying declaration, we move one step closer to achieving our vision of a cholera-free Hispaniola and a cholera-free Americas," said PAHO Director Dr. Mirta Roses Periago in presenting the declaration at the 33rd Congress of AIDIS.

On January 11 of this year, the presidents of Haiti and the Dominican Republic, together with representatives of PAHO/WHO, UNICEF, and the CDC, issued a call to action to eliminate cholera from both countries through new investments in water and sanitation infrastructure. The new Regional Coalition on Water and Sanitation for the Elimination of Cholera in the Island of Hispaniola will bring together the necessary technical expertise, raise new funds, and mobilize previously committed pledges.

More than half a million people are estimated to have been sickened by cholera in Haiti between October 2010 and May of this year, and more than 7,000 have lost their lives. The Dominican Republic has reported more than 21,000 cases and over 400 deaths from cholera.

"The situation is unacceptable and requires our joint attention. Only major improvements in Haiti's water and sanitation systems will provide durable solutions to the epidemic over time," said Dr. Roses. "Communities where everyone has clean water to drink and a safe place to go to the toilet are within our grasp. Lives can be saved, productivity increased, security heightened, and health costs reduced."

Even before the January 2010 earthquake, only 69% of Haiti's residents had access to safe drinking water, and access to sanitation had declined from 26% of the population in 1990 to only 17% in 2010. In the Dominican Republic, 86% of the population had access to improved drinking water sources and 83% had access to improved sanitation in 2010.

The coalition pledged to support efforts to achieve "water and sanitation for all" on the island by promoting cross-sector and multi-institutional dialog and action at the local, national, and international levels, as spelled out in national and bilateral plans for the elimination of cholera on the island of Hispaniola.

The plans include efforts to guarantee chlorinated water and surveillance of quality for all water sources, and include support for the responsible institutions at the national and provincial levels to improve or construct new sewage systems and provide training in their correct use and in personal hygiene.

In her remarks, Dr. Roses recalled the cholera epidemic in the 1990s that spread to over 20 countries in Latin America, with the last case reported in 2002. She said investments in water and sanitation infrastructure and health promotion helped stem the epidemic and contributed to the virtual elimination of cholera from Central and South America within eight years.

"If left unchecked, these deadly but preventable diseases threaten to spread once again to the rest of the American hemisphere, with their high toll on human life and well-being and producing an economic catastrophe as a result of impacts on agricultural trade, tourism, and a hesitancy to invest by private sector industries," warned Dr. Roses. "Every case and death from cholera is preventable. Every new case highlights the unacceptable social and economic inequities reflected in poor living conditions and limited access to clean water and sanitation services."

Dr. Roses pointed out that there is a historical precedent for the Regional Coalition. Beginning in the 1960s, PAHO/WHO managed a "Community Water Supply Fund" based on voluntary contributions from countries. PAHO developed the pre-investment proposals that were subsequently financed by the Inter-American Development Bank. The fund was used to train civil, chemical, and biological engineers, laboratory technicians, and program administrators responsible for monitoring water quality and promoting human resource development in the area of water and sanitation.

"We need to think once again—a half-century later—of innovative technical and financial mechanisms to provide durable solutions to eliminate the scourge of cholera from the island of Hispaniola," said Dr. Roses.

PAHO, which celebrates its 110th anniversary this year, is the oldest public health organization in the world. It works with all the countries of the Hemisphere to improve the health and quality of life of the people of the Americas and serves as the Regional Office for the Americas of WHO.