Fighting Disease: Haiti

Catalyzing Disease Elimination in the Caribbean

In September 2008, The Carter Center, in partnership with the Dominican Republic and Haiti, launched a historic 18-month initiative to help the two countries and their other partners accelerate the elimination of two devastating mosquito-borne infections — malaria and lymphatic filariasis — from Hispaniola. As long as lymphatic filariasis and malaria exist on any part of these two nations' shared island, they will threaten the rest of the Caribbean with devastating human and economic consequences.

The initiative stems from a 2006 recommendation of the Carter Center's International Task Force for Disease Eradication (ITFDE) —  a group of 12 global experts on infectious disease — that it is "technically feasible, medically desirable, and would be economically beneficial" to eliminate these two parasitic diseases from Hispaniola. (Read the updated ITFDE recommendation from 2008.) Since then, the binational project broke new ground in collaborations between these two countries for the betterment of public health on the entire island. (Read the 2008 Carter Center Press Release: Carter Center Launches Effort To Spur Elimination of Malaria and Lymphatic Filariasis in Haiti and the Dominican Republic.)

Haiti is the poorest nation in the Western Hemisphere, with 80 percent of its population living below the poverty line. Serious constraints to efforts to control malaria and lymphatic filariasis in Haiti include: inadequately trained health care professionals, weak public health infrastructure, and insufficient funds to conduct disease prevention and treatment programming. In addition, the island was devastated by four hurricanes in four successive weeks during the summer of 2008, disrupting health services and providing additional breeding grounds for mosquitoes that spread malaria and lymphatic filariasis.

Malaria is a potentially fatal parasitic infection that causes fevers and flulike symptoms and is endemic throughout Haiti. Testing and treatment for malaria are provided free of charge in Haiti.

Lymphatic filariasis is a debilitating disease that causes severe swelling in the limbs and genitals, which often devastates victims socially, emotionally, economically, and physically. A nationwide survey in 2001 found that lymphatic filariasis affected more than 5 percent of the population in most of Haiti's communes (counties). Haiti's Lymphatic Filariasis Elimination Program began annual mass drug administration with diethycarbamazine (DEC) and albendazole in 2000, treating approximately 1 million people or 12.5 percent of the 8 million people at risk in 2007 and 2008.

Achieving elimination would improve not only health but economic opportunity, including agriculture. Funding for this project was channeled by the Centers for Development and Health (a nongovernmental Haitian organization) to the Haiti Ministry of Public Health and Population.

Through these efforts, the technical objectives of the binational project have been met:  The countries have developed a standard protocol and procedures, including free diagnosis and treatment of malaria; primaquine has been added as a tool for treatment of malaria; and surveillance and use of microscopy to confirm diagnosis of malaria have been intensified.

With support from The Carter Center, the Dominican Republic and Haiti have prepared binational plans to complete elimination of both the diseases from the island.

Read the New York Times feature: "Haiti and Dominican Republic Urged To Fight Mosquito Illnesses Together" >

Finally, in October 2009, former U.S. President Jimmy Carter led a Carter Center delegation to the Dominican Republic and Haiti to underscore — and stimulate international support for — the binational plan to complete elimination of both diseases from Hispaniola.  The delegation also included former First Lady Rosalynn Carter, Carter Center President and CEO Dr. John Hardman, Vice President of Health Programs Dr. Donald Hopkins, and Malaria Control Program Director Dr. Frank Richards.

Read the Real Lives, Real Change feature: Tracking Fevers and Teaching Prevention: A Haitian Health Agent's Story >

Watch the video: Two Countries, Two Diseases, One Island >

Learn more about the Carter Center's work to improve health in Haiti (in search result format) >