October 9, 2009
A group* representing The Carter Center flew to Puerto Plata, Dominican Republic, to help finalize and publicize an agreement between Haiti and the Dominican Republic to eliminate malaria and lymphatic filariasis from the Island of Hispaniola. Our International Task Force for Disease Eradication had identified this as a worthy project, as this is the only island in the Caribbean on which the two diseases still exist.
The Dominican Republic expects to stop transmission of lymphatic filariasis in 2010, but about 100,000 of its population have malaria. Among the people of Haiti, approximately 5 percent (500,000) have malaria and an equal number are afflicted with lymphatic filariasis. (Each country has a population of approximately 10 million.) A special challenge is that close cooperation between the two competitive nations has been relatively rare, but everyone realized that success in this project would not be possible without a team effort.
The Carter Center allocated $379,000 to finance personnel training, microscopes, motorcycles, bed nets, and expert advice to health officials and political leaders. Our early work was concentrated on two border communities as a test case: Dajabón, D.R., and Ouanaminthe, Haiti. The two cities are on opposite sides of the Massacre River, which forms the international border, and they are highly endemic with malaria. A survey last winter revealed that, in some municipal areas, up to 30 percent of the people had the disease.
After meeting with our consultant, Dr. Phuc Nguyen Dinh, we drove to the border communities and found medical doctors, nurses, local officials, and citizens excited and enthusiastic about the joint project. It was obvious that their procedures would be suitable for adoption throughout affected areas of Hispaniola. The Margards remained in the communities to assist with field work.
The next day we visited Santo Domingo, where we had an extensive briefing from Minister of Health Dr. Bautista Rojas Gomez and his associates and then met with President Leonel Fernández. In Port au Prince we had a similar presentation from Minister of Health and Population Dr. Alex Larson and consulted with President René Préval. All these top officials are dedicated to the joint project. In each of our visits to the border communities and the national capitals we had extensive press conferences and individual news media interviews.
Because of the evident common commitment of medical and political leaders, technical capability, and prospects for funding, we are confident that the goal of eliminating the two diseases by 2020 will be reached. Total projected costs of the malaria project in both countries will be $194 million and for lymphatic filariasis in Haiti $46 million. This amounts to a total annual cost of approximately $1.25 per person, a good portion of which is already committed to come from the Global Fund and other sources. In comparison, a malaria epidemic in 2004 cost the Dominican Republic an estimated $200 million in lost tourism revenue.
In addition to the permanent humanitarian benefit among citizens whose health will be improved, there are additional political and economic rewards for the two countries. This proven success in bi-national cooperation can lead to other exciting partnerships, and it is well understood that for a tourist family or a potential commercial investor contemplating a visit or investment in the Caribbean area, the absence of these two diseases will be a major positive factor in inducing them to come to Hispaniola.
The Carter Center will continue to monitor progress of this joint project, and regular reports will be made by both nations to our International Task Force for Disease Eradication.